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utmost encouragement and sympathy. Every method known for the teaching of
reading is attempted; if one fails another is tried and the teacher must be experienced
and resourceful. Ample opportunity is given for creative work; painting, pottery,
general handicrafts help different children to achieve satisfaction.
However well the environment may be planned, however free and encouraging the
atmosphere and sympathetic the teacher, a small minority of children still do not
respond. For them psycho-therapeutic treatment is necessary, and this can only be
undertaken extensively as a rule in child guidance units and clinics. At the Maudsley
Hospital the Council provides a hospital school for children and adolescents who
because of the intensity of their psychological disturbance need in-patient treatment.
There, teachers work in close co-operation with doctors and occupational therapists;
lessons are voluntary, but generally popular with the small patients. The work in the
school is considered to play a very definite role in the treatment of the children and young
people.
A considerable amount of home visiting is undertaken by care committee workers
and psychiatric social workers attached to child guidance clinics with a view to bringing
about a better understanding by the parents of maladjusted children: if this can be
attained, the chances of readjustment are improved.
As from 1st January, 1948, the Council took over full administrative and financial
responsibility for the voluntary clinic at Bishop Creighton House, and on 6th September,
1948, a further centre (part-time) was opened in the Putney Health Centre. The
Council on 13th May, 1947, decided that the Education Committee would make
arrangements for the medical treatment of school children through the Health Committee,
and accordingly the Education Committee on 16th June, 1948, delegated to the
Health Committee so much of its child guidance duties as involved treatment in clinics.
Circular 179 (4th August, 1948) of the Ministry of Education, paragraphs 18 and 20,
recognised the duty of local education authorities to provide child guidance centres
closely linked with the school and home and that these centres should include a psychiatrist,
psychiatric social worker and an educational psychologist and, as a rule, in addition,
a paediatrician. Part of the work of these centres would be concerned with the
ascertainment of maladjusted pupils under Section 34 of the Education Act, 1944. The
circular also stated, however, that the Minister of Education, in agreement with the
Minister of Health, considered that children needing psychiatric treatment should be
referred to the new clinics to be set up by the regional hospital boards.
The School Medical Officer, with the concurrence of the Education Officer, reported
to the Health Committee and to the Education (General Purposes) and (Special Purposes)
Sub-Committees in September, 1948, on Circular 179 generally, and mentioned that on
the appointed day the regional hospital boards took over twelve child guidance clinics
in the London area to which pupils were officially referred by him. The School Medical
Officer also stated that the Council had two centres functioning and that proposals
with regard to six others were under consideration, and added: 'The main difficulty lies
in deciding at what point a child is in need of psychiatric treatment as opposed to social
and educational adjustment. It is also questionable whether it is good for a child under
investigation or treatment to be transferred from one team of workers to another after
initial investigation or during the course of his or her treatment.
In a memorandum to the Chairman of the Health Committee dated 24th September,
1948, the School Medical Officer set out the stages in dealing with a maladjusted child—
(a) reference to a problem case conference on which the Education Officer and the
School Medical Officer were both represented; (b) arrangements for attendance at
what used to be called a child guidance clinic, where necessary advice and treatment
were given. The Ministries of Health and Education had differentiated between child
guidance centres, where no treatment was given, and child guidance clinics, where
treatment was provided.
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