Appendix F.]

E.r-2.

Schools of Grade IV (earlier classification--average attendance 36-80) and upwards are all that it has so far been possible to include in the scheme. The practice has been continued of medically examining children of S2 as well as special cases of suspected defect from other classes. Children examined the previous year and found to have defects were also re-examined with the object of ascertaining if the required attention had been received. The total number of children examined was 16,019, of whom 5,771 were special cases. 'Pablo Ql shows the number and percentages of defects reported among children examined at the routine examination, and Table Q2 the number of defects found among the special cases. Variation in the percentages in different districts is probably due to some extent to the fact that different, Medical Inspectors were employed in them. The personal equation cannot be altogether eliminated. It will be noticed that 869 per cent, of the children examined at the routine examination arc recorded as suffering from one defect or another, and 651 per cent, from defects other than dental defects. Although these percentages appear to be high, it is to be borne in mind that many of the ailments and defects included are of a minor character and easily remedied if the necessary steps are taken. The percentage given by dental caries (68) is slightly lower than last year's record, but this form of disease still stands out prominently among school-children. It is difficult to infpress parents with the seriousness of dental decay, as its widespread occurrence has led it to be accepted largely as an unavoidable evil. The Medical Inspectors are of opinion, however, that much could be done to improve the existing conditions if more attention were given to cleanliness and to diet. Every effort is made to educate children on these points, and the matter is also under; consideration of arranging for lectures to be given or pamphlets distributed to parents on this and other subjects. The recommendations of the Medical Inspectors have resulted in conservative dentistry being resorted to in numbers of cases that would otherwise have probably been neglected. The expense involved and the difficulty of obtaining dental service in country districts are, however, difficult obstacles to overcome. On the other hand, instances have been brought under the notice of the Department in. which through the initiative of the schoolmaster in a country school very satisfactory arrangements have been made for the dental treatment of the children collectively at a small cost for each, and what has thus been, successfully carried out in some cases might well be done in many. Twenty-four per cent, of the children were found to be suffering from obstructed breathing, and nearly one-third of the special cases dealt with were similarly affected. Pamphlets have been sent to parents of children suffering from this cause, and in a large proportion of cases the advice of the Medical Inspectors has been taken and the necessary treatment obtained. The necessity for after-care in deep-breathing and handkerchief drill has also been emphasized. The number of children suffering from malnutrition (bad and medium cases) amounted to 19 per cent., those living in the congested areas of the towns and the remote country districts apparently being the worst sufferers in this respect. The causes leading to this undesirable condition may be many and varied, among them being overcrowding in the homes, excessive strain on the children's strength in walking long distances or in performing heavy manual duties, and the lack of knowledge or opportunity on the part of parents required to provide proper food and care. The necessity of large numbers of children taking cold and not very nutritious lunches >Jk to school is commented upon by the Inspectors as being unfavourable to their health. The provision of a hot drink of some kind is advocated, and also some supervision of the luncheon meal to ensure that the food is taken at the right time and in a proper manner. Plrysical deformities, including stooped shoulders, spinal curvature, flat chest and pigeon breast, were observed in 26 per cent, of the routine cases examined. This is a high percentage, but it is lower than that reported for the previous year. Some of the minor defects of this kind, although in many cases they may not be regarded as harmful from a health point of view, are always disfiguring, and should be remedied. It is in this direction that improvement is looked for as one of the results of the physical exercises now being practised in the schools, and already some improvement is noticeable. The unsuitable desks and seats in many of the older schools have something to answer for in this respect, as well as the improper direction of the lighting, which is not infrequently such as to cause the child to sit in an unnatural position in the effort to obtain sufficient light on his work. Ten per cent, of the children have defective vision, this defect being more common in the town scohols than in the country schools and among girls than among boys. Mentally defective children, including for the most part those that are classed as backward, were found in numbers, amounting to 2"3 per cent., at the routine examination, and to 6 per cent, of the special cases examined. The necessity for some special provision for the education of backward children is urged by the Medical Inspectors. Such children are not only a source of great hindrance to the teachers, but in many cases may be a moral danger to the other children. In addition, they are not receiving the kind of education they require. Arrangements are now being made under which children of limited mental capacity may receive instruction in manual subjects usually confined to the upper standards, which such children never reach. It may be noted also that special classes for backward children may now be recognized in the training colleges to enable teachers to observe and learn any special methods applicable. Besides examining the children the Medical Inspectors have continued to direct their attention to the school surroundings in so far as they affect the health of the children, and to suggest improvements where possible. Many such have been carried into effect with resultant benefit to both scholars and teachers.

III