A BASIC PLAN FOR STUDENT HEALTH AND HEALTH EDUCATION IN TEACHER-TRAINING INSTITUTIONS Issued Jointly by FRANK G. THOMPSON, Director Department of Registration and Education ROLAND R. CROSS, M.D., Director Department of Public Health VERNON L. NICKELL, Superintendent Office of Public Instruction PRINTED IN JULY, 1944, BY AUTHORITY OF TH£ STATE OF ILLINOIS DWIGHT H. GREEN. Governor The companion volume to this report, prepared by the Illinois Joint Committee on School Health, is entitled A Basic Plan for Health Education and the School Health Program. STATE OF ILLINOIS DWIGHT H. GREEN, Governor a basic plan for STUDENT HEALTH AND HEALTH EDUCATION IN TEACHER-TRAINING INSTITUTIONS prepared in 1944 by the ILLINOIS JOINT COMMITTEE ON SCHOOL HEALTH under the leadership of ROLAND R. CROSS, M.D., Chairman Director of the Department of Public Health VERNON L NICKELL Superintendent of Public Instruction FRANK G. THOMPSON Director of the Department of Registration and Education CLAIR E, TURNER, Dr.P.H., Consultant 248 (68080) In war or in peace, the foundation upon which rest the strength and welfare of the State and Nation is the health and physical stamina of the people DWIGHT H. GREEN, Governor. Table of Contents PAGE > Foreword * 5 Definitions 7 Suggested Organization for Program Planning 8 The Student Health Service 9 A Hygienic Regimen 18 Instruction in Health and in Health Education 25 In-Service Training in Health and Health Education for Teachers . . 31 List of Committee Members 34 Foreword . . . This report comes to you from three agencies of your State Government, and represents the work of the committees listed herein. Its purpose is to lay a foundation upon which a program of student health and health educa- tion in teacher training institutions may be built. The report deals with student health services, a hygienic regimen for students, the instructional pro- gram and the in-service training of teachers in health and health education. This report should provide a helpful framework within which each teacher training institution may build its own specific program adapted to its needs and situation. The proposals herein are intended to be helpful and suggestive rather than rigid and dogmatic. A basic plan such as this should be revised from time to time as the science of school health progresses. Suggestions for such revision from those using the report will be welcomed by the three agencies concerned. This document will be of value only to the extent to which it is im- plemented in the individual institutions of higher learning. Suggestions for organizing the faculty and students in the promotion of the program are indicated on another page. Members of the staffs of the three agencies con- cerned will be glad to be of any possible assistance as will also the continuing Illinois Joint Committee on School Health and its Liaison Committee. We would like to express our appreciation to the consultant, Professor Clair E. Turner; to the committees; and to the many other individuals who gave valuable assistance in the preparation of this report. Roland R. Cross, M.D., Director Department of Public Health Vernon L. Nickell, Superintendent Office of Public Instruction Frank G. Thompson, Director Department of Registration and Education Definitions of Selected Recurrent Terms Relative to Health Education* Health education is the sum of experiences which favorably influence habits, attitudes, and knowledge relating to individual, community, and racial health. School health education is that part of health education that takes place in school or through efforts organized and conducted by school personnel. Hygiene is the applied science of healthful living; it provides the basic scientific knowledge upon which desirable health practices are founded. Sanitation is the application of scientific measures for improving or con- trolling the healthfulness of the environment. Health in the human organism is that condition which permits optimal functioning of the individual enabling him to live most and to serve best in personal and social relationships. Health instruction is that organization of learning experiences directed toward the development of favorable health knowledge, attitudes, and practices. Health service comprises all . those procedures designed to determine the health status of the child, to enlist his cooperation in health protection and maintenance, to inform parents of the defects that may be present, to prevent disease, and to correct remediable defects. Healthful school living is a term that designates the provision of a whole- some environment, the organization of a healthful school day, and the establishment of such teacher-pupil relationships as make a safe and sani- tary school, favorable to the best development and living of pupils and teachers. Health examination is that phase of health service which seeks through examination by physicians, dentists, and other qualified specialists to determine the physical, mental, and emotional health of an individual. Physical education is that phase of the school program which is con- cerned largely with the growth and development of children through the medium of total body activities. Briefly stated, the objectives of the phys- ical education program are the protection and improvement of health; the development of neuromuscular skill and motor fitness; the development of desirable social attitudes and standards of conduct; and attitudes in physical education activities which will contribute to wholesome and enjoyable leisure pursuits. * The first definition listed is by Dr. Thomas D. Wood, in the Fourth Yearbook of the Department of Superintendence of the National Education Assn., 1926, page 226. The last definition is adapted from a statement presented by the State Society of Directors of Physical and Health Education. The other definitions are from the Committee Report, Health Education Section, American Physical Education Association, Journal of Health and Physical Education, December 1934. 