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The School As A Health Factor

( Originally Published 1924 )

THERE has begun to be an awakening concerning the physical needs of our people. The story of the draft examinations, with about half of the young men showing defects and over thirty per cent refused because the defects were serious enough to lessen their value as soldiers, has had a wide influence. The results of searching examinations given children in various schools is confirming the belief of physicians that much of the adult physical wastage is preventable. That it is a good investment to pre-vent it is beyond question. Considered economically alone, the annual loss in man and woman power due to preventable sickness is a staggering total; add to that the sorrow and suffering involved, and to allow it becomes even more inexcusable.

The family physician does not seem to hold the solution to the problem. He is called in usually because of a definite illness. In diagnosing and curing that illness he may find other conditions that require attention and therefore may do actual preventive work. But the percentage of cases in which he makes a really complete examination, or in which he is equipped to make such an examination, is small.

The schools are the only places where all the children of the country are brought together and where it is feasible completely to survey and care for them physically.

As conditions stand to-day, school examinations range all the way from no examination or perhaps the more dangerous supposed examination that takes but a few seconds to a complete investigation of the child's condition. A complete investigation includes testing the major organs, examining the throat, mouth, eyes, and ears, the feet and the spine. There are blood tests and urine analyses; in fact, nothing is left to chance. When defects are discovered they are usually reported to the parents for treatment by the family physician or a specialist. Some are likely to be cared for at school, particularly minor posture-defects.

There need be no idea that such examinations are necessary only for the poorer section of the population. The children supposedly best cared for will often show a good percentage of cases needing attention. Such children are often undernourished, not from lack of food, but from poor choice. Lack of muscle-tone, anaemia, defects of feet, spine, ears, and eyes, are no respecters of persons, and they are present to a surprising degree in the children whose parents would be most likely to scoff at such possibilities.

Another factor in the preventive side of the school's work is related to its building and equipment. Here too, recent years have seen very great advances, and more and more thought is being given to the conditions under which children are to live while in school.

For example, the study and care that is now being given to the lighting and ventilation of schoolrooms is probably. greater than that given similar problems in any other kind of buildings. The facts that schoolroom windows should reach as nearly as possible to the ceiling, that they should not approach too near the front wall of a classroom, that they should be arranged in solid banks with as little unlighted space between the windows as possible, are examples of this thought. The formulas for the amount of window-space in a room and the possible width of the classroom that will still allow the light to be distributed efficiently are no longer guesswork.

One school recently, in determining the orientation of the building so as to give the classrooms the best light when the children were studying, conducted an experiment that for thoroughness is probably the most complete ever made. A model classroom with windows where they would be in the real building was placed on a rotating circular platform that was in turn on a second platform, also rotating. The sun was represented by a searchlight that was fixed in direction but movable in elevation. It was therefore possible to place the sun at the right elevation for any hour of any day of the year, to move the outer platform so that the direction of the sun in relation to it was also correct, and then to try various orientations of the room to see what conditions would exist in regard to the sunlight. As the room was so made that papers could be placed inside of it covering the floor and walls, it was possible by marking the boundary between the light and shadows for any position to keep a permanent record of what would happen in an actual schoolroom.

After a complete investigation with this model the school determined on the orientation of its building that would best fit its latitude and the other local conditions.

Equal thought is being given the question of temperatures, humidity of the air, ventilation, and the related problems. Very many school executives and school architects have become convinced that ventilating systems are less satisfactory than a window system of a kind that can be used without drafts but with a maximum of outdoor air coming in at its outside temperature. Some schools use no heat. Others heat their rooms but never allow the windows to be closed while the children are present. The author's experience has been that the rooms that are cool and fresh give all the health advantages of cold rooms without the disadvantages that must come when the children are clothed to stand extreme out-side temperatures. Elementary school rooms kept, during the winter, at about fifty-five degrees by a combination of window ventilation and ample heat, seem to satisfy this requirement.

School furniture, too, is receiving most careful attention. Posture defects are so easy to start, so dangerous in their possibilities, and so difficult to eliminate, that much time and expense are justified if they lessen the likelihood of such weaknesses.

