LETTER OF TRANSMITTAL DEPARTMENT OF THE INTERIOR, BUREAU OF EDUCATION, Washington, January 1, 1913. SIR: In the older Greek education one-half of the school day was regularly spent by the Greek boys in exercises and games designed to make them strong and also to teach them the mental significance of sound health. During the middle ages this high ideal of soundness and sanity was lost, and even looked upon as spiritually dangerous. There is emerging to-day a new health consciousness. We now know that diseases are not providentially sent, but are the results of natural forces which man may overcome. We know, too, even better than the Greeks, that physical soundness and mental sanity are vitally related. Hence, we realize that mental Hence, we realize that mental progress demands physical progress. Medical inspection of school children has for its chief purpose the early discovery of physical defects or disease, so that such defects may be corrected in early life, or that contagion may be reduced to a minimum. No educational movement in modern times has had more vital relations to the children, to the homes they represent, and to the Nation, than medical inspection of school children and the general hygienic movement it typifies. The work began in this country less than 20 years ago, but we are now in the midst of the most rapid development of this part of the public educational service. Information is eagerly sought from all parts of the country. The manuscript hereby transmitted, entitled "Annotated Bibliography of Medical Inspection and Health Supervision of School Children in the United States for the Years 1909-1912," was compiled in the Division of School Hygiene and Sanitation of this bureau. It is a digest of the chief literature on this subject published in America during the past four years, and will be very helpful, especially to school and health officers. I therefore recommend its publication as a bulletin of the Bureau of Education. Very respectfully, The SECRETARY OF THE INTERIOR. P. P. CLAXTON, Commissioner. ANNOTATED BIBLIOGRAPHY OF MEDICAL INSPECTION AND HEALTH SUPERVISION OF SCHOOL CHILDREN. GENERAL REFERENCES. ALLEN, Arch Turner. The school and physical welfare of the child. In North Carolina association of city public-school superintendents and principals. Proceedings, 1911. Raleigh, Edwards & Broughton printing co., 1911. p. 19-27. "It is the business of the school to see that the physical surroundings of the child comply in every detail with the laws of healthful living. The room should be large; the air space ample; the ventilation continuous; the light free from shadows and properly directed; the sittings accommodated to the child's size and not to the grade; the water pure and of the right temperature, and sanitary arrangements for using it; the toilets clean; the playgrounds large and dry; and plenty of time to use them. ... "The school is under urgent obligations legally as well as morally to see that it does not become a distributing center for contagious diseases. . . . "When we consider what medical inspection will do for the schools, its cost becomes a legitimate school expenditure. It is just as much so as the salary of the teacher.... "The three essential things in this inspection are the following: "1. To know the health records of the community. "2. To know as far as possible the physical condition of the children who attend school. "3. To follow up this knowledge by having as many of them treated as we can find a means for, and to use these health records in every helpful way possible." American medical association. Report of committee on administrative methods of physical examination of school children. Its Journal, 57: 1750-51, November 25, 1911. Signed: Ernest B. Hoag, M. D. and Everett C. Beach, M. D. Recommends: That city and county boards of education should secure the services of trained medical inspectors sufficient in number to instruct all elementary school teachers in making preliminary physical examinations or health surveys; that city boards of education maintain departments of medical inspection, the heads of such departments to be medically trained men; that the cities be divided into districts with a medical inspector in charge of each district. That each child be given a physical examination each year, preferably at the beginning. That this examination be sufficiently thorough to detect defects that interfere, or are liable to interfere, with the health, growth, and development of the child, such examinations to include the examination of the eye, ear, mouth, nose, throat, teeth, heart, lungs, thorax, shoulders, spine, hips, inguinal region, feet, nutrition, mentality, and nervous system. That the preliminary examination in the elementary schools be made by the teacher or nurse and in the high schools by the director of physical education or one of his assistants. That the supplementary physical examination be made in the elementary schools by the trained medical inspector, and in the high schools by the director of physical education if he be medically trained; otherwise by the medical inspector; that a careful record be kept of the results of the preliminary and supplementary examinations to include only such data as would be of future use to the teacher or director. That these records be kept by the teacher and passed on with the promotion slip, a duplicate being retained in the office of the health