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quently confirmed by Radiography in not a few cases, and these facts alone
point to the great importance of a detailed examination in every fresh patient,
not being merely content with the parent's statements. Careful study of the
anatomy and physiology of these regions shows their close inter-relationship.
"Amongst the series of cases, there are some who have not kept their
subsequent appointments and, so far as I know, have not received the treatment
advised."
Children recommended for the removal of their tonsils and/or adenoids
were admitted to the Royal Waterloo Hospital, S.E.I. Children were conveyed
to the hospital by ambulance and brought home again. Children referred
for other throat operations other than tonsillectomy were referred to the
Prince of Wales's General Hospital.
The number of children who received operative treatment for tonsils
and/or adenoids during 1946, was 124.
Arrangements were also made for children to see the Ear, Nose and
Throat Specialist at the North Middlesex County Hospital, when parents
preferred this, and the number of operations carried out there during 1946
was 211.
(f) Speech Defects.
Cases of speech defects were dealt with by the Speech Therapist, and the
following is an account of the year's work
"The Speech Clinic has had a very active year of post-war reconstruction
and re-adjustment. The outstanding event has been our removal to Pymmes'
Park Clinic. Here, for the first time since the Clinic was inaugurated in 1937,
we have our own rooms with suitable equipment, adequate cupboard accommodation,
etc. The move was only effected in November and there has not been
time for any obvious results but the therapist already feels the benefit of working
in surroundings especially designed for the purpose and where, moreover, the
Clinic has a right to be held and is not merely loaned accommodation in a school
or office building. At present we are enjoying the use of a large and a small
room, the larger being used for all group work and the smaller for interviews,
individual treatments, etc.
"There has been an increase in the number of new cases seen (90 compared
with 52 in 1945); we have also been able to re-establish contact with
most of our' pre-evacuation patients and all those still in need of treatment have
received it during the year. 743 children of school age have been seen in the
Speech Clinic since it was opened. With the opening of the 5th weekly session
in January and the increased number that it will be possible to see in our new
premises we hope to eliminate a waiting list.
"There is a perceptible lowering of the average age of children referred for
Speech Therapy, the majority of children are now seen early in their school life
but there is still a considerable number who are not brought to our notice till
after the age of 10 (23 or approximately 25% last year). In certain exceptional
cases the onset of a speech disorder may be delayed as late as the 11th or 12th
year, also there are those cases of children coming from other districts, but the
therapist feels that much work and valuable educational time could be saved by
early admission. Statistics show that the length of time required for treatment
is frequently doubled or even trebled in older children. It is interesting also to
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