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ence, so far, indicates the value of this procedure which
reveals many cases of unsuspected hearing loss, at the speech
frequencies, which may have prevented the children concerned
from deriving the maximum benefit from the spoken
word on which their educational progress so largely depends.
Even minor departures from the normal are recorded and
all cases are followed up and appropriate treatment instituted
in school clinic or hospital as required. The co-operation
of teachers in ensuring a favourable position in class is
always forthcoming.
It has been our practice, in the past, to examine the
vision of schoolchildren at the Periodic Medical Inspections
at five, eight, eleven and fourteen years but as children
between these ages are, often, found to have visual defects,
arrangements have now been made for additional examinations
by the School Nurses at ten and thirteen years at
special sessions. In addition any child may have an eye
examination at any time on request of a head teacher or
parent.
From 1956, the third periodic Medical Examination of
Schoolchildren which had previously been carried out during
the last year in the Junior School will be carried out as soon
as possible after the transfer of the child to the Secondary
School. The main reason for this decision was that the examination
was becoming increasingly burdensome to the
Primary Schools as the selection tests for Secondary Education
became more elaborate and prolonged and that, in any
case, an additional examination at the age of eight is already
carried out. The Secondary Schools on the other hand did
not have a medical inspection until the children were in
their last year and the new arrangement provides an additional
opportunity for contact between the School Health
Service and the head teachers and staff of the Secondary
Schools.
An important development in the School Health Service
has been the extention of immunisation to include vaccination
against tuberculosis and poliomyelitis. B.C.G. vaccination
against tuberculosis is now being offered by the Local
Health Authority to schoolchildren during their fourteenth
year and poliomyelitis vaccination to children born between
1947 and 1956 whose parents decide to have them vaccinated
and progress in this work will depend at all times on the
availability of vaccine. Mention should, however, be made
of the fact that regular vaccination of schoolchildren against
diphtheria, tuberculosis and poliomyelitis makes a considerable
call on the time of medical officers and health visitors
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