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172
Referral
The number of sources from which children were being referred for possible
ascertainment, apart from primary schools, increased.
Widening the scope of the definition to educational subnormality and the fact that
children aged five years must (and some children below this age may) be provided with
special education contributed to this increase. In addition psychiatrists and child guidance
clinics were dealing with maladjusted or behaviour cases daily and were referring a
proportion of their cases. In spite of the increase in possible sources of reference,
however, the majority of ascertainment examinations still result from headteachers'
reports that a child has failed to respond to ordinary teaching in primary school.
Documentation
The procedure remained similar to that already instituted as a result of the Act of
1921 whereby a child was first seen by the school medical officer.
In essentials the material required for the information of the administrative medical
officer who advised on the need for a formal statutory examination and the approved
medical officer who conducted it remained the same—information from anybody who
had reliable knowledge of early history, habits, rate of progress and behaviour. In some
cases a dossier of relevant information, including medical reports, is available and up to
date reports from any doctor, whether general practitioner or specialist, under whose
care the child had been are essential. On this information the administrative medical
officer decided whether to obtain consultant opinion before recommending an
examination.
In the case of children already in attendance at an ordinary school the report of the
headteacher recorded on Ministry of Education Form 3 H.P. constitutes a statutory part
of the procedure and is most important. This gives a complete picture of school life,
the teacher's estimate of educational age and rate of progress and opinions about
parental character, co-operation and supervision. Headteachers understand that, in
addition, any other information, written or verbal, will be welcome and fully
considered.
In 1948 the administrative picture was altered slightly as a result of the National
Health Service Act, 1946. Nine administrative divisions were set up for all health
service purposes each with a divisional medical officer who became responsible for the
school health service in his division. Thus the five school health service areas already
mentioned were replaced and the divisional medical officer in the first instance undertook
the administrative decisions relating to educationally subnormal children and
immediate responsibility for the examination of children in his division.
Ascertainment
The Education Act, 1944, differentiates sharply between the procedure for ascertaining
children in need of special education and capable of benefiting by it and that used
in the case of children incapable of education in any school because of ineducability or
conduct detrimental to other children. In the first case, subsections 1 and 2 of section 34
lay down the action to be taken, in the second, subsections 3 and 4 of section 57. The
provisions are so strict that if a child is examined under one procedure but proves on
examination to be suitable for action under the other, the medical examination is invalid
and, even though the parent may agree with the action proposed, another has to be
arranged. The administrative medical officer's first responsibility therefore is to assess
whether the child is of very low grade and thus likely to be ineducable or whether
mentally he is likely to be in the E.S.N. range of intelligence so that a notice to the parent
can be issued under the right section of the Act, thus avoiding the risk that a second
examination might be necessary.
When the principal school medical officer has informed the education officer that
he is prepared to examine a child under section 34 (subsections 1 or 2) the authorised
officer of the local education authority delivers a notice of 'intention to examine' to the
parent. This tells the parent what is proposed and why and the penalty for failing to
produce the child for examination. Section 34 (3) stipulates that the local education
authority must itself give the parent notice of the time and place of the examination.
This is done by placing the child's name before the appropriate sub-committee of the