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117
if possible. Research work, with which Miss Edith Whetnall, the Council's consultant
otologist, is closely concerned, is being carried out into various methods of testing
hearing at younger ages.
The development of the audiology centres to cover the pre-school training of very
young children, to which reference was made on page 123 of last year's report, was
carried a step further during 1953, by the receipt of the approval of the Ministry of
Education. However, the Ministry of Health advised that the procedure of submitting
an amendment to the Council's approved proposals under the National Health Service
Act, 1946, was required, and the necessary legal formalities were not completed by the
end of the year.
Epileptic children
A central register has been kept since January, 1951, of epileptic school children, and
school doctors have been asked to notify all cases of epilepsy that they come across in
the course of their work. Where special educational treatment is considered necessary
the children are examined at the County Hall. The consultants at hospitals, particularly
at the Maudsley and National Hospitals, have been most co-operative in carrying out
special investigations on any cases referred to them. At the end of the year there were
416 names on the register. Of these 277 were in ordinary schools, 36 in day schools for
educationally sub-normal children, 36 in day schools for physically handicapped children
and 36 in boarding schools for epileptics. This probably does not represent all the
epileptic children in London schools as there may be some in ordinary schools who
have yet to be notified.
Enuresis
Special enuresis clinics are held at certain hospitals, although some enuresis cases are
dealt with through the special investigation clinics. The following summary of the
report from the Westminster Hospital (All Saints Urological Centre) is given as an
example of the work done at these clinics:
Three sessions a week are devoted to London school pupils suffering from
enuresis. The figures for 1953 were as follows:
New cases 420
Old cases 1,860
Total attendances 2,280
Cases discharged 126
Fewer cases were seen than in previous years, since there are now a number of other
clinics treating enuresis, often situated nearer to the patient's homes than the All Saints
Centre, which, at one time, catered for the whole of South London, even receiving
some cases from North of the river. The waiting list has fallen to an average of one
month.
The following abstract from the report of the physician in charge of the enuresis
clinic in the children's out-patient department of Paddington Hospital illustrates how
this problem is dealt with clinically: 'At the first attendance a search for an organic
cause of the enuresis is made, the child's home and school background is assessed and
the confidence of parent and child is gained as far as possible. The main lines of treatment
are to restore the morale of the family by explaining that enuresis is not uncommon,
and that it does not mean that the child is seriously 'abnormal' in any way. It is a
childish habit which will certainly be grown out of by perseverance and determination.
Simple advice is given regarding drinking, charting dry nights, and waking, and an
attempt is made to improve any difficulties at school or in the family. Drugs are rarely
used. Children are seen at intervals until improvement is satisfactory, and in most
cases the results are encouraging and the parent grateful for the assistance given. The
liaison with the Council's medico-social worker at the clinic is of great value, as also
are the home and school reports obtained from the care committee workers.'
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