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There is no doubt that at all the centres useful work was done and improvements
effected by taking the parent into consultation in regard to the child's
condition and by discussing ways and means and helping in the management of the
weekly budget.
The territory which is being explored is that containing the subnormal child
who has no disease and yet does not thrive like his fellows at school. It is of course
solely due to the school medical service that the existence of this group of children
is recognised.
When sent to hospital where the approach to all problems is from the standpoint
of disease and not from that of health, the children are there regarded as
normal. From the school standpoint where the children are seen in the company
of normal children their subnormality is at once appreciated.
One physician was only convinced of the reality of the problem by visiting the
schools from which the children had come, and noting the appearance of the referred
children in contrast to that of their normal classmates amongst whom they sat.
Dr. Hogarth reports : " Parents and children are undoubtedly benefiting from
the careful investigation and discussion of home difficulties. The parents' interest
is being maintained by frequent periodic examination and by the encouragement
they experience at the special interest taken in the child's progress by sympathetic
social workers and a friendly doctor."
Dr. Batten thinks as a result of his experience that " it is hard to believe that a
new light will be thrown on the nature and cause of ' malnutrition ' by the clinical
examination of any number of subnormal children. On the other hand the clinic
can perform a useful function if it be regarded as a place where the individual subnormal
child can be examined, watched and helped according to its needs."
Dr. Morgan finds at the south-eastern centre that the most striking results are
obtained from convalescence which in almost every case has produced marked
improvement in the child's general condition, and a jump up in weight. There are
also many clinical evidences of good results. Many children come up fatter, happier
and with good home and school reports.
Dr. Elman finds that out of 38 cases in the north-eastern division on whom it
has been possible to make an assessment of the results, improvement ranging from
slight to very good took place in 28.
Several of the observers discuss the future place and continuance of the
nutrition centres. Dr. Hogarth remarks " whether the school population as a whole
would derive greater benefits from the multiplication of nutrition centres depends
very much upon how great a benefit to the individual child such nutrition centres
constitute. In no case were children attending the nutrition centre offered facilities
for medical treatment which were not available for every school in London."
Dr. Morgan thinks the results of the work show that a clinic concerned purely
with nutrition can never exist because many other problems necessarily come
within its purview ; but as a welfare centre for school children which it has become
it has before it a highly important field for investigation and later of social service ;
it may well be said to represent one of the most important modern lines of development
of the social services.
Dr. Simpson considers that the functions of the nutrition centres should as a
result of the present experience be better defined. Up to the present there has been
confusion between the scientific and research aspect of the centres and the social
or remedial aims. He doubts the value of the attempt to evaluate tests which will
facilitate and give added precision to the diagnosis of potential malnutrition, which
must, in his opinion, remain a vague entity. By giving up this side of the work it
will be possible to concentrate upon the practical problem of helping the parents and
children, and it would be possible to deal with larger numbers. The simplification