View report page

of the children appear to be left with any serious disability from these particular defects although
persistently enlarged tonsils and adenoids may affect the child's hearing and sometimes speech in
the following years.
Speech defects
The acquisition and development of clear verbal communication is recognised by everyone as an
extremely important factor in the cultural and economic life of a person. All accept the faculty of
speech as an expected continuous development in normal maturation from babyhood, into childhood,
to adult stature. Every parent has thrilled to the first babblings of its infant child and has endeavoured
to recognise purposeful sounds indicating the baby's gradual identification of people and objects
in the world around it. This verbal development varies among children, and a degree of departure from
the normal may require simple observation during the child's development over a longer or shorter
period of time, or demand the assistance of a speech therapist. 240 children were reported as needing
some help, the majority of these (204) being among the entrants. A further 34 were gathered from
the intermediate inspections; two only being from the leavers, neither of whom needed active
treatment. There has been a slight rise in the proportion of children with speech defect, 7.2%
compared with 6.6% in 1971 and 6.3% of all defects in 1970. These figures may reflect a slightly
better service being offered due to an increase in the number of speech therapy sessions available to
the service. A fuller report on the speech therapy service is presented on page 155.
Defects of lymph glands
This rather anachronistic heading deals with palpable regional lymph nodes situated in strategic
areas of the body, limbs, trunk, neck where enlargement of the nodes indicate acute or chronic
infection or new growth involvement in the lymph area drained. Gross enlargement was only noted
in 13 children. The proportion varies little from year to year—0.5% of all defects.
Defects of heart and circulation
The proportion of children presenting with possible heart defects remains the same as last
year—2-1 % of all defects. Of 74 children noted 46 were among entrants; this dropped to 25 among
intermediate examinees and only three in the leavers group. Among the infants, two were referred
for investigation, the remainder requiring observation only. The presenting sign was usually a heart
murmur, the significance of which must be carefully evaluated by the doctor.
The evaluation of abnormal heart sounds presents particular difficulties for the school medical
officer and as part of the programme of in-service training arrangements were made for one of the
consultant paediatricians at Hillingdon Hospital to give a tutorial on the subject. Dr. S. M. Tucker was
able to spend a whole morning with the medical officers explaining the features that might suggest the
need for further specialist investigation and illustrating significant points by practical demonstrations
on individual children. This session was most valuable not only for educational purposes but for the
practical demonstration of close links between all doctors working with children upon which the
future efficiency of the child health service depends.
Defects of Lungs
Sixty-five children were noted to have lung defects, a proportion of 1.9% of all defects.
This proportion is much lower than last year (2.7%) and that of 1970 (2.5%). Twenty-three of the
total of 65 children were among the entrants, this figure rising to 37 children offering themselves for
intermediate inspection. This is a reverse of the usual figures obtained—probably an artifact due to
groups of children being examined at different seasons of the year.
Developmental defects
The figures under this heading provide a consistent but small percentage of the total defects.
Four children were sent for treatment of herniae; i.e. inguinal or umbilical. 104 children had some
developmental anomaly i.e. absence of testis, absence of certain muscles, webbing of fingers or
toes, presence of cleft palate etc.
138