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

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London County Council 1934

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

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to be ineducable. Although the number of girls nominated is smaller the proportion
of those nominated who are deemed to need special education is slightly greater :
42.7 per cent, girls compared with 40 per cent. boys. This may depend on several
factors, probably the most important is instability of behaviour. In early years
the mentally defective boy is likely to be a somewhat greater nuisance in the school
and to the community than is the mentally defective girl, and it has always been
found that active or aggressive aberrant behaviour attracts attention, while mere
placid failure to make progress tends to be overlooked or to be for a considerable
time accepted as backwardness or shyness. It may be, too, that the woman teacher
exercises patience under the adversity of endeavouring to teach the seriously retarded
for a longer period than her male colleague. When it comes to a later phase there is
some evidence that the woman teacher seeks the protection afforded by the Mental
Deficiency Acts for her seriously retarded girls more readily than the man who is
hopeful for the temporary employability of the boys in unskilled work unless they
show aggressive anti-social traits.
The proportion of the sexes among the mentally defective who are in some way
being cared for by the Council under the Mental Deficiency Acts, viz., 50.3 per
cent, males and 49.7 per cent, females, is so similar to the proportion of the sexes
in the elementary schools as a whole, viz., 50.6 per cent, boys to 49.4 per cent, girls,
as to show there is no real sex difference, but the proportion for whom the stricter
form of community control, institutional care or guardianship is required, 52 per
cent, males to 48 per cent, females, shows the slight difference which may be accounted
for by anti-social behaviour.
The prevalance of instability in the children sent to schools for the mentally
defective is noteworthy. Of course, naughtiness and lack of discipline are common
in those of normal intelligence ; but, when with marked intellectual retardation
there co-exists irresponsible and irrational behaviour, there is the more reason
for special care. In the school medical officer's report for 1922, in referring to the
later history of defectives, it was noted that social and industrial failure were much
more marked when both features were present, e.g., a lad of extreme stupidity but
of stolid type might keep a simple job, while one of the same intellectual capacity
but irresponsible or slightly lacking self-control would be dismissed from every post
after a few weeks.
That temperamental instability plays an important part even in the earlier
years is shown by further inquiries made by Dr. A. C. Williams into the differences
between children nominated for examination and as a result either passed into special
schools for the mentally defective or returned for a further trial in the ordinary
elementary school.
Special schools have been functioning in London since the middle of the eighteennineties,
and this educational provision has been accompanied by an increasing
degree of medical and social supervision. In the earlier years, the greater number
of children found in the schools to need treatment were of necessity referred to
voluntary hospitals and in this connection the help given by the voluntary workers
of the Invalid Children's Aid Association proved invaluable in the matter of the
persuasion of parents, arrangements for regular attendance at hospital and for
the interchange of information between the medical officer visiting the school and
the physicians or surgeons of the hospitals concerned. With the establishment of
care committees, after the coming into force of the Education (Administrative
Provisions) Act, the extent of the social services which could be rendered materially
increased, while the introduction of medical inspection into the elementary schools
secured the attendance at special schools of a number of children who might not
all have been ascertained under the previous system. Gradually arrangements
were made for supplementing the efforts of the voluntary hospitals, largely
through the use of the facilities of the Metropolitan Asylums Board. Cases of
ophthalmia were dealt with at the White Oak hospital and later this provision was
rendered available for cases of interstitial keratitis and other affections of the eye
and following
up of