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78
pares unfavourably with the already low figure of 12 children
referred in the previous year. I find this extremely disappointing;
I previously stressed the view that the referral and treatment
of children in pre-school years holds out the best hope of
solving the problems common to all child guidance clinics of
excessive pressure of work, due largely to problems which
might have been prevented had appropriate guidance or treat'
ment been provided at an earlier stage. Progressive medicine
concentrates on prevention, and this principle is of particular
application in the field of child psychiatry, where it is almost
universally admitted that the foundations of mental health or
ill health are laid down during the first five years of life.
"In child guidance clinics dealing largely with children of
school age, and in schools for maladjusted pupils one is continually
impressed with the magnitude of the problem and with
the fact that in most cases one can see clearly that the problem
originated in the very early years, long before the child is
brought for advice. One's experience in handling such problems
when they are, in fact, brought in the pre-school period,
encourages one to believe that in many cases the later problem
could have been averted had the earlier one been dealt with
in good time. When one considers the expense incurred by
public authorities, not merely in the running of child guidance
clinics, but also the costly residential schools for maladjusted
pupils, one realises how much scope there is here, not only for
better medicine but also for national economy. In this way, I
believe, in the long run the present excessive demand for
places at schools for maladjusted pupils might be diminished,
and the places there be made available for those children far
whom this form of education is unavoidable.
"I would like to stress in connection with this mental
health work the need for co-operation between the infant welfare
services and the Child Guidance Clinic. The staff at the
Child Guidance Clinic would always be happy to help the
health visitors or any other persons concened in the social and
medical welfare of young children, with discussions of problem
families or arranging psychiatric interviews for particular
parents and children at the West Avenue or Walthamstow
Child Guidance Clinic. I am glad to record that in the course
of the year the clinic staff were invited to give talks at "Brookscroft"
Maternity and Child Welfare Centre on June 12th, and
at the Nursery Association at Leyton on November 20th.
"Further to the subject of prevention, I believe that the
provision of more nursery schools to which children could go
who show signs of early maladjustment in their homes, would
often provide a satisfactory means of solving their problems.
The present housing shortage with consequent overcrowding
and restriction of the child's normal activities, leads to frayed