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DEFECTS OF EARS
After visual defects, hearing presents the next largest number of defects, being 12% of the
total this year and marginally higher than the previous year's figure of 11.5%. All children who
have problems in hearing are at risk in this modern world of fast machinery and traffic; and especially
so in the educational world where a missed lesson or even a missed part of a lesson may have
an effect on future work.
All children in the Borough's schools are tested audiometrically at the ages of 6 years and
9 years. A standard method of testing is applied by the Audiometrician who is employed by the
School Health Service on a part-time basis. A child who fails any part of this simple test is referred
to the school doctor who fully examines the child and advises the parent if treatment is found
to be necessary. Dr. Fisch, Consultant Otologist attends the Hearing Clinic in Heston in the London
Borough of Hounslow, and advises the School Health Service of children referred to him. Hearing
aids, either of National Health Service type or of commercial manufacture, where these are considered
necessary, may be supplied to pupils on Dr. Fisch's recommendation. A peripatetic Teacher
of the Deaf visits schools to advise headteachers where partially hearing children are educated
in their schools.
The number of children who present at routine medical inspection with middle ear disease,
has shown a drop in 1970 and only represents 0 3% of the defects. Modern anti-biotic treatment
has reduced this formerly common and disabling disease to a fraction of its severity and importance
and has robbed it of much of its danger. However, it does still exist and several children each
year are discovered to be suffering from it.
DEFECTS OF NOSE AND THROAT
The diseases of the upper respiratory tract continue to plague children, though nearly all
the figures represent children in the infant classes. Only a few of the junior and less of the senior
pupils are affected at any one time. The first year at the infant school is a time of infection and
re-infection of the child with germs from outside the family and its immediate environment.
Enlarged tonsils and adenoids, sore throats and enlarged cervical lymph nodes are very common.
DEFECTS OF HEART AND CIRCULATION
There was a slightly higher incidence this year over 1969 (2.7% 1970—2.1% 1969). Mainly
these represented heart murmurs often of little significance but all requiring careful reassessment.
DEFECTS OF LUNGS
The outstanding disease with which school doctors are concerned in this field is probably
asthma or spasmodic bronchial asthma. Many children with this complaint continue at ordinary
schools with varying degrees of absence; but with the severe type of asthma associated with
frequent absence from school, a child's education as well as his health will suffer. Sometimes
these children find it difficult to keep up with the inevitable competition of an ordinary school
and an argument can be advanced for a small day special school for children with this and other
chronic diseases where the child's health could be improved with a variation of education and
outdoor activity, together with closer medical supervision. Where necessary, some children can
be given education in a special residential school for delicate children where most of their needs
can be met.
DEVELOPMENTAL DEFECTS
A few children are seen at routine medical inspections with herniae of various kinds mainly
umbilical, occasionally inguinal. The numbers are small and fairly constant.
ORTHOPAEDIC DEFECTS
These defects are mainly of posture, especially in the senior pupils, and of feet which affect
all groups of pupils. There is a slight reduction this year from the 1969 figures. Of the 39 children
seen with postural defects, 27 were of senior school age, and in most cases represent poor stance
and slack musculature. Occasionally one finds a severe scoliosis (twisting and curvature of the
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