Special Educational Treatment (1946)

This pamphlet explained the implications of sections 33 and 34 of the 1944 Education Act for the provision of education for children with special needs.

The complete document is shown in this single web page. You can scroll through it or use the following links to go to the various sections.

Introduction (page 4)
I Types of special educational treatment (5)
II Selection of children (9)
III Numbers involved (11)
IV How and where should treatment be given (12)
V Who should give special educational treatment (33)
VI What results may be expected (35)

The text of Special Educational Treatment was prepared by Derek Gillard and uploaded on 21 March 2021.

Special Educational Treatment (1946)
Ministry of Education Pamphlet No. 5

London: His Majesty's Stationery Office 1946
Crown copyright material is reproduced with the permission of the Controller of HMSO and the Queen's Printer for Scotland.


[inside front cover]

Selected Publications of the




THE EDUCATION ACT, 1944. 2s. (2s. 2d.)



THE NEW SECONDARY EDUCATION. (Pamphlet No. 9) 1947. 1s. 6d. (1s. 8d.)


MEMORANDUM ON THE BUILDING REGULATIONS. April 1945. 6d. (7d.). CIRCULAR No. 10. November 1944. Deals with the Building Regulations. 1d. (2d.).



STANDARD CONSTRUCTION FOR SCHOOLS. Post-war Building Studies No. 2. (Ministry of Works.) 1944. 6d. (7d.).



HEALTH SERVICES REGULATIONS. (S.R. & O. 1945, No. 1076). August 1945. 4d. (5d.).

HANDICAPPED PUPILS AND SCHOOL HEALTH SERVICES AMENDING REGULATIONS. No. 1. 1946. (S.R. & O. 1946, No. 1290.) July 1946. 1d. (2d.).

CIRCULAR No. 41. April 1945. Deals with the Regulations. 2d. (3d.).

PROVISION OF MILK AND MEALS REGULATIONS. (S.R. & O. 1945, No. 689) June 1945. 1d. (2d.).

CIRCULAR No. 34. March 1945. Deals with the Regulations. 1d. (2d.)

THE HEALTH OF THE SCHOOL CHILD: Report of the Chief Medical Officer of the Ministry of Education for 1939-45. 1947. 2s. 6d. (2s. 9d.).

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Pamphlet No. 5


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SECTION 33 of the Education Act 1944, and the Regulations made thereunder, have placed on Local Education Authorities new responsibilities for the provision of suitable education for children suffering from disability of mind or body. This pamphlet is intended mainly for the guidance of Local Education Authorities and teachers in the discharge of a difficult and important duty, which has the dual claim of succour to the afflicted and practical value co the community.

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Blind children29
Partially sighted children30
Deaf children32
Partially deaf children33
Delicate children39
Diabetic children43
Educationally sub-normal children45
    Larger urban areas55
    Smaller urban and rural areas69
Epileptic children74
Maladjusted children75
Physically handicapped children84
Children with speech defects87
Children with dual or multiple disabilities94
    Note on the Intelligent Quotient95



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1. WE know that normal healthy children even of the same age vary one from the other in many ways and the Education Act 1944, requires that each one of them shall have an education designed to suit his age, ability and aptitudes.

Children suffering from some disability of mind or body clearly cannot be treated quite in the same way as their more fortunate fellows if their schooling is to benefit them as much as it should. In addition, the differences existing among themselves are even more pronounced than those found in similar groups of normal children.

Experience has shown that unless favourable conditions are provided for handicapped children they tend to have their special problems overlooked, with consequent shortcomings in their education and general well-being. Local authorities are enjoined by the Act [Section 8(2)(c)] to take such steps as are necessary to safeguard the interests of these children, and it is the arrangements made to this end which are called special educational treatment.

2. The special educational treatment required by the Education Act is not confined to treatment given in special schools. Such schools, wherever they are practicable, are the necessary provision for pupils whose disability is serious, but where they are impracticable or the pupils' disability is not serious special arrangements have to be made in the ordinary schools.

3. This pamphlet is intended both to supply answers to some of the questions asked by those who have to consider what provision should be made for handicapped children, and to afford some help and guidance to teachers who find handicapped children in the schools in which they work.

The questions considered are:

(i) What kinds of children require special educational treatment?

(ii) How should they be selected?

(iii) How many may be expected of each kind?

(iv) How and where should the special educational treatment be given?

(v) Who should give it and what preparation do they require for their work?

(vi) What results may be expected from it?

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4. The Minister of Education, in the Handicapped Pupils and School Health Service Regulations 1945, has determined that the following categories of children require special educational treatment: the blind, the partially sighted, the deaf, the partially deaf, the delicate, the diabetic, the educationally sub-normal, the epileptic, the maladjusted, the physically handicapped and those with speech defects. Anyone who has known children in any of these categories will agree that the varieties of education offered in ordinary primary and secondary schools do not, without modification, meet their needs.

The regulations define the categories: these definitions, with a few words of explanation and amplification, are given below.

5. Blind pupils, that is to say pupils who have no sight or whose sight is or is likely to become so defective that they require education by methods not involving the use of sight.
This category corresponds to the type of child at present taught in schools for the blind using Braille as the medium of reading and writing. It includes as well as the totally blind those children who cannot be taught by visual methods employing large print, blackboard writing, or lenses for magnifying ordinary print, either because they cannot see well enough, or because, though they may have sufficient sight at any given moment, there is a strong probability that their sight will soon deteriorate to such an extent as to make the use of Braille essential. It is not a sufficient reason for educating a child as a blind pupil that he may at some time in the remote future need to use Braille. While he can be trained by the use of sight this should be done, since it is found that most pupils with sight acquire fluency in Braille with great difficulty and tend to use their eyes as much as possible. Such children should be classed as partially sighted so long as they can be educated through visual methods.
6. Partially sighted pupils, that is to say pupils who by reason of defective vision cannot follow the ordinary curriculum without detriment to their sight or to their educational development, but can be educated by special methods involving the use of sight.
This category has been differentiated from the blind in the previous paragraph. The partially sighted include both children whose visual acuity is so poor that they cannot see to read the ordinary school books without the aid of a magnifying lens, and those who, on medical grounds, should not read them because this involves strain which may be injurious to their eyes. If a child is not making satisfactory progress in his school work in the basic subjects because of difficulties caused by his eyesight, this may be taken into account in classifying him as partially sighted.

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7. Deaf pupils, that is to say pupils who have no hearing or whose hearing is so defective that they require education by methods used for deaf pupils without naturally acquired speech or language.
This category corresponds to Grade III of the classification suggested by the Committee on Children with Defective Hearing.* It includes those children who have never heard sufficiently well to have acquired speech and language in the normal way, but not necessarily those who have lost their hearing, totally or partially, after speech and language have been developed and become habitual by use; these may not require for their education the methods used for children who have never heard.
8. Partially deaf pupils, that is to say pupils whose hearing is so defective that they require for their education special arrangements or facilities but not all the educational methods used for deaf pupils.
This category corresponds to Grade II of the classification by the same Committee, and covers both their sub-grades IIA and IIB. It includes all those children with defects of hearing (except those in the category of deaf pupils) who are or would be in any way handicapped in their progress in ordinary schools by their defect.
9. Delicate pupils, that is to say pupils who by reason of impaired physical condition cannot, without risk to their health, be educated under the normal regime of an ordinary school.
This category includes those children who are temporarily below par in their general health or physical well-being. In general, it may be said that any child may be classified as a delicate pupil if in the opinion of the School Medical Officer the special educational treatment which he could receive would improve his health and well-being. Among the conditions which have been found in the past to justify this classification are sub-normal nutrition, anaemia, certain rheumatic manifestations (such as chorea), debility, particularly that following illness (e.g. infectious disease), and chronic pulmonary conditions other than tuberculosis.

This category may overlap to some extent that of the physically handicapped (see paragraph 14 below) and has no very definite boundaries. It is intended that children should rarely be classed as delicate pupils if their disability is likely to be of a permanent nature involving their removal from an ordinary school for the rest of their school life.

10. Diabetic pupils, that is to say pupils suffering from diabetes who cannot obtain the treatment they need while living at home and require residential care.
Where regular and effective medical treatment and care can be given to a child living at home he should be regarded for school work as a normal child. Where conditions make such requisite medical care impossible the child may be put into residence in a hostel, in order to ensure that treatment is carried out; then, too, he will attend an ordinary school.

*Report of the Committee of Enquiry into Problems relating to Children with Defective Hearing, 1938, H.M.S.O.

