The Need for Improved Records of the Physical Condition of School Children
- Author:
Walter S. Coknekl, M.D.,
University of Pennsylvania and Bureau of Health, Philadelphia.
The reports on the physical condition of school children which have been issued in the past by school and health authorities, have been fair statements of conditions found and have served to demonstrate the wisdom of medical inspection and to further its universal adoption. It must be admitted, however, that up to the present time they have not, as a rule, been compiled in the most scientific manner, nor have the records of the original physical examinations evidenced a comprehensive understanding of the various diseases and defects encountered. Curable and noncurable, primary and secondary, temporary and permanent, mild and severe defects have been lumped together to form totals which have further been swelled by the addition of mere symptoms such as headache, earache, and toothache. No intelligent conception has been given of the relation to each other of the number of defective children, the number of defects found, and the number of children receiving parents’ notices. As a consequence, enormous figures may be quoted which are impressive enough, but which fail to add to our medical knowledge. As a matter of fact they have on occasion actually done harm by reason of their employment as a basis for deductions as to the degeneracy of the race, the relation of physical to mental defect, etc. Thus it is not uncommon to see such press notices as, “of two hundred and fifty children examined in the schools of , eight per cent were found to be physically defective,” “of fifty children examined at , forty possessed decayed teeth,” “Dr finds by a statistical study that there is no relation between physical and mental defect.” Such reports fail to state that the first investigator had zealously included every minute imperfection, and had multiplied one eye-strain case into the four defects of “defective vision,” “headache,” “blepharitis,” and “stye;” that the second had examined a class of eight-year-old children whose age bespoke a large number of decaying temporary teeth; while a third had drawn his inferences after ruining his work by including decayed teeth and the enlarged cervical glands secondary thereto among the physical defects considered.
Let us make our physical examinations and compile our statistics in conformity at least with the following principles: 1. The principal defect should be clearly recorded and emphasized. Those most frequently met with are ten in number, eyestrain, enlarged tonsils, nasal obstruction, defective hearing, discharging ears, poor nutrition, decayed teeth, stoop shoulders (including flat clhest), lateral curvature, nervous exhaustion and mental defect. In this way only can a comprehensive analysis of conditions be obtained.
2. Secondary symptoms such as headache and catarrh should not only be recorded in such manner that their secondary character is understood, but should be grouped so that medical knowledge as to their relative frequency may be acquired. 3. The number of physical defects reported to the parents for treatment should be stated separately from the number of physical defects noted of minor degree or character. Also any statement as to the number of defective children should specify the nature of the defects recorded. Without minimizing the importance of sound teeth, it is evident that the number of decayed teeth encountered is so enormous that their addition to a general list of the other physical defects practically doubles the total number. The various physical defects are of such a widely different significance that such a general list is of little scientific value.
4. Non-curable defects such as weak heart, high palate, paralyzed limbs, and temporary ailments such as styes, boils, and infrequent headaches, should receive separate record. , 5. The individual eye records should state the acuity of vision, the existence of squint, and the wearing of eye-glasses. By this method only can material for proper further study be produced. Routine official statistics as to these details is unnecessary, since they are nearly constant factors and standard figures can be established by a few intelligent studies.
6. Age, grade and social condition should be considered in connection with physical defect. By this method developmental defects can be traced year by year throughout school life, the maximum prevalence of nasal obstruction and decayed teeth at definite ages demonstrated, and the relation of these various defects to the environment of the children determined.
In an article in a former issue of this journal1 the writer endeavored to follow these general principles in his record of the physical condition of the school children attending the School of Observation of the Department of Pedagogy of the University of Pennsylvania. While the small number of children, their aboveaverage social station, and the fact that they attended the school for personal reasons in each case, all forbid the assumption that the figures presented correspond closely with those drawn from the examination of the total school population of a great city, the general ideas here advocated were utilized in their preparation so far as opportunity permitted.
‘The Psychological Clinic, Vol. Ill, No. 5, October, 1909, p. 134.
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