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16
Developmental Defects
The number of these defects has fluctuated in recent years. There was
a sharp rise in 1966 followed by a reduction last year. The number of defects
reported in 1968 shows a return to the higher figure of two years ago.
Orthopaedic Defects
All categories of orthopaedic defects showed a marked decline in
1968, particularly the one described as "flat foot". This latter change may
represent an alteration in recording policy rather than an improvement in
foot health as a result of health education efforts in recent years. It is now
realised that symptomless flat foot may not require the energetic treatment
advocated in the past and this may have resulted in fewer cases being reported.
Less than half the number reported in 1967 were referred for treatment
last year in spite of the improved physiotherapy services, and this
lends support to these tentative conclusions.
Dr. Thelma Wield, school medical officer with special responsibilities
for orthopaedic conditions, has drawn attention to the relative increase in
physically handicapped children as fewer of them die at birth or in infancy.
Clearly St. Giles' School cannot accept all of these children and, indeed,
there is good evidence that many parents of handicapped children would
prefer them to attend ordinary schools when this can be achieved without
detriment to their educational progress. Schools in Croydon have for many
years accepted children with minor physical handicaps but increasingly they
may be called upon to receive the child with rather more severe orthopaedic
problems. Ingenuity will sometimes be needed to ensure that an otherwise
perfectly satisfactory placement is not jeopardised by an inconvenient
flight of steps or an unecessarily long journey to school. Increasingly the
special schools will be needed to accommodate the child who presents
severe medical, physical, or educational problems.
Defects of the Nervous System
The number of these defects was similar to that reported in previous
years, but a further slight increase (10%) was reported in the number of
children known to be suffering from epilepsy.
Psychological Defects
Although psychological defects are an increasing proportion of the
total defects found, it is likely that the true incidence is much higher than
the 4.5% reported in Table 3. Possible reasons for assuming a higher real
incidence were mentioned in last year's report (page 15). The most striking
feature in 1968 was the quite dramatic increase (20%) in the number of
defects which were referred for supervision by the school medical officers
themselves. This allowed a greater total number of defects to be supervised
even though the number referred for specialist treatment actually declined.