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11. Educationally sub-normal pupils, that is to say pupils who, by reason of limited ability or other conditions resulting in educational retardation, require some specialised form of education wholly or partly in substitution for the education normally given in ordinary schools.
This category includes not only the children who in the past were certifiable under Section 55 of the Education Act 1921, but also dull children who are retarded in their school work by reason of "limited ability", and those who are backward in the basic subjects because of "other conditions". A fuller discussion of these types of children is to be found in paragraphs 45-53.
12. Epileptic pupils, that, is to say pupils who by reason of epilepsy, cannot be educated in an ordinary school without detriment to the interests of themselves or other pupils and require education in a Special School.
This category includes only those pupils suffering from epilepsy (whether major or minor) whose continued attendance at an ordinary school would be harmful to themselves or would upset the routine of an ordinary school and so be against the interests of other children. Even a child with minor epilepsy should not in his own interests attend an ordinary school if he requires the frequent medical attention that can best be given in a residential institution. On the other hand a child who has infrequent or nocturnal major fits, which are not thought to require this frequent medical supervision may continue to attend an ordinary school provided he is not a nuisance to the other pupils, and therefore he should not be classified as an epileptic pupil.
13. Maladjusted pupils, that is to say pupils who show evidence of emotional instability or psychological disturbance and require special educational treatment in order to effect their personal, social or educational readjustment.
This category has no counterpart in Part V of the Education Act 1921, but it corresponds to the class of children for whom child guidance treatment has formerly been provided under Section 80 of that Act. The terms "emotional instability" or "psychological disturbance" will, it is, thought, cover the cases of all children for whom psychiatric or psychological investigation or treatment seems appropriate because of their conduct or behaviour or habits, wherever displayed, or their abnormal response to the activities of school. Backward children who show no evidence of such instability or disturbance should not be classified as maladjusted pupils; neither should those whose delinquency or troublesome behaviour is not complicated by emotional instability or psychological disturbance. These may require to be dealt with in other ways, e.g. by attendance at an approved school where they may be educated in such a way as to overcome the results of bad training. It should be recognised, however, that though such children may not prove to be maladjusted they may require examination at a child guidance centre or clinic to determine the causes of their conduct, and for a recommendation of the best course of treatment or training to be followed.

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14. Physically handicapped pupils, that is to say pupils not being pupils suffering solely from a defect of sight or hearing, who, by reason of disease or crippling defect, cannot be satisfactorily educated in an ordinary school or cannot be educated in such a school without detriment to their health or educational development.
This category includes children of the types now educated in hospital schools - sanatoria, orthopaedic, heart, and general hospitals - convalescent schools for crippled children who have had hospital treatment but are not yet fit to return home and go to an ordinary or day special school, and day schools for cripples or children suffering from heart disease which does not require treatment in bed. These children differ from delicate pupils in that their physical handicap is either more severe, necessitating medical or surgical treatment and staying in bed, or more lasting, requiring special educational treatment for the main part, or all, of their school life, bur there is bound to be some overlap between the two categories. It is to be noted that in deciding whether a physically handicapped child is in need of special educational treatment his educational development as well as his physical condition must be taken into account. This is particularly important in the case of children who are in attendance at special schools for physically handicapped pupils and who, on account of improved health, are felt by the medical officer to be ready to leave. In some instances to transfer the child back to an ordinary school at once would be disadvantageous to his educational development because the stage of educational progress he had reached might nor admit of a break. The definition allows him to be retained in the special school until he is ready, on educational grounds as well as medical, to take his place in an ordinary school, or, if he is very backward, to receive special educational treatment as an educationally sub-normal pupil.
15. Pupils suffering from speech defect, that is to say pupils who on account of stammering, aphasia, or defect of voice or articulation not due to deafness, require special educational treatment.
In this category, the children other than the aphasic children and those who stammer are those whose speech is not clear and intelligible, either because of lack of voice control or faulty voice production or because they have not learned to pronounce the sounds of speech properly. Children should not be classified here merely because of defects of articulation associated with "baby talk" unless these persist after the usual age for discarding it, i.e. six or seven years. Those children whose defect of voice or articulation is due to lack of hearing, whereby they cannot properly appreciate the sound of speech made by others, are excluded from this category and fall into that of partially deaf or deaf pupils. Aphasic children are those who show no defect in hearing preferably after testing with an audiometer, yet do not speak or speak very little and very indistinctly. They usually exhibit a certain amount of confusion in their expression of written language, showing that the defect is not merely one of speech. The defect is rare, but children who are deaf to high notes while hearing low notes are sometimes

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mistakenly called aphasic because their hearing has not been scientifically charted. Occasionally children who fail to talk do so for psychological reasons, and the aid of a child guidance clinic may be necessary as well as otological examination, in order to classify them properly. Children whose defective speech is due to very low mentality should be excluded from this category: for them intensive treatment by a speech therapist is unlikely to be profitable.


16. The process of selecting children who need special educational treatment is known as "ascertainment". If it is to be properly carried out, so that no child who needs special educational treatment is overlooked, the co-operation of a number of interested people is required. The people principally concerned are the child's parents, his teachers, the head teacher of his school and the School Medical Officer, but other officers of the authority, e.g. the educational psychologist, consultant medical officers and other teachers, and on occasion persons outside the educational system altogether may be asked for advice. It is for the local education authority to make clearly understood what the procedure is in their area, so that their teachers and other staff may know exactly what to do when a child is suspected of being handicapped. The final decision rests with the authority, subject to appeal to the Minister.

17. At any time after a child is two years old the parent may ask to have him examined to see if he requires special educational treatment. The authority is bound to have this done and if it is found that the child requires special educational treatment this must be provided, if the parent so wishes. The child need not be in attendance at any school when the request is made. Many of the types of disability which affect handicapped children are not likely to be regarded as serious by parents before their child goes to school; but the graver disabilities such as blindness, deafness, or crippling defects are plainly to be seen, and the sooner special educational treatment is begun the better are the prospects of overcoming the consequences of the disability, should it be permanent or of alleviating it, should it be amenable to medical treatment. At the present time many blind and deaf children between the ages of two and five are in nursery schools or departments for the blind or deaf, while the decrease of crippling defects among children of school age is due in large measure to orthopaedic treatment having been given before the age of five, or even, outside the educational system, before two. Operations for cleft palate are undertaken with most success in infancy.

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18. While these requests by parents are to be encouraged, the great majority of handicapped children will not be found to be so until they come to school, where their teachers have opportunities for observing their behaviour and of noticing that they are handicapped in making progress because of their disability. Teachers have far closer and more continuous opportunities for detecting the presence of physical or mental disabilities among their children than anyone else, and the success of ascertainment rests largely on their shoulders. As soon as a child is suspected of having difficulty in seeing, hearing or speaking, or of being delicate or crippled, or backward for his age in school work, or maladjusted and showing problems of conduct or social adaptation, or of having epileptic fits, the fact should at once be reported to the authority. Even though examination discloses that the disability is too slight to warrant giving special educational treatment, the sooner the School Medical Officer knows of the child's handicap the better he is placed to adopt remedial medical measures, and the more likely the teacher is to receive help in adopting any modifications in the child's education that may be desirable. The authority should make clear to its teachers the local procedure for securing examination by the School Medical Officer.

19. When the School Medical Officer learns of the suspected presence of a disability, he should arrange to have the child medically examined, with a view to offering advice to the authority on the need for special educational treatment. More than one examination may be necessary if a specialist, e.g. in ophthalmology in the case of eye defects, is needed. The examination must be made by a medical officer possessing adequate qualifications or experience in the particular type of disability from which the pupil may be suffering, and in the case of all disabilities except delicacy, diabetes, epilepsy, physical handicap and speech defect, he must be approved by the Minister. The parent must be told that his child is to be examined, and is entitled to be present.

20. After making the examination and considering such other information as may be in his possession, the School Medical Officer must then offer his advice on the child to the authority and the parent must be told what his advice is. Every teacher taking any part in training the child should be kept informed of what has been done or is to be done.

21. Under the 1944 Act the authority should also seek and consider all further information supplied by a number of other interested persons able to add to the knowledge of the particular child who may be needing special educational treatment. For instance, doctor, teacher, educational psychologist and perhaps others who really know the child well, will, it is hoped, put their heads together in his interest. Past experience suggests that such team work by understanding people is well worth while. It is particularly valuable in border-line cases.

22. Educational psychologists, fitted by their training and experience to give expert advice on a child's educational needs, are employed by some authorities. It is hoped that every authority will now make

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such help available for its children. In the past, the value of the psychologist's advice on educationally sub-normal and maladjusted children has been recognised; actually, his advice has extremely high value also in many cases of other types of disability.

23. After all the advice and information have been submitted, the authority will decide whether the child is to be given special educational treatment and, if so, whether he should attend a special school or some ordinary primary or secondary school.


