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115
B, and 19 children (l.9 per thousand) were found to require
favourable position in class",
The Pre-School Child
The primary object of the clinic from its beginning to the
present time has been to emphasise the importance of prevention as
well as the treatment of diseased conditions, Many of the
defects, including deafness, found in the ear, nose and throat in
school children originated before the child attended school, and
many such as otitis media, during early infancy. Prevention is
the most important of all the problems connected with defective
hearing and it is during early preschool age that prevention can
play its important part. The advisability, therefore of including
pre school children in the clinic scheme becomes obvious and was
recognised by the Ministry of Health in its issue of Circular 1337
(a), in the early thirties,, This urged local authorities to
arrange for co-operation between the school medical and child
welfare services and make provision for the inclusion of preschool
children in the specialist school clinics. This is
important particularly in the case of the detection and treatment
of defective hearing and its potential causative factors.
It is very gratifying to be able to record that Tottenham was
again among the earliest authorities to make provision for the
inclusion of infants and pre school children in its ear, nose and
throat clinic scheme,, The wisdom of this decision has been amply
proved over the years in the results obtained by the discovery and
removal of many defects ia their early stage in pre'school life,
which, if left untreated,, would have insidiously progressed into a
state of chronicity by the time the children had reached school
age and this advancement of the disease in certain instances,
would inevitably tend to make its final cure much more difficult
and uncertain.
At the present time and for a number of years past the ear,
nose and throat clinic provides for the examination and treatment
of all children, infants, pre school and school. It is fully
equipped to deal with the varying ear, nose and throat diseased
conditions met with among these children, with the exception of
those cases, a small number, which require operations in hospital.
The defects most commonly found among the clinic patients are
those due to the ill effects of "nasal obstruction", such as
deficient nasal respiration and mouth-breathing;; rhinitis in its