7 A Basic Plan for Student Health and Suggested Organization for Program Planning It is believed that each teacher training institution needs to organize for the effective planning and operation of its student health and health edu- cation program. Two suggestions are made in this connection: I. There should be a faculty health council, to include the dean of the faculty, the dean of men and the dean of women, the superintendent of buildings, the college physician and college nurse, teachers of biology, physical education, home economics, chemistry, psychology, and any other persons in a position to contribute to the establishment of an overall health program for the college or university. Such a health council might formu- late general policies and clarify the general philosophy of the college regard- ing health instruction, but more specifically it should determine what in- struction applicable to health is being given in each department, and be the means of finding gaps and of preventing duplication. Studies made by the faculty health council should result in better understanding and co- operation between various departments and better coordination of the whole health program, and might well lead to specific recommendations made to the president, the faculty, or its curriculum committee. The health council may also render assistance to local school systems in the development of their own health education and school health programs. II. It is recommended that the college authorities set up a student health council or a discussion group for the purpose of reviewing student problems and making recommendations to the college authorities for con- sideration and action. From four to six students selected by the student body should compose this group for the discussion of campus health prob- lems and related subjects. The committee should meet with the Medical Director or his representative at least once a term for the discussion of current situations related to school health. The student health committee should act as an intermediary between the students and the administrators. 8 Health Education in Teacher-Training Institutions The Student Health Service Health Examinations for Students—The Clinical Staff and Facil- ities for Examining Students—Suggested Health Examination Record Forms—Services Rendered by the Student Health Service— Hospitalization of 111 Students—Correction of Remediable De- fects—Sanitary Supervision—Counseling and Guidance. I. Health Examinations for Students As a result of a study of a questionnaire sent to the five State teachers colleges, it is obvious that the methods and programs of the Student Health Services vary decidedly and that these programs are at present much in need of revision for the provision of adequate service. To this end, a regular annual health examination or re-check should be made of every student. A complete health examination includes a dental examination made by a dentist. Obviously, only physicians licensed to practice medicine in all of its branches should be permitted to give health exami- nations, interpret the results and make recommendations. Registered nurses, internes, trained student assistants and other trained personnel, under the direction of the physician in charge, may assist in these examinations. The time when the report of the initial examination is available will probably vary according to the size of the entering class of students and according to the number of physicians, nurses, and assistants employed by the college. In view of the importance of knowing at an early date what deviations from the health norm a given student may show, these examina- tions should be done either before admission to college or as part of the registration procedure at the time of admission. It would, of course, be necessary to exclude those who have acute or chronic diseases which would make them dangerous to the student body. The health requirements of the Illinois State Teachers’ Examining Board should be borne in mind (see Section VI). Information regarding students’ personal adjustment previous to entering college should be availaWe to the proper college authorities at the time of entrance, and should include, if possible, the family situation as well as ad- justments to contemporaries. Continued mental health supervision is important. II. The Clinical Staff and Provisions for Examining Students One physician should be provided for every five hundred students, with both sexes represented on the clinical staff. Two nurses should be employed for every five hundred students, one nurse to serve in the train- ing school only. Adequate dental services likewise should be established. There should be one nutritionist for consultation in the cafeteria and with students doing light housekeeping. There should also be adequate lab- oratory, receptional and secretarial services. In addition, consultation should be available in such special fields as speech correction and psychological and guidance services. Adequate quarters for the student health service should be provided. There should be a separate, easily accessible health building which includes: 9 A Basic Plan for Student Health and a reception room, an individual examining room for each doctor, treatment room, record rooms, a private office for each physician for consultations and interviews, a dental examination room equipped for emergency treatments, dressing rooms for students, adequate lavatory facilities, a well equipped laboratory and suitable nurses’ offices. Provision should also be made for the care and isolation of individuals suspected of having communicable diseases. If there is no infirmary, these isolation rooms should be located separately from the service rooms. III. Suggested Health Examination Record Forms The following medical history and health examination forms are rec- ommended: Medical History* (All information furnished here will be held confidential.) Date- 1. Name 2. Address 3. Date of birth 4. Present occupation 5. County of birtl State 6. White. 