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19
When the baby is a few months old a developmental assessment examination
is carried out on all those who attend a child health clinic and if the reexamination
is not entirely satisfactory re-examinations are undertaken.
CONGENITAL DEFORMITIES AT BIRTH
Notification to the Registrar General is standardised throughout the
Country for all babies born with a detectable abnormality. These notifications
are completed monthly in coded form. A total of 100 abnormalities in respect
of 84 babies were reported in 1967. This was 14 fewer than in 1966.

OBSERVATION REGISTER
A great deal of study has been done in this and other countries during the
past few years of the ways in which babies and young children develop and learn
the skills which are fundamental to their physical and mental health later in
life.
It is now known that there are factors operating during the mother's pregnancy
and labour, and in the first few days of the child's life, which may
affect development. Doctors who work in child health centres need to be specially
orientated and trained to observe normal development in children and to recognise
when very early signs of anything abnormal or a slowing up of development are
present.
Ideally all children should be seen at quite frequent intervals by the
child health doctor and be "screened" especially for hearing and vision development.
As far as possible this is done in our child health sessions, but after
the initial full examination at the first attendance it becomes too great a task
for the present staff. It has become the practice to decide, after assessing the
history of the mother and the child early in its life, to place on an observation
register all those who must be re-examined at least three or four times in the
first year of life. If their "milestones of development" appear quite normal
at the end of 6, 9 or 12 months according to the doctor's clinical judgement,
their names are then removed from the register, but some need to remain on it
a good deal longer, as there are some handicapping conditions which only become
apparent later.
A survey was undertaken in the Borough in which it was found that of 11,523
babies born in the two years between April 1st 1965, and the 31st March, 1967,
2,316 (18.5%) were placed on the Observation Register, and, by the time of the
survey later in 1967, 114 (5%) of these had developed handicapping conditions.
There was, of course, a considerable number of handicapped children who,
because they had an obvious defect recognisable at birth, were under the care
of the hospital and were never placed on the Observation Register but on the
Handicap Register mentioned below.
Although the figure of 114 children developing handicaps out of a total