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74
In the treatment of convergent squint, anew advance has been the used of eye drops
causing contraction of the pupil. This has resulted in dramatic improvement in
carefully selected cases since, with contracted pupils, the habit of over-convergence
for near object is broken. Needless to say, such children require constant supervision
by the consultant and, whilst treatment may sometimes be an alternative to surgery, it
is usually complementary.
Similar eye defects have been the chief concern of Mr. T. Kletz, the consultant
at the Tottenham Ophthalmic Clinic. An indication of the value of early investigation
in cases of manifest or suspected squint is reflected, he feels, in the statistics of
the orthoptic department where the number of cases treated is now less than the number
of new cases referred.
With recent advances in treatment and investigation of certain types of squint and
amblyopia, a number of cases previously considered incurable are now being treated by
special techniques. At present, such cases have to be sent to hospital for both
investigation and treatment, but in the new year it is hoped to purchase the necessary
equipment to enable these techniques to be practised in the clinic.
Child Guidance Clinic
1961 saw the appointment of Dr. Nina Meyer, as Consultant Psychiatrist and Miss C.
Tibbetts, as Play therapist, to the Tottenham Child Guidance Clinic, which has enabled
more children to be seen for diagnostic purposes and to be taken on for psychotherapy.
In his report. Dr. Wi11iam Craike, the Senior Consultant Psychiatrist, focuses his
attention on the so-called school phobias where, he points out, the anxiety is'centred
round the home relationship rather than the school itself. The early referral of these
cases to the clinic is of cardinal importance, for it is often too late to do anything by
the time the child has reached the age of fourteen. Nevertheless, in these older
children, Dr. Craike feels that a forced separation from the mother, through the intervention
of the Juvenile Court, and aperiod in a Remand Home, might be helpful for some
of them, as long as psychotherapy is immediately available when they return home.
During the year under review Dr. A.K. Graf took up his appointment as Consultant
Child Psychiatrist and Medical Director of the Hornsey Child Guidance Clinic. Here,
the approach to the problems of the maladjusted child is based on the team work of
psychiatrist, educational psychologist, psychiatric social worker and psychotherapist;
and the opinions of all the members of the team are pooled at weekly case conferences,
before any action or treatment is undertaken.
A useful innovation has been the introduction of an evening session which has
enabled the consultant psychiatrist to meet working parents, and adolescents who do
not want to miss time from school or employment. Particularly encouraging has been
the attendance of the father at these interviews, hitherto the somewhat neglected
partner in the investigation of a child's difficulties; and, in many cases, Dr. Graf
has found that he can make a valuable and crucial contribution towards the treatment.
Speech Therapy
Throughout 1961 children continued to be referred for speech therapy from a wide
variety of sources. From teachers, health visitors, school medical officers and
specialists came a steady stream of cases; the mothers, too, whose older children had
had speech therapy in the past, brought younger siblings for similar help, or were
sometimes instrumental in sending new cases.