inspector. That whenever feasible the physical examination be conducted preferably by examiners, employed by and under the direction of the board of education. When this is not feasible the appointee of the board of health should be approved by the board of education. That a greater effort be made to establish hearty cooperation between the school physician, the teacher, the family physician, the home, and the free dispensaries in following up and in securing the correction of physical defects. American medical association. Report of committee on medical inspection of schools. Its Journal, 57: 1751-57, November 25, 1911. Chairman, George L. Leslie. "Two divisions of this field of work are advisable: "A. Under the control and direction of boards of education-that part of the work essential for the intel- "EDUCATIONAL HYGIENE-UNDER THE Control and DIRECTION OF boards of EDUCATION. "1. The establishment of biennial, annual, and, when necessary, more frequent skilled physical and developmental examinations of pupils and students by a staff of experts. The establishment of initial examination of pupils by the teaching force of the schools, as far as the teaching force is qualified, prior to the skilled examinations by experts. "2. By effective action, based on the data of these examinations, to secure (a) the correction of physical anomalies and thus remove the growth-barriers of children and youths, and (b) whenever possible and practicable, to adjust educational activities to meet the requirements of physical and mental health, growth and development, and thus establish a special field of education for the maintenance of continuous health and development supervision of pupils and students. "3. To maintain a scientific and systematic study of mental retardation and mental deviation of pupils and students by skilled examination, and whenever possible and practicable, by skilled training in special schools. "4. To establish skilled physical and health examinations of candidates for teachers' positions prior to their election to determine vital fitness for their work, and thereafter to maintain continuous supervision of health and efficiency to teachers as related to the work of the schools. "5. (a) To organize and supervise courses of technical instruction in hygiene for pupils, students and teachers, in the means of conservation of physical and mental health, growth and development; in the means of correction and prevention of defects, disease and degeneracy; (b) whenever necessary for efficiency, to give practical and technical instruction to the teaching force of the schools, while engaged in teaching, in the initial physical and developmental examination of pupils; and in the skilled physical and developmental and psychoclinical examination of exceptional pupils, abnormal and supernormal. "6. To establish and maintain well-equipped medical anthropometric and psychoclinical laboratories in the public schools which shall afford opportunity and equipment "(a) for sufficiently skilful medical, anthropometric and psychoclinical examination of exceptional pupils and of all pupils requiring special examination. "(b) for such technical training of teachers in the laboratory and experimental phases of educational work, connected with the physical and mental examination of pupils, in clinical psychology and in experimental pedagogy as is essential for the intelligent handling of pupils. "(c) for essential work in hygiene and sanitation. "7. To exercise expert sanitary supervision in the planning and maintenance of school buildings and grounds. "8. To bring about the establishment of dental and medical clinics for pupils whose parents are financially unable to provide essential medical and dertal aid. "9. Whenever possible and practicable, to cooperate with State, county, and city health officers in the detection of and reporting of contagious diseases. "10. Each department of educational hygiene to constitute a bureau of practical investigation and research in educational hygiene, and as such to cooperate with State bureaus of educational hygiene whose functions will or ought to be the organization and supervision of State-wide work and investigation in this special field of education-looking forward to the establishment also of a national bureau of educational hygiene. "An approrimate grouping of pupils.-Based on the data of physical and developmental examinations which ought to follow the examination of pupils and students. 1. Those for whom medical and dental aid is essential. 2. Those whose respiratory or circulatory systems are defective or are poorly developed, for whom a larger amount of out of door life and physical activity is essential, or other modification of school activities necessary. 3. Those whose nervous systems are defective or poorly developed and who require an unusual amount of out of door life, physical activity, special care and skilled training. 4. The segregation of pupils requiring an unusual amount of physical activity for possible mental growth-both sexes. 5. Segregation of pupils of truancy and criminal tendencies or otherwise showing more or less degeneracy, and assignment to special schools with special training. 6. Segregation of mentally defective pupils and assignment to special schools. 7. The segregation of supernormal pupils and assignment to special schools. 