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Developmental Defects
These are usually a fairly consistent proportion of the total number and are tabulated as
Herniae (usually umbilical or inguinal) and other developmental defects such as absence of one
or both testes in the scrotum, cleft palates, extra digits, etc. 20 children were noticed to have
herniae, 13 infants and 7 juniors. No school leaver was found to have a hernia. Of the remainder
of children with developmental defects, 59 entrants and 53 intermediates were so noted and
12 leavers. 29 of these required treatment.
Orthopaedic Defects
12-4% of all defects are gathered under this heading and after eye and ear conditions, produce
the highest figure afflicting school children. From the earliest days of the school medical service,
this group of defects has attracted the attention of teachers and doctors, mainly because of their
obvious nature, i.e. poor stance, posture, awkward or crippling gait, deformed limbs, etc. Orthopaedic
clinics were, therefore, among the first to be set up to improve these conditions and have
remained in the forefront of treatment centres with specialist attendants.
The Borough has had an orthopaedic clinic on its premises since it took over responsibility
for the School Health Service from the Middlesex County Council. An account of this clinic is
presented in Part II of this report.
The headings of defects under this general orthopaedic grouping are:
(a) Posture (b) Feet (c) Other
51 children showed abnormal posture at inspections, 29 of these among the intermediate
examinees. The large number of 11/12 year olds displaying this defect is somewhat surprising but
could be associated with the period of rapid growth, or of slack attitudes adopted at desks. 7 of
the 29 children were sent for further investigation and treatment compared with one of the 13
entrants.
Defects of the feet affected the largest number of children in this group. Again the 11/12
year olds were the greatest sufferers accounting for 184 children, 55 of whom were referred for
treatment. During this period of rapid growth of the feet, shoes need to be changed frequently
to allow for this. Tight socks and shoes are responsible for many crippled feet and wise choice of
footwear pays dividends in the future. Feet well cared for will cause little trouble in the middle
and later periods of life, but when neglected in childhood will reward their owners with much
pain and misery. So the emphasis is directed towards healthy, well-shod feet in childhood and
where early defects noted, treatment must be applied quickly and energetically.
Defects of the Nervous System
Epilepsy was recorded in 29 children examined at routine medical inspections in 1971, all
except three of whom were receiving adequate treatment. The three children were referred for a
review of therapy to ensure a satisfactory school attendance. Most of these children progress
normally through ordinary schools and do not present difficulties in teaching or in behaviour.
Headteachers and school medical officers should be given full details by parents of any fits or
fainting attacks which occur in their children or of any treatment they may be receiving, thus
promoting healthier attitudes to this disease amongst all who may be faced with an otherwise
unexpected attack.
Psychological Defects
These are considered under two headings—Development and Stability. Development involves
the progress of a child's intellectual capacity in reasoning and space abilities, memory, etc.
Generally speaking, the tests of intelligence made during the first five years on the occasions when
they need to be done, must be regarded as indications of possible future progress and not necessarily
for decisions of future need to be made; but observation made during the next two years or
so will be of great value and added to previous records of ability and progress, will show the need
of the child for special schooling or otherwise. Thus, whilst the figures indicate that 25 entrants
were identified as showing some degree of psychological under-development, only five needed
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