24. Before an authority can make arrangements for special educational treatment to be provided for its handicapped children it requires to have an estimate of the numbers likely to need it. Local circumstances may be expected to cause variations in the proportion of handicapped children in any area. It must be recognised that far more research is needed before any accurate figures can be given. As a rough guide to estimates, the figures in paragraph 25 are offered. These may be useful to authorities in making preliminary estimates of what is required. Before detailed arrangements can be made ascertainment must be carried out.

25. It should be emphasised that these estimates refer to the numbers of children who suffer from particular disabilities (and require special educational treatment in some way) and are not estimates of the number who should have special educational treatment in any particular way, e.g. in special schools. This point will be referred to later (e,g. in paragraph 26 sqq.).

Blind children0.2 to 0.3 per 1,000 registered pupils
Partially sighted children1.0 per 1,000 registered pupils
Deaf children0.7 to 1.0 per 1,000 registered pupils
Partially deaf children1.0 upwards per 1,000 registered pupils
Delicate children1 to 2 per cent of registered pupils
Diabetic children†No estimate available
Epileptic children†0.2 per 1,000 registered pupils
Educationally sub-normal children*10 per cent of registered pupils
Maladjusted childrenAbout 1 per cent of registered pupils
Physically handicapped children5 to 8 per 1,000 registered pupils
Children with speech defects1.5 to 3 per cent of registered pupils

*See also discussion of number of these children in paragraphs 57, 59, 63 and 71.

†Since this pamphlet was first printed it has been suggested that a suitable figure for diabetic pupils may be 0.03 per 1,000 and that the figure for epileptic pupils is nearer 0.3 than 0.2 per 1,000.

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"Registered pupils" refers to the total number of children aged five to fifteen on roll of the primary and secondary (including special) schools in the area.

Except in the case of delicate and educationally sub-normal children, the difference due to the leaving age not yet having been raised to fifteen may be neglected, as the numbers are so small.


26. Section 33 (2) of the Act states:

The arrangements made by a local education authority for the special educational treatment of pupils in any such category shall so far as is practicable provide for the education of pupils in whose case the disability is serious in special schools appropriate for that category but where that is impracticable or where the disability is not serious the arrangements may provide for the giving of such education in any school maintained or assisted by the local education authority.
27. The Handicapped Pupils' and School Health Service Regulations 1945 prescribe that all blind, deaf, epileptic, physically handicapped and aphasic children are seriously disabled by their condition and must be educated in special schools. Whether any individual child of any of the other types is so seriously handicapped that he needs to go to a special school will depend not only on the degree of his disability but also on the adequacy of the provision that can be made for him in an ordinary school. It may in general be said that it is not impracticable to educate all of the children in these first five groups in special schools since enough schools of the types appropriate for them are or can fairly readily be made available for them. It has for long been known that it is impracticable to educate in special schools all of the children falling into the other types, and it is not believed that this would be in the interests of all of them, though for some in each category it is the best and indeed the only way to educate them properly.

28. While, therefore, it is quite clear that any child found to be blind, deaf, epileptic, physically handicapped or aphasic should be educated in a special school, and authorities can plan their arrangements on this basis, the provision for the other types of child is not so simple. Some should go to special schools and some have arrangements made for them in the ordinary primary or secondary schools. It will be convenient to set out the considerations authorities should have in mind in making their plans for each category of children separately.

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29. As it is estimated that the number of educable blind children of school age in the whole country does not exceed about 1,200, it is clear that no authority can maintain a blind school of reasonable size solely for their own children. There should be not fewer than five classes in a school for the blind taking children of all ages. In fact, it has already been found that a relatively small number of boarding schools conducted by combinations of authorities or by voluntary managers will suffice for the whole country. What authorities have to do, therefore, is to arrange to send their blind children to one of these schools.


30. The more seriously affected, both those who have very little sight remaining and those in serious danger of progressive deterioration of vision, require education in special schools. These may be day schools if there are enough children to form a five-class unit of children of all ages, that is to say seventy-five children, or may be boarding schools of similar minimum size. Until recently the boarding schools attended by partially sighted children have always been schools for the blind, but efforts are being made to establish boarding schools for the blind and the partially sighted separately since the association of the partially sighted with the blind has been shown to be against the interests of the former, and already three boarding schools for the partially sighted separately have been opened. The less seriously affected may be educated in their own classes in their own schools under the arrangements described in the next paragraph. No special classes in the ordinary schools are suggested, since almost inevitably the age range in classes of this kind would be too wide to allow education suited to all the children to be given. While experiment on the lines of the current American practice of having a class of partially sighted children of a wide age range up to four years closely associated with the normal classes in the primary or secondary school would not be discouraged, opinion in this country has not so far thought its clear advantages outweigh the equally clear difficulties it entails in school organisation. A plan adopted by several authorities before the war was to have a class or classes of partially sighted children in a day open-air school. The children mixed with the delicate children for those of their activities which did not involve reading and writing, which were done in their own classrooms. Where the age range of the pupils in the class was not too wide, this plan worked well, but a class with pupils of all ages is not recommended.

Authorities should therefore plan to send their most seriously affected partially sighted children to day or boarding schools for the partially sighted (or meanwhile to those schools for the blind which make provision for the partially sighted) and to educate the others in their ordinary classes in primary or secondary schools, or in open-air schools.

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31. When it has been decided that a partially sighted child should remain in his own ordinary school the School Medical Officer should be asked to indicate clearly to the head teacher whether he is a myope whose sight may deteriorate unless special care is taken, or whether his visual defect is not a progressive one where there is little risk of damage to sight through school work. In the first case he should be asked to indicate the modifications (if any) that he wishes to have made in curriculum or teaching method. The child should remain in his own class and should always occupy a position in the classroom where the light on his work is good, and where he can see the blackboard clearly. The most useful equipment for partially sighted children attending the ordinary schools is as yet a matter of experiment. Large sized sheets of paper and exercise books, both without lines, are desirable for written work, and thick, soft black pencils should be provided, as well as broad pens for older children.

Reading matter presents difficulties as yet unsolved. There are no specially printed books on the market, and even if there were they would not be suitable for children working in an ordinary class where a variety of books is in use; though they could be invaluable in special schools where all the children are partially sighted. Partially sighted children in ordinary schools do not require the large hand-printed reading matter made in the past in some special schools. If they do they should not be in ordinary schools. The greatest boon would be some kind of lens to magnify the print in the books normally used in the class. Experimental work on the design and production of lenses was interrupted by the war, but this is being resumed. The special desks of various types used in special schools for the partially sighted to provide a large blackboard surface or a surface to hold a large sheet of paper should seldom be necessary for partially sighted children in ordinary schools, but if they are provided they should be designed to promote and not to hinder good posture, as has sometimes occurred in the past. Probably a drawing board with clips to hold the paper and some means of attaching it to an ordinary desk or table would be sufficient.


32. The number of deaf children is several times the number of blind children but it is still very small. Again only the largest authorities can make provision in schools of adequate size for their own children and again the boarding school fills a necessary role. The largest urban authorities, may, if they desire, conduct day schools if they have eight classes or over of deaf and seriously partially deaf children together. This is the minimum size that provides a reasonable chance of classification by age, and even this disregards ability and aptitude and degree of deafness. Larger schools permit much better classification and are altogether preferable in the interests of the children. If authorities do not provide day schools of their own they must arrange to have their deaf children educated in day or boarding schools maintained by other authorities or combinations of authorities or by voluntary managers.

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33. These fall into two groups which are easy to differentiate on paper though the decision to allocate a child to one or the other may be difficult. A full discussion may be found in the Report on Children with Defective Hearing,* Chapter V, but for purposes of guidance in making provision the following may suffice.

34. Partially deaf children are those who have defects of hearing sufficient to prove a handicap in ordinary class conditions but whose disability is not grave enough to have led to their failure to learn to speak as children and to acquire language through the ear as hearing children do. Their articulation may be very faulty, their vocabulary limited, and their speech ungrammatical and childishly simple but they differ from the deaf in that they can (or in some cases could) hear enough to learn to speak and be taught orally, i.e. by hearing the voice of the teacher with or without amplification. Whether they should go to special schools for the partially deaf - at present departments of schools for the deaf, though this may not always be so - or be educated in their own classes in ordinary schools depends entirely on the gravity of their handicap. This does not depend on the degree of hearing-loss alone, since other factors of the greatest importance, speech, language development, ability to lip-read, and educational progress, also enter in.

35. There are clear cases of severe partial deafness who may have to go to special schools as soon as they have been ascertained; but many, perhaps half, of the partially deaf children should have a chance to show what they can do in their own schools. They should have hearing aids and courses in lip-reading where these are recommended by the School Medical Officer. If they make satisfactory progress under this regime in their own schools they may remain there, but their progress must be watched, and if, after a period of trial, which should seldom be less than six months, and may be a year, they fail to attain or maintain reasonable clarity of enunciation, to develop and retain their spoken language to a degree commensurate with that reached by hearing children of a similar age and intelligence, and to comprehend what is said in ordinary school situations, they should be sent to special schools.

