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With financial support from the National Deaf Children's
Society Dr. G. S. Udall of St. Bartholomew's Hospital has
investigated 106 children with a high frequency hearing loss
as shown by pure tone threshold audiometry. An extensive
questionnaire was used to elucidate the causes of this
condition and the reasons why in some cases, it is not
diagnosed before school entry. Hearing tests in the
near-perfect conditions of the clinic compared the benefits
gained by such children from lip reading and/or hearing aids
and contrasted the ability of the child to repeat balanced
high and low frequency words at varying distance from the
speaker's voice. Further tests of vision, balance and manual
dexterity were aimed to uncover any correlated
neurological damage; whilst the establishment of left or
right handedness, together with simple reading and
arithmetical-tests sought to determine whether such
children have any learning difficulties other than might be
expected from the hearing loss per se. In this way, a wealth
of clinical data has been amassed which at the present time
is being prepared for statistical analysis by computer.
Medical Advisory Unit and Cerebral Palsy Unit

(a)The children classified as brain damaged include those
who have been handicapped following a head injury or
following an infection such as meningitis.
For the second consecutive year the number of children
with spina bifida seen as new patients has not increased but
the high number of children attending both the school and
pre-school group continue to cause problems in
management. The group classes for spina bifida children
have continued this year and it was found that these
children had increased their mobility and coordination from
attendance at these classes.
The nursery classes which were opened last year
continue to be of great benefit to the children. At the end
of the year the classes consisted of 10 children with
cerebral palsy, 8 with spina bifida, 1 dwarf and 1 child with
multiple congenital defects. The cooperation between the
educational staff and the medical staff continues to be
particularly close with the children in these classes.
Because the children need to spend varying lengths of time
in the physiotherapy departments educational and medical
programmes are arranged to suit each individual child. The
bladder control of the spina bifida children is of particular
concern and attempts are made to help the children to
gain bladder control if at all possible by regular attention
to potting.
The new Hounslow Day Nursery was opened in
January 1972 together with the specially planned and
equipped unit for 9 handicapped children. The full
functioning of this unit was delayed until suitable staff
had been appointed and further delays were caused by
repeated episodes of quarantine for infectious diseases. A
staff nurse and 2 nursery nurses were appointed to this unit
together with a part time physiotherapist. In March 1 child
with Spina bifida and 1 with cerebral palsy were admitted
to the new unit and there are now 6 children in the unit.
Child Guidance
I am grateful to Dr. P. Calwell MB, BS, DPM, for
submitting the following report
1972 statistics show that more cases were referred last year
than previously, especially by the Education Department
and the School Health Service. Since September, with the
extra sessions given by the Regional Hospital Board,
Dr. Calwell was able to offer 3½ more sessions to the
Clinic and a half session to Ashford Hospital. Part of this
extra time has been used to visit the Autistic Unit and the
Marjory Kinnon School each term as well as visits to other
special schools in the area. Several residential schools for
maladjusted children have been visited by the Psychiatric
Social Workers and Educational Psychologists. Personal
links with these schools lead to more appropriate
placements and better communication so essential in
difficult and complicated cases. The fact that an increased
number of children has been recommended for residential
schools does in some instances reflect the need for another
day maladjusted school in the Borough. There is a lack of
adequate provision particularly for the truanting
educationally backward boy, who tends to become bored
and delinquent when special educational care is not
available.
Close links with the Social Services Department have
been maintained by continuation of regular teaching
seminars until the Autumn. Since then, discussions have
been in progress about the use of the Clinic staff in the
assessment of children before the Courts and in the care of
the Social Services Department. In this connection, seven
visits have been made to approved schools, assessment units
and hostels by the Senior Clinic staff, who were
accompanied by local magistrates. Diagnostic interviews
have continued to be offered to the Social Services and the
histories are supplied by the Social Worker from the
Department. Mrs. Lees has taken an active part in a working
party, drafting forms for use by the Social Services
Department.
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