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Editor,—May we please correct an unintentional impression of therapeutic nihilism in the article on school nursing.1 One of us (DH) commented in the article on the work of Bax and Whitmore. These authors described the process by which they assessed school entrants, with the aim of identifying children who might develop learning problems and thereby prevent the adverse outcomes associated with failure in school.
It was implied in the article that there was no treatment for the conditions identified by this process. When Bax and Whitmore carried out their studies this was probably true, but with greater sophistication of diagnosis and management there are many children with neurodevelopmental (and psychological) disorders, such as attention deficit disorder, coordination problems, or reading difficulties who could now benefit from assessment and intervention. The unresolved challenge facing paediatricians, child mental health services, and educationalists is to develop better ways of finding these children and providing effective intervention before it is too late to help them.
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