London's Pulse: Medical Officer of Health reports 1848-1972

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Hillingdon 1970

[Report of the Medical Officer of Health for Hillingdon]

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DEAF BLIND CHILDREN
This particular combination of handicap makes early diagnosis peculiarly difficult and such
children often appear to be mentally sub-normal. Indeed mental subnormality may also exist so
that the child has a triple handicap. Where the sensory loss in both categories is severe, specialised
teaching is the only satisfactory method of implementing the requirements under this Act. The
number of such children is so small that provision on a national basis in residential schools would
seem to be the appropriate solution.
If one sensory loss is greater than the other, and the child is not severely mentally sub-normal,
then education could be provided in an appropriate local unit. Where mental severe subnormality
co-exists, then the right course would be to educate the child under this category.
AUTISM AND EARLY CHILDHOOD PSYCHOSIS
Autism is a mental handicap where the child appears oblivious to its surroundings. Behaviourally
such a child appears severely mentally sub-normal and available evidence indicates that at
least half the children who are "autistic" are also severely mentally sub-normal. Such children
are usually placed according to mental ability in junior training centres which will become special
schools for educationally sub-normal pupils with the implementation of the Education (Handicapped
Pupils) Act, 1970, in April 1971.
Children who are found to be autistic and not severely mentally sub-normal should be placed
in appropriate day special units and this authority has had this provision for several years.
The characteristics of an autistic child have been described as follows:
1. History
(a) Appears normal or perhaps slightly backward in milestones until age of
15-18 months when speech slows or ceases.
(b) Relationships with others become less tenuous and child becomes more
withdrawn and less affectionate.
2. Child appears to have a low I.Q. but with islets of average or above average ability.
3. Less affected by pain.
4. Obviously more interested in objects than in persons.
5. Temper tantrums.
6. Speech nil or nearly so and often thought to be deaf.
ACUTE DYSLEXIA
Although no agreement has been reached on what is specifically meant by the term "dyslexia",
it is generally accepted to mean "reading disability" or "word blindness".
The causes of reading disability where there is no brain damage have been cited as a failure
to provide special educational facilities at the right time of a child's development and emotional
relationship within its family. The utmost concern must be shown for a child of average or above
average intelligence who has a reading delay without obvious physical or emotional handicap.
In such children, where the reading delay is of some three years, then a diagnosis of dyslexia
may be justified. Reading delay in the older child, indicates a waste of educational opportunity.
Other forms of identification have been given as a child whose writing is somewhat bizarre
and characterised by reversals of letters and mirror writing, and a child whose reading difficulty
is unrelated to general educational retardation.
This authority has provided remedial reading facilities for several years, but the extent of
the problem of dyslexia has not yet been clearly identified. The provision of a remedial reading
centre with all available teaching aids would be the greatest incentive for bringing "dyslexic"
children to the notice of the authority.
A meeting was convened between the Director of Health and Welfare Services and his staff
and the Chief Education Officer and her senior officers to examine the responsibilities imposed
by this Act on this Authority towards the children suffering from conditions mentioned above.
A joint report was prepared for submission to the Education Committee. The number of
children who are blind and deaf is very small and one unit could be shared by several authorities.
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