Imágenes de páginas
PDF
EPUB

BOARD OF EDUCATION, NEWARK, N. J DEPARTMENT OF MEDICAL INSPECTION.

[blocks in formation]

BOARD OF EDUCATION, NEWARK, N. J., Department of Medical Inspection,

191.. I, parent of..

..living at..

.herewith request that the nurse of the department of education adopt such procedures for the proper care or treatment of such diseases or defects as in her judgment are necessary for the cure of my child.

(Signed)

DEPARTMENT OF MEDICAL INSPECTION, BOARD OF EDUCATION, NEWARK, N. J.

INSTRUCTIONS TO PARENTS REGARDING THE CARE OF THE MOUTH AND TEETH.

The physical examination of school children shows that in many instances the teeth are in a decayed and unhealthy condition.

Decayed teeth cause an unclean mouth. Toothache and disease of the gums may result.
Neglect of the first teeth is a frequent cause of decay of the second teeth.

If a child has decayed teeth, it can not properly chew its food. Improperly chewed food and an unclean mouth cause bad digestion, and consequently poor general health.

Il a child is not in good health it can not keep up with its studies in school. It is more likely to contract any contagious disease, and it has not the proper chance to grow into a robust, healthy adult.

Is the child's teeth are decayed it should be taken to a dentist at once.
The teeth should be brushed after each meal, using a tooth brush and tooth powder.

The following tooth powder is recommended: Two ounces powdered precipitated chalk, 1 ounce pow. dered castle soap, 1 dram powdered orris root. Thoroughly mix.

This prescription can be filled by any druggist at a small cost.

The child should take the tooth brush and powder to the school and receive instructions from the nurse as to their proper use.

RING WORM.

Directions: Remove the scales with soap and warm water. Dry thoroughly and apply the medicine morning and night until disease is cured.

[To be filled at a drug store.)
R
Tincture of iodine.

10
Alcohol......

20 M. Sig. Apply once a day until the disease has disappeared.

The following method of treatment for the itch is recommended:

Before going to bed wash the body well with soap and hot water, and when dry rub this ointment thoroughly, 20 minutes, over the whole skin. Do not bathe for three days. All bedclothing and clothes that have been worn next the skin must be boiled before using again.

[To be filled at drug store.)
R
Sulphur..

7.50
Beta naphthol.

7.50 Lard q.$....

90 M. Sig. Apply as directed.

CONTAGIOUS IMPETIGO.

Directions: Wash the affected parts with warm water and soap. Apply the ointment morning and night until the disease has disappeared.

(To be filled at a drug store.)
R
Resorcin....

. 15
White precipitate.

50 Lard q.S......

15 M. Sig. Apply morning and night until the disease is cured.

1

BOARD OF EDUCATION, NEWARK, N. J.

RECOMMENDATION FOR SPECIAL CLASS FOR MENTALLY DEFECTIVE CHILDREN.

Child's name
(Family.)

(Given.)
Grade.
School.

. Principal. Birth: Date.

Place Order.

Boy. Girl. White. Colored. Parent's name.........

Residence..
Occupation...
Birthplace

Educated. Can read and write. Niterate. Date of examination

Examined by. Mental development as indicated by test. years. Age,

years. Family history: Medical-Feeble-mindedness, insanity, nervous disorder, alcoholism, tuberculosis, sickness or accident

to mother before birth of child. Social

Financial-Well-to-do, moderate, poor.
Housing

Entire house, number of rooms
Apartment, number of rooms

Tenement, number of rooms
Home treatment-Good care, neglect, brutality.
Number of normal-Living, dead. Feeble-minded-Living, dead.
Brothers

Sisters
Personal history and characteristics:
Medical-

Injury to head-At birth; after birth.

Acute illness-Scarlet fever, diphtheria, meningitis, convulsions, early malnutrition. Bad companions, truant, lies, cheats, steals, profane, smokes cigarettes, vicious habits. Dependable, willing and tries, good natured, affectionate.

Apathetic, restless, mischievous, quarrelsome, obstinate, incorrigible, marked peculiar traits.
Nervo-muscular coordination:

Speech-Clear, indistinct, thick, inarticulate, fluent, slow, hesitating, mute, lisp, stammer.
Facial expression-Intelligent, stupid, happy, sullen, animated, apathetic, nervous.
Posture--Stooping, erect, spinal curvature.

