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thought in child neurology and its practical application.
I began to wonder whether, in view of the recent advances, I ought to
take another look at my methods of examination and appraisal of young
children. I re-read Gesell's work on child development, the more recent works
of Professor Illingworth, and took out a subscription to the Journal of
Developmental Medicine. Armed with this little knowledge, a copy of Dr.
Sheridan's booklet on Child Development and her testing material for vision
and hearing, I asked Dr. Gillet if he would allow me to use a session to
experiment in this field. He very kindly gave his permission. So, with the
assistance of one Health Visitor, Miss Milbank, we started. Only, of course,
looking at normal children, any age group from 0-5 years, the mothers of
whom we could persuade to let us examine their babies.
Even in these very early days when our knowledge was so limited and our
tools so few, we had a wonderful response from the mothers. At the end of
six months I was fortunate enough to go on Professor Illingworth's short
course on child development held in Sheffield. I returned to the clinic with
greater knowledge, particularly of the very young child showing aberration
from the normal pattern, also with new ideas of simple equipment which would
help in the assessment of children.
Miss Milbank became very adept at vision and hearing testing in young
children and I gained a great deal of experience in neurological examination
of the young child. As time progressed this careful "looking" at the child
taught us a great deal also about their emotional and mental development and
we began searching for better and more accurate methods of doing this, and
among the many tests we tried out at this time was the "Goodenough Man".
This we found very helpful, since it is easy to use, particularly on say a
rather difficult 4 year old, and on later re-testing by other methods we
found this very accurate.
As time progressed and our knowledge increased, we became a little more
choosy in selecting children for the Development Clinic, as we had begun to
call it, and we started our "At Risk Register". Our special clinic appointments
were getting rather heavy, so we decided that some reorganisation was
necessary. This is the scheme in operation at present. At the first visit
of the mother to the clinic, usually at about 15 days, a neurological examination
of the baby is carried out and a careful family, ante-natal and birth
history is taken. If any anomaly is present, a small coloured tab is placed
on the infant welfare card indicating that this child needs following up,
either at the ordinary well baby clinic or at the special clinic. All babies
are re-examined at 6 weeks and again a decision made whether the baby ought
to be followed up. At present, if follow up is indicated at this stage, it is
usually carried out at the Development Clinic. All babies coming to the
clinic at 6 months have their hearing tested as part of the routine procedure.
Where indicated this is carried out earlier. This may seem to be a lengthy
procedure, but, in fact, after some experience in these methods, only a few
minutes is needed for each child and the well baby clinics are not unduly
prolonged. In fact, I believe that in the long run we save time. Mother
feels that the baby has been thoroughly examined and is less inclined to
worry.
Last year I attended the Ruth Griffiths Course on the "Abilities of
Babies from 0-2 Years". This course is designed for psychologists and
doctors in infant welfare work - the slant is definitely psychological and
divides the child's attainments into the following fields: Locomotion,
Personal and Social, Hearing and Speech, Hand and Eye, and Performance. A
general quotient figure can be produced, but, more important, a profile of
the five categories can be drawn up. Obviously, if a child were to show a
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