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61
the medical service has gradually come about through the recognition that underlying
the manifestation of behaviour is very often some phobia or hidden neurosis
which is not readily apparent to the lay person, and can often be brought to light by
the intensive study of the child's antecedents, medical history and mental attainments
and reactions by the trained psychiatrist. He is able, by the correlation of
the various factors thus obtained, to draw conclusions as to the underlying causes
contributory to the peculiar behaviour manifestations, and to suggest suitable therapeutic
action relative to the type of case under observation. For this reason, child
guidance has now become an integral part of the medical services available for the
people, and many clinics have been established and in some instances special departments
have been opened at voluntary hospitals to deal with cases of this type. So
far as the school medical service of the Council is concerned, the only assistance
hitherto given has been by allowing free exchange of information between the
educational and medical services and the clinics, and the recognition of the attendances
of school children at specific clinics as equivalent to attendance at school.
One clinic has been established under the Council's own jurisdiction as an auxiliary
to the work of the Maudsley hospital, Denmark-hill, S.E. With this exception no
financial assistance had hitherto been given by the Council to child guidance clinics
in respect of children attending elementary schools. During 1936, however, special
circumstances arose in connection with the London child guidance clinic which led
the Council to make a grant to that clinic in connection with the treatment of school
children. An arrangement had previously been in operation at that clinic under
which diagnostic psychiatric work had been undertaken for the Council's remand
home, and payment had been made by the Council at the rate of £400 a year in
respect of this service. This payment ceased, however, when the Council decided
that the work should be withdrawn from the clinic and undertaken at the remand
home by a psychiatrist appointed by the Council. To meet the loss of income thus
sustained by the clinic the Council decided that, in view of the special circumstances
and of the amount of work undertaken in connection with the treatment of children
from the schools, the grant of £400 should be continued for the current year, as a
contribution towards the cost of their child guidance work, conditional upon the
Council being represented on the clinic committee.
Including this clinic there are at present eight child guidance clinics recognised
by the Council and the Board of Education under section 80 of the Education Act,
1921, in order that the attendances may be counted as equivalent to attendance at
school.
The information set out below regarding the work of the clinics has been
supplied by the authorities of the clinics concerned.
Maudsley
hospital
child
guidance
clinic.
The work of the child guidance clinic at the Maudsley hospital is undertaken
by the staff of this hospital, of which Dr. Mapother is the medical superintendent.
Close co-operation is maintained with the school medical service and with the
schools, and information regarding the cases is exchanged. During the year the
number of Council school children dealt with was 374, of whom 215 were boys and
159 girls.
The sources of reference of the cases were: hospitals, 98; school doctors, 66;
care committees, 58; private doctors, 38; head teachers, 16; various other
agencies, 98.
The reasons for reference were: difficult and unmanageable, 55; backwardness,
54; nervousness, 47; stealing, 33; enuresis, 31; nervous movements, 24;
temper, 23; night terrors and fears, 14; fits, 12; sex difficulties, 10; other
reasons, 71.
The results obtained were: recovered, 10; improved, 38; not improved, 16;
unsuitable, 53; failed to attend, 5; psychological tests only, 23; still under treatment,
229.
London
child
guidance
clinic.
Reference has already been made in this report to the arrangements between
the Council and the London child guidance clinic. The work is carried on under
the direction of Dr. William Moodie. During the year 1936 certain domestic and
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