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entitled "Unilateral Deafness" and it has proved highly
successful.
Papers given by Dr. L Fisch:-
Parental Age - Birth order and congenital deafness.
The Deaf Child - The effects of hearing loss in children.
This article is included in the
publication "Modern Trends in Diseases
of the Ear, Nose and Throat".
Lectures were given by Dr. Jepson during the year to
students at the Gypsy Hill Teacher Training College, The
Royal College of General Practitioners, The Royal College
of Nursing and Chiswick Polytechnic.
Medical Advisory Unit and Cerebral Palsy Unit
The referral of multiply handicapped children to this unit
for diagnosis, assessment and recommendation for
educational placement continues. During the year a total
of 123 children were seen as outpatients of whom 37 were
of school age and 86 of pre-school age. 61 of the children
of pre-school age had cerebral palsy, 18 had spina bifida and
7 had other physical defects. 15 of the children of school
age had cerebral palsy, 4 had spina bifida and 18 had other
defects. 103 pupils attending Martindale School were
examined during the year. The following table shows the
type of handicaps dealt with at the unit in 1971.

(a) The children classified as brain damaged include those
who have been handicapped following a head injury or
following an infection such as meningitis.
An increasing number of children under school age now
attend the unit regularly for treatment after school closes
each day.
The figures for the last three years are:—
1969 1970 1971
45 53 58
The high number of children attending both the school
and the pre-school group continue to cause problems in
management of the time allotted to treatment. For many
of the children daily visits to the department in order to
have adequate supervision of their backs and skin are
essential. Group classes for the spina bifida children started
last year have continued in an attempt to stimulate them
and to increase their mobility and co-ordination, with
considerable success.
An evening meeting was held for the parents of children
to be admitted to the nursery class after Easter, where the
programme for the physical and educational development
of the children was fully discussed.
At Easter two new nursery classes were opened each
taking 10 children and this has resulted in children being
admitted to the school at the age of 3 years and has been
of great benefit to them mentally, physically and socially.
During the first term 7 children with spina bifida were
admitted to the group and 4 children with cerebral palsy,
one child with brain damage following a road accident and
one child with congenital defects were admitted and the
group was completed in the September term when a further
7 children were admitted, 3 with spina bifida, 3 with
cerebral palsy and 1 with hydrocephalus. The children
need to spend varying lengths of time in the physiotherapy
department but the staff of the medical unit work closely
with the teachers in order to arrange individual programmes
to suit each child. In the case of children with spina bifida
particular attention is paid to the locomotor difficulties and
also the problems arising from urinary tract involvement.
The opening of this class has resulted in a considerable
amount of extra work in the medical unit and the principal
medical officer now spends 4 sessions per week in the
school. An extra physiotherapist has been appointed and
the department has been fully staffed this year despite a
great shortage of physiotherapists nationally.
The physiotherapists carried out 11,182 treatments,
3201 more than the previous year. The number of
treatments and counselling given to pre-school children and
their parents continued at a high level. The physiotherapists
carried out their usual programme of sports coaching and
teams were sent to Stoke-Mandeville and the Inter-schools
meeting. This year a relay team was invited to give an
exhibition of racing against Grove Park School at a charity
football match at Willesden. Eight students from the West
Middlesex School of Physiotherapy each spent 6 weeks in
the unit as part of their paediatric training. Talks and
demonstrations were given by the staff on various occasions
to parents of spina bifida children and students from St.
Bartholomew's hospital and post graduate students from
the Wolfson Centre were amongst the visitors who heard
these talks.
The speech therapy department suffered staffing
troubles during the year, one of the two speech therapists
unfortunately having to resign for health reasons and the
continuity of treatment was difficult to maintain. Many of
the children attending the school and those who attend the
unit as outpatients have difficulty in speech and
communication and the speech therapist plays an important
part in the management of all aspects of feeding, language
development and articulation. Progress must in many cases
be slow and it is often difficult to measure but even the
severely speech handicapped children need to be helped to
communicate in some way. All children need to learn how
to express their own personalities and those with a speech
defect need special help so that they become more self
confident and less withdrawn.
86 children received speech therapy during the year, the
defects treated being:-
40