36. Authorities who do not maintain a school for the deaf should nor hesitate to ask, from the nearest of such schools or, preferably, from an educational clinic for the deaf if one is available, advice on the best ways of educating any particular partially deaf child. Such specialist advice should also be enlisted in estimating the progress of a partially deaf child who is on trial in a primary or secondary school.

37. It is reckoned that the partially deaf are some 1 per 1,000 of registered pupils, and that about 0.5 per 1,000 should be educated in special schools. Unless the authority maintains a day school for the deaf and partially deaf these children should be sent to a boarding school for the deaf which has a department for the partially deaf or,

*Report of the Committee of Enquiry into Problems Relating to Children with Defective Hearing, 1938, H.M.S.O.

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if in future there are established separate boarding schools for the partially deaf, to one of these.

38. The authority should provide courses in lip-reading (and speech improvement where necessary) for those who remain in their own schools. How this should be done must be for the present a matter for experiment. There is little experience and no supply of appropriately qualified teachers. The ideal would seem to be the collection of a group of these children, five to ten in number, in a class held in some central place twice a week for about an hour. The teacher might be a teacher of the deaf if one were available, or a speech therapist, if adequate theoretical and practical training in the teaching of lip-reading and in the needs of deaf children were introduced into their training course. Where it is impracticable to collect the children, as in scattered rural areas, or where no teacher is available locally, an arrangement might be made to admit the children for perhaps one term to a boarding school for the partially deaf. Intensive teaching and the day-long atmosphere of reliance on lip-reading would then probably suffice to raise the children's ability to such a degree that they could return and resume their place as partially deaf children having special educational treatment in their own schools. Experiment by authorities and schools for the deaf would be welcomed.


39. The special educational treatment of delicate children consists less in adjustments in their curriculum than in enabling them to recover healthy vigour through strengthening them by well-tried methods. The means developed for this purpose in the last thirty years and more has been the open-air school, in which education modified to suit the children's physique takes place in an environment specially designed to be healthy. The class-rooms are built to enable one side to be fully open in all weathers. The premises are intended to be specially hygienic, arid the instruction to encourage a hygienic way of life. Rest takes place in the open air after the midday meal which is taken by all children as a matter of course, and the children are under close medical supervision. In every urban area there should be one of these schools to which delicate children may be sent by day on medical advice for a period of six months to two years, or occasionally more. It is generally felt that less than six months, or two terms, is insufficient to ensure that improvement will be maintained and it is clearly undesirable to break any child's education twice within a short period.

40. There is also a need for boarding schools for delicate children. These, often called schools of recovery, are in practice merely boarding open-air schools. The children are not normally confined to bed as in hospital schools, so the schools take delicate children from areas where there is no day open-air school, and also those children who seem to make little progress at a day open-air school, either because of the seriousness of their condition or because home circumstances undo by night the good the school does by day (see also paragraph 85).

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41. The length of stay in a boarding school is sometimes less than at a day school because of the more intensive treatment residence makes possible, but a large body of opinion favours a stay of not less than six months.

42. Until now the open-air school has been the only method of providing special education for the delicate. In the newer primary and secondary schools the conditions of the buildings, which are designed hygienically on open-air lines, and the general provision of milk and meals may make it beneficial to some delicate children to continue in attendance there. If the School Medical Officer says they should rest after dinner stretcher beds and blankets should be provided and the head teacher should arrange for them to rest in some quiet open-air or well-ventilated place until about ten minutes before the afternoon session begins.


43. Those diabetic children who cannot receive the treatment and care they require while they remain in their own homes yet do not require in-patient treatment in hospital should be accommodated in hostels from which they can attend ordinary primary and secondary schools in the neighbourhood. The hostels should be under medical and nursing supervision to ensure that treatment is carried out and modified diets provided and consumed. They should be associated with the diabetic unit of a hospital. Diabetes is a very serious condition in children, and if their health is to be preserved they must be taught the reason for the restrictions placed upon their diet so that they will co-operate in observing them. Those living in the hostels will attend only a limited number of schools, and it should be practicable to obtain the co-operation of the head and assistant teachers in regulating the consumption of sweets, etc., in school hours. The teachers should report to the hostel at once, preferably by telephone, any serious symptoms which may require immediate medical aid.

44. Experience in providing for diabetic children is almost entirely confined to the war period. No estimates of numbers are available, but it is at present expected that a very few of these hostels will be sufficient for the needs of the whole country. It is hoped that a few of the largest authorities, and possibly some voluntary bodies, will establish enough to supply the needs of England and Wales.


45. The definition of educationally sub-normal pupils, quoted in paragraph 11, indicates that all these children are educationally retarded. Educational retardation may be caused by "limited ability" or by "other conditions'', or, it may be, by both operating simultaneously.

46. Our present psychological knowledge leads us to believe that general ability and possibly some special abilities, such as verbal or practical ability, which may be utilised as a basis of a sound education, may have an innate basis, and that some at least of the factors which go to the production of a stable or unstable temperament are present from

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birth. Whether this is so or not, it is a matter of general agreement that "intelligence" cannot be substantially improved by any methods known to us at present, and that aptitudes verbal or practical are not readily alterable except, perhaps, by skilled teaching continued over a long period. Retardation due to limited ability, therefore, is not likely to be quickly or easily overcome even by the best forms of. special educational treatment, and where the limitation is in general intelligence, the retardation is unfortunately likely to be permanent. That is not to say that children with limited intelligence - generally called dull children - cannot be educated to play a useful part in the community, or effectively trained to develop special skills. The experience of the best special schools and of progressive modern schools in the past clearly shows that, in attempts to solve the special problem of these children's education, standards of school work and character far in advance of those normally reached under ordinary school conditions have often been attained. It is to be expected that by receiving special educational treatment either in special schools or in ordinary schools, results of this nature will be achieved by far more children in the future than in the past.

47. Among the more common causes of educational retardation other than limited ability are the following:

late entry to school and subsequent irregular attendance caused by truancy or ill-health, by over-indulgence or irresponsibility on the part of the parents, or, especially with older girls, by undue pressure of home duties;

frequent changes of school due to changes of address;

disharmony between school and home;

the keeping of late hours by children;

psychological maladjustment which may absorb so much of a child's mental energy that he becomes unsuccessful in school.

Not least among such causes are faults within the educational system itself. These last undoubtedly include unsatisfactory school conditions such as large classes and bad buildings which make it difficult to give teaching suitable for each individual child. Lack of such teaching is one of the prime causes of backwardness. It may be that the child has become bored or restless because the curriculum provides too little stimulus for his interest or outlet for his energy; or the methods employed may be too abstract and the steps in difficulty too few and too steep. The lack of interest so commonly shown by the retarded child is clear evidence that the teaching is unsuitable for him. The relative proportion of backward children of course varies in different parts of the country.

Improved attendance, better health, better social conditions or psychological treatment may actually remove the cause of backwardness for those of the educationally sub-normal children who, though retarded, are not innately dull. Special educational treatment should then enable them to make better use of their powers.

48. These two groups of the retarded (i.e. those who are dull through

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their very limited ability and those whose backwardness is due to other causes) have been distinguished by the above descriptions because upon a clear understanding of the cause of the retardation the ultimate success of educating a child depends, but it is not to be thought that in providing for the educationally sub-normal a local education authority should make two separate sets of arrangements. That is unnecessary, and in many cases would be unwise, since some of the children are retarded both by limited ability and other conditions, and, while the retardation of others may be due to only one cause, it may not be at all apparent at the outset which cause it is. In the past, many children who could not derive proper benefit from the education provided in ordinary schools were not given the instruction they needed in a special school because it was not clear to what their inability was due, and till that was settled they could not be admitted to a special school; in fact they might not be qualified for admission. One of the advantages of the new Act is that no decision on the cause of retardation need be made before the child is given special educational treatment; it may be made during the process. Obscurity of the cause of a child's retardation may hamper his teacher's efforts, but the efforts themselves may cast light on the cause.

49. No child should be classed as educationally sub-normal unless he is retarded in school work, but some agreement should be arrived aeon the degree of retardation that would justify special educational treatment. Here the regulations are not at all specific, but it is suggested that a large body of opinion would be found to favour giving special educational treatment if the child is so retarded that his standard of work is below that achieved by average children 20 per cent younger than he is. For example, a ten-year-old whose school work is below the level reached by an average eight-year-old would be retarded by at least 20 per cent. It is unlikely that special educational treatment will be required on account of educational subnormality for children under the age of seven unless they are so gravely limited in their ability that they are unable to profit by the simplest of infants' school teaching and require the attention that can best be given in a special school.