7. Single. Married Widowed Divorced. Colored. 8. Number and ages of children, if any: 9. (a) How much do you drink daily of: Milk Tea-... (b) Do you use tobacco? If so, how much and in what form?. (c) Do you use alcphol? If so, to what extent? Soft drinks. Water. Coffee. 10. Do you have a movement of the bowels daily?. 11. Have you been ill with any of the following diseases ? If so, at what age ? Do you use a laxative?. If so, how often?. Measles Whooping Cough Scarlet Fever Diphtheria Tuberculosis Poliomyelitis Typhoid Fever, Malaria Syphilis Gonorrhea Rheumatism Allergy Tonsillitis Frequent Colds. Bronchitis Pneumonia • Pleurisy Epilepsy Migraine Headaches. Others. 12. Have you been protected against any of the following diseases? If so, state date of last time protected: Smallpox Whooping Cough. Typhoid Fever. Scarlet Fever. Diphtheri; _ Tetanus. 13. Have you had any serious accidents? If so, describe: 14. Have you had any broken bones? 15. Have you had any surgical operations?. If so, for what, and on what date? If so, describe: 16. How often do you consult your dentist?. 17. (a)When did you last consult a doctor?. When last?. (b) Are you taking any medicine regularly?. For what purpose?. If so, indicate its nature: * Adequate case records reflecting mental health status should be kept with the medical records. 10 Health Education in Teacher-Training Institutions 18. Are the following members of your family living? If not, give causes of death and age at death: Living or Dead If Dead, Age at Death If Dead, Cause of Death Father Mother Brothers Sisters Children Husband Wife 11 A Basic Plan for Student Health and 19. Indicate which members of your family have had or now have any of the following: Tuberculosis. Epilepsy. Kidney Disease. 20. Do you have any health complaints at the present time?. Diabetes. Mental Illness Other. Cancer. Heart Disease. 21. FOR WOMEN: Are your monthly periods regular? ; prolonged? ; Is there any respect in which your health is not good ?. excessive ?. regularly ? ; unusually painful ?. .. Do you miss classes Health Examination 1. Name. Pate 2. Weight stripped: Present _ Usual Recent gain or loss. 3. Pulse: Height (without shoes): inches. (a) Sittin, (b) Standin (c) After exercise (d) Two minutes after exercise. (Schneider test) 4. Chest measurement; Inspiration 5. Blood pressure: (Left arm, student seated) (a) Before exercise: Systolic (b) After exercise: Systolic 6. Posture: _ Diastolic _ Diastolic Abnormalities (head) _ (shoulders) . (spine) 7. Musculature: Abnormalities. 8. Skin: Abnormalities. 9. Superficial glands: Enlarged ? _ Location. 10. Female Breast: Abnormalities- 11. Hands: Abnormalities. 12. Arms: Abnormalities. 13. Male genitalia: Abnormalities 14. Hips, legs, knees: Abnormalities 15. Ankles, feet: Athlete’s fool Condition of arches (flatness, rotation) 16. Hernii Type, if present 17. Hair: Conditio 18. Eyes: Texture. _ Abundance. Lid margins Vision F L Corrected R L Color vision Ophthalmoscope Other abnormalities. . Test used Pupillary refle: Lid reflex (Use Ishihara test). 19. Nose: (if indicated). 20. Teeth: Functional abnormalities. 12 Health Education in Teacher-Training Instltutions DESCRIBE MOUTH AND GUM ABNORMALITIES INSTRUCTIONS Cross out teeth that are missing—as follows: X Strike teeth that cannot be restored—mark as follows: / Circle teeth that are carious but may be restored—mark as follows: O Underline filled teeth. Letter all teeth no caries experience—as follows: S 13 A Basic Plan for Student Health and 21. Gums: 22. Tongue: Ulcerations. Bleedim Receding— Color. 23. Tonsils: Appearance. Deviation from midline. Tremor. Out?_ _ Infected?. Acute_ Chronf Type- 24. Pharynx: Abnormalities 25. Speech; Abnormalities and type. 26. Ears: Outer canal—presence of infection or wax Condition of drum Hearing R (Watch test — Audiometer L 27. Neck: Abnormalities. Thyroid enlarged. Evidence of hyperthyroidism. 28. Chest; Shape Heart Friction rub Lungs Breath sounds. . Rhythm . Symmetry Regu laritv Size Functional or organic _ Murmurs, if any Presence of rales. 29. Abdomen: Respiratory rate. 30. Abdominal reflexes Palpable masses. Localized tenderness. _ Scars 31. Skin—sensitivity to stimuli. 32. Liver Tenderness Palpable 33. Spleen Palpable Enlarged 34. Kidneys Tenderness Palpable 35. Female genitalia: Abnormalities 36. Rectum: Abnormalities. 37. Reflexes: Romberg sign. 38. Urine: Knee jerl Appearance. - Sp. gr Sediment Albumin. Acidity. Sugar. (Microscopic, if indicated) Acid or alkaline. 39. Blood; Hemoglobin: RBC if indicate % (Sahli or Talquist). WBC if indicate' Serology: Positive. Negative. (Kahn or Wassermann) 40. Tests: Schick test: Positivi Negative. Date_ Date Tuberculin test: Positive. (Mantoux recommended—second strength tuberculin). Negative. 41. Results of chest x-ray: (X-rays should be performed on all students regardless of the tuberculin reaction. After six months, another x-ray should be taken on all positive reactors to the tuberculin test so that the second x-ray may be compared with the first.) 