Gait-Normal, lively, shupling, unsteady, clumsy.
School history:

Schools attended-City, country, or institution (specify).
Standing-Months in present grade...... Months in preceding grade ...... Prospects of promotion-
RECORD BLANKS FOR REVISED BINET TESTS.
DEPARTMENT OF RESEARCH TRAINING SCHOOL, AT VINELAND, N. J.

Good, fair, poor, none.
Attendance Regular, irregular, punctual.
Arithmetic-Good, fair, poor.
Writing-Good, fair, poor.
Spelling-Good, fair, poor.
Reading--Good, fair, poor.
Language--Good, fair, poor.
Drawing-Good, fair, poor.
Attention-Good, poor.
Memory-Good, poor. Common sense.
Physical condition--Height ...... inches. Weight pounds. Miscellaneous .

Medical inspector's last record.

Eyes.

Ears.

Nose.

Throat.

Skin.

Orth.

Nervous.

Teeth.

Nutrition.

Remarks

To the principal: Kindly see that the above form is filled out as accurately as possible. The data may be obtained from parents, children, and teachers, as well as from your personal knowledge of the case.

Please underline the descriptive words applicable to this case, and return the blank as soon as possible to the city superintendent of schools.

Present era mination by committee.

Eyes.

Ears.

Nose. Throat. Skin.

Orth.

Nery-
ous.

Teeth.

Nutri- Misceltion. laneous.

V.R.V.L.

H. F. R. L. są.

Glasses

date child.

Diagnosis:

Degree of mentality-Dull, backward, backward-emotive, feeble-minded, imbecile, idiot.

Etiology.. Recommendations: Medical, social, educational, special class for backward-feeble-minded-disciplinary

cases.

Born.

Admitted......

Name...

[blocks in formation]

1. Morning or afternoon (afternoon or morning).
2. Defines fork, table, chair, horse, mama.
3. Puts key on chair; shuts door; brings box.
4. Shows right hand; left ear.
5. Chooses prettier? 1 and 2. 4 and 3.5 and 6.

VIL
1. Counts 13 pennies.
2. Describes pictures. (See III 4).
3. Sees picture lacks eyes, nose, mouth, arms.
4. Can copy diamond (over).
5. Recognizes red, blue, green, yellow. (Time 6"'.)

VIII.

1. Compares (time 20'') butterfly, fly, wood, glass, paper, cloth.
2. Counts backward 20-1 (time 20'').
3. Repeats days. M. T. W. T. F. S. S. (Time 10".)
4. Counts stamps. 111222 (time 10'').
5. Repeats 4 7 3 9 5.

IX.
1. Makes change 200.-4c.
2. Definitions (see VI 2).
3. Knows date.
4. Months. J. F. M. A. M.J.J. A. S. O. N. D. (time 15'').
5. Arranges weights (2 correct) l' each). 1. 2. 3

1. Money Ic. 50. 10. 25c. 50c. $1. $2. $5. $10.
2. Draws design from memory (show 10 seconds).
3. Repeats 8 5 4 7 2 6. 2 7 4 6 8 1. 941 7 3 8.
4. Comprehends:

1st series time 20'' (2 out of 3)(a) missed train, (6) struck by playmate, etc., (c) broken something. 2d series time 20'' (3 out of 5)-(a) late to school, (6) important affair, (c) forgive easier, (d) asked

opinion, (e) actions o. words. 5. Sentence: Philadelphia, money, river. (Time 1').

XI.

1. Sees absurdity (3 out of 5) (time 2'): (a) Unfortunate painter, (o) three brothers, (c) locked in room,

(d) railroad accident, (e) suicide. 2. Sentence: Philadelphia, money, river (See X 5.) 3. Gives sixty words in three minutes (record on back). 4. Rhymes (time l' each) (3 rhymes with each word): Day, spring, mill. 6. Puts dissected sentences together. (Time l' each): a.

b.

C.

XII.

1. Repeats 2 9 6 4 3 7 5. 92 8 5 1 6 4. 1 3 9 5 8 4 7. 2. Defines charity, justice, goodness. 3. Repeats, “I saw in the street a pretty little dog. He had curly brown hair, short legs, and a long tail.” 4. Resists suggestion (Lines). 1. 2.

3.

4. 5. 6. 5. Problems: (a) Hanging from limb; (0) neighbor's visitors.

XV. 1. Interprets picture. 2. Change clock hands. 6.20

2.56. 3. Code. Come quickly. 4. Opposites: (1) good, (2) outside, (3) quick, (4) tall, (5) big, (6) oud, (7) white, (8) light, (9) happy, (10) false.

