London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1958

[Report of the Medical Officer of Health for London County Council]

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171
than those previously accepted as it was no longer necessary for the school medical
officer to certify them as mentally defective. Indeed this widening of the legal concept
made it possible for children to be admitted to E.S.N. schools even if their educational
subnormality was due to causes other than intellectual failure. This interpretation of
the legal definition was rarely used except at the parents' request but it did mean that
special schools began to receive children with I.Q.'s ranging up to 80—85 (provided
they were functioning educationally at E.S.N. level). This was welcomed by teachers
in E.S.N. schools as among other things it enabled them to obtain far better results,
thus setting higher standards and encouraging them to introduce more modern
methods of education. With this raising of the upper intelligence level of educationally
subnormal children there was a tendency in some instances to raise also the lower I.Q.
level, below which a child could be considered ineducable in any school and suitable
only for occupation centre training under the Mental Deficiency Acts. The Ministry of
Education, however, very rightly make it clear that local education authorities should
give a trial to any child who had not had any school experience unless the child was
obviously completely unsuitable.
This improvement in the I.Q. range of special school children resulted inevitably in
an apparently steady rise in the number of children receiving special E.S.N. education,
either in special schools or the newly created special E.S.N. classes in ordinary schools.
Close investigation showed, however, that so far as mental deficiency and genuine
intellectual retardation was concerned there was very little basic change from the figure
issued in the Wood Report of 1929.*
The enlarged scope of the special E.S.N. school increased its attractiveness for young
teachers as a career. Finally the subject attracted so much attention that in 1950 the
Institute of Education of the University of London instituted a Diploma in Special
Education awarded by examination after a year's course in the subject which is now
recognised as a qualification in E.S.N. teaching.
The fundamental change was that the age at which education could be provided
for any handicapped child was two years if the parents wished. Few, if any, local
education authorities had any nursery school provision for educationally subnormal
children under five years and the majority of school medical officers foresaw great difficulty
in coming to a firm conclusion as to the educability of a mentally retarded child of
two years. This last point was of particular importance as the new Act provided no
method of revoking a report that a child was ineducable once made. Representations
resulted in the issue of Circular 146† which recommended that the local education authorities
should not issue reports in respect of children alleged to be educationally subnormal
and under five years of age. Section 8 of the Education (Miscellaneous Provisions) Act,
1948, enabled a local education authority to cancel a report that a child was ineducable and
to provide education suitable to its ability and aptitudes. This relieved the school medical
officer of the heavy burden of deciding to recommend a report with the knowledge that
if he was wrong in his diagnosis and prognosis the decision was irrevocable and the
child would be deprived of any further education. As the Act had originally been
interpreted, if a child had been reported as ineducable by one local education authority,
no other local education authority could admit to school unless the authority that had
issued the report recommended its withdrawal. In most of the small number of cases of
this kind some delay was the only disadvantage which resulted but in the last ten years
in three cases which occurred in London the local education authority concerned required
much persuasion before agreeing to withdraw the report and in one case it
refused to do so. About two years ago the Ministry took a different interpretation which
allowed one authority's report to be withdrawn by another authority to whose area the
child had removed subsequent to the issue of the report.
* Report of the Special Committee appointed to consider the problems presented by Mental Deficiency among children
of school age, 1929.
†Ministry of Education Circular 146 (30th June, 1947).
M*