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12
Spinal curvature in the "leaver" girls was reported in 1.2 per cent. of the cases
compared with .9 per cent. at age 12; on the other hand heart defect in the "leaver"
girls was 1.8 per cent. compared with 2.4 per cent. in the 12-year old group.
The falling off in the condition of the teeth of the "leaver" children is not a
satisfactory feature of the school medical work. It is due to the fact that skilled
inspection of the teeth by the inspecting dental surgeons does not extend as a rule
to the children aged 12 and 13 years, but ceases at the age of eleven in most schools.
This should be remedied by increased dental inspections so soon as the time is
favourable.
During 1932, of the total of 38,754 children who had been examined in this group,
16,352 were found to require medical or dental treatment; prima facie this showed
the need for the inspection of this particular age group, but, in order to obtain
further assurance on this point, an analysis was made of the medical cards, chosen
at random, of 500 children who had been medically examined as "leavers."
Analysis of
inspection of
500
"leavers."
This analysis showed that in these 500 cases, whilst 267 children were marked
as free from any defect, there were 296 defects noted either for treatment or observation
in the remainder, some of the children having two or even three defects. It is
important to observe that of these 296 defects, 181 were noted as having arisen since
the previous inspection at the age of 12 years. These 181 new defects were classified
thus: defective teeth, 80; vision, 40; enlarged tonsils or adenoids, 13; skin
disease, 12 ; ear disease and hearing, 7; heart and circulation, 7; deformities
(spinal and flat foot), 9; others, 13. Attention was then drawn to the possibility
that, inasmuch as these children leave school within a comparatively short period
after their inspection, they might not receive the treatment indicated owing to the
care committees not having sufficient time in which to follow up the cases adequately.
It was urged that if discovery of a defect did not lead to immediate remedial treatment,
the primary object of the inspection had not been achieved, and the cost incurred
had been wasted. Whilst it cannot be admitted that the giving of advice
to older children of this age and the warning of parents are not in themselves of considerable
benefit, it was, in fact, ascertained that, at one typical medical treatment
centre, about one-eighth of the medical cards in that centre, respecting children for
whom appointments for treatment were requested, related to children in the " leaver "
group, thus showing that a considerable amount of treatment is obtained as a result
of the inspections of the "leavers"; in fact, it is found that certain parents who
neglect earlier advice to obtain treatment, accept it when work is about to be commenced
and an untreated defect will cause difficulty in certification by the certifying
factory surgeon.
Special
examinations.
An analysis of the results of medical inspection of children in the age groups
does not tell the whole story with regard to the health of the children in the schools.
The children are, day by day, under the intelligent observation of their teachers,
the school care committees, and the school nurses, and any gross variation from health
is unlikely to pass unnoticed.
The number of children, not in the age groups for routine examinations, submitted
to the school doctors as special cases was 95,855, and this figure does not include
another 58,870 who came under inspection in the course of enquiries into outbreaks
of infectious diseases.
Although the number of children seen at special inspections was much less than
one-half of the number seen in the routine age groups, yet in the case of many diseases
the actual numbers found to be suffering therefrom in the former generally exceed
those in the latter. Thus 1,795 children with scabies were referred for treatment
at special inspections, compared with 117 only at routine inspections. Heart trouble
requiring treatment was detected in 352 children at special inspections, compared
with 257 at routine inspections. So far as tuberculosis is concerned 76 children were
referred for treatment from special inspections, but only 27 from routine inspections
(including that of the extra "leaver" group). In regard to epileptics 79 first came
to notice at special inspections, compared with 20 at routine inspections, and 197
children with chorea were referred for treatment at special inspections, compared
with 78 at routine examinations.