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The Council appointed an orthopaedic consultant to the schools in September, 1905.
Children were referred to hospitals for treatment as the Council has never maintained
its own clinics for orthopaedics. The fact that in London so many teaching and other
hospitals are within easy access has meant that suitable hospital and specialist services
have always been readily available for school pupils referred to them from the school
health service.
Children
suffering from
speech defects
During the later years of the last century, it was recognised, especially on the
Continent, that stammering was a serious disorder which required treatment, but very
little was done in this country until a few years before the 1914-18 war. The many
speech disorders which are now recognised under separate categories were not formerly
considered to be due to definite causes.
In 1911 a speech clinic started work at St. Bartholomew's Hospital, another at
St. Thomas's Hospital in 1913 and a London County Council evening institute group
for stammerers began work in 1914.
During the 1914-18 war it became more widely recognised that stammering was a
nervous disorder. (The theory of psychological causation of stammering was first
formulated in England in a paper read in 1912 at the first Conference on Speech Training,
held in London.) Many 'shell-shocked' men developed a stammer, and its incidence
was increased among children living in air raid shelters. In 1917 an experimental clinic
for stammerers was opened in Westminster by Miss Elsie Fogerty. The experiment
was successful, and in 1918 the Council opened its first four school centres for
stammerers. During the next few years the number was increased.
In 1934 the Association of Teachers of Speech and Drama formed a section for
remedial speech, later known as the Association of Speech Therapists. In 1935 the
British Society of Speech Therapists was formed. Both these societies were recognised
by the Board of Registration of Medical Auxiliaries. In 1945 the two societies completed
their amalgamation to form the College of Speech Therapists, upon which
Royal Patronage was conferred in 1948. The College is the official examining body for
entry into the profession.
In 1945 speech therapy for schoolchildren suffering from speech disabilities was
made a statutory obligation under the Education Act, 1944, and in 1947 the first
residential school for children suffering from certain speech disorders was opened at
Moor House, Surrey.
Speech difficulties in children can be considered under three headings:
a. Those who stammer—these children are easily recognised, and should be
brought for examination and treatment without delay. There is no difference between
stammering and stuttering.
b. Those who confuse sounds, or who substitute one sound for another, or who
fail entirely to make the wanted sound—this is not usually a matter of any urgency
unless there is no improvement in the speech between the ages of six and seven.
c. Those with some organic defect which interferes with speech. Any child with
such a defect should be brought for examination without delay. It is particularly
necessary in cases of cleft palate; the longer the delay in treatment, the more difficult
it is to obtain correct speech.
There are also special cases, for example, spastic children, who are naturally spastic
all over. Physiotherapy directed to the general muscular state is likely to aid the muscles
of speech too. Teaching those spastic children who dribble, to swallow, is sometimes the
first stage in gaining proper speech. It is advisable to refer these children to a centre if
they are of normal intellect.
Those children whose defect of voice or articulation is due to lack of hearing,
whereby they cannot properly appreciate the sound of speech made by others, are
excluded from this category and fall into that of partially deaf or deaf pupils. Aphasic
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