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We conduct only two periodic medical examinations of all school children during their
school life; one in the second or third term after entry into the primary school, and the other
after entry into secondary school, All other medical examinations in school are on a selective
basis. The basis of selection is a conference in school (every term, staffing permitting),
consisting of Head Teacher, School Medical Officer and School Nurse. Every member of the team
can raise their problems and bring forward cases for discussion. Here children are selected
for examination in addition to those who were considered in need of follow-up examination by
the Medical Officer at the previous medical examination.
Besides, each School Medical Officer has a weekly school clinic at which children are
seen, referred by various agencies for special examination or referred by School Medical Officers
themselves, when a problem may require more time than can be given during an examination at
school.
In view of the thorough follow-up of children in the pre-school period, the possibility
of dispensing with periodic medical examinations in school and replacing them by selective
examinations only was contemplated. It is however considered that the emotional impact of entry
into school and the child's reaction and response in a learning situation, brings to light
unexpected symptoms which fully justify an assessment of all children at this stage. Similarly,
the entry into secondary school, the new environment, the impact of puberty and adolescence,
again justify a "new look" at all school children at this critical stage of development,
There is no routine examination at school leaving age. The follow-up of senior pupils on
our selective basis, focuses attention on those leavers whose special problems have to be
considered on leaving school and warrant communication with general practitioners and careers
officers.
Children with learning problems in school are brought to the attention of Educational
Psychologists by the Head Teacher. The Psychologist's reports are forwarded to the Principal
School Medical Officer. School medical records are then perused and any additional information
including a health visitor's report on social background obtained ready for one of our standing
Educational Case Conferences. The Conferences are attended by Educational Psychologists, Head
Teachers of E.S.N. Schools, the Principal Medical Officer and the Senior Medical Officer for
mentally handicapped children. In addition to the above regular members of the team, other
professional workers such as Head Teachers, Social Workers, Speech Therapists and others who
may have special knowledge of this particular child, are invited to make their contribution'.
These conferences serve as a reference point for most matters relating to the mentally subnormal
and severely sub-normal children, and all decisions relating to their education are made
by the team.
Severely emotionally disturbed children deemed maladjusted are dealt with by the Child
Guidance Service.
Handicapped children in special schools are under regular supervision of School Medical
Officers who collaborate with other professional workers as may be appropriate for the type of
handicap. This working of an interdisciplinary team is well exemplified in the case of our
Elizabeth Fry Special School for Physically Handicapped Children. This School has a Nursery
Class that was originally designated as a Cerebral Palsy Unit but admits now all young children
with physical or multiple handicap. This School has a very well equipped medical unit with
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