50. All degrees of retardation may be found among educable children, from the minimum indicated above to a maximum which may be as much as 50 per cent, where the child can do school work only as difficult as that done by average children half his age. In the case of a child who cannot do this after he has had the appropriate special educational treatment, the question arises whether he is educable at school at all. Upon the answer to this question the success of the arrangements for special educational treatment to some extent depends. If ineducable children are retained either in special schools or ordinary schools not only is it impossible to teach them, but they also take up an undue share of their teachers' time and energy. Moreover, children with so low a degree of ability often have undesirable social and personal characteristics, and even appearance. It is not fair either to the other children or to their parents to make them associate with ineducable children. Section 57 of the Act details the procedure to be followed by

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an authority when they think that any child cannot be educated at school. It is worth pointing out that he may be deemed to be incapable of receiving education at school not only if he is himself ineducable, but also if, in his own interests and the interests of the other children, it is inexpedient that he should be associated with them in any type of school.

51. Past experience suggests that children cannot be educated at school when their intelligence quotient is below about 55. A slightly lower figure may be used in the case of younger children (50 to 55) and a slightly higher (55 to 60) for those approaching the end of their school life, when a standstill often occurs and further growth in ability and progress in school work seem to cease. There is no doubt that in the past too low a standard has been adopted in many places, and children have been retained in school long after it was obvious that they were receiving no benefit to themselves and were hampering the progress of others. It is hardly necessary to enlarge on the circumstances which would make it inexpedient for a child to be associated with other children in school. If a child behaves in so disorderly a way or has such objectionable habits that his presence upsets the smooth working of the class or school, and if it is impossible to correct his behaviour or habits by the usual methods of school discipline or by medical or psychological treatment, it is clearly advisable to prevent his continued attendance. A variety of other circumstances may occur in these rare and troublesome cases.

52. In the past, numbers of children who have been recognised by their teachers and even by School Medical Officers to be ineducable or detrimental to others, have, on sentimental grounds, been allowed to attend school. In future this practice should cease. One detrimental, or low-grade child can create havoc in a class, distract the children, occupy the full attention of the teacher, and bring the school into disrepute among parents and the public. It is too great a price to pay for kindhearted acquiescence in his continued attendance. He should be reported to the local mental deficiency authority who have the statutory duty of dealing with him under the Mental Deficiency Acts. By refraining from reporting such children, the local education authority will be depriving the mental deficiency authority of information upon which they can make suitable arrangements for carrying out their duties.

53. The category of educationally sub-normal children may thus be regarded as consisting of those children who are retarded by more than 20 per cent of their age and who are neither so low-grade as to be ineducable nor detrimental to others. Suggestions may now be made on the arrangements for their education.

54. It will be convenient to divide the suggestions into those applicable to populous urban centres on the one hand, and smaller urban and rural areas on the other, and to consider the needs of children of various ages.

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55. In these areas there will be a need for three types of provision for the educationally sub-normal. (The number will probably be in the region of 10 per cent, see paragraph 25.)

Boarding special schools.
Day special schools.
Arrangements in ordinary schools.
56. Boarding special schools. In all types of area there will be a small number of educationally sub-normal children who require for their own good to be taken away from home and educated in a boarding special school. These comprise educationally sub-normal children (a) committed to the care of the authority by the Courts, (b) in the care of the authorities Public Assistance or Social Welfare Committee who, if they were not seriously sub-normal, might live in cottage homes or be boarded out, and attend normal schools or day special schools if these were available, (c) from unsuitable homes, (d) who are truants and others unmanageable in a day special school, and (e) who, in exceptional circumstances, are most seriously retarded owing to limited ability. Where there are day special schools the decision to send children into residence will seldom, if ever, be reached purely on grounds of the degree of retardation; it will be because residence is advisable in the view of the authority and of the parents (or even against the wish of the parents, with the Minister's consent) in the children's own interests.

57. It is suggested that even where day special schools are provided an authority may expect to find about 2.0 per 1,000 registered pupils in need of boarding special schools for the educationally sub-normal. Since ninety to a hundred pupils of both sexes and all ages are needed to form the minimum school unit of five classes of twenty each,* which will allow for proper classification, only the largest authorities can provide a school for the exclusive use of their own children. Consequently co-operation between neighbouring authorities for the provision of a school will often be necessary. Such schools have been successfully conducted both as mixed and as single sex departments. The great majority of the children will be found to be over ten years of age.

58. Day special schools. The day special school is one way of providing special educational treatment for those children who suffer from the more serious degrees of educational subnormality but yet do not require education in a boarding school. It has the following advantages over any other provision for them: the ordinary school is relieved of the presence of its most difficult children; the children are relieved of the need to associate with others so much brighter than themselves that they always experience a sense of failure; classification for teaching purposes by age, sex and degree of disability is easier when more children are collected together than within one or two class groups in an ordinary school, and the attention of the teachers, being concentrated upon the needs of the educationally sub-normal, is more likely

*About sixty pupils in three classes would be a minimum for a junior or senior school.

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to produce appropriate methods and curricula. Nevertheless, removing the child from the school attended by children of his neighbourhood, to some extent marks him out as different in the public estimation, and it is not suggested that all, or even the majority, of the educationally sub-normal should be sent to special schools.

59. It can be gathered from the report of the Wood Committee* that it was thought that about 1.2 per cent of registered pupils in an urban area would need special school provision. Subtracting those who need boarding education, we are left with about 1 per cent for day special schools. The wider definition of educational subnormality of the new Act and the new arrangements for giving special educational treatment in an ordinary school will affect conclusions drawn from the Wood Report, but it seems safe at present to say that large urban authorities should provide in day special schools for little less than 1 per cent of their children. This corresponds closely with the amount of provision made during the decade before the war by some such authorities. If the provision of special educational treatment in ordinary schools should in the future prove so successful that less special school provision is required so much the better, but no authority should suppose that these new arrangements will dispense altogether with the need to provide day special schools.

60. The children for whom the day special school is the most suitable are to be found among those whose limited ability corresponds with an intelligence quotient of about 55 to 70 or 75. Those with lower intelligence (55 to 60 or 65 intelligence quotient) might all attend, bur among those in the group with the higher intelligence, more and more other factors have to be taken into account before a decision is made to send a child to a special schooL Thus one with an intelligence quotient of 65 to 70 might well succeed in a class providing special educational treatment in an ordinary school, if he were a steady, stable child who received full support in his efforts from his parents and sympathy from his classmates, and had not a long and depressing experience of failure behind him. A child of similar intelligence who attended irregularly from a home which discouraged his efforts and who was flighty or nervous might be better with the support of the special school.

61. In general only those educationally sub-normal children whose retardation is felt to be mainly due to low intelligence should be sent to special schools. There may be a small proportion of children with intelligence quotients over 70 who should be sent there if the local education authority thinks there are strong indications that this is the right course, but a child with an intelligence quotient over 75 should rarely find his way there as his recuperative powers are so much greater than those of the majority of the pupils in special schools that he would usually be out of place, and would be better in a class in an ordinary school in which special educational treatment is provided.

It must not be assumed that because a child is once admitted to a special school he should remain there for the rest of his school life.

*Report of the Mental Deficiency Committee, 1929, H.M.S.O.

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62. Special schools may be for children of all ages, or be separate primary or secondary mixed departments, or have a primary mixed and a secondary one-sex department, or be otherwise organised. If the school is for children of all ages and both sexes, there should be at least enough children to form five classes of twenty each. Where the age range is restricted to junior or senior pupils, the minimum should be three classes. Special schools up to about one hundred and fifty pupils may be formed with advantage where there are enough children. The very small special school of two or three classes of children of all ages does not provide such clear advantages over conditions in ordinary schools as to outweigh the disadvantages of removing children from the ordinary schools.

63. Special educational treatment in ordinary schools. When these more serious cases of educational retardation are removed to special schools there will remain the less seriously retarded children who may amount in some schools to 8 or 9 per cent of registered pupils over the age of seven.* Some of these children will be juniors and some seniors. Arrangements should be made for them to have special educational treatment in ordinary schools, normally primary and secondary modern schools. How this can best be done must be found by experiment, for though the problem of the dull and backward child is no new one, and was the subject of a pamphlet issued by the Board of Education in 1937†, there is as yet no unanimity of view on how schools can make the best arrangements for their retarded children. In the past arrangements for dealing with dull and backward children have been made on the assumption that there were few of these, and that something makeshift might serve their purpose. It is now realised that they are many, probably as many as are suitable for grammar school education, and something at once more permanent and more carefully considered is needed. In a good school drawing from a suburban area the proportion of the children may be small; in a school where the average intelligence is low or where there may still remain a lack of facilities for a treatment of the curriculum on modern lines it will be large; in an average primary school it may be 8 or 9 per cent of the children, and in an average secondary modern school, owing to the process of selection for other forms of secondary education, it will be higher.

