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37
would have its individual interest and be worth observing at any given stage
as a warning of potential significance for the future. It is from such observations
of individual symptoms that the totals shown in the table are made. The
figure 18 per cent. is therefore extremely generous and must not be taken to
represent the number of children that at any given time might be estimated
to require treatment, or even unusual lines of management. To the figure,
however, should be added some proportion of the 6.5 per cent. enuresis cases,
a group which has in the last two years been separately recorded (under genitourinary
conditions), and which must comprise both behaviouristic and organic
cases. Of this group, however, more than half again occurs amongst the
two year olds, and at that age enuresis during the night while worth observing
(and in individuals always worth recording) can hardly be put down as pathological.
A large number of these cases (or symptoms) are simply circumstantial,
seen at their best in the only child and big interval families (c.f. Annual
Report, 1931), and in the course of time yield to a happier play of circumstance
—as for example in the instances cited when the children go to school, acquire
normal companionship, form their own social contacts and find worthy outlets
for their manifold energies. The truth of this is abundantly seen in the fact
that 50 per cent. of the total behaviour symptoms are noted at the age of two
(a stage when they are not pathological developments, when they are nothing
but fingers pointing a possible way) and by the ages of three and four, when
a majority of the children now fortunately are able to go to school, the percentage
has already by natural forces halved itself. Nothing could be a
clearer indication of the foolishness of placing too much weight on these symptoms
as pathological entities—as social tendencies and indications they are real
enough—or treating them by precipitate and exaggerated methods by anything
more than normalising so far as possible the surroundings and social contacts
of the child than this spontaneous tendency of the problem to diminish
and solve itself. Further, the marked change in the attitude of parents
towards school for their pre-school age children that has occurred since the
facilities were provided (in the interval since the 1931 report was written),
is the best testimonial possible to the success of these provisions and the best
augury for happier times for the lonely and difficult child in the future. The
figures for symptoms themselves have come tumbling down in the last three
years in a manner which would excite the frankest scepticism were it not that
the great majority of the total toddlers' examinations are still carried out by
the same observer, and she at least is certain that she has not slackened her
standards nor begun to omit recording symptoms.
The figures for dental caries have been recorded this year with some
endeavour at precision in regard to the amount of damage present. The total
figure shows a slight diminution, 22 per cent. of cases as compared with 24
per cent. last year and 25 per cent. in 1933, but the figure for caries at the
age of two years has relapsed from 3.5 per cent. of cases in 1934 to 6.7 per cent.
In 1933 this figure was 9 per cent. so that last year's improvement was illusory