42. The following immunizations should be required before admission: Smallpox: Date Result Diphtheria: Date Result Typhoid fever: Date Result 14 Health Education in Teacher-Training Institutions 43. Findings and recommendations: (a) For limited activity in physical education classes^ (b) For reduced academic "load” (c) For limited extra-curricular activities. (d) Recommendations of psychiatrist or counselor. (e) Others IV. Services Rendered by the Student Health Service Clinical examinations, including a general examination of ill students and special tests where indicated, should be made. Students who cannot be adequately cared for or in whom diagnosis cannot be made by the school staff should be referred to outside physicians. Laboratory examinations, including retests as indicated, should be made. These should include initial routine urine and blood tests (including the Kahn), the Mantoux and the x-ray. All persons having a positive Mantoux reaction should be re-x-rayed after a period of six months. Therapy, including injections, should be given as indicated, or on writ- ten order of the home physician, for example: endocrine, allergy, first-aid, 'physiotherapy. Medication should be provided for treatment of simple ailments such as colds and dysmenorrhea which do not require special diag- nosis, as well as simple treatments such as eyewashes, gargles and compresses. Public health supervision involving complete control of communicable diseases should be provided, including notification of deans, parents and householders regarding isolation of cases and contacts, and regarding quaran- tine measures and isolation precautions in impending epidemics. Sanitary su- pervision of the campus should also be exercised. Notification of remediable defects should be made to both parents and students. An opportunity should be provided for conference with the stu- dent health physician relative to the correction of these defects. A re-check of all returning ill students should be made. Re-admission to college, and the indication of needed subsequent program adjustment should be the responsibility of the college physician. Advice and consultation should be given. Dental examinations should be provided and the extent of dental as well as medical treatment should be determined by individual school facilities on the basis of funds available. V. Hospitalization of 111 Students General If there is no hospital connected with the school, arrangements should be made for adequate hospitalization and clinical care in some available institution. If there is a hospital controlled by the school, all cases may be taken care of by the college physicians with consultations as needed or desired. Surgery cases should be referred, depending on the training of col- lege staff members and the policies of the school and community. Hospitalization Fund It is recommended that a portion of the student activity fee be set aside each term for a hospitalization fund. This fund should cover the 15 A Basic Plan for Student Health and expenses of from one to four weeks in the hospital but should not include laboratory work beyond routine entry urinalysis. Any special tests, medi- cations or doctor fees should be paid for by the student himself. If there is a hospital controlled by the school, the fund may cover such items as diagnostic tests, x-rays (partial or complete payment) and special medica- tions as indicated. Payment for house calls referred to outside physicians is to be made by the student or from the college student health fund as the school policies indicate. School physicians may make only the initial house call, or may follow up the case as the school and medical societies agree upon. Such calls, if made by the college physicians, may be limited to the hours during which school is actually in session, or may include night calls and week-end care also. Adequate facilities for isolation of cases of communicable disease should be provided by each school, either in the school hospital or in local hos- pitals if this is permitted. If the school attempts isolation, suitable quarters and especially trained personnel should be provided. Isolation Measures Transportation for III Students Adequate transportation services for ill students to hospital or room- ing house, via ambulance, taxi, or State-provided vehicle, should be pro- vided. VI. Correction of Remedial Defects In recommending teachers, consideration should be given to their hav- ing had physical defects corrected and meeting set standards, since the teacher’s health habits are a basis of her understanding of the health prob- lems of her students. Prospective students are reminded to study carefully the Health Examination Record of the Illinois State Examining Board for Teachers’ Certification, with reference to the fact that non-correction of these defects will prevent their certification under the Illinois State Teachers’ Examining Board. Significant health data should be available to the ex- amining board or to the employing superintendent upon request. VII. Sanitary Supervision A teacher training institution is fortunate if it is located in a com- munity with a full-time health department staff from which it may secure professional sanitary supervision. If such service is not available, the col- lege should provide for adequate sanitary supervision through a competent individual who is a member of the college health department staff. The activities of this member of the college staff would necessarily be confined to the institution itself. A comprehensive sanitation program includes: (1) the inspection of campus-controlled eating places; (2) frequent inspection of drinking fountains, toilets and restaurant food handling; (3) adequate instruction of food-handlers and supervision of food sanitation, including periodical 16 Health Education in Teacher-Training Institutions tuberculin and x-ray testing for food-handlers; (4) a monthly re-check for communicable disease, particularly respiratory infections and skin infec- tions; (5) proper screening, adequate lighting and suitable ventilation of all eating places; (6) adequate sanitary control of food and milk supplies; (7) adequate refrigeration; (8) adequate