64. In a large primary junior school with an entry of one or two or even more forms it is important that any arrangements for giving special educational treatment should not cut across the normal system of classification of the school, whatever that may be, and should not impair the organisation found best for the other children.

65. Any groups in which special educational treatment is given should

*It has already been indicated that special educational treatment is not normally required for infants unless they are so seriously retarded that they should attend a special school.

†"The Backward Child", Educational Pamphlet No. 112, H.M.S.O., 1937.

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be small. Their merits depend on a degree of individual attention that is precluded with large numbers. In almost all schools of moderate size there should be arrangements for at least a group of children to have special educational treatment, but where the primary schools are very small there may be a case for having an arrangement to serve a group of schools. To make this an acceptable arrangement the class should be housed in a pleasant building and taught in a well-equipped and attractive room and it is most important to select a teacher who believes in the value of this kind of work.

66. An authority may decide that in the circumstances of a particular school special educational treatment for educationally sub-normal children could not be provided there. In such a case the school would not be suitable for the ability and aptitude of a child needing special educational treatment and he would need to go to another ordinary school, or in default to a special school, since special educational treatment must be provided for him somewhere.

67. A group of children requiring some special educational treatment must not be so organised as to lead a separate existence but should always be regarded as an integral part of the school. These children may need special help in certain parts of their work, but it is important that they should not be deprived of general activities with other children which are suitable for their age. This kind of organisation presents opportunity for experiment and careful planning which schools will try out for themselves, but clearly the defects to avoid are on the one hand, the isolation of a special class, and on the other, too wide a spread of age among children selected for special help.

68. The staff of a modern school has for some years been accustomed to the problem of educating pupils of eleven plus who are severely handicapped by not being able to read fluently or to take an easy share in the work of the other children of their own age. These children, in some areas as much as or more than 10 per cent of the school intake, are either considerably retarded for a variety of reasons or are innately dull. The problem of finding a way of educating them is one which the modern school must face, and the staff will be justified in trying out enterprising methods and organisation. It is of outstanding importance that such pupils should not be entirely segregated from their fellows and from the corporate life of the school, and that whatever course of work they follow it should have a real meaning and purpose for them. There are obvious advantages in a boy or girl being a member of his own age group for a considerable part of his time, and at any rate for a consecutive period before he leaves school. There is room here for much thought and experiment.


69. In these areas the establishment of a day special school will in general be impracticable owing to the difficulty of collecting in one place ninety to a hundred children to form a day special school of

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minimum size. The provision of special educational treatment will therefore have to be made either in boarding special schools or in ordinary primary or secondary schools.

70. Boarding special schools. These schools in areas where there is no day special school will have to provide not only for the types of children mentioned in paragraph 56 dealing with boarding special schools for large urban areas, namely Court cases, public assistance children, those from unsuitable homes and those unmanageable in day special schools, but also for some of those who would have attended a day special school had one been available. They will therefore have to provide for such of the children with severely limited intelligence (intelligence quotient from about 55 to 65) and such of those above this level with additional causes for their retardation as cannot be satisfactorily educated by the arrangements for special educational treatment made for them in ordinary schools.

71. It is very difficult to estimate the numbers who should be provided for in the area of any local education authority which does not make day special school provision. The Wood Committee estimated the incidence of severe retardation to be much higher in the rural than in the urban areas and on that ground one would suppose that if 1 per cent of urban children should be in day special schools over and above the 2 per 1,000 in boarding schools, the rural provision, necessarily all in boarding schools, should be more extensive than 1 per cent. Nevertheless the known difficulty of persuading parents to send their children away from home unless they are very troublesome, or their disability is very clearly recognisable (as in the case of the blind) makes provision to that extent out of the question. After balancing all the evidence available, and considering the practice of those authorities who before the war made the most generous provision of boarding special schools, it is recommended that in the smaller urban and rural areas authorities should make boarding provision in special schools for educationally sub-normal children for about 4 per 1,000 registered pupils.

72. Ordinary primary and secondary modern schools. In areas where there is no day special school these must provide for all the educationally sub-normal children who are not boarders. At the present time many of these children, seniors as well as juniors, are in small rural or country town all-age schools, but it is the intention of the Act that re-organisation, into separate primary and secondary schools shall be fully accomplished. When this has taken place most of the educationally sub-normal senior children will be in modern schools of fair size, and the juniors may be in fairly large primary schools in the urban parts of the areas. The problem as it affects schools of this type has already been dealt with. In the rural parts primary children are likely to be in schools taking both infants and junior from five to eleven and with four teachers or fewer.

73. The rural school. In these small primary schools with less than a hundred children and very often with seventy or fewer; special classes

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are out of the question. Setting aside the infants, there may be only forty or fifty juniors only four or five of whom are likely to be educationally sub-normal. In fact it is unlikely that there will be more than one or two in any class, and the class may contain children of two or three age groups who are habitually taught together. No means of collecting the children from several schools so that they may be given special educational treatment as a group is practicable. They must be educated by their own teachers in their own classes. The present position will be eased when any ineducable children are excluded, and the more seriously retarded sent to boarding special schools, and it is to be hoped that these measures will be taken as soon as it is at all practicable. For those who remain it is suggested that special educational treatment should be given by the normal staff with such specialist assistance as may be desirable and that the authority should help by the generous provision of special materials and apparatus and the provision of classes for teachers. The services of educational psychologists would be useful in this connection.


74. Where a child suffering from epilepsy requires special educational treatment on this account, he should be sent to a boarding special school for epileptic children, of which there are six in existence. It is probable that, with better ascertainment and a greater readiness on the part of parents to agree to their children going to a boarding school, it will be found that the present provision is inadequate, and it is expected that extension of some of the existing schools will be necessary and probably the provision of one or two additional schools.

It may be that some of the larger authorities who have had unfortunate experiences in having their children refused admission to existing schools may wish to establish a school of their own of the minimum size of five classes. While accommodation has been short the schools have had to reject children with records of low intelligence as less likely to benefit than others who seemed more intelligent. This has caused many borderline cases to be refused trial which might have shown that they were educable, and has resulted in some heartburning. There may be a case for a school with a trial class for borderline children. It would nevertheless prevent disappointment if authorities would realise that the combination of epilepsy with low intelligence makes very difficult the whole educational process, and that many epileptic children are found to be ineducable if their intelligence quotient is below about 60 or even in some cases higher. Owing to the unreliability of response of epileptics, they should be tested for intelligence not less than twice, or preferably oftener, before application is made for them to go to special schools, and if the intelligence quotient is found to be under 60 the propriety of reporting their names to the mental deficiency authority under Section 57(3) of the Education Act 1944, should be considered.

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75. Maladjusted children require as their form of special educational treatment a greater variety of additions to or modifications of the education given to normal children than it is possible to describe here. The regulations indicate that they should have what an educational psychologist employed by the authority or other suitably qualified person on the staff of a child guidance centre may recommend. Though children requiring child guidance treatment may not show any symptoms of maladjustment in school, they frequently do; and a large number of them can be helped to get rid of their problems through co-operation with the staff of the centre. The child guidance team investigates the causes of the child's problem and decides on a line of treatment which may include treatment at the centre, visits to the child's home, and often educational measures. The experience of the last ten years suggests that these latter may be described under three heads, remedial teaching, often not on the premises of the child's own school, but while he continues to attend it, action taken by the teachers of the child's own school, and removal of the child from his own school to another.

76. If a maladjusted child is backward in his school work, or in one or more aspects of it, he may have acquired such a distaste for school or its methods or teachers, that unless he can reassure himself that he is able to progress, he cannot make a new start. In these cases some periods of individual tuition by the educational psychologist, or a "remedial teacher" working under his direction, may be recommended to set him on his feet and enable him to face with renewed self-confidence the classroom situation in which he has formerly failed. This special tuition, which may be given once or oftener in each week for a period of an hour or so will not, of course, overcome the child's retardation, but it has been found in these cases, that once a start has been made the process of rehabilitation may go on successfully under the child's own teacher.

77. In many cases of maladjustment where the cause lies in the school situation, or where causes outside the school have led to a maladjustment in school, an explanation of the child's difficulties as elucidated by the child guidance staff can greatly assist the teachers to further a cure of the child's problems and overcome the past effects of them on his school work. This explanation is usually best done by the educational psychologist who, in almost all instances, has been a teacher and understands the teacher's point of view. Friendly discussion by the psychologist with the head and class teacher may do much to enlighten an obscure problem and suggest ways in which the school can collaborate in restoring the child to a normal happy state in which he can renew his educational progress. Nothing that the psychologist may say should reduce the head teacher's freedom and responsibility for conducting his school as he thinks fit, but if the normal professional relationship of colleagues equally interested in the child's welfare obtains there is no reason why the co-operation between the two should not be fruitful and harmonious.

