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resolution. The behaviour of a child is not conditioned by its innate
endowment only; the experiences which befall it, more especially the
emotional experiences, have a very marked influence on conduct and attitude.
Whilst those qualities which are inborn may be very difficult to
modify, the effects of experience are more readily influenced. The problems
of personality are largely the result of emotional experience in very
early childhood, so that the task of helping the child to make a satisfactory
adjustment cannot be undertaken too early. This adjustment may involve
treatment of the child or modification of the environment which
has served to cause, and if unaltered perpetuate, the ill-health from which
the child suffers. The diagnosis involves much patient investigation
by a skilled child guidance team, the work of each individual being welded
into a whole at a conference held on each child.
Whilst all the members of the team take a part in the conduct of the
case, the direction of treatment properly falls to the psychiatrist. The
form of treatment is not stereotyped, but varies with the type of case,
so that there is opportunity for all members of the child guidance team
to undertake treatment.
The team at this clinic consists of a full-time psychiatrist, two fulltime
psychiatric social workers, two part-time psychologists, who
together give five sessions (2½ days) per week, and two part-time play
therapists, who together give ten sessions per week.
New Cases in 1946.
Two hundred were seen in 1946. Of these, 126 including 57 from
Harrow, were investigated for diagnosis, and 74, including 37 from Harrow,
were also selected for treatment. The sources of referral were as in previous
years, i.e. over half by school medical officers, including cases
ascertained by head teachers, who bring them to the notice of school
medical officers for the exclusion of organic disease in the first instance ;
the remaining cases are referred by hospitals and welfare centres, private
doctors, juvenile courts, and some by the education or public health
departments from various indirect sources.
The total number referred between January 1st and December
31st, 1946, was 277. 126 were from the Harrow area and 151 from all
other areas covered by the clinic—the main contributors being North
West Middlesex 56, Wembley 40, and Hayes 29.
Of the total number referred during the year, after home visit and
further investigation, 42 children (16 from Harrow) were gradually
removed from the waiting list as their names came up for appointment.
12 of these were found to be unsuitable for child guidance, 8 had left
or were about to leave the area, 8 had had only transient symptoms
and did not need to attend, 1 had been taken to a private doctor, and in
the remaining 13 cases, the parents were unco-operative, and, for one
reason or another, unwilling to pursue the matter further.
Children Under Treatment Previous to 1946.
Total 41 from all areas, including 19 from Harrow.
Of these, 33 were discharged during 1946 (25 cured or markedly
improved; 1 unimproved; 4 because further improvement was prevented
by lack of parental co-operation; 2 were unable to continue
attendance; 1 adolescent schizophrenic was transferred to Shenley