"The teachers tested the visual acuteness of 52,493 children, and found 18,565, or 35 per cent., to be below what is regarded as the normal standard.
"I examined the 18,565 defectives by retinoscopy, and found that 11,209, or 21 per cent. of the whole, had ocular defects.
"The percentage with ocular defects was fairly constant in all the schools, but the percentage with defective vision was very variable--_i.e._, many children with normal eyes were found to see badly.
"The proportion of these cases was highest in the poor and closely-built districts and in old schools, and was lowest in the better class schools and in those near the outskirts of the city.
"The proportion of such cases in the country schools of Chryston and Cumbernauld was much lower than in any of the city schools; and in Industrial Schools, where the children are fed at school, the proportion was lower than among Board School children of a corresponding social class.
"Defective vision, apart from ocular defect, seems to be due, partly to want of training of the eyes for distant objects, and partly to exhaustion of the eyes, which is easily induced when work is carried on in bad light, or the nutrition of the children defective from bad feeding and unhealthy surroundings.
"Regarding training of the eyes for distant objects, much might be done in the infant department by the total abolition of sewing, which is definitely hurtful to such young eyes, and the substitution of competitive games involving the recognition of small objects at a distance of 20 feet or more.
"Teachers can determine the visual acuteness, but they cannot decide whether or not an ocular defect is present.
"Visual acuteness, especially among poor children, is variable at different times.
"Teachers should have access to sight-testing materials at all times, and should have the opportunity of referring suspected cases for medical opinion.
"An annual testing by the teachers, followed by medical inspection of the children found defective, would soon cause all existing defects to be corrected, and would lead to the detection of those which develop during school life."
An examination of 502 children attending the Church of Scotland Training College School, Glasgow, as regards defects in eyesight and hearing, was made by Drs. Rowan and Fullerton respectively, with the following results:--
"As regards eyesight--
"61.55 per cent. were passed as normal, while of those defective 7.57 were aware of the fact; some few of these had already received treatment, but 30.88 were quite unaware that there was anything wrong, these unfortunates being expected to do the same work as, and hold their own with, their more fortunate classmates.
"As regards hearing-- 54.4 per cent. were found normal.
27.6 " " were defective.
18. " " were distinctly defective."
I append the very valuable suggestions and conclusions of Dr.
Rowan, who conducted the examination on the eyesight of children:--
"After examining 502 children, which involved the examination of 1004 eyes, one is forced to certain conclusions. These children are taken at random, and in this way they may be considered as a fair sample of their age and class.
"I think one of the first things that force themselves on our notice is the difficulties under which many of those children labour, and of which they, their parents and teachers are quite unaware. The children are considered dull, careless, or lazy, as the case may be: they themselves, poor unfortunates, do not know how to complain, and seem just to struggle along as best they can, though this struggle, without adequate result, must discourage them, and in this indirect way, too, make their future prospects more hopeless.
"Some would be considerably benefited by treatment and operation, or both, while for some little can be done. Some of those who could be benefited are deprived of help by their parents' ignorance or prejudice.
"In the case of those for whom little or nothing can be done, and whose sight is very defective, it seems to me the question ought to be raised as to whether their present mode of education should not be replaced by some other, which would endeavour to develop their abilities in other ways than through their eyesight; in short, they should have special training with the view of fitting them for some form of employment for which they are more fitted than the ordinary occupations of everyday life. This raises a difficult question, and each case would have to be settled on its merits. The difficulty must be faced; otherwise the children will simply drift and become idle and useless, while, if educated, at any rate partly, on the system for the blind, they would become useful members of society.
"I think no one, after studying the result of this examination of what may be by some considered a small number of children, can doubt that a thorough medical examination of all school children should be made when they enter school, and this examination repeated at regular intervals.
"I hold this applies not only to the children of the poor, but to children in all ranks of life, as one constantly, and that, too, in private practice, meets with cases where children are considered dull and lazy, while the real fault lies with the parents, who have not taken the trouble to ascertain the physical fitness or unfitness of their children.
"I am glad to say it is now becoming more common for children to be taken to the family doctor, to a specialist, or to both, to be thoroughly overhauled before starting school-life; and in many cases with most satisfactory results, as their training can be modified or treatment ordered which prevents the development of those pathological conditions which, in many cases, would limit the choice of occupation, or, if these are already present, they can at least be modified or even overcome.
"I wish to emphasise the fact that those thorough medical examinations should be repeated in the case of all children at regular intervals, as in this way alone can a proper physical standard be maintained, and deviations from the normal detected promptly and in many cases cured before the sufferer is aware of their presence.
"How often in examining our adult patients do we find them much surprised when they are told and convinced by actual proof that all their life they have depended on one eye only! This fact, of course, they sometimes accidentally discover for themselves, and come with the statement that the eye has suddenly gone blind. In the majority of these cases the weaker eye is useless, and the possibility of making it of any use is, at their age, practically _nil_."
