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Audiometric screening of all children entering primary schools is carried out by our three audiometricians
and repeated again when the children reach the age of nine and 13 years. Children who fail these
tests are referred first to the school doctor who decides whether the child requires further investigation at the
Audiology Unit. Close co-operation is maintained between the Audiology Unit and ear, nose and throat
consultants, paediatricians and other specialists in the hospital services. We are particularly grateful to Mr.
Pease at Central Middlesex Hospital to whom we refer the majority of children who require further investigation
and possible surgery.
During 1971 two sessions were held weekly at Neasden Audiology Unit, one by Dr. Fisch, the
Consultant Otologist, and the other by the Principal Medical Officer for School Health. The three teachers of
the deaf have continued to supervise the auditory training of the young deaf and partially hearing children
and to visit schools where children with hearing difficulties or those with hearing aids are integrated with
ordinary pupils.
During the year there have been many visitors at Neasden Audiology Unit, coming from all services
involving the care of children and the observation room has been in constant use and usually very full.
Visitors have included medical students, health visitors, school nurses, Matrons and Day Nursery and Children's
Homes staff, paediatricians, general practitioners and G.P. traineees, speech therapists and many others.
We welcome visitors because we believe that in this way we can help those working with children to understand
the problems of deaf and partially hearing children.
SCHOOL DENTAL SERVICE
report of the principal school dental officer
The fluoridiation of water supplies has still not been approved.
The progressive introduction of modern equipment in Clinics has resulted in a higher output of
work per dental clinical session. An evaluation of the methods of intra-oral application of fluoride has been
undertaken and a practical clinical trial is to be introduced at one Clinic over a minimal period of two years.
Anticipating the new National Health Service due to be introduced in 1974 it must surely be
mandatory on some section of the dental profession to provide dental treatment for school children and this
in turn must involve close liaison with Education Authorities.
The pattern of treatment is unaltered but again emphasis must be put on the number of children
found to require treatment at their first school dental inspection. If children arrived at their first school
dental inspections "dentally fit" the foundations would have been laid for their remaining "dentally fit" for
the rest of their lives.
CHILD GUIDANCE SERVICE
prepared by dr. c. graham. b.sc., f.b.ps.s., chief educational psychologist
Organisation of the Service
The four Educational Psychologists each has specific schools allocated to him and all referrals from
the schools are seen initially in the School Psychological Service. They are then referred to one of the two
Child Guidance Centres if full team assessment is considered necessary. Referrals from other agencies, unless
clearly educational problems, are considered for a full team assessment. The Kilburn Child Guidance Centre deals
with children living south of the Borough and the Kingsbury Centre deals with children living north of the
Borough Cases are normally dealt with in chronological order but of course urgent cases are given priority.
There are waiting lists both for diagnostic facilities and treatment and also for placement in many of the
Special Schools, especially Residential Maladjusted.
The Child Guidance Service is geared neither in Brent nor anywhere else for that matter for immediate
action involving facilities for placing children. This is often forgotten by some of the referral agencies
who frequently imagine that immediate placement of a difficult child elsewhere is a practical proposition. At
the end of the year there were 394 children waiting to be seen by one of the four educational psychologists
(compared with 327 at the end of 1970) and 51 children to be seen by one of the two half-time consultant
psychiatrists (compared with 128 at the end of 1970). The shortened waiting list for full psychiatric diagnostic
procedure is gratifying.
Referrals
There were 936 children referred to the whole Service in 1971 and this is in keeping with the pattern
over the past four years viz: 900—1,000 referrals per year. Just about half of these referrals were school
referrals to Kilburn.
In 1971 in Brent there were 209 ascertained maladjusted children, 277 ascertained as E.S.N. and 226
ascertained as E.S.N. (Severely subnormal). Quite obviously all these children would need assessing by psychologists,
and the maladjusted group would need a full team investigation.
Table 1 showing the children referred to the Centres for full psychiatric investigation, has the usual
higher proportion of boys to girls. It also shows that n;arly 300 children (about the same as last year) were
being seen for some form of individual psychotherapeutic help.
Table 2 shows the sources of referrals to the Child Guidance Centres. About a third come from
schools, a third from medical agencies and a third from other sources, notably the parents themselves. The
Child Guidance teams find most profitable those cases where the parents themselves ask for help, since there
is greater motivation to receive help. So often when referral is pressed on reluctant parents, it ends up as a
case withdrawn before full investigation, or one where treatment interviews are kept only spasmodically.