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The arrangements are on the following lines: (i) each child attends twice
weekly for periods of 50 minutes each; (ii) each group of children is limited to 9; and
(iii) three groups are dealt with by the same speech therapist on each half day.
The two centres for secondary school pupils at the Henry Thornton school
(south London) and the North-Western polytechnic (north London) were continued;
51 pupils attended, of whom 5 were discharged cured and 10 left.
At Salter's Hill school, 48 children from residential schools of the Council
attended a special centre. Of these, 18 were cured and 4 left.
One of the speech therapists, Miss Grace Lloyd, has analysed the histories of 100
consecutive children referred for stammering.
Place in family: only child, 6; first born, 31; second, 25; third, 16; fourth, 8; fifth, 7;
sixth, 6; seventh, 1. In regard to five, the child was one of twins.
Stammering in other members of the family was found in 33 families. Fathers stammered
in 18, mothers in 7 and brothers and sisters in 12.
Squint was present in 6 stammerers.
Left-handedness was found in 18 of the 100 stammerers and in 31 near relations of stammerers.
The stammer was stated always to have been present in 16 cases, and to have come on at
2 years in 2; 3 years in 12; 4 years in 14; 5 years in 19; 6 years in 7; 7 years in 3; 8 years
in 5; nine years in 1; 10 years in 7; 11 years in 6; and 12 years in 2. The age of onset was
uncertain in 6.
Causation was said to have been due to: shock, 31; start of school life, 6; imitation (other
than cases of heredity), 7; after exanthemata, 7; after tonsillectomy, 4; change from left hand
to right, 1; heredity, 21; no cause assigned, 23.
Rheumatism scheme
Dr. C. E. Thornton, who supervises the rheumatism work, under the direction of
Dr. C. J. Thomas, has prepared the following report
During 1938 the smooth working of the rheumatism scheme was to some extent
interrupted by the events of the international " crisis " in September. In accordance
with the general principle which had been decided upon, a large number of the children
in the rheumatism units who were not acutely ill were at this time discharged home.
Many children also were removed by their parents in order that the chance of their
being evacuated from London might not be missed. Except in a few instances where
serious cardiac lesions were present, no great immediate harm appears to have resulted,
although it is to be noted that subsequently nominations for re-admission were fairly
numerous.
Nominations
for
institutional
treatment
The number of applications received, during 1938, for institutional treatment
(2,371), showed a slight increase on the figure for the previous year (2,367); but,
owing to a somewhat larger number than usual of these applications being withdrawn
(mostly due to parental objections), the number remaining to be dealt with fell
slightly below that of 1937. In addition to these withdrawals, 109 children were
found on examination not to be suffering from rheumatism, thus leaving a total of
1,987 children for whom institutional treatment had to be arranged. The difference
between this total and the corresponding totals for the two preceding years is negligible,
and it seems evident that there is little change at present in the prevalence of juvenile
rheumatism. The nominal accommodation of the rheumatism units remains at 900
beds, of which the average number available during the year was 835. This accommodation
is adequate, but only just adequate, to cope with the demands made upon it.
At times of pressure a waiting list tends to be built up, but the system of preliminary
examination by specialist medical referees ensures the careful grading of cases, and
thus only in the less urgent ones is admission delayed.
Rheumatism
units
During the year 2,030 children were admitted to the units. Approximately 37
per cent. of these showed signs of cardiac involvement, and it is gratifying to note
that this is a decrease of 6 per cent. compared with the preceding year. An analysis
of the condition of the children on discharge also shows an improvement in the
results of treatment. During 1937, 1,925 children were discharged, of whom 23.7
per cent. had cardiac involvement of a degree necessitating some restriction on their
activities. In 1938, only 21.3 per cent. of the 2,037 children who were discharged
were so handicapped.