National Survey of Health and Development
1957 (Age 11)
1957 School Nurse's Interview with Mother
nshd_57_iwm
STRICTLY CONFIDENTIAL
JANUARY 1957
SCHOOL NURSE'S INTERVIEW WITH MOTHER
NATIONAL SURVEY OF THE HEALTH AND DEVELOPMENT OF CHILDREN
INSTITUTE OF CHILD HEALTH (UNIVERSITY OF LONDON) SOCIETY OF MEDICAL OFFICERS OF HEALTH and POPULATION INVESTIGATION COMMITTEE At the LONDON SCHOOL OF ECONOMICS
Ref. No.
Name
Address
School
IF THE FAMILY HAS MOVED TO ANOTHER AUTHORITY PLEASE ENTER THE NEW ADDRESS AND THE NAMES OF THE NEW L.E.A. AND NEW SCHOOL IN THE SPACE PROVIDED. IF THE CHILD CANNOT BE TRACED PLEASE ENTER THE LAST ADDRESS AND ANY OTHER INFORMATION THAT MIGHT HELP US TO TRACE HIM. IN EITHER CASE RETURN THE FORM TO WHOMEVER HAS BEEN DELEGATED BY THE SCHOOL MEDICAL OFFICER TO RECEIVE IT.
Approach to the Mother
Remind her that in previous years she gave us most valuable information about herself and her child. We now want to find out what progress her child has made during the last year. All information she gives will, of course, be ABSOLUTELY CONFIDENTIAL.
Purpose of this inquiry
This child was enrolled at birth in a national survey which is being made by a Joint Committee of the Institute of Child Health, the Society of Medical Officers of Health and the Population Investigation Committee. The purpose of the present examination is to bring the medical and social history up to date. The children in this sample are representative of all births in England, Wales and Scotland. They are drawn from all social classes and during the first ten year of their lives only 8% of the original sample have been lost. The value of this inquiry depends on information being obtained for every possible survey child. The Joint Committee are therefore most anxious that this form should be completed.
How to fill in this form.
Five thousand Mothers scattered all over the country are being interviewed, and it is therefore important that the many hundreds of Health Visitors and School Nurses who are seeing them should record their findings in a comparable way. For this reason, and also to reduce the amount of clerical work, this form has been framed as a series of questions, many of which can be answered by one of several printed alternatives. All that is required is to put a circle round the number opposite the printed answer that most nearly describes your findings. If no alternative fits please write the answer in the space directly under the question. Similarly, if you feel that any printed answer, though applicable, does not fully explain your findings, we should be most grateful for any further information you can give us. In order to ensure that this information is obtained in the same way by the many people taking part in the survey, it is important that the wording and order of this form should be adhered to.
COMPLETED FORMS SHOULD BE RETURNED TO THE SCHOOL MEDICAL OFFICER AND NOT DIRECTLY TO THE JOINT COMMITTEE.
RING THE CODE NUMBER OPPOSITE THE MOTHER'S ANSWER. IF A QUESTION DOES NOT APPLY, STRIKE IT THROUGH.
Person interviewed.
If mother not interviewed because she was ill, refused, etc., please give reasons.
(For all living children)
Where is this child now living?
I. ACCIDENTS
Last accident recorded. Type
Last accident recorded. Age when injured ... yrs.
(Since this accident, or since OCTOBER, 1955)
Has this child had an accident in which he was BURNT or SCALDED, BROKE A BONE, or was BADLY CUT or BRUISED?
II. INFECTIOUS DISEASES
(Attacks recorded in previous surveys are given in red.)
III. ADMISSIONS TO HOSPITAL
Details of last Hospital Admission Recorded in this Survey. Illness
Details of last Hospital Admission Recorded in this Survey. Hospital
Details of last Hospital Admission Recorded in the Survey. Age
(If nothing recorded there has been no admission before OCTOBER, 1955)
Has this child been an IN-PATIENT in a HOSPITAL or NURSING HOME since OCTOBER 1955 ?
