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16
Naturally those referred for detailed examination produced a higher proportion
of defects than a normal age group, as they were specially selected cases. For
instance, of the specially referred boys 12.4 per cent. were found to have enlarged
tonsils and adenoid growths, whereas in the whole 8-year group in 1933, 8.4 per cent.
of boys were so found. Of the referred children (boys and girls) 4 per cent. had heart
disease, compared with 1.8 per cent. in the 8-year group in 1933. But if the children
found defective are related to the whole group from which they were derived, it will
be seen that this method is not to be compared in efficiency with the normal complete
medical examination usually carried out.
Of the whole group, enlarged tonsils and adenoid growths were recorded in 3.8 per
cent. of the boys compared with 8.4 per cent. of the 8-year boys in 1933, while heart
disease in the whole group (boys and girls) was found in .5 per cent. compared with
1.8 per cent. in the 8-year group in 1933. It is clear therefore that, as similar figures
are reported for every ailment charted, large numbers of defects were not discovered,
particularly those which are slight and in their early stages, when it is so important
to discover them, for the service is primarily a preventive one. It is well to put this
apparent failure to discover the whole of the defects in this group on record.
In times of national stress and difficulty it is often proposed that medical examinations
should be curtailed or carried out in some more cursory way such as this. It is
even sometimes suggested that it would be sufficient for the teachers to bring before
the medical officer such children as they note to be ailing. The experience with the
shortened method of inspection which has been employed in the past year confirms
previous experiences of the same kind, and proves that it is impossible, if proper
service is to be given and justice done to the children, to substitute superficial inspection
for the detailed examination of every individual child.
One of the most important reasons for not missing out the children born in 1926
was the fact that they would have had no investigation of their visual acuity until
reaching the age of eleven. All the children were tested in the usual way and referred
for treatment if defective. For this purpose the preliminary examination was quite
effective, as 8.5 per cent. of the children in the group were referred for refraction.
As the figure for the detailed examination of the 8-year-old group in 1933 was 8.3
per cent., it is clear that in 1934 no 8-year-old child failed to receive the usual attention
in regard to visual acuity.
Special
examinations.
The number of children, not m the age groups for routine examinations, submitted
to the school doctors as special cases was 91,880, an increase of 6,520 over that
for the previous year, and this figure does not include another 44,917 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
the number seen in the routine age groups, yet in the case of many diseases the actual
numbers found to be suffering thereform in the former generally exceed those in the
latter. Thus 1,865 children with scabies were referred for treatment at special
inspections, compared with 91 only at routine inspections. Heart trouble requiring
treatment was detected in 282 children at special inspections, compared with 271
at routine inspections. In regard to epileptics 82 first came to notice at special
inspections, compared with 39 at routine inspections, and 297 children with chorea
were seen at special inspections, compared with 101 at routine examinations.
This is evidence that considerable advantage is being taken of the doctors' visits
to the schools to present to them promptly really ailing children.
The health
of the
leaving child.
The Council has undertaken the examination of a fourth age group, namely,
children who are leaving school. This examination takes place in the term prior
to that in which the children are due to leave school. The results of this examination
are available at the school-leaving conference, and are of assistance in determining
the choice of a suitable occupation. Coming at the end of the school career, the
examination is useful in estimating the results of medical attention received since
the children entered school.
This year's "leaver" group was formed of the children born in the year 1920-21
and consequently the numbers are again, in consequence of the high birth-rate at