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78. The large majority of maladjusted children who find their way to child guidance centres attend their own schools during treatment, and continue to do so afterwards, a potent factor in the success of their treatment being the interest taken in them by teachers who know them. There are, however, a few who should change their school, either for another day school near their home or for a day or boarding school at a distance. The number of children in each group is relatively small, and past experience has been insufficient to be any guide to the percentages involved. At least four ways in which a child may have special educational treatment by change of school have been tried, each with success according to circumstances.

79. Transfer to another ordinary school. Where the cause of a child's maladjustment is so closely connected with his attitude to his own school that it appears impossible to cure him while he attends there, it may be sufficient to transfer him to another ordinary school in the district and give him a fresh start away from associations which are painful to him. Parents are usually willing to agree to the change being made when the reasons are suggested to them, preferably by the child guidance staff.

80. The day special school for maladjusted children. In at least two areas in England, the local education authority has established a day school for children of the type now called maladjusted, together with a few who are backward though of good intelligence and who possibly have some psychological reason for their backwardness. These schools for children of unfulfilled promise have not been called special schools since there was no provision for the establishment of special schools of this type in Part V of the Education Act 1921, but such schools may now be regarded as special schools under the 1944 Act. The children attend full time, upon the advice of the educational psychologist, and not only have remedial teaching of the type mentioned in paragraph 76, but have a full curriculum designed both to carry on their general education and to provide activities suitable to children who need a more personal interest taken in them than can be given in ordinary school conditions. The educational psychologist is closely associated with the teaching staff in planning the children's work. The period of attendance ranges from six months to two years.

81. Boarding out with foster parents. Children who cannot be adjusted while they remain in their own home may have boarding arrangements made for them. Where the cause is in the home circumstances, boarding out with suitable and carefully selected foster parents while they attend an ordinary school near the foster home may itself be the most appropriate form of special educational treatment. The authority must arrange for the inspection of the foster home by an officer appointed for the purpose. Since maladjusted children require special understanding if they are to benefit by foster-home placement, the officer appointed should have experience of such children. It has been found that a psychiatric social worker, preferably the one who is employed in the child guidance centre or clinic where the child was examined, is a most suitable person to use for this purpose.

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82. Boarding homes and boarding schools. Some children, because of their conduct and habits, would not be accepted as foster children, and for these residence in a boarding home or boarding school for maladjusted children may be desirable. This kind of provision is relatively novel in the experience of local education authorities, but the experience of the hostels for difficult evacuees described in the Ministry of Health pamphlet entitled "Hostels for Difficult Children" has made it clear that hostels and schools of this kind can be most useful adjuncts to child guidance treatment. The distinction between a school and a hostel is that in the former education is provided on the premises, while children living in hostels go out to an accessible and suitable primary or secondary school. Hostel provision is easier to make, since many houses are suitable for hostels, but few can easily be adapted for schools. It is desirable so far as possible to maintain contact between these children and their normal contemporaries and this can be ensured by their attendance at ordinary schools. The parents of their schoolmates may invite them to their homes and do something to lessen the segregation which residence in even the best hostel inevitably involves. Nevertheless, the benefits of contact with normal children and ordinary schools should not be overstressed. Apart from the difficulties which may be raised by the presence of a large number of maladjusted children in an ordinary school, which may be quite a small one if the hostel is in the country, some of the more seriously maladjusted probably gain little from the contact with other children, and gain much from having one specially designed atmosphere and discipline spreading over the whole twenty-four hours. There is need, therefore, for boarding schools for maladjusted children in which education is provided on the premises, and in which the head teacher is also warden.

83. All local education authorities, in carrying out their duties with regard to maladjusted children, should therefore (a) have proper child guidance arrangements, or at least, until the staff for the increased number of centres which will be needed is available, employ an educational psychologist, and (b) have arrangements for boarding out with carefully selected foster parents children who should be removed from their homes and are suitable for foster homes. The larger authorities or combinations of smaller ones should also (c) have one or more boarding homes for children who may attend ordinary schools, and (d) have a boarding school for maladjusted children. Some authorities may like to establish day schools of the kind mentioned above in paragraph 80.


84. Physically handicapped children, though grouped under one heading in the regulations, are of many types, and require a variety of educational provision depending largely on their medical condition.

The principal types are:

Children suffering from tuberculosis requiring education while they are in a sanatorium.

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Children likely to spend a long time in a hospital and requiring education during their stay for treatment. Children with defects requiring orthopaedic, cardiac or ophthalmic treatment, or a variety of other medical or surgical conditions, may require a long period in hospital and therefore of absence, from an ordinary school.

Children who do not require hospital treatment and need not occupy a hospital bed may yet not be able to attend a day school. They may be still convalescent from the result of operations or have some intractable condition which keeps them in bed; or they may be unable to attend a day school-while living in their own homes. They require education in a boarding school for cripples, in which some of the children may be in bed and some up.

Other physically handicapped children may be able to live at home and attend a day special school if they get transport daily, and for them some large towns have established day special schools. Where, there are not enough of them to warrant having a day school for them alone they may be sent to boarding schools for cripples, which may in fact be the schools described above, or they may satisfactorily be sent to day open-air schools if their stay is likely to be short.

85. It is unlikely that the number of large urban authorities which can and should provide day schools for physically handicapped children will greatly increase. Only the largest can support such a school, and most of them already have them. There is, however, a great need for more schools, especially in the midlands and north, for the residential care of cripples and of children suffering from heart disease. Children who do not need hospital treatment, or those who are discharged from hospital, may, nevertheless, need boarding schools if they cannot or should not attend day schools. There is at present little of this half-way kind of provision, where the teaching may be by the bedside or in a classroom according to the needs of each child. The large authorities and combinations of the smaller should consider including in their plans the provision of such schools, which in some cases may also be used for the boarding of delicate pupils (see paragraph 40).

86. When a child has been found to require special educational treatment as a physically handicapped child he should be sent to an appropriate special school. Children with minor physical handicaps which do not interfere with their progress in ordinary schools and do nor require medical or surgical treatment should continue to attend ordinary schools and should not be regarded as physically handicapped pupils. Some of them may however be delicate pupils.


87. These children may be divided into two groups, the aphasics and the other children.

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88. Relatively little is known of the best methods of educating aphasic children. The condition is rare and no figures exist to show how many may be expected. There are at present no special schools established for them alone though it is hoped that one will shortly be opened. Good work has been done for them in the past in some schools for the deaf, though whether this is the best place in which to educate them must for some time be an open question. Further research and experiment may cast light on an obscure condition and suggest more satisfactory means of educating aphasic children. Meantime, when it has been concluded that the disability is not merely a defect of articulation, the child should be admitted to a deaf school where all that can be done for him will be done.

89. The other children, the stammerers and those with defects of voice or articulation, should attend their own schools while having treatment by qualified speech therapists employed by the authority.

90. Speech therapists should work as part of the school health service under the School Medical Officer who should be the link between them and the dentists and ear, nose and throat surgeons for defects of articulation, and with the child guidance centre for stammerers and any others who show emotional reaction to their disability. Children should be referred to a therapist by teachers through the School Medical Officer.

91. Treatment should take place at a few clinics or centres in urban areas and well-populated rural ones where transport is available. The therapists' time is wasted in travelling if there are many clinics. Only if it is not possible for children to come to a centre should treatment take place in the child's own school, and this is seldom satisfactory since the therapist cannot spare time to travel to an individual school as often as is desirable. Normally children should be treated twice a week for twenty to thirty minutes at a time. In most places therapists prefer nowadays to take their children individually, rather than in groups. This is always necessary in the case of defects of articulation, but in the later stages of the treatment of stammering some therapists collect up to six children in a group if a sufficient number of those at the same stage can conveniently be gathered. When there is more work than a therapist can manage, it is more important to aim at quality of work for a few than to try to give a little treatment to many.

92. Defects of articulation when not due to deafness (which a therapist ought not to treat) or to low mentality (which no one can treat) are usually amenable to treatment if continued for six to fifteen months and a very large proportion of cures can be expected.

93. Stammering requires longer treatment, since it involves psychological factors both in its causation and its effects and is not a matter of a local speech defect to be treated in isolation. Two years or more is commonly necessary; only in about half the cases can cures be expected, and some of these may not be complete. A further number

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of children will benefit though they cannot be claimed as cured, but about 20 per cent - less or more according to the success of the therapist - usually show complete failure.