There is now a very marked tendency toward movable furniture and toward much freedom in its use. The best models are designed to fit the body, the advice of posture experts being followed by the manufacturers. Some even have adjustable backs. It goes without saying, of course, that each child in the school should be fitted with a chair and desk suited to his size. Any other condition is archaic.

The question of other details that are being worked out to better health conditions could be expanded almost indefinitely. The important fact, however, is that expert school men and their medical advisers are considering every detail with the thought of its effect on the child, and that there is, therefore, less and less direct danger from contagion, bad posture-habits, poor ventilation, eyestrain, and other such causes.

Perhaps one of the greatest advances is in making the school a place of less nervous strain. There seems no question that in the past many children have suffered a definite setback during the school months. Despite the various theories of why children grow at one time of the year and fail to gain at another, there are enough definite cases where gain has at once followed removal from school or transfer to a school of a different type, to prove that the nervous condition of a child under strain does affect growth and generally injure physical condition. The child who is continually repressed, who is always kept quiet, who is never allowed to move, is affected adversely. A boy about twelve years old sat by the school window and against orders looked out at the passers-by. When he reached home he said to his mother, "When I saw a woman going by I thought to myself, `What would you do if you were made to sit in a seat all day long and never were allowed to move? I don't believe you could do it.' And the boy was right. That children cannot do it with impunity has been shown by tests that found nervous reaction in most children after very short periods of enforced quiet.

On the other hand, a happy school-child, enjoying reasonable freedom, enthusiastic over the work and play of the day, is in the best possible environment in which to grow and become strong.

But the work of the school in preventing defects is still only the negative side of the story. There is a positive side fully as hopeful in its promise for the future.

Unfortunately, crowded community conditions have been more and more eliminating children's opportunity for physical recreation the play that is the greatest factor in giving them sound, strong bodies, quickly responsive to their wills. As a corollary to their loss of play-space there has been a loss of time spent in the open air and an increase of time spent in dwelling-places, more often than not over-heated and poorly ventilated. The schools are trying not only to make up this loss sustained by the children, but to add a more complete and better play than has been available in the past.

The first attempts of schools to give children exercise were forced by a realization that the pupils became nervously and mentally fatigued in school to a degree that made them inefficient. These attempts often failed of their purpose to a greater or less extent, because they were gymnastic in character, and called for a minimum of pleasure-stimulation and a maximum of attention. They therefore did not greatly lessen fatigue, although they did add an element of activity, gave a changed direction to attention, and sometimes served as an excuse for the opening of the windows and the introduction of some fresh air.

I have known a teacher to occupy the short gymnastic period required of her by playing a game with the children, where they put their hands and arms in various positions on order and she attempted to catch them napping. The amount of exercise given was so small as to; be negligible while the strain on attention was very great. The children seemed to finish their recreation period more tired than when they began it.

Those who have studied the effect of various forms of exercise are now quite generally united in the belief that the major part of physical recreation should be games and free play. Without question it should be as enjoyable as possible. To as great an extent as possible also it should be out of doors, almost irrespective of the weather, and when not outside, it should at least be in thoroughly ventilated, cool rooms.

This emphasis on play is one of the chief reasons for the "country day school" movement that is sweeping the private schools of this country. The boarding schools have long had the monopoly of real country surroundings with ample playgrounds and an entire day spent at the school. The new type of school has similar conditions within reach of the city, but while its pupils spend most of the day at school, they return home late in the afternoon and consequently have the advantages of family life without being deprived of the play they need.

Fortunately this need is also being recognized by the public schools, and different ways of giving similar play advantages are being urged and to an increasing extent are being tried. The great deterrent is expense, but even that cannot stand in the way if the need becomes sufficiently understood.

One expedient is that of putting the schools on the outskirts of the city instead of in the more settled sections. The theory is that it is just as easy to go out as to come in perhaps it is easier, as the school travel is then opposite to the "rush-hour" traffic; that the somewhat longer average trip is of small importance compared with the advantages gained; that land is cheap enough and in little enough demand in such sections so that the buying of large school-grounds is justified.

