View report page

Registers of all babies with congenital handicaps, as well as registers of all babies ' at risk'
are being set up in each health division. The 'at risk' register must be compiled from
notifications, sent by the hospital maternity services and the domiciliary midwifery service,
of factors occurring in the pre-natal, peri-natal and post-natal periods. For this purpose a
'notification of discharge' form for mothers and babies has been introduced by the Council
which provides a list of factors which can be ringed as appropriate. The current list of
factors suggesting child may be at special risk are as follows:—
Genetic: Family history of deafness, blindness, etc.
Pre-natal: Rubella or other virus infection in first 16 weeks of pregnancy
Blood incompatibilities (e.g. Rhesus sensitization)
Hyperemesis
Ante-partum haemorrhage
Severe illness necessitating chemotherapy or major surgery in early months of
pregnancy
X-ray other than chest X-ray
Thyrotoxicosis
Diabetes
Toxaemia of pregnancy
Other complications of pregnancy, e.g., pyelitis
Any psychiatric illness during pregnancy
Peri-natal: Prolonged or difficult labour
Birth weight under 4 lb. or gestation under 36 weeks
Birth asphyxia
Prolonged poor sucking
Post-natal: Jaundice
Convulsions
Respiratory distress, cyanotic attacks
Any congenital abnormalities
Not all maternity hospitals have as yet accepted the form; in some instances a copy of
the discharge letter sent to the family doctor is still in use. All medical officers in the Council's
services have been given the opportunity to attend training courses in standard screening
tests for hearing for young children and Stycar testing sets have been provided in all the
Council's clinics. Health visitors have made home visits to encourage mothers to bring
babies who have been included in the 'at risk' register for screening tests at critical periods
during the first two years of life. In some divisions these screening tests are carried out at
special sessions, in others they are done as part of the normal work of the child welfare
session.
When a hearing loss is suspected, the baby is referred either to one of the Council's
otologists or to hospital. Transistorised hearing aids are provided and auditory training is
given by peripatetic teachers of the deaf in the Council's clinics. A reviewing medical officer
has been appointed in each division to supervise the registers and to plan any special
medical or social services which may be necessary. If deafness is confirmed, the child's
name is transferred to the deaf register.
Children under three years of age whose speech development is not progressing can be
admitted to a day nursery free for three hours daily. These, on recommendation of the
otologist, include children of deaf parents who need a hearing environment; children who
appear to have a hearing loss, but whose deafness has not been confirmed; and some children
whose hearing loss is not so severe as to require admission to a nursery class for the deaf.
It is hoped that by these measures, in due course, many cases of congenital deafness will
be diagnosed during the first year of life.
139