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personnel and the tempo of such schools ; nevertheless there will still remain a certain
number of severe cardiac cases for whom such accommodation will be considered
essential'.
Cerebral palsy
Table (ii) and Diagram ' A ' clearly illustrate how today the special schools for the
physically handicapped contain a much higher proportion of cerebral palsied pupils
than formerly. Of recent years the subject of cerebral palsy has been prominent, and in
Circular 300 the Ministry of Education has advised local education authorities on
the provision of special educational treatment for cerebral palsied pupils.
Dr. William Dunham, the Council's consultant on cerebral palsy, has contributed
the following note about the increased proportion of children with cerebral palsy in
the schools for the physically handicapped :
' In view of the decreasing toll taken by chronic infective and nutritional conditions
over the period studied, an increase in the proportion of children who have cerebral
palsy was to be expected, and this expectation is borne out by the figures. The percentage
in 1957 (25.8 per cent.) was over three times that in 1928 (7.7 per cent.). That the
increase cannot be accounted for entirely in this way is, however, demonstrated by the
fact that the rates for children with cerebral palsy attending schools for the physically
handicapped per 1,000 children on the total school rolls have, in the period, increased
from 0.49 in 1928 to 0.72 in 1951 and 0.77 in 1957. These figures, of course, reflect
inter alia, the changes in duration of compulsory school attendance brought about by
the passing of the 1944 Education Act.
' It may well be that a reluctance on the part of the parents of some physically handicapped
children to leave the facilities in London or even an increased number in search
of better facilities have operated to make the fall in the numbers of physically handicapped
children smaller than the fall in the total school population, and so to produce an
apparent increase in incidence of physical handicaps. It is impossible accurately to
estimate this effect, but it seems likely that it will have been exerted equally on the
figures for cerebral palsy and on those for "brittle bones" "muscular dystrophy ",
and " other congenital defects ".
' It can confidently be stated that much of the increase in the proportion of children
who have cerebral palsy can be accounted for in the ways already discussed, but it
seems likely that the increased interest taken in these conditions in recent years may also
have had some influence. Some children who previously were kept at home or admitted
to institutions of various kinds would probably, today, be admitted to schools for the
physically handicapped. It is certain that the motor defects of many mentally retarded
children with a minor degree of cerebral palsy would, in the past, have been overlooked,
whereas now they are detected and the children are admitted to such schools. Further,
a smaller number of children whose general incompetence due to mental retardation
is reflected in motor incompetence are also admitted to the sheltered environment
there provided.
' While it appears that the problem of cerebral palsy is not an increasing one, it is
certainly one of increasing importance in the schools for the physically handicapped.
The factors responsible for the increased proportion in such schools of children with
cerebral palsy over the period studied are likely to remain operative in the future.
The training of personnel in the specialised management called for if these children are
to make the best progress of which they are capable is clearly a matter of great and
increasing importance in these schools. '
Cerebral palsy survey
Starting in 1955 a survey has been made of the prevalence of cerebral palsy in London.*
Information was obtained from hospitals, institutions, schools, clinics and general
practitioners of all children known to be suffering from cerebral palsy and domiciled
* Cerebral Palsy in the County of London. MacGregor, Pirrie and Shaddick. The Medical Officer, 27 December, 1957,
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