8. As far as practicable, the grouping of pupils in accordance with development age. "In this program, school nurses are assistants to the staff. Their field work is essentially as follows: "To assist members of the staff in the skilled examination of pupils and otherwise as assistance is needed; to assist teachers in making preliminary surveys of their pupils and in giving initial examina tions, notifying parents of essential needs of pupils, etc.; visiting parents and in all justifiable ways establishing effective cooperation between home and school. Further, the function of the school nurse is that of the social educator in the field of hygiene. As such, the work of the school nurse is one of high order. "The staff of experts, the teaching force of the schools and school nurses, working from the standpoint of education, form an educational corps to secure the effective cooperation of home, school and school authorities in meeting the requirements of the physical and mental health and growth of pupils. When educational means fail, the law must remedy instances of neglect of health and growth of children. "Each department of educational hygiene should act, as far as practicable and consistent with the required established work, as a bureau of investigation and research. "The functions of departments of educational hygiene are twofold: 1. Carrying out certain established work of the schools. 2. Investigation and research of problems of health and development, of clinical psychology and of experimental pedagogy. "Two classes of experts stand out as preeminently qualified for work in this special field of education: 1. The psychologist-educator. An expert in child hygiene, in educational and clinical psychology and in practical experimental pedagogy; skilled in physical and mental diagnosis, of normal and abnormal growth and development and having a knowledge of elementary medicine; a thoroughly trained, broadgauged expert in education. 2. The skilled physician who has had sufficient training and acquaintance with educational work. "Your committee, therefore, joins in a recommendation already made by Dr. Terman of the department of education of Leland Stanford university, essentially as follows: That steps be taken to bring about a conference of representatives from the United States department [bureau] of education, the National education association, the American medical association, the American institute of homeopathy and other national medical associations and the Russell Sage foundation for child welfare, which committee, after joint consideration of the problems involved, shall formulate and recommend alternative systems of educational hygiene which in time would be accepted as standard requirements in this special field of education." American school hygiene association. Report of Committee on status of medical inspection of school children throughout the United States. In its Proceedings, 1910. Springfield [Mass.] American physical education review, 1910. p. 176–83. Chairman, John J. Cronin, M. D. A questionnaire (see Appendix, p. 129] was prepared by the committee and sent to 50 places. Of these, 14 submitted forms properly made out. All declared that some form of organized medical inspection of school children was adopted. All places have a system of following up and controlling the cases found with contagious disease and physical abnormality. Particularly in towns, the percentage of children brought under treatment is very high-75 to 100 per cent. In one place only are the parochial schools under municipal supervision. General inspection for contagious conditions is made regularly once a year, and thereafter as the emergency arises. The physical examination is made on selected cases. The number of children under the care of one inspector varies from 900 to 10,000. Not one place provides baths for the use of school children in the school building, and only two places report facilities for bathing in municipal baths. Of the 14 places reported, 13 are supervised under the direction of departments of education. Seven places report some form of instruction in the care of children's teeth. American school hygiene association. [Report of Committee on] Status of medical inspection in the United States. In its Proceedings, 1911. Springfield, Mass., American physical education review, 1911. p. 144-48. tables. Chairman, John J. Cronin, M. D. About 1,400 questionnaires were sent out. Returns were received as follows: 308 from North Atlantic States; 45 from South Atlantic States; 67 from South Central States; 286 from North Central States; and 52 from Western States. The chairman says: "In concluding this statistical report, I am constrained to inquire why is it that only 337 places of 758 reporting have made any attempt to protect the health of their school children." AYRES, Leonard Porter, comp. Medical inspection legislation. New York City, Russell Sage foundation, Dept. of child hygiene [1911] 53 p. map. 8°. ([Russell Sage foundation. Dept. of child hygiene. Pamphlet] Health, education, recreation. no. 99) Principal features of State laws and regulations providing for medical inspection, 1911: p. 6. AYRES, Leonard Porter. Physical defects and school progress. American physical education review, 14: 197–206, April 1909. tables. Also in Hygiene and physical education, 1: 599-606, September 1909; and with some additional tables end paragraphs in his Laggards in our schools. New York, Charities publication committee, 1909. p. 117-31. |