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of the mass media and the prosperity and tolerated independence of youth, who also challenge established
codes and question traditions, Broken homes, irresponsible or mentally disturbed parents,
housing shortage, communication difficulties between the generations, prejudices associated with
migration, the reorganisation of education and lack of private or public funds can create difficulties
for children, who will vent their feelings and express their insecurity through behaviour problems in
home or school. These difficulties lead to their referral to our Clinic, but they are not always easily
treated by the traditional child guidance methods because we have no control over social factors and
the shortcomings of the responsible adults. It is for this reason, more than ever before, necessary for
all referring parties to consider the competence of a child guidance clinic and not to expect a quick
solution of problems which are produced by factors which can be dealt with more appropriately by other
social agencies. Child Guidance is a highly specialised service which diagnoses and treats emotional
disturbances of children who are creating problems in the family or at school. While many behaviour
problems are caused by emotional maladjustment, not every difficult child is disturbed, and even when
psychological factors are clearly operating in the causation of problems they are not always amenable
to treatment. As I have tried to show in my report to you last year, / consider that the child is influenced
in his behaviour by so many factors that only very careful investigation by several experts in different
spheres of competence will be able to arrive at a reliable diagnosis. It is for this reason that our
investigations seem to take a long time and our waiting lists are long. It occurs that referring bodies
get impatient at the slowness of our procedure and the production of results. However, shortcut
methods have been tried and were found to be unreliable, if not actually dangerous, because it must
not be forgotten that the mental constitution of children is sensitive and highly delicate. It also
happens that children are not usually referred to us before other well established methods of handling
have been unsuccessfully tried. Added to this difficulty there is a perpetual shortage of staff which
is not only caused by the limitations of public funds, but even more due to the extreme care that is
necessary in selecting staff for appointment at the clinic, as certain minimal requirements of training
and personality are essential and the second best will not do for children.
The Child Psychiatrist (and his locum) saw 108 new cases and 15 reviews. He saw four children
more regularly for treatment, while many more were seen at weekly intervals or more often by the
psychotherapists who provide fairly intensive and deeper therapy. Apart from seeing the children and
parents who were referred to us from the usual sources, as described in more detail previously, we
spent some time in discussion of cases in interviews with Child Care Officers, Probation Officers,
Wardens of Children's Homes and other experts in child and community care".
Rheumatism Supervisory Centre
The Rheumatism Supervisory Centre is held at the Prince of Wales's Hospital under the direction
of Dr. I.M. Anderson, consultant paediatrician, with the close co-operation of the Health Department.
One session is held each week.
Originally the clinic was set up to deal with children suffering from acute rheumatism and its aftereffects,
but its scope has widened to include the investigation of symptomless heart murmurs and cases
of congenital heart disease.
Dr. Anderson has supplied the following details of the year's work:-
"During 1967 there were no new recorded cases of rheumatic fever.
There were thirty-two new cases of cardiac murmurs referred from Welfare Clinics and General
Practitioners. These cases are classified as follows —
Patent Ductus Arteriosus 2
Aortic lesions 4
Ventricular septal defects 2
Auricular septal defects 5
Mitral stenosis 1
Innocent murmurs 18
Total 32
Of these thirty-two new cases, twenty-six are from the Borough of Haringey — eighteen male and
eight female. Six came from other areas — two male and four female.
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