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9
The additional age group in London is that of the leavers. Great importance
is attached to the examination of this group. It not only affords an opportunity
for a final survey of the results of the child-care activities in school,
but gives a last opportunity for pressing attention to defects which have been
ignored or have developed late, and, perhaps most important of all, provides for
advice upon the choice of occupation in relation to physical condition and needs.
The arrangement whereby the two intermediate medical surveys are made at
ages 7 and 11 brings the system of medical inspection into close relation with
the modern educational ladder and provides for examination at the most important
moments of school life—the promotion of children from infant to junior school at age
7, and from junior to senior school at age 11.
The examination at age 7 provides an earlier examination of the vision
of the school children at the best possible moment, since such examination is not
possible in the case of entrants to school.
The change in London from the usual age groups to those specified above, took
place in 1933. During that and the following two years, there was a departure from
normal procedure in carrying out the routine examinations necessitated by the gradual
change over from eight to seven years in the intermediate group. This was completed
by the end of 1936, and in 1937 normal conditions were re-established.
The routine inspection of the children is one of the foundations upon which is
built a complete system of care in which reference of children is made for special
modifications of education, for convalescence, to supervisory centres for rheumatism,
or for nutritional observation, or to treatment centres or hospitals for defects of all
kinds. Many children detected at primary examinations to have defects are kept under
continuous observation by systematic re-inspection until the school doctor is satisfied
with their condition, and, apart from routine inspections, increasing numbers of
children not falling within the age groups are examined by the school doctors as
special cases at the instance of teacher, care worker, parent, or attendance officer.
The average roll of children in London elementary schools for the year 1936-37
was 479,974, and the average attendance 417,028.
The number of elementary school children examined in the three statutory
age groups (entrants, children aged 7 and children aged 11) during the year 1937,
was 131,841. These were made up of 48,689 entrants, 40,017 children aged 7, and
43,135 children aged 11. In addition 48,224 children were examined in detail in the
term prior to that in which they were due to leave school, and 1,044 children in
special schools were examined on reaching their respective age groups.
Apart from the routine groups, children referred by nurses, school teachers, care
committee workers, divisional officers, etc., for examination for special reasons
numbered 133,850, and 24,027 were examined in connection with outbreaks of
infectious disease.
The total inspections amounted to 338,986. To these must be added the children,
114,015 in number, who were re-inspected because of some previously noted defect.
As inspections of all kinds and re-inspections totalled no less than 453,001, it is
clear that, although some duplicate inspections are included, very few indeed of
the children in school escaped coming under the eye of the doctor in some way or
another during the course of the year.
Parents are invited to be present at all routine inspections, and attended in
77.3 per cent. of the examinations in the three prescribed age groups, compared with
76.9 per cent. in 1936 and 78.5 per cent in 1935. At the inspection of entrants, the
proportion was 90.8 per cent., and in the "leaver" group 39.7 per cent. The
presence of the parent has a very considerable effect, and relieves very greatly the
task of following-up, as it eliminates the necessity for home visiting and correspondence.
Co-operation
of parents