disposal of garbage; (9) the provision of a safe, a satisfactory and an adequate water supply; (10) the provision of adequate sewage disposal facilities; (11) housing sanitation; and (12) rodent and insect control. VIII. Counseling and Guidance Counseling and guidance should be the concern of every member of the faculty and may be done informally or through guidance agencies, and with the cooperation of the medical staff and householders as necessary. The guidance program should be under the direction of a qualified indi- vidual trained in the field of guidance and counseling. Any deviation on the part of the student from his usual behavior pat- tern should be investigated; e.g., depressed moods, quarrelsomeness, with- drawals, tensions, periods of irritability, homesickness, aggressiveness, de- velopment of facial tics, suspiciousness, and seclusiveness are symptomatic. Academic failure should be investigated immediately, as should sudden or consistent rule-breaking, and persistent conflicts between student, com- munity and college social and moral standards. Emphasis should be placed on good health habits and upon good study habits, including supervised study for freshmen. Likewise, there should be an evaluation of the study load weighted against time, health, energy, and extra-curricular activities, in cooperation with the necessary consultants. There should be some organization providing for the sharing of informa- tion and for cooperation between the various people concerned in this program, such as faculty, householders, and others. 17 A Basic Plan for Student Health and A Hygienic Regimen Sanitary Housing for Students—The Maintenance of Adequate Nutrition—Physical Education—The Relationship of Assignments and Examinations to the Health of the Student—The Effect of Extra Work on the Health of the Student—The Provision of Ade- quate Social and Recreational Activities for Students. I. Sanitary Housing for Students The responsibility of the teachers’ college in setting up and maintaining sanitary housing for students falls upon both the college health service and the deans. The relationship of these parties to the problem should be some- what as follows: the responsibility of defining sanitary housing should rest with the health service and that of implementing the standards with the deans. This is not an easy task since there is no standardization among private dwellings and few schools provide dormitory accommodations suit- able for the entire student body. The greatest problems are created by those students living in private homes scattered about the community. The dwellings they occupy provide a wide range in living comfort and sanitation. The householders represent a loosely organized body, for the most part willing, but often financially unable to meet the health needs of students. It would be ideal if all students could be housed in halls or dormitories. Since this situation is yet to come, all students not living in college halls should be required to live in rooms that are approved by college authorities. To provide adequate off-campus housing facilities for students, college authorities should take the initiative in calling together and organizing householders for the purpose of adopting approved living standards. Effecting a functional organization of householders rests primarily with the college deans. It should be their responsibility to call the householders together, to present to them the framework of a democratic organization and to assist them in the selection of qualified officers. The officers of the organization, together with the deans and such other college representatives as deemed advisable, should constitute an administrative council. This body should define the problems and determine the policies that are to come before the organization for discussion and adoption. They should provide the means of implementing procedures to meet these needs. Minimum standards should be set up by the college, in cooperation with the householders, under which rooms may be rented to students. These should include standards regulating: minimum floor space allowable, types and size of closet space, bath and toilet facilities, beds and bed linen, housecleaning arrangements, heating, lighting and ventilating accommo- dations, the observation of public health measures relating to disease and sanitation, the reporting of illness within the household or among the students to the health service and deans, and the availability of first aid in case of accident or sudden illness. Housing Standards and the Householders’ Association 18 Health Education in Teacher-Training Institutions Suggested Minimum Standards 1. All students except those residing at home should live in houses approved by the college. 2. The minimum floor space for a double room should be 120 square feet. 3. There should be a minimum of twelve square feet of window space per student. 4. There should be a minimum closet space of twelve square feet per person. Curtained or open closets should be discouraged. 5. Rooms should be warmed to a temperature of 68-70° F. in spring and fall as well as in winter. Each room should be equipped with a ther- mometer. 6. Standard bath facilities should provide a full modern bath and toilet unit for each eight persons, including the famiiy. (It is recommended that this standard be adjusted as rapidly as possible so that facilities are provided for each five persons.) Hot water should be provided for both men and women students in sufficient quantities to provide daily baths for Itoomers. There should be a towel rack for each person either in the bath- room or in the students’ room. 7. Clean bed linen should be provided weekly by the householder. 