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Employment of children
The bye-laws governing the employment of children require, inter alia, that the
Principal School Medical Officer shall certify that the employment of the child will not
be prejudicial to his health and physical development and will not render him unfit to
obtain the proper benefit of the education provided for him. Such a certificate is valid
only (i) during a period of six months from the date of its issue, and (ii) for the class
of employment referred to in the certificate.
During the year, 4,521 medical examinations were carried out locally in respect of
the issue of employment certificates. In addition, medical examinations were carried
out at the County Hall of children concerning their employment under licence in
public entertainments, comprising 232 boys and 318 girls.
Children under five years of age
At the end of 1955 there were 168 nursery classes with accommodation for approximately
5,040 children aged 3 to 5 years. In addition to a mid-day meal, these children had
one-third of a pint of milk daily and cod liver oil and other vitamin preparations ;
medicaments containing iron were also prescribed for those who required them.
Nursery class children attend during the ordinary school hours of primary schools,
but nursery school children can attend between 8.30 a.m. and 4.30 p.m. and have
dinner (and breakfast and tea when necessary) and two-thirds of a pint of milk daily
in addition to other supplements supplied to the nursery class children.
At the end of the year there were 22 maintained day nursery schools with accommodation
for 1,310 children from 2 to 5 years, three nursery centres each providing
part-time education for 80 to 100 children half of whom attend in the mornings and
half in the afternoons, and five assisted nursery schools with accommodation for 230
children.
Health visitor/school nursing sisters attend nursery classes and schools frequently
and each child is examined every term by a school medical officer.
There were 15,790 children under five years of age on the day school rolls, 13,161
being in the Council's schools and 2,629 in voluntary schools.
Gramophone audiometer testing
Routine hearing testing is carried out by school nursing sisters using gramophone audiometers
in schools. Since the gramophone test takes the form of a series of numbers
which are ' read ' to the class pupils must be old enough to write from dictation, the
tests therefore are carried out on entrance to junior school at the age of 7+ years.
Pupils failing in two consecutive gramophone tests are referred to the audiology clinic
at a local school treatment centre for pure tone testing by the same sister. This is an
individual test carried out under quiet conditions and takes the form of a note of
variable pitch and volume which may be intermitted or continuous to which the child
listens through earphones which exclude as far as possible external noise. Any pupils
failing their pure tone test are referred to an otologist at the audiology centre. The
sisters who act as 'audiometricians' are engaged exclusively on this work and are
responsible for the clerical work, home visits, transport of equipment, arrangements
with schools, cure tone sessions and attendance at audiology sessions.
Audiometry
Whilst in the hospital services the duties of hearing aid technicians and audiometricians
include the fitting, testing and maintenance of individual hearing appliances
and the emphasis is on the technical side, both in their training and duties, the work
done by these school nursing sisters is an extension of their normal nursing duties.
They are not concerned with the technical aspect, e.g., the repair and maintenance of
the apparatus they use is the responsibility of the Council's Chief Engineer. Testing
the hearing of children is as much or more a mattec of establishing a personal relationship
based on a knowledge of their management, as of methods of testing hearing. Hearing
tests of this type are useless if carried out by an unsuitable person and this is particularly
Audiometricians
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