FOOTNOTES:
[16] Cf. _Special Report on Educational Subjects_, vol. ii.
[17] Cf. _Report on Elementary Schools of Berlin and Charlottenburg_, by G. Andrew, Esq.
[18] Cf. Appendix, pp. 62-65.
[19] _Report Royal Commission on Physical Training_ (_Scotland_), vol.
i. (Neill & Co,. Edinburgh).
CHAPTER VII
THE RELATION OF THE STATE TO EDUCATION--THE FEEDING OF SCHOOL CHILDREN
A much more important and far-reaching question than that of the State provision for the medical examination and inspection of children attending Public Elementary Schools is the question of whether, and to what extent, the State should undertake the provision of school meals for underfed children.
Of the existence of the evil of under and improper feeding of children, especially in many of our large towns, there is no doubt. The numerous voluntary agencies which have been brought into existence to cope with the former are sufficient evidence that the evil exists and that it is of a widespread nature. Again, the high rate of infant mortality amongst the children of the lower classes is largely due to ignorance on the part of parents of the nature and proper preparation of food suitable for children. Further, the social conditions under which many of the poor live in our large towns is a contributing cause of this improper feeding. In many cases there is no adequate provision in the home for the cooking and preparation of food, and in others the absence of the mother at work during the day necessitates the children "fending" for themselves in the providing of their meals. However, in considering this question we must carefully distinguish between three distinct causes operating to produce the condition of underfeeding, and as a consequence resulting in three distinct classes of underfed children. As the causes or groups of causes are different in nature, so the remedies also vary in character. Moreover, in many cases we find all three causes operating, now one and now the other, to produce the chronic underfeeding of the child.
In the first place, the underfeeding of the child may arise through the temporary poverty of the parent due to his temporary illness or temporary unemployment. In normal circumstances, in these cases relief is best afforded by means of the voluntary agencies of society. In abnormal circumstances, such as are caused by a widespread depression of industry, the evil may be met by a special effort on the part of the voluntary agencies or by municipalities or other bodies providing temporary relief-work.
In the second place, the underfeeding of the child may be due to the chronic and permanent poverty of the parent. The wages of the breadwinner even when in full work may be insufficient to afford adequate support for a numerous family. This condition of things is not peculiar to Great Britain, but is a common characteristic in the life of the poor of all civilised nations. This is where the real sting of the problem of underfeeding lies, and the causes at work tending to produce this condition of things are too deep-seated and too widely spread to be removed by any one remedy. Moreover, in endeavouring to cure this disease of the Commonwealth we are ever in danger of perpetuating and intensifying the causes at work tending to produce the evil.
In the third place, the underfeeding of the child may arise through the indifference, the selfishness, or the vice of the parents. In such cases the parents could feed their children, but do not. Manifestly in cases of this character there is no obligation placed upon the State and no rightful claim upon any charitable agency to provide food for the children. To give aid simply weakens further the parental sense of responsibility, and leaves a wider margin to be spent on vicious pleasures. But while there is no obligation placed upon the State to provide the necessaries of life for the child, there is need and justification in such cases for the intervention of the State. There is need, for otherwise the child suffers through the criminal neglect of the parents, and the community must interfere for the sake of the future social efficiency of the individual and of the nation. There is justification, for here as in the case of the parents of the morally defective, parental responsibility has either ceased to act or become too weak a motive force to be effective in securing the welfare of the child. As the individual parent neglects his duty, so and to the corresponding degree to which this neglect extends, must the duty be enforced by the State. But in the enforcing of this or of any duty we must be quite sure that the neglect is really due to the weakened sense of responsibility of the parent, that it is a condition of things which he could remove if he had the moral will to do so, and that the neglect is not due to causes beyond the power of the parent to remove.
Cases in which there is culpable neglect of the child due not to poverty, but to the fact that the money which should go to the proper nutrition of the child is squandered in drink, or on other enervating pleasures, are therefore cases in which recourse must be had to measures which enforce upon the parent the obligation to feed and clothe his children. The really difficult question is as to the best means of enforcing this obligation. Manifestly to punish by fine or imprisonment does little in many cases to alleviate the sufferings of the children.
The punishment falls upon them as well as upon the parent, and where the latter is dead to, or careless of, the public opinion of his fellows, it fails to initiate that reform of conduct which ought to be the aim of all punishment. If indeed by imposition of fine, or by imprisonment, the individual realises his neglect of duty, repents, and as a consequence reforms, then good and well, but as a rule the neglect of the child is in such cases a moral disease of long standing and not easily cured, and so we find often that neither punishment by fine nor imprisonment, even when repeated several times, is effective in making the parent realise his responsibility and reform his conduct. All the while the child goes on suffering. He is no better fed during the period of fine or imprisonment, and the wrath of the parent is often visited upon his unoffending head.
