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number, especially when compared with 1970 (21) and demands a close scrutiny of the hearing
of senior school children. Some of these children so referred will have had hearing losses as a result
of previous illnesses during their early childhood, but some loss may be due to the noisy environment
which many senior school children seem to enjoy. Sustained loud noise as produced in
discotheques, etc., has been shown to give rise to gradual loss of hearing ability and a warning
should be given that young people run risks with this precious faculty under such conditions.
One of the penalties of advancing age is the gradual loss of hearing particularly in the higher
frequencies which impedes the enjoyment of music and quiet verbal communication; this process
can be expedited if the noise pollution increases beyond reasonable limits.
It is gratifying to note the very small number of children with middle ear disease, 22 out of
13,459. The impact of modern drugs on this one-time scourge of children has been immense.
Defects of Nose and Throat
202 children were noted to have some condition of the nose and throat which needed
attention. Entrants to school provided the largest number, this age group inevitably having to deal
with the infections of the large school population after leaving the shelter of the family and the
neighbourhood environment. Running noses (rhinorrhoea) and sore throats with inflammation of
tonsillar beds and enlargement of lymph nodes are common but settle down after varying lengths
of time with no further trouble. Occasionally, a child is left with a chronic tonsillar enlargement
and infection which will require surgery, but the mass removal of "tonsils" of the school child
population has now gone. Only 36 of the 131 children seen at these inspections required any form
of treatment. The figures are even less for the junior (20) and senior (5) pupils.
Defects of Speech
The reports of speech therapists have been included elsewhere in this report (page 150).
It is interesting to note the comparatively large numbers of infant school children who display
some difficulty in speech production. 45 of this group needed attention and referral to a speech
therapist and a further 152 were asked to return for re-examination after a period in a communicating
environment.
Children with defective speech are confronted with considerable difficulties in a normal
infant class. They are frequently unwilling to talk because of the unfortunate effect their speech
has on other children; they become shy and unresponsive, frustrated in their attempts to communicate.
Their education often suffers and time lost in prolonged speech therapy can add to the
deprivation. Also there may well be a correlation between defective speech and later reading
ability. All this really means that children with speech defects should be identified earlier than
the school entrance age and the appropriate treatment begun.
Defects of Heart and Circulation
The figure obtained for this defect remains at a low level, 2.1% (2.7% in 1970). For the most
part, the children were in infant classes and presented with heart murmurs many of no great
significance but all needing careful examination. 5 of the 47 were referred for further investigation
or treatment, the remaining 42 for observation and re-assessment. In all three groups examined,
9 children needed referral for consultant opinion and 70 were noted for further observation.
Defects of Lungs
The proportion of defects of the lungs to the total number of defects is similar to last year
(2.7% in 1971; 2.5% in 1970). The number of entrants presenting with lung conditions is similar
to that of the intermediate examinees, 41 entrants and 49 intermediate. The commonest diseases
are bronchitis, and asthma. Many of these children are seen with wheezy chests which may be
due to underlying bronchitis with spasm and which may develop into frank asthma or may not.
It seems that many children who display these conditions in early childhood are free of them by
the time they reach school leaving age and this clearly appears to accord with the figures for
routine inspection. The number of school leavers with lung defects is only 12; 2 of whom needed
treatment and the remaining 10 having treatment already and requiring supervision only if they
remained at school. A few children will still be left with their asthma or bronchitis when they
begin their working life.
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