London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1927

[Report of the Medical Officer of Health for London County Council]

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161
the Mental Deficiency Act. The removal of these cases diminishes the number which
might otherwise come to the notice of the education authority at the commencement
of the period of compulsory education. It also appears that the cases which come
to notice at an early age contain a large proportion of cases in which the amentia
is of a secondary character. The following statement shows the relative frequencies
of different types of defect in children under seven years of age who have been
ascertained by the certifying officials of the Council:—
Primary amentia, 60.2 per cent.; Epilepsy, 8.2 per cent.; Paralysis, 6.8 per
cent.; Cretin, 0.8 per cent.; Mongol, 18.2 per cent.; Micro-cephalic, 4.2 per cent.;
Hydro-cephalic, 0.8 per cent.; Blindness, 0.8 per cent.
From the age of seven to sixteen years preliminary ascertainment is conducted
under the aegis of the Education Authority and the bulk of the cases which come to the
notice of the control authority in this period are derived from this source. A small
number comes to notice from the police courts or industrial schools under section 8
or section 9 of the Mental Deficiency Act. Such children or young persons have,
however, most often been known previously and ascertained to be mentally defective
so far as the Education Acts are concerned.
The general procedure under the Education Act is that a statutory examination
is conducted of every child nominated by the school attendance officers as not being
in attendance, or by head teachers and school doctors in conjunction, as not making
adequate progress in school, although minor physical defects have been dealt with so
far as possible. In the year 1927, the nominations numbered 2,178, and showed the
following results after examination:—
Returned to elementary school, 1,084 ; Invalided temporarily with a view to
re-examination, 122 ; Deemed suitable for admission to a school for the mentally
defective, 853 ; Notified under the Mental Deficiency Act as—Imbeciles, 101;
Idiots, 11 ; Feeble-minded, 7.
The special schools are visited regularly and every child present is seen at least
once during the year, the total number on roll of the M.D. Schools being 5,998.
The doctor's examinations at rota visits to these schools, in 1927, amounted to 8,076.
Special examinations were made of children already on the rolls for application for
non-enforcement of attendance, as a result of which some 65 children who had been in
attendance for varying periods of one to three years were excluded as imbecile.
No particular difficulty arises at the earlier age periods, but towards the end of
the time difficulties may arise regarding the children who have appeared sufficiently
intelligent to derive some benefit from education in an ordinary school, but who
have proved incapable, generally on account of temperamental difficulties or lack of
control, of facing the conditions of the world when commencing employment at
the age of fourteen years. Since they are over the age of compulsory school attendance
it would not seem that school attendance could always be enforced de novo at a
special school, yet if not in attendance at a special school they cannot be notified
by the Education Committee as being about to be withdrawn or discharged from a
special school under section 2 (2)6 of the Act. The machinery of notification as
cases of special circumstances is very cumbersome, and it seems to be a matter of
doubt how far it can be employed; the procedure may possibly be rendered easier
by the Mental Deficiency Act, 1927.
Steps are taken to secure the special examination of every child brought before
a juvenile court who is known to have attended a special (M.D.) school, or to have
been nominated at any time for a statutory examination with a view to such admission
if necessary. In 1927, 76 children were so examined and, in consequence, 15 were
recommended for admission to a special (M.D.) industrial school, and 7 for transfer
to an institution under the Mental Deficiency Act, the action being taken under
section 8.
In the case of children who have been sent to certified industrial or reformatory
schools, but who, while there, prove incapable of deriving proper benefit from training