The second method of cure proposed is to feed the children at the public expense and to recover the cost by process of law. But the practical difficulties in carrying out this plan are similar in kind to those formerly experienced in the recovery of unpaid school fees. The cost of recovering is often greater than the expense involved, and as a consequence local authorities are not inclined to prosecute. Further, there is the difficulty of discriminating between underfeeding due to wilful and culpable neglect and underfeeding due to the actual chronic poverty of the parent. If this plan is to be effective, some simpler method of recovery of cost than that which now prevails must be adopted.
_E.g._, it might be enacted that the sum decreed for should be deducted from the weekly wages of the parent by his employer. Here again many difficulties would present themselves in the carrying out of this plan.
In the case of certain employments this could not be done. In other cases, employers would be unwilling to undertake the invidious task.
Moreover, the cost of collection might equal or be greater than the cost incurred. Above all, such a method would do little to alleviate the sufferings and better the nutrition of the child. In most cases the school provides but one meal a day. Experience has shown that in the case of children of the dissolute the free meal at the school means less food at home. Were the cost deducted from the weekly wages of the parent, the result would be intensified. So great have been the difficulties felt in this matter that with one or two exceptions no foreign country has made the attempt to recover the cost of feeding from the parent. Yet the disease requires a remedy. The evil is too dangerous to the future social welfare of the community to be allowed to go on unchecked and unremedied. Moreover, to endeavour to educate the persistently underfed children of our slums is to do them a twofold injury. By the exercises of the school we use up, in many cases, with little result, the small store of energy lodged in the brain and nervous system of the child, and leave nothing either for the repair of the nervous system or for the growth of his body generally. We prematurely exhaust his nervous system, and by so doing we hinder his bodily growth and development. To make matters worse, we often insist that the child in order to aid his physical development must undergo an exhausting system of physical exercises when what is most wanted for this purpose is good and nourishing food and a sufficiency of sleep. At the same time that we are neglecting the nutrition of his body we are spending an increasing yearly sum on the so-called education of his mind. What, then, is the remedy? If fining and imprisonment of the parent only accentuate the sufferings of the child, if they fail to make the parent realise his responsibility and reform his conduct, if the provision of a free meal at school means less food at home, then there is only one thorough-going remedy for the evil, and that is to take the child away from the parent, to educate and feed him at the public expense, and to recover the cost as far as possible from the parent. In Norway this drastic method has been adopted. Under a law passed on the 6th January 1896, the authorities are empowered "to place neglected children in suitable homes or families at the cost of the municipality, the parent, however, being liable, if called upon, to defray the cost."[20]
The reasons for taking this extreme step are obvious. By no method of punishing the persistently dissolute and neglectful parent can you be assured of securing the proper nutrition and welfare of the child.
Parental affection in these cases is dead, and parental responsibility for the present and future welfare of the child has ceased to act as a motive force. As a consequence, the child grows up to be, at best, socially inefficient, and liable in later life to be a burden upon the community. In many cases, the evil and sordid influences of his home and social environment soon check any springs of good in his nature, and more than likely he becomes in later life not merely a socially inefficient member of the community but an active socially destructive agent. Hence, on the ground of the future protective benefit to society, on the ground of securing the future social efficiency of the individual, on the ground that it is only by some such system we can ever hope to raise the moral efficiency of the rising generation of the slums, the method above advocated is worthy of consideration.
Against the adoption of such a method of treatment of the dissolute parent many objections may be urged, and it would be foolish to minimise the dangers which might follow its systematic and thorough carrying into practice. But the possible injury to the community through the weakening of the sense of parental responsibility seems to me small in comparison with the future good likely to result from the increased physical, economic, and ethical efficiency of the next generation which might reasonably be expected to follow from the rigorous carrying out of such a plan for a time. The fear lest a larger and larger number of parents might endeavour to rid themselves of the direct care of their children, if this plan were adopted, need not deter us. If this plan were carried into practice, then some extension of the scope of the Industrial Acts would be rendered necessary, and some such extension seems to have been in the minds of the Select Committee in their Report on the Education (Provision of Meals) Bill, 1906, in considering their recommendations.[21]
But the importance of the two classes of cases already considered sinks into comparative insignificance compared with the third class of cases.
Temporary underfeeding caused by temporary poverty can be met in many ways without to any appreciable degree lessening the sense of the moral obligation of the parent to provide the personal necessities of food and clothing for his children. In the case, again, of the persistently dissolute and neglectful parent, moral considerations have ceased to operate, and so the individual by some method or other must be forced to perform whatever part of the obligation can be exacted from him.