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64
speech defect. Subsequently, the aim has been that
children should enter the class at 4½ years old and
only when the disability has been sufficiently overcome
enter an ordinary class.
The facilities available are well known in the
Area to school medical officers, medical officers of
child welfare clinics, health visitors, teachers, and,
indeed parents themselves. Referral in the first instance
is to the medical officer in charge of speech
therapy as it is felt that the causes of defective
speech are so diverse that speech therapy in its narrow
sense plays only apart. Diagnosis and effective treatment
may require the services of ENT surgeon neurologist
or psychologist, and the appropriate co ordinator
of these is considered to be the medical officer.
The medical assessment consists of,-
(1)(a) General medical history and inquiry into
the child's milestones, disposition play habits and
home background.
(b) The history of the child's speech defect,
together with family speech history.
(2)(a) General medical examination.
(b) Examination of tongue and palate movement
formation of mouth and teeth, hearing central nervous
system and preliminary estimate of intelligence.
(3) Special investigations -
(a) Routine assessment of Intelligence Quotient.
(b) Routine pure tone audiometry.
(c) Tape recording.
Following the medical examination the child is
seen by the speech therapist and a joint conference
between medical officer, teacher and speech therapist
is held to determine whether admission is indicated.
If this is the case formal ascertainment as a handicapped
pupil is made. As a general rule the criteria
are: -
(1) That a child should have a speech defect sufficient
to impede education if admitted to a normal
class and that this would be unlikely to improve in
these circumstances.
(2) Although children with other handicaps are
admitted, the speech defect must be the primary disability.
Subsequently the child has a routine medical exam
ination twice yearly and is referred for special exam
ination whenever required by conditions coming to
light as a result of observations by teacher or speech
therapist. In addition to this the medical officer
visits the class at frequent intervals. In this way
the children accept him as a normal visitor and he is
able to observe the progress of the children under day
to day conditions.
Since the class commenced 30 children (19 boys and
11 girls) have been admitted. Of these, 21 have been
discharged leaving nine still in the class. The average
age of admission during the last six terms under review
has been five years five months. The average age of
discharge has been seven years six months, after an
averaee st.av in the class of three terms.