8. Premises should be hygienically clean. Bathrooms should be cleaned daily by the householder. Students’ rooms should be cleaned regularly, and should be cleaned thoroughly during vacation, and whenever there is a change of occupants. 9. Lights provided in each room should total at least 150 watts.* A table or floor lamp should be provided for each student. These should have a 75 to 100-watt bulb as a minimum. All lights should be shaded, the shades or reading lamps to have a light colored lining. The shade should be wide enough to permit light to fall on work at the desk or chair. 10. Single beds should be provided in all rooms for two or more students. Minimum standards for twin beds should include: 39" bed, baked enamel finish, double deck coiled springs, five-layer cotton-felted mattress or equivalent. 11. Students’ rooms should not open into the family living room. 12. Students’ rooms should not be used as passage-ways to any part of the house. 13. Each room should be equipped with a waste-paper basket. 14. Provisions should be made for laundering and pressing privileges. 15. Halls and stairways should be free from obstructions such as trunks or unnecessary articles of furniture. 16. A hand fire extinguisher should be immediately available to the occupants of each room. 17. Halls should be lighted (minimum 25 watts) until the house is closed for the night. 18. A social room should be provided for students at specified times. 19. Regulations of the State Department of Public Health regarding communicable disease control and sanitation should be observed. There * The American Institute of Architects recommends a minimum of 15' candles illumination for ordinary work. Fluorescent lights also make a difference in the wattage required. 19 A Basic Plan Fok Student Health and should be complete cooperation with local health authorities in isolating students with communicable diseases. 20. Illness of students should be reported promptly to the college physician or the college nurse. 21. It is desirable that some member of the household should be fa- miliar with, and capable of administering, simple first aid in case of acci- dents or sudden illness. 22. Possession of bed pan, wash basin, thermometer and hot water bottle or hot pad is indispensable for each household. These should be available to the students, if needed. 23. Adequate first aid supplies should be available to students. Housing Inspections There is always a certain amount of resistance to full compliance with any set of standards. Therefore, frequent inspection of premises with subsequent check-list ratings is essential. Thorough inspection requires a personnel intimately familiar with the details of adequate housing. The variety of situations encountered in making visitations is often confusing even to an expert. To offset this, deans should provide themselves with mimeographed or printed check-lists with which to rate the several items to be inspected. These check-lists should cover: the desirability of the location; the outward appearance and attractiveness of the premises; the neatness and arrangement of the living-room available to students; size and arrangement of student rooms; closet space; heating, lighting and ventilating facilities; bath and toilet facilities and fire hazards. In case students are permitted to do light housekeeping, inspections should include the accommodations for cooking by students, the equipment available, provisions for garbage and waste paper disposal and the storage and refrigeration of food. Students, also, should accept their share of the responsibility in the maintenance of sanitary conditions and in the observation of healthful prac- tices. They should cooperate with the householder by: keeping their rooms neat and homelike, being careful of furniture and premises, being considerate in the use of all utilities, observing accepted codes of conduct and courtesy, and reporting any illness in the house to the school physician. The organized housing of groups in the dormitories and fraternity houses presents its own problems in the maintenance of hygienic living, for which the college must accept responsibility. However, the detailed procedures involved are not discussed in this report because there is an organized personnel which has this responsibility. II. The Maintenance of Adequate Nutrition Students need to be supplied with sufficient knowledge and instruction as to what constitutes an adequate breakfast, lunch and dinner so that they may choose suitable meals at minimum cost in cafeterias and restaurants, plan and prepare proper meals in light housekeeping rooms and prepare adequate packed lunches. 20 Health Education in Teacher-Training Institutions The college should aid the student with respect to well-balanced meals by: providing a cafeteria on the campus where adequate meals may be se- cured by students at a minimum cost. This cafeteria should be managed by a graduate Home Economist with a major in Institutional Management and Nutrition. The cafeteria should be a part of the educational program and its manager should be considered a member of the college faculty. If the provision of a cafeteria on the college campus is not feasible, at least a suitable lunchroom should be available for the use of students who carry their lunches. Students should be given a sufficiently long lunch period (at least 20 minutes for eating and a total lunch period of 50 minutes). The college or university should provide consultation service by trained personnel for boarding houses and restaurants and for students doing light housekeeping. The consultant would assist the boarding-house keeper and restaurant manager in the planning and preparation of balanced meals for students. He would assist students in the economical purchase of foods, in the planning and preparation of balanced meals and in providing knowl- edge about proper facilities for the