View report page

have been working in the same area for 10-15 years getting to know the families and their
problems well. As each clinic is comparatively self contained, each is responsible for the
supervision of the welfare of the children in that area from birth until school leaving age
unless a child attends a school in a different area. Both these factors provide valuable
continuity in the School Health Service where schools and clinics tend to regard the other
as "our clinic" or "our school" with a happy relationship existing between the two.
Staff who have been working for many years in the borough are able to look back over
the past decade and see that during that time there has been a gradual change in emphasis in
the work with children. There has been a gradual change from seeing that the child is healthy,
through the stage of finding defects as young as possible, to seeing that the child is developing
normally and, if not, finding the cause and if possible the treatment. This is Developmental
Paediatrics and true preventive medicine. We would still be concerned if wee Jamie
was losing weight and had a sore throat, but far more attention is now given to whether he is
able to lift his head or use his fingers correctly at the normal age. This has meant special
training for the staff and has added, not only to the interest of the work, but has made it more
exacting and heavy.
At birth some babies are found to have congenital abnormalities. In 1970,73 were
found to have defects apparent at birth. 3 I of these are minor defects such as birth marks which
cause no handicap and disappear without treatment. About 25 will respond to treatment leaving
no handicap. About 11 would be expected to cause no serious defect, but 6 would be expected
to require special help all their life. Not all congenital abnormalities are apparent at birth
and appear later. These also are noted in the At Risk and Pre-School Handicap registers and
receive the necessary supervision and help. Those apparent at birth are notified to the
Department of Health providing not only statistical information but would serve as an early
warning system if there was an increase in the total number of one defect. Investigation
could then provide information regarding a possible causative agent.
The handicapped and potentially handicapped children are specially watched during
the pre-school period so enabling a fuller picture of the child to be available at school. Many
by school age already having experience of attending a Day Nursery or Play Group. The
parents are also able to know what facilities are available well before school age.
Infants and toddlers continued to attend the appropriate clinics in large numbers so
the Medical Officer already knows many children and families well on their admission to
school and the time for their child's first statutory school medical examination. All children
are seen during their first year at school and many are found to be perfectly healthy. Others
with defects are referred for treatment and observation. With the improved standard of health
it was found that the majority of children at the 9-10 year old medical inspection were healthy
so when Waltham Forest first came into existence it was decided to continue the Leyton
method of selective medicals for a trial period. After scrutiny of a comprehensive questionnaire
completed by the parent, the results of hearing and vision tests carried out by the
school nurse, perusal of medical records and discussion with the Head Teacher and Class
Teacher, varied time was allocated to children selected on a basis of being in most need of
the attention of the Medical Officer. Attendance of parents at the medical examination has
been very good. This has not reduced the total time spent in a school but after four years
we are satisfied that this is a more advantageous way of using the available personnel at this
age group. All children are seen before they leave school and at this time future plans are
considered in the light of any physical defect.
- 18 -