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13
There were again changes of staff so that the decrease could reflect
slightly different standards of acceptable response by the audiometricians.
It will be interesting to study the figure in future years since the
decrease could also be due to a gradual decline in the incidence of
defective hearing as a result of improved treatment for the pre-school
child.
Unfortunately the number of children found to be suffering or to have
suffered from middle ear disease (otitis media) at school medical inspections
has shown a further marked increase during 1966. Last year's
annual report drew attention to this disturbing trend (page 15) which has
continued its upward course. There does seem to be an increasing
number of children referred to hospital specialists with a condition of
the ears caused by an incomplete resolution of an otitis media. The
condition is thought to arise from the current practice of treating virtually
all cases of acute otitis media in children with antibiotics. The number
of children who were being followed up by the school medical officers
themselves for middle ear disease actually doubled during the year.
Such continuous observation will be necessary for several years before
the possibility of long term sequelae can be excluded. It is clear that
this problem is continuing to receive the careful attention of school
medical officers in Croydon.
Defects of Heart and Circulation
It is often difficult to assess the significance of heart murmurs in
symptomless children. It was helpful to have a visit from Dr. Samuel
Oram, a leading specialist in cardiac disorders, who gave a lecture to
the school medical officers during the year on the assessment of cardiac
murmurs in childhood. He stressed the value of regular examinations of
children in whom such heart murmurs were found before reaching a final
decision. It is therefore encouraging to find that school medical officers
have followed this advice most diligently and, although the number of
heart defects referred to a specialist showed a slight reduction in 1966
there was a considerable increase in the number of children whom the
medical officers wished to follow up in school for this condition. This
experience emphasises the value of regular specialised in-service training
for professional personnel.
Defects of the Lungs
There was a significant increase in the number of lung defects
reported during the year. This increase may partly reflect the increase
in the numbers of children who could receive breathing exercises consequent
upon the recruitment of a full-time physiotherapist in the Purley
area.