94. Children with dual or multiple disabilities often present very great difficulties to those who have to advise on their education, yet many can benefit by education and no pains should be spared in the search for the most appropriate type if the child is really educable, even though it may appear that he is unlikely to become an effective earner after leaving school. There are already a few schools which specialise in the education of children with dual disabilities, among others, one for deaf and partially deaf children with defects of vision, or physical handicaps or educational retardation, and one for blind educationally sub-normal children. Nevertheless there is need for further provision, which may have to be made on a national basis as no authority is likely to have more than one or two children with any particular combination of disabilities. The subject is complex and bristles with difficulty. It is at present being considered by a committee at the Ministry and no more can be said of it within the limits of this pamphlet.

95. Note on the Intelligence Quotient. In this pamphlet reference has been made to the intelligence quotient. It is assumed here that no authority or teacher will place any reliance upon an intelligence quotient unless it has been obtained from a recognised standardised test of intelligence administered by a qualified and experienced person strictly in accordance with the instructions. The use of intelligence quotients derived from group tests of intelligence is, in the case of retarded children, to be deprecated, since in almost all these tests reading ability is a weighty factor in success, and the poor reader's score will be unduly low. The use of such a test for survey purposes may be valuable but since the purpose of a survey is merely to select those children who require further investigation the intelligence quotient on a survey test will be replaced by a more accurate one found later by an individual test.

96. It is also assumed that the probable errors of measurement of intelligence quotients will be remembered. No single intelligence quotient can be taken as accurate within less than five points. Before any action is taken with respect to a child on grounds of limited intelligence not less than two and preferably three tests should be made at intervals of time to allow for temporary indisposition. The highest of several measurements made by a qualified examiner is likely to be the most nearly accurate.

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97. Debate on the relative difficulty of teaching children of different ages or capacities is profitless, and no discussion will be found here of the difficulties of giving special educational treatment. This may be more or less arduous or rewarding than other fields of education. Experience of special schools and classes offers evidence that the teaching of handicapped children presents no difficulties which are not within the powers of reasonably accomplished teachers. None of the arrangements described in the foregoing paragraphs depends on the availability of quite exceptional teachers. Nevertheless, just as the qualities and training that go to make a good infant teacher differ from those likely to produce a good sixth form master so there are certain qualities of personality and outlook which make success with handicapped children more likely, and some forms of training which are particularly appropriate.

98. Patience and understanding, and a generous sympathy with children, are particularly valuable in dealing with handicapped children. Only those who have a very real interest in the individuality of their pupils are likely to be successful or to feel happy in work with the handicapped. Except perhaps in the higher forms of schools for the blind, the pupils' attainment of high academic standards must not be expected since nearly all the handicapped are to some extent backward. Nevertheless understanding and sympathy, though necessary, are not enough. Devotion to the job is not enough. Teachers who take up work with the handicapped to indulge their feelings of motherliness and pity for the afflicted may be a menace, since they may encourage self pity in their pupils. Despite all that can be done for the handicapped, their way in life is likely to be hard, and they must be encouraged to be self-reliant, optimistic in outlook, hard-working, and so far as possible skilled. So their teachers must bring to them freshness and vigour and emotional normality as a pattern or example, and a skill in instruction that will make the most of their children's mental or physical abilities.

99. The techniques of teaching the blind and the deaf are so specialised that for many years teachers in these types of school have had to undergo special training before entering upon or during service and to pass examinations approved by the Ministry. There is no such requirement for teaching other types of the handicapped, either in special or in ordinary schools. Beyond the ordinary preparation of the teacher in college or university no special schemes of training are available except short courses, and these, even before the war, were totally inadequate to meet the needs or even the expressed desires of teachers or authorities.

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100. An important part of the work of the training college course deals with the individual differences among children and their bearing upon the aims and techniques of teaching. The handicapped are merely those who differ so markedly for one reason or other from the average that they require special provision to be made for them, and reference to their characteristics and needs should therefore form a part of a course which deals with individual differences. It is not to be expected that students in their general preparation for teaching should learn the methods of teaching appropriate to special schools, in which few, except possibly teachers of the deaf, should take part directly on leaving college. Nevertheless, since special educational treatment may now be given in any school the student should at least be able to detect the presence of a handicapped child in his class and know what lines his education should follow if he is not removed to a special school. If the training colleges tackle this restricted field thoroughly it will be of greater value to the handicapped child than if they attempt to cover a wider field superficially. Nevertheless, any student who shows a particular interest in the handicapped should be encouraged to devote some of his time - possibly in the way of an essay or individual study - to this topic.

101. Among teachers who have left college and found their feet in the schools some will inevitably be drawn to interest themselves especially in individual differences among children and be led to the study of particular pupils, among them the handicapped. From these teachers should be recruited staffs for special schools and classes. Intrinsic attractions in this kind of work are the small classes prescribed for handicapped children, the absence of external pressure whether of examinations or of comparisons between classes, the opportunities for coming to know children thoroughly, the gratitude of children and parents expressed in no uncertain way to anyone who will trouble to understand their problems, and the satisfaction which comes from participation in a social service which can be rendered only by a teacher. Most teachers of the handicapped find their work abundantly repaid by these personal satisfactions. Success in dealing with a difficult class could well be reckoned as an additional qualification for the post of Head Teacher.

102. In order to be a successful teacher of the handicapped, however, it is important not only to receive satisfaction but to give it. The right attitude is necessary, but so is the right skill. Where the abilities of children have been limited by mental or physical handicaps it is necessary to use the best methods if good results are to be achieved, and stress should be laid on the importance of the technique of teaching if time - often so short - and energy - often less than normal - are not to be wasted.

103. Courses for teachers on handicapped children may be divided into three types, those which may be run by local education authorities for their own teachers on special educational treatment in ordinary schools, those which they may run for teachers in a particular field of special

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educational treatment, and courses which can only be run for the country as a whole because the number of teachers concerned is so small.

104. The first of these types of course may cover all the problems in the recognition and teaching of handicapped pupils who remain in ordinary schools, and is likely to be of value to a very large number of teachers in any area; the second is applicable only to areas where there are numbers of teachers directly concerned with teaching handicapped children in one or more categories, e.g. physically handicapped or educationally sub-normal; and the third applies to more specialised courses for teachers who are rather isolated in their areas because there are so few teachers working in their field in any one place, e,g. teachers of the blind or partially sighted, deaf or partially deaf. There need be no clear line of distinction between the first and second type of course, and care should be taken to see that teachers giving special educational treatment, especially those in special schools, have every opportunity of joining in any courses on subject matter or other topics which may be held by local education authorities.

105. A large increase in the number of courses on special educational treatment and allied topics, an increase at present limited by the small number of people suitable for staffing them, is required if these new provisions of the Act are to be implemented. These courses not only benefit those who attend, but serve as an earnest of the interest of the authority in handicapped children and stimulate the schools to interest themselves in their education and welfare.

106. Besides teachers other people are engaged in giving special educational treatment to handicapped pupils. The staffs of child guidance centres and clinics, speech therapists, the non-teaching staffs of hospitals, boarding schools and hostels, parents and foster parents all have a part to play. Detailed consideration of the qualifications and preparation these people ought to have would be out of place in this pamphlet, but their importance should not be overlooked.


107. It is sometimes asked whether the provision of special education, special schools or classes or extra teaching power for handicapped children is worth the trouble and expense involved. Are these children not the least profitable to the community? Would it not be best to concentrate on the normal and the bright and only when their needs are fully met to worry about the handicapped?

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108. It is a tribute to the increasingly humane social consciousness of the community and to the work of the special schools in the past that these questions are now less often asked, but when they are asked answers can be given. From the Christian standpoint we believe in the worth of every human soul, from the democratic in the opportunity of education for everyone, from the national in the value of every child as a potential member of the community. Every child who is not quite ineducable should, if we are to live up to our beliefs, have religious and moral education, and be brought up to be as good a member of the community as he can become. For all these reasons we should do what we can for handicapped children. A few of them will not be self-supporting when they grow up but their education will make them better members of their family circle, better neighbours, less troublesome patients should they have to live in hospitals or institutions and possibly enable them to contribute something in cash and, more important, in happiness to their household. The vast majority of the handicapped however can with appropriate education become self-supporting. The uneducated and untrained, blind or deaf person is practically unemployable; the educated one can support himself and a family. The uneducated mentally retarded child grows up into an unemployable or unstable casual worker; the educated one into a more dependable and useful citizen. The uneducated cripple is a burden to his family; the educated one may become a useful worker. This applies to every category of the handicapped. It is a matter of common prudence as well as humanity to do everything possible to equip these children to take their place as self-reliant and responsible members of the community.

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