preparation and storage of foods. \ If a cafeteria or lunchroom is needed in the training school of a college, it should be an ideal example to students of location and arrange- ment, management, and provision of suitable food from which a balanced meal could be procured at a minimum cost. The lunchroom should be an integral part of the educational program. III. Physical Education Objectives Physical education should be closely coordinated with other parts of the school health program. Suitably guided recreation should play an important role in the development and maintenance of stabilized emotional health. Teachers of physical education should center their attention on the effect of physical activities on the entire personalities of students rather than solely the effect on circulation, respiration, muscle and other bodily systems. The objectives of physical education, as an integral part of the school health program should be: (1) to provide supervised activity during the school day as a means of relaxation from the formal types of education, as a preventive of mental fatigue, as a means of self-expression and as an aid to the development of physical fitness per se; (2) to teach the skills of many types of activities and provide sufficient opportunity for their use, so that a reasonable degree of carry-over proficiency may be attained; (3) to utilize school and afterschool activities as opportunities for students to develop leadership and group adaptability. Scope In order to be properly integrated with the general scheme of health education, a physical education program should include the regular class program, a program of voluntary intramural athletics, a varsity athletic program and "sports and play days. The completion of this program requires trained personnel and adequate facilities. The following requirements ap- pear to be essential in order to make the physical education program a well integrated part of the general school health program. 21 A Basic Plan for Student Health and 1. There should be a complete health guidance program in connec- tion with physical education along the lines indicated in the preceding section. 2. There should be close cooperation between the school medical ad- visers and physical education teachers in developing plans for modifying the physical education program for those students who are temporarily or permanently below par. Some provision should be made for an adapted program for those students who are relieved from the regularly prescribed work in physical education, in whole or in part. According to the needs of the student, a modified physical education program or a medically prescribed regimen should be arranged. 3. The physical education instructor should be versed not only in physical education, but he should also have a knowledge of and concern for the personal hygiene and nutrition of students under his care. He should understand essential first aid procedures and he should have a knowledge of the physical condition and emotional make-up of his students. 4. Adequate space should be provided. Crowding makes impossible a constructive program of physical education. Proper supplies and equipment should be available so that all members of the class may participate at one time. Adequate provisions for the practical application of the principles of personal hygiene should be made available to carry out the full intent of the program. 5. A written course of study is essential. It should give specific and progressively more difficult student goals adapted to individual capacities. In addition, students should understand the "why” of the various goals so that they in turn will be better teachers. 6. Individual schedules should be adapted to individual differences and interests, as revealed by all the various types of tests and examinations recorded within the school. Physical education should be given proper con- sideration in scheduling the student’s program. Special attention should be given to handicapped students, so that they will be in classes suited to their abilities. A physical education program in which the above recommendations are incorporated will have real meaning and significance for the individual student and should provide a carry-over interest. It will offer opportunity to the individual to meet educative situations as one of the social group and to satisfy those socially desirable urges and impulses of nature through engagement in motor activities appropriate to age, sex, condition, and stage of development. Finally, it will provide good physiological results, in- dicative of wholesome functional activity of organic systems, sufficient for the needs of the growing organisms. IV. The Relationship of Assignments and Examinations to the Health of the Student In addition to adjusting the academic load for individual students, there should be provisions whereby assignments or examinations a*e made with consideration for the health status of the student. Several factors * are involved in establishing hygienic practices in this respect. Satisfactory pro- cedures may be insured by: 22 Health Education in Teacher-Training Institutions 1. Establishing a process of education for all instructors and students with the view toward acquainting them with acceptable health practices and developing a willingness on their part to abide by them. This should em- phasize that health is really more important than an examination and that the college administration expects and demands rigid observance of health practices rather than the fulfillment of one assignment. 2. Eliminating fear on the part of the student that the instructor will punish or give low grades because of absences for illness. This should be accomplished by the instructor and student working out the details of make-up work on an individual basis and recommendations made by the school physician as an aid in guiding the instructor to make suitable ad- justments. 