ADULT. 1. Cutting paper. 2. Reversed triangle. 3. Gives differences of abstract words. 4. Difference between president of a republic and a king. 5. Gives sense of a selection read

STATE REGULATIONS OF NEW JERSEY.

BOARD OF HEALTH OF THE STATE OF NEW JERSEY.

DIVISION OF MEDICAL AND SANITARY INSPECTION.

RECORD OF SA TITARY INSPECTION OF SCHOOL BUILDING.

1. Name of school buil ling.
2. Location.
....; town.......

...; county.
3. School district..
4. Name aud post-office address of principal.....
5. Na ne and address of secretary of the board of o lucation or district clerk.
6. Total number of classrooms..
7. Enrollment of pupils..

.; average daily attendance. 8. Size of lot... 9. Surface covered by buildings. 10. Height of building.... 11. Date of erection. 12. Material of construction. 13. Nearness and height of surrounding buildings. 14. Fire escape on building... 15. Yard, for what purpose used. 16. Privy vault on pre nises.

; size.

.; location.. 17. Cesspool..... .........; construction..

......; condition. 18. Any objectionable accumulation on premises or adjoining premises?...

condition

CELLAR

19. Cellar under entire bu il ling.
20. Depth beneath ground surface...
21. Material anl condition of cellar bottom...
22. Number an 1 size of vindows..
23. Is cellar well lighted?...
24. Is cellar damp?.....

PLUMBING, DRAINAGE, AND WATER-CLOSET APARTMENTS,

25. Is building connected with sewer?.
26. Any leaks or defects noted in drains?.
27. Size and location of water-closet apartments.
28. Material and condition of floors.....
29. Number and size of windows opening to outer air..
30. Ventilation of apartment....
31. Cleanliness of apartment....
32. Number and style of water-closets.
33. Are water-cla ats in good repair?..
34. How flushed..

35. Number and style of urinals..
36. Are urinals in good repair?..
37. How fushed?....
38. Cleanliness of fixtures.
39. Any disinfectant or deodorant used in fixtures or apartment?.. kind.
40. Are there facilities for pupils to wash hands after using closets or urinals?.

HEATING, LIGIITING, AND VENTILATION.

41. Method of heating..
42. Method of lighting...
43. Method of ventilation...
44. Location of fresh-air intake..
45. Size and construction of fresh-air duct..
46. Any visible sources of contamination of fresh-air supply?.

WATER SUPPLY.
47. Source of water supply....
48. Is water supply delivered through tank?.

Location. 49. Location of well. 50. Is well driven or dug?. 51. Depth..

.; how covered. 52. Surroundings. 53. Sample taken.

; number

; result. 54. Are drin <ing cups used in common?.. 55. Are there drinking fountains in building? Number.

.; location.

; condition.

HALLS,

; width

; height.

56. Length..
57. Exits..
58. Light..
59. Ventilation..
€0. Do doors swing in or out?.
61. Cleanliness of hall...

CLASSROOMS.

...; width

62. Designate room.. ; grade......; total enrollment; greatest average attendance for any preceding

month 63. Size: Length.

; height.

-; cubic contents. €4. Square feet of floor space per pupil.. 65. Cubic feet of air space per pupil.. 66. Number and size of windows. 67. Percentage of light to floor space.. 68. Light enters from east, west, north, south. 69. Are there window shades to control volume of light?. 70. Desks face east, west, north, south. 71. Color and finish of ceiling and side walls. 72. Do doors s ving in or out?. 73. Il swinging doors, have they plate-glass panels?. 74. Style of desks and seats.... 75. How frequently are seats and desks adjusted to pupils?. 76. Adjustment at tim of inspection..... 77. Material of construction and condition of floor.. 78. Number, size, and location of fresh-air inlets in classroom. 79. Number, size, and location of vitiated air outlets.... 80. Amount of fresh air entering through inlets per minute. 81. Temperature of air at inlet.

; outlet.

.; at breathing line 82. Humidity of air in room.. 83. Was air tested for CO,?.

; result.

...; at what time. 84. Weather conditions and temperature of air out of doors. 85. Objectionable odors noted in air in classroom? 86. Are furnishings and ledges free from dust?... 87. Any facilities for washing hands?.. 88. Are clean towels and soap provided?.

Kind of towels 89. Are slates used by pupils?..

how cleaned ? 90. Are individual pencils and penholders used?.

if so,

« AnteriorContinuar »