Another way consists in locating the schools adjacent to, or inside of, the city parks. Public athletic fields and playgrounds can then be used by the pupils without extra expenditure for the land.

Where conditions are too congested even for these suggestions, there are still possibilities in the roofs. The flat tops of many of the larger city buildings are waste spaces. With some expense for surfacing and enclosing in netting they might well meet the needs of the children. This last suggestion seems never to have been given an adequate trial on a large scale, so real roof athletic-fields are yet in the future.

Whatever the solutions prove to be, for there will be many, depending on local conditions, the fact remains that the schools must provide plenty of opportunity for free play or else fail in the constructive side of their physical program. The more quickly the public recognizes this and not only backs the schools that are giving it but demands that all give it, the better will be the results.

In the handling of play too there is coming a shifting of emphasis, brought about by a broader outlook and made possible by the larger playing-fields so many schools are acquiring. The older type of school athletics stressed school teams, and sometimes even now a school's reputation depends as much on its athletic prowess as on any other factor. This of course, if carried to an extreme, means that a small percentage of the pupils probably overdo the athletics while the majority fail to receive adequate attention if they are not left entirely on the side lines. The ideal to-day is to have every pupil engaged in physical recreation some part of each day, and many schools are approximating this condition. It emphasizes competition among pupils of the same 'school with teams of every size and every degree of skill, rather than one "all star" team toward which the whole energy of the school is bent.

There are many interesting possibilities in this kind of play and it can be made as competitive as seems wise. One worth-while type of activity is that of entirely free play. It consists of attempting "stunts" on the playground apparatus and trying athletic events individually or in small groups with-out coaching, such, for example, as throwing weights or the javelin, trying different kinds of jumping and so forth, of playing tag and other such games, of skating or sliding or skiing, or of getting up matches in any sport by choosing sides. It in fact includes any kind of athletic play that springs up more or less spontaneously if conditions are right for it.

Then there is the more organized play. A simple way to encourage this is to divide the pupils of a school into two or more groups that compete with each other. If each child in the school belongs to one group, and competitions fitted to every age and size are carried on in various kinds of sports chosen for their constructive influence, such a program will serve many useful purposes.

Again, insignia may be given to those attaining certain levels of achievement in standardized tests of strength, speed, agility, and endurance, and in this way even the poorest may be given an attainable goal and an incentive for working toward it.

Then too the help of the stronger in raising the standard of the weaker can be secured through "average contests" in which the competition is not between individuals, but between the average performances of groups. A good example would be a contest between the average standing-broad-jumps of two classes of the same age. Such a contest, if planned ahead of time, is certain to start all the pupils practising broad-jumping, and to make those who do it well teach the poorer ones, whose jumps will count equally with their own in determining the result.

Schools using these and similar methods, and those that send teams of all sizes and degrees of skill to compete against other schools, are almost certain also to develop " first teams" in the various sports. Under such conditions first teams are very much more likely to be a natural outgrowth of development and ambition and are less likely to be artificially and almost professionally built up. While such teams seem to justify their existence as a stimulus to ambition, there seems to be little doubt that the future of constructive physical training in our schools depends upon general participation in games rather than on specialization in athletics.

The subject of play and athletics should not be left without a word concerning its other values. Its results in rapid coordination as well as in physical condition were shown in the success of athletes in aviation. Some of those in charge of this branch of the service in the recent war have been definite in saying that the best candidates for the flying corps came from the young men of athletic experience.

Again, physical recreation is almost certain to supply a lasting interest in exercise of some kind, and therefore to influence for the better the child's adult life.

But perhaps the greatest values that come from the playground are the social and moral ones: social adaptation, open-mindedness to the viewpoints of others, ability to win without boasting, to lose with-out rancor, to put team play above individual triumph, cooperation above selfishness. If, as has been said, England's battles are won on her athletic fields, it is equally certain that America's citizens are being prepared on her school playgrounds.



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