An interesting feature of organization is the plan whereby each year a
different series of problems is attacked, and the energies of the
entire staff directed along this line. Thus, 1910-1911 shows special
emphasis laid upon eye defects, and nearly 11,000 children were found
in need of glasses. In 1911-1912, although the number of defects
discovered increased, the number of children examined strikingly
decreased. Extra study was made of adenoids, glands, nutrition, and
goitre. The following year less emphasis was laid on discovering
defects and the entire staff united in an effort toward correcting
those already noted. Practically every child in the system was
examined. At the same time one member specialized on hunting for
tuberculosis cases and another on mental examinations of backward
children.
In 1913-1914, the force was especially interested in the question of
communicable disease and the proportion of conjunctivitis, ring worm,
impetigo, scabies, and pediculosis discovered and treated was very
large. As a natural accompaniment of this activity, the number of
home visits and school treatments decidedly increased. In addition,
there was a notable rise in the frequency with which parents came to
the dispensary for conferences with the doctor about their children.
The record for 1914-1915 shows a decrease in the number of home
visits, which is partly accounted for by the fact that the number of
dispensary visits made by nurses has practically doubled. The number
of parent consultations with doctors has increased by one-half the
record for 1914, and in contrast with 500 health talks given to
classes by nurses last year, we have 1,260 talks by physicians and
4,431 by nurses to classes in 1914-1915.
This method of varied problems is unquestionably effective in
promoting growth and maintaining interest on the part of the staff.
Care should be taken, however, to provide that within each four-year
period--twice during the eight years of school life--special emphasis
be laid upon the discovery and cure of each of the more important
defects. How this emphasis should be distributed is a matter best
decided by the staff in conference. It might be found advisable to
adopt a plan whereby special attention is given to teeth, adenoids,
tonsils, and glands in the lower grades; posture and heart in the
upper grades; and eyes, hearing, lungs, and nutrition straight through
the grades. Whatever plan is adopted must be the result of study,
consultation, and experiment, in an endeavor to find the most
economical investment of effort on the part of nurses and doctors in
terms of results gained.
[Illustration: Columns are proportionate in height to the per cent of
physical defects corrected each year for five school years.]
Speech defects are very common among children. At first they yield
readily to treatment, but if allowed to continue through the
adolescent period the habit becomes fixed so that trying to cure it is
a difficult and often fruitless task. Judging from the experience of
other cities, about 200 boys and 800 girls in the Cleveland public
school system are suffering from some form of speech defect. There are
few fields in which the medical inspection department has such an
opportunity for effective work and in which so little has been done.
Effort should be made to locate these children, and form them into
groups for daily training, under the direction of a teacher specially
prepared to handle speech cases.