View report page

Continued Defect No, of children in whom found
Nervous System (a) Epilepsy 8
(b) Other 2
Psychological (a) Mental Development 34
(b) Stability (Behaviour Difficulties) 101
Other Defects 31
Fifty-two per cent of the children were found to be in satisfactory health
and free from any defect (as compared with 55% for the previous year), and in addition
there were 22% in whom there was no defect except carious teeth (compared with 14% last
year).
Taking into account the slight decrease in the total number of children
examined, there is little change in the defects recorded. By far the largest number
is "defects of teeth" which usually means dental caries. It is indeed a pity that one
out of every seven children should have decayed teeth at this tender age, in spite of
efforts to teach parents how to avoid it by correct feeding and dental hygiene.
"Foot defects" also remain high, but this may be of less significance. There
is still a great deal to be learnt about the structure and function of the foot and
considerable difference of opinion as to what is normal at this age. What is certain
is that attention should be directed to the prevention of foot deformities, which are
so crippling in the adult, and particularly in the aged; this cannot begin too soon.
Daily washing and drying the feet, washing of socks, and drying and cleaning of shoes
so as to avoid shrinkage are important. Young children's shoes should be carefully
fitted, and the practice of buying shoes without the child is to be condemned* Toddlers1
feet grow quickly and both socks and shoes need replacing frequently. Fortunately,
there are now a number of good shoes on the market, though the price often discourages
parents from buying the most suitable makes. The cost is, however, well worth while
if balanced against future disability and suffering. The health visitors are well
equipped to guide parents on matters of foot health and footwear.
"Behaviour difficulties" are the next most frequent "abnormality" which is
recorded, but this does not necessarily indicate any serious maladjustment in pre-sfchool
children. Doctors and nurses are now better trained to detect an exaggeration of the
manifestations which accompany normal growing up (the transition from infancy to the
relatively mature five year old is a stressful time for all children), and parents also
are more knowledgeable and less reluctant to talk about emotional problems. This is
also to the good, because a better understanding of normal emotional development and
of faulty parental attitudes, may be of great help at this stage. It is also important
that the staff should be sufficiently skilled to pick out those few children who are
in serious trouble and refer them where they and their families will get effective
diagnosis and treatment. In-service training is one of the best ways of improving
these skills. To this end, the discussion group for a small number of health visitors
and two medical officers has continued once a fortnight, with the Psychiatric Social
Worker, and under the personal direction of our own psychiatrist, Dr. Whatley. On
the alternate weeks the psychiatrist has been available to discuss cases with any
doctor or health visitor who wished to consult her.
Attendances at the Child Welfare Sessions (including the Toddlers' Clinics)
are set out in the following table for the period 1955-1959. The percentage of
children under one year, and one to five years who attend does not vary greatly from
57