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handicapped in the ratio of about 160: I , and a larger proportion of handicapped children
die during the first year of life.
Pre-School
Our aim is that every baby living in this borough should be examined thoroughly
between 2 — 6 weeks, at 7 months, one year, two years, three years, four years and then in
school at five years. Unfortunately we do not have adequate staff to enable such examinations
to be carried out on all the children so we still have to confine our examinations to those who
come routinely to the clinics, or who are asked to attend because some complication before,
during or after the child's birth has made us consider the child to be "At Risk". At these
examinations the child is examined to see that vision, hearing, health, motor and mental
development are within normal limits. The children enjoy playing with 'Doctor's toys' and do
not realise that these toys are used to judge their movements and ability. The doctor finds
this work more interesting but more exacting and tiring. The results are important.
If a defect such as squint, defective vision, defective hearing, muscular skeletal
defect or speech defect are found the child is referred to the appropriate clinic in the borough,
for further investigations or treatment. If the child has any more complicated abnormality or
suspected abnormality arrangements can be made for them to be seen at the special assessment
clinic which was started in 1971 and which provides a combined local authority and hospital
service with the backing of both sets of facilities.
School
There will still be children who will not show their handicap until they have been
placed in a more academic learning situation after the age of six but it is anticipated that
the majority of chi Idren with a handicap will be diagnosed we 11 before the age of five years
and the parents made aware of the special facilities to meet the needs of the child from an
early age. Not all children who are handicapped at birth will be handicapped at school age.
Surgery, special diets and medicaments have enabled children to take their place in ordinary
schools and live a normal life. Others who have had very severe illnesses and would previously
have died, or who have defects at birth which were previously fatal, now live on and require
special facilities. This therefore causes the number of children with handicaps to be no
fewer than previously. Some of the children attending ordinary schools have severe handicaps
but if they can cope in an ordinary background without any detriment to their education this
is a more advantageous place for them. They, however, require special supervision to see
that they are holding their own and are therefore seen more frequently than others who are
seen in their first year at school and unless selected for the selective medical, based on the
questionnaire completed by the parents, medical records, vision and hearing test results and
comments from the head and class teacher, are not seen for a routine medical inspection until
they are near school leaving age. The majority of children are therefore only seen for routine
medical inspection twice in their school days or when they wish to do "Out-of-school" work,
but others are seen frequently for poor attendance or at the request of the school staff or
parents. Vision and general hygiene checks are carried out annually and any defects noticed
by the nursing staff on these occasions are also referred to the School Medical Officer for
further follow-up or treatment.
Although the majority of children are able to attend ordinary schools we are fortunate
in this borough to have a comprehensive series of special schools.
The Senior Medical Officers visit these special schools almost each week, examine
the children more frequently and become even more involved in their welfare and future career
than is possible in the larger ordinary schools. At present the borough lacks a partially
hearing unit and we hope this can soon be remedied.
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