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Orthopaedic defects
After defects of vision and hearing, this group attracts the greatest proportion of defects (8 8%
of the total). This is smaller than last year's figure (12.4%) and that of 1970 (10.1 %). The importance
attached to these disabilities is demonstrated by the establishment of an orthopaedic clinic to which
children can be referred for advice and treatment. The headings of defects under this general orthopaedic
grouping are:
(a) Posture—The children seen at intermediate inspection provide the largest number in this
section (18). This follows the pattern of last year's figures.
(b) Feet—A total of 234 children were noted to have foot problems and the figure indicates
the importance of careful surveillance from babyhood onwards of the child's feet. The
proportion of foot defects unfortunately remains a fairly constant figure compared with
other defects. Health education concerning the care of the feet is making very little impact
upon those who are responsible for this field of a child's care. The fact that the figures
of both entrants and intermediate examinees are similar (100 entrants, 107 intermediates)
indicates that throughout the very important period of rapid physical growth of children,
the same factors, year after year are producing defects of the feet. These are socks and
shoes which become too small during growth of the child and inhibit the free movement
of feet and toes. Frequent examinations of these articles of footwear are essential to
avoid future deformity and pain.
Defects of the Nervous System
Twenty-three children were recorded as suffering from epilepsy of whom three were referred
for investigation and treatment or for revision of treatment. The proportion of children with this
condition remains at a low but constant level—0.7% of all defects in 1972. All of these children can
be educated in normal schools, sometimes with some slight variation of the school regime to suit
their particular needs. Providing full information is exchanged between parent, headteacher and
doctor, few serious problems emerge during school life. Sixty-five children presented with other
defects of the nervous system, 15 of whom were referred for treatment or investigation. These defects
may cover a larger number of disabilities; weakness of limbs, or extremities, slight degrees of cerebral
palsy, ataxia or some other dysfunction of the central nervous system.
Psychological Defects
There was a slight drop in the proportion of psychological defects noted this year—5.3%
compared with 6.3% in 1971. There were fewer children recorded as having developmental defects
compared with last year's figures, but there was a similar proportion presenting with problems of
emotional instability.
The former require careful assessment if their future educational needs are to be met in an
appropriate environment; and the results of studies by teachers, educational psychologists and
doctors of the children must be collated, and recommendations made to the Authority with that end
in mind. Many of these children display other medical problems as well and the progress over the
next few years of their physical and mental development will be recorded, and, where necessary
treatment offered.
The fact that all of these 28 children were noted among the entrants and intermediate groups
indicates that this screening is successful in identifying the children early so that appropriate educational
treatment may be quickly begun.
The latter group of children, showing some degree of emotional instability, is still a comparatively
large one—153 among all the groups which represent 4.5% of all defects. This figure is the same as
last year. One half of all children so discovered were among the entrants to school and 10 of these
were sufficiently disturbed as to warrant referral to the consultant child psychiatrist. Among the
intermediate group of 66 children, 21 needed referral to the Child Guidance Clinic.
It has been noted in former reports that hospital provision for severely disturbed children is still
under discussion for this area; in the meantime the non-placement or unsuitable placement of even
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