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42
part of her time. Psychiatrist sessions were at the same time
increased from 2 to 4. As these changes came only towards the
end of the year, they cannot yet show any marked effect on the
volume of work done in the centre.
Only 10 cases were awaiting treatment at the end of the year
and although it is unsatisfactory not to be able to provide treatment
immediately after or within a few weeks of the diagnostic
interview, this is an improvement over 1946, and it is hoped that
with the increase of staff, this particular waiting list will diminish
or disappear.
Table II. Symptoms.
As usual the number of symptoms exceeds the number of
children seen, i.e., many children come to the centre with two or
more symptoms, thus for 158 children, there are 239 symptoms.
The 4 predominating categories are "fears and anxiety," enuresis,
delinquency and backwardness. Backwardness and school difficulties
constitute a considerable smaller group of those referred to
the centre last year, and it is of particular interest, that children
referred to us for school difficulties have been well above the
average in intelligence, the average of this group being 118. This
is accounted for by the fact that we have had an unusual number
of referrals in this group from the grammar schools, and, as in
the case of other symptoms, the particular difficulty has not been
in itself of such great significance. There have been indications
of underlying emotional disturbance in the child and also difficulties
in the home, which tends to affect children under the strain of
academic work, more perhaps than children where the intellectual
standards are lower.
The predominance of the category, "fears and anxiety," and
the fact that children presenting difficulties in this group are
among the youngest coming to the centre, confirms the opinion
expressed last year that the system of ascertainment in Ealing is
of great value, and that children are referred before their problems
have crystallised into specific forms.
With regard to delinquency and the group of problems referred
to under behaviour disorders, we are still concerned with the
comparatively advanced age at which these children reach us.
(See Table V).
Table III. Home Conditions.
In a certain number of children some constitutional disability
—either innate or acquired—determines the maladjustment,
irrespective of post-natal environment ; examples of this type are
children who manifest a change of personality after a head injury,
or after meningitis, encephalitis, etc., or who presumably because