(When a single illness involves more than one admission give information separately for each period in hospital)
(When a single illness involves more than one admission give information separately for each period in hospital)
IV. SCHOOL CLINIC AND OUT-PATIENT DEPARTMENT ATTENDANCES
(Include child guidance and all other clinics wherever held)
Details of last Clinic Attendance Recorded in this Survey. Name of Clinic
Details of last Clinic Attendance Recorded in this Survey. Reason for attending
Details of last Clinic Attendance Recorded in this Survey. Age
Has this child attended a School Clinic or Out-Patient Department of a Hospital since OCTOBER 1955?
V. SCHOOL ABSENCES
(Only absences of more than one week are recorded)
VI. SCHOOLING
During the last year have you or your husband met this child's class teacher or head teacher ?
Did you discuss this child's school progress with either or both of them ?
Until what age do you want this child to stay at school ? ... years
Do you have any specific ideas on the job you would like this child to do on leaving school ?
What are they ?
Which of the following types of school do you NOW wish your child to go to?
Which of the following types of school do you NOW wish your child to go to? (Alternative answers for Scotland)
Have you changed your mind since this question was asked last year ?
Why have you changed your mind
Are you in any way worried about this child's progress at school?
Please give your reasons for worrying.
VII. HOBBIES AND OUTSIDE INTERESTS
Has this child any hobby or special interest?
What is it?
Does he belong to any club or organisation outside school?
What organisation(s) does he belong to ?
Does this child go to Church or Sunday School ?
What Church or Sunday School does he go to ?
At what time does this child go to bed at night ? ... p.m.
At what time does this child get up in the morning ? ... a.m.
VIII. GENERAL HEALTH AND BEHAVIOUR
Are you in any way worried about this child's behaviour?
Please give your reasons for worrying
Has this child any habits such as thumb sucking, nail biting, nose picking, tics or general fidgetiness ?
During the last year, have you or any member of your household ever had to go to this child because of his nightmares or disturbed sleep ?
IX. DOMESTIC HELP
X. OCCUPATION OF PRESENT HUSBAND
XI. SUBSEQUENT PREGNANCIES
XII. THE MOTHER'S WORK
XIII. THE HOUSEHOLD AND DWELLING
Ownership of dwelling.
(Please start with the youngest and end with the oldest. INCLUDE THE PARENTS AND THIS CHILD.)
Total in household. ... persons
Does this child sleep in a room by himself or in a room with others ?
Who else sleeps in his room ? (Please give names and ages).
Does he sleep in own bed or with others ? (If with others, please give names and ages).
Is your kitchen shared with another household?
Is there a bathroom for your use ?
How do you obtain hot water ?
Where does this child do his homework ?
Does mother think that this dwelling lacks any essential amenities that would help you in bringing up your children ?
please give details)
INFORMATION GIVEN BY SCHOOL NURSE OR HEALTH VISITOR
(Please answer the following Questions from your own knowledge. DO NOT ask the mother directly.)
Is any member of this child's family or household known to have tuberculosis ?
Please state the name and the relationship Name
Please state the name and the relationship Relationship
Was B.C.G. Vaccination offered to this child and if so, was it accepted ?
Does this family possess any of the following ?
Please give your assessment of the state of repair of the dwelling.
Please state from your OWN KNOWLEDGE whether the parents of this child are-
Date of interview
Length of Interview ... mins.
Name of School Nurse or Health Visitor
nshd_57_iwm
FOR THOSE WHO HAVE MOVED
I. ACCIDENTS
II. INFECTIOUS DISEASES
III. ADMISSIONS TO HOSPITAL
IV. SCHOOL CLINIC AND OUT-PATIENT DEPARTMENT ATTENDANCES
V. SCHOOL ABSENCES
VI. SCHOOLING
VII. HOBBIES AND OUTSIDE INTERESTS
VIII. GENERAL HEALTH AND BEHAVIOUR
IX. DOMESTIC HELP
X. OCCUPATION OF PRESENT HUSBAND
XI. SUBSEQUENT PREGNANCIES
XII. THE MOTHER'S WORK
XIII. THE HOUSEHOLD AND DWELLING
INFORMATION GIVEN BY SCHOOL NURSE OR HEALTH VISITOR
1957 School Nurse's Interview with Mother