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made with Day Nursery, School or play-group, so that the
speech therapists' time can be used for children with severe
defects, or those judged unlikely to improve without
specified help.
A further aspect of the increased interest in speech and
language has been the requests for the Senior Speech
Therapist to talk to various groups of other professions.
These have included regular twice annually talks on the
course for Play-Group Supervisors at Hounslow Old School,
Dr. Tyson's In-Service training for the staff of the Oaklands
and Lindon-Bennett Schools and the course held in
March 1972 for teachers with classes of children from
multi-lingual homes. Talks were also given to student
teachers at Maria Grey College and Chiswick Polytechnic.
Great interest in speech therapy was shown by all these
varying groups.
The work at Martindale has progressed smoothly,
particularly since Miss Richardson joined Mrs. Hatton as
speech therapists in the Medical Advisory Unit. Staffing
during the time of shortage, by various speech therapists on
different days, prevented the valuable team approach.
There are still too many children needing urgent speech
therapy at the Marjory Kinnon School, a trend that has
increased during the year, but it is hoped to increase the
number of sessions to a full time post in 1973.
Despite good relations with staff at the Oaklands the
Lindon-Bennett Schools, the numbers of children to be
seen and the small amount of time available make it
difficult to assess the progress made. The report of the
Quirk Committee appointed by the Secretaries of State
for Education and Science and Social Services to look into
speech therapy services makes a point of underlying the
needs of the mentally handicapped, and a more satisfactory
staffing arrangement is needed in this area. Dr. Harper
commenced a most valuable and interesting project in
November 1972, assessing the progress of young mentally
handicapped children and advising their parents on the best
way of stimulating the child to reach his potential. The
physiotherapist and Senior speech therapist join the Health
Visitor concerned with the family with Dr. Harper at the
assessment. The children are followed up in their homes
and as "out-patients" after school hours by the speech
therapist and physiotherapist and it is hoped that this long
term project may obviate problems that arise, support the
parents, and achieve greater progress in the children's
development.
Of the requests for speech therapy in other areas in
1971, it has been possible to send a speech therapist to the
Autistic Unit for two sessions a week, commencing
October 1972, and this is proving of value. It is unfortunate
that it has not been possible to follow up the request from
Mr. Barrett at the Heston School for the Deaf that a speech
therapist call at the school, but this is looked forward to at
a later date.
1972 was an encouraging year in the Speech Therapy
department. The increased waiting lists for children were
solely due to the larger number of children referred, and
the field of work widened further.
Asthma and Allergy Clinics
I am grateful to Dr. R. Prothero, MD, LRCP, LRCS, DCH,
Senior Departmental Medical Officer for the following report
158 children (102 boys 56 girls) attended the Allergy
Clinic during 1972, of these 43 were new referrals. 112
suffered from Asthma, 38 from Pollenosis or Vasomotoric
Rhinitis, 6 from Eczema or Urticaria, 2 from Migraine. Of
the 112 patients with extrinsic Asthma 72 started their
attacks at or before the age of 3 years, i.e. 64%.
Of the asthmatic children 5 had a history of Convulsions
in the past but 3 actually suffer from Grand Mai.
18 'asthmatics' came from severely traumatized homes
(parental separation, mental illness, death of one parent).
Convalescence was arranged for 9 pupils, the main
indication being adverse environmental conditions. The
same indication was operative in the 7 cases referred to or
attending Open Air Schools. 4 children were referred for
Child Guidance treatment.
Hospitalization was required for 8 children, in 3 for
Status Asthmaticus, 1 for severe epileptic fits, 1 for
Pneumonia, 1 for severe Prurigo, 1 for Henoch's Purpura
and 1 for investigation of severe Asthenia (weight below
the 3rd percentile).
10 of the asthmatic pupils left school during 1972 and
but for 2 who went into Army careers the choice of the
future work and the physical condition were satisfactory:
the P.E.F.R. being at least at 300 l/m. The two youths
keen on the Army were referred for further assessment to
the Brompton Hospital and were given a — though guarded
— 'all clear'.
The majority of the patients manage with conventional
therapy (Ephedrine and its derivatives) or the newer more
powerful sympathomimitec amines (Orciprenaline,
Salbutomal, Terbutaline); the latter in the older children
for more rapid relief as Aerosols. If not controlled Intal
(Di-solium cromoglycate) is, of course, the drug in
management and was successfully used by 41 patients
('quite marvellous' the comment of a chronic sufferer).
After a 6-8 weeks trial the 4-hourly dose is reduced
according to symptoms and maintenance treatment is
advised of one inhalation daily in the 'quiescent' period of
Asthma. The main success of Intal is in the blockage of
Exercise induced Bronchoconstriction and our Schools
should be advised of this effect, as children can now
participate in sport of which they had to be excluded in the
past.
None of our clinic-attenders were on maintenance
Steroids and there has been no indication for a trial of
Beclomethasone Inhalation.
Hyposensitisation against the Grass-Pollens was given in
5 cases. This proved successful in all these children and all
were able to lead a normal life without loss of schooling and
examinations ('A' levels in one pupil) were not affected.
One patient did well on nasal cromoglycate ('Rynacrom')
who had previously been injected unsuccessfully (by his
G.P.) against Pollenosis.
The overall impression is that with more powerful drugs
and with the advent of the Cromoglycates (which are mast
cell specific) the 'Asthma problem' might be under control
in the near future.
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