The medical officer and old people

Towards th: Good Animal

J a n t m r y 1957 fessional o p i n i o n . T h e o n e is t h e t r a i n i n g a n d us.e of d e n t a l auxiliaries. T h e o t h e r p r e v e n t i v e m e a s u r e is the f l u o r i d a t i o n of water. Its v a l u e is b e y o n d d o u b t , a n d many waters containing much larger quantities of fluorine t h a n are n e c e s s a r y f o r this p u r p o s e h a v e b e e n d r u n k f o r g e n e r a t i o n s w i t h o u t h a r m f u l effects. But in this instance, the n a t i o n t h a t o n c e r e f u s e d to be m a d e clean by Act of P a r l i a m e n t , h a s r e t a i n e d its a n c i e n t prejudices. A n d t a l k i n g of h e a l t h e d u c a t i o n , h o w does one e d u c a t e t h e school leaver a b o u t the d a n g e r s o f s m o k i n g ? It w o u l d be silly a s well as futile to try to frighten him, and, a f t e r m u c h c o g i t a t i o n a n d discussion, m y o w n d e p a r t m e n t has p r o d u c e d a leaflet o f a d v i c e t o school leavers c o n t a i n i n g ten simple m a x i m s . E i g h t of t h e m are positive, a n d in o n l y t w o d o the w o r d s " do n o t " appear. S a n d w i c h e d in tfiese 10 c o m m a n d m e n t s , t h e fifth s a y s : " D o not take u p

s m o k i n g . O n c e the h a b i t is f o r m e d it m a y be difficult to b r e a k . C a n c e r of t h e lung is 20 times m o r e c o m m o n in h e a v y s m o k e r s t h a n a m o n g t h o s e w h o do n o t s m o k e . " A n d so the j o b of t r y i n g to m a k e e a c h successive generat i o n into g o o d a n i m a l s c o n t i n u e s . W e c a n c l a i m o n t h e w h o l e t h a t o u r c o n t r i b u t i o n to t h a t m a k i n g h a s been significant: w e c a n e q u a l l y claim t h a t we h a v e m u c h to c o n t r i b u t e in t h e future. A n d the s a t i s f a c t i o n s o f the w o r k e n o r m o u s l y o u t - n u m b e r the f r u s t r a t i o n s ! References

COWAN, H. K. (1956). Mcd. ()fir. 96. 47. (hnnorr, & BEi.t. (1939). " H i s t o r y o[ the l~ondon County Council, 1889-1934." MacMillan, London, 1939. Mimsa'Rv ov I';~UCAT~ON(1954). Report of the Chief Medica! Officer for 1952 and 1953. H.M.S.()., London. SORSBV, A., et al. (1955). Lancet. il. 214. UNnr.:RWOOD COMr~TTEI': (1955). Report of the Committee on Maladjusted Children. H.M.S.O.

Appendix 9

The Auditory Training of Young Deaf Children By O L I V E M O R L E Y ,

Certificate [or Teachers o[ the Deaf, University of Manchester (5) Susan. Aged five years six .months when first seen. Very co-operative parents. (Father a postman.) Speech was unintelligible and there was very little of it. Susan was shy--did not mix with other children--and backward. A very conscientious child. After one year of training now speaks well, has all sounds, but needs reminding to use them in connected speech. Reads well, including all sounds, and can build phonetic words or break words d o w n - - a n achievement for a partially deaf six-year-old. Is writing little stories, given pictures, and will hold a conversation even if she cannot see the lips of the speaker. Now with an aid appears to hear ve(y much better than before training. Mixes well with others. (6) Malcolm. (Adventitious deafness.) Deaf at two years in one ear, sudden overnight severe deafness in the other at seven years, in July, 1955. Musical parents, to whom this was a great shock. Only child. First seen a month after becoming deaf, then a terrified and shocked little boy whose speech was beginning already to deteriorate. A partially deaf school was suggested. However, because of the emotional disturbance involved in a change of school, he was allowed to remain at his normal school. Now, 12 months later, he has justified this decision by coming seventh in a class of 27 bright children. His speech is normal, with beautifully musical intonation ; both in spontaneous conversation and reading which he does well. He is severely deaf but has conquered his handicap so well that it is almost unnoticeable in conversation with those he knows. Mixes as a normal child at school and it is hoped that he will continue to do very well because he is determined to conquer his deafness. Parents, who were-so badly shocked, have benefited from training at the unit and are now adjusted and looking forward to their son's future career. (7) Mary comes from a large Limehouse family with a very good mother. Three children are partially deaf. First seen June, 1955, aged 10 years. Could not read--speech was unintelligible. Seemed not to hear very much even with aid. Now can hear a quiet voice, reads and builds words (instead of guessing) ; speaks almost without a fault except for slightly throaty " k " sound. Much more self-confident. Has transferred to secondary modern school this term and is discontinuing training. In all cases a close contact has been maintained with the class teacher and headmistress or master of school : visits made about once in six weeks. In every instance the school has proved interested and co-operative and the parents have continued the training at home. They have been taught the reasons for, and results of, auditory t r a i n i n g .

The following are examples of cases which have been dealt with in the two L.C.C. Audiology Centres since they were opened in May, 1955. (1) Anne. First seen November, 1955, then aged 11 months. Appeared to be totally deaf. Parents have been very co-operative. Now at 22 months Anne hears, with an AN.C. aid, a drum at 4 ft., and will- babble from instruction given behind her, but into the microphone (BaBaBa). Tries to say " A . . . . " for Anne, calls and understands " M u m m u m m u m " for " Mummy " and is beginning to lipread. Uses voice to attract attention. (2) Mervyn. ( C a u s e : Maternal rubella.) First seen May, 91955--aged then three years and three months. At this time he was wilful, uncontrolled and understood nothing of speech. Severely partially deaf. Both mother and child were a problem to the-Nursery where he is still attending. Now at four years six months, he is talking in phrases, e.g., " W i n d it up," '~ Stop it," " I'll show you," " D o n ' t do it," etc. Lipreads and listens .well. " Sings '" Davy Crockett to the gramophone and joins with hearing children in sin~ing games (although not understanding the language). Mother and child relationship is now good and Mervyn is an animated happy little-boy loved by all. Mother, now that she understands the problem, is most co-operative. (3) Katie. (Deaf and spastic.) Mother Rhesus negative group. Highly intelligent parents who were told that their daughter was ineducable. Deafness not suspected until-four years except by mother. First seen May, 1955. At that time was uncontrolled without a word of language, either spoken or lipread. Often had tantrums, and was beginning to disrupt the family life of her home. Now at six years old, attends a P.H. school, can be told almost anything by speech which she lipreads well. Has begun to read and write, for example, she can read " I have a fish at h o m e - - h e is called Bobby." Talks as a means of communication. Speech of course is imperfect, but is intelligible enough for there to be excellent understanding between Katie and her family. Appears to be very intelligent. (4) Michael. (Cause : Otitis media.) Age eight years. First seen May, 1955, after he had failed and been removed from his first school. A very difficult child to handle, frustrated and with a sense of failure ; because of this did not want to work and appeared to be lazy. Speech was unintelligible and parents found him difficult to manage. After 12 months was discharged from the Unit as being able to hold his own in a hearing school without regular auditory training. Speech now good--only the " s " being defective (lateralised). Holds his own in any conversation. Always wears Medresco aid. 69