3. Permitting re-admission to classes following an illness only after an examination by the college physician or nurse, and an assurance that the student is ready to resume normal responsibility with reference to class work. 4. Making temporary allowances for transient defects or problems of v adjustment. 5. Providing that the assignment and examination program of each instructor should be so arranged as to be compatible with health and educa- tional values. This may be accomplished by seeing that courses of equal credit are entitled to equal preparational time, by recognition of the fact that it is a faculty and professional responsibility to help keep assignments of a course within the reasonable capacity of the average student in the time available to him for that course, by making examinations in a par- ticular course many in number and scattered throughout a semester, rather than allowing a grade to rest on the results of one examination (the emotional reaction toward final examinations is often detrimental to present and future health) and by scattering of time for final examinations as effectively as possible for all courses. V. The Effect of Extra School Work on the Health of the Student Responsibility for provisions to avoid injury to health in a college student who works rests upon the local college administrative board, col- lege physicians, and upon counseling by the deans and personnel divisions of the school. The health situations, academic problems, and needs of each student should be studied on an individual basis. The decisions and recom- mendations rendered to that student should be final, and need not serve as a precedent for future action on similar cases. There are limitations in the amount of increase of academic program beyond which no student should be allowed to go. VI. The Provision of Adequate Social and Recreational Activities for Students Suitable social and recreational activities are essential for both students and faculty. Many colleges have adequate facilities for recreation, but have provided no definite time for their use. Recreation is considered necessary, but there is a serious gap between theory and practice. 23 A Basic Plan for Student Health and Sufficient time for recreation is important. Recreation aids the individual in making a satisfactory adjustment to college life. Under supervision it acts as a substitute for less desirable forms of activities. Students should be encouraged to enter school activities, clubs and dramatics. Some of the solutions in providing adequate social and recreational activities follow: (1) enough time must be provided—late afternoon hours offer particularly good time for certain activities; (2) lounge and recreational rooms are helpful; (3) social and recreational dancing have a contribution to make; (4) ex- cellent recreational activities may be provided through nature study clubs in which the individual may pursue special interests such as the study of birds, insects and handicrafts; (5) departments in applied arts may offer "service courses” to cultivate self-expression through the arts; (6) sports clubs are effective forms of intramural recreational activities (while cen- tered around a particular form of activity, they, like all other club pro- grams, offer opportunities for social education and practice in the demo- cratic procedures used in clubs). Special provisions should be made to accommodate non-resident students during their free periods, particularly during the lunch hours, so they will not find it necessary to frequent undesirable off-campus "hang-outs.” In instances where the college is unable to offer a suitable location every effort should be exerted to induce a private individual to sponsor a tearoom or lunchroom, managed according to the college’s social standards. Every college should have an Activities Committee composed of both faculty and student representatives, through which all extra-curricular en- gagements must be cleared. Thus the social and recreational life of the student can be, to a certain extent, guided in such a way that there is neither a lack of activities at certain periods nor an over-abundance of activities at other periods. In other words, the scheduling of extra-curricular activities should be arranged with students’ scholastic program in mind. The place of the guidance counselor in assuming responsibility for help- ing those students who do not have a well-balanced program of activities is of vital importance when it comes to giving necessary push and incentive to non-participants. The development and maintenance of adequate social and recreational activities is a problem to be solved by each individual school. This demands close cooperation between the school authorities, the students themselves and the townspeople. 24 Health Education in Teacher-Training Institutions Instruction in Health and in Health Education Formal Instruction of Prospective Teachers—Health Instruction Through Student Teaching—Preparing Teachers to Detect Symp- toms or Abnormalities in Children. Health instruction is an organization of learning experiences directed toward the development of favorable health knowledge, attitudes, and practices. While it is the formal or organized health instruction of the pros- pective teacher with which we are concerned here, it is well to recognize that learning experiences, which touch upon health knowledge, attitudes and practices begin long before a child enters school, and continue throughout life, in or out of school. Whatever body of information, desirable attitudes and sound health practices a teacher or a prospective teacher may have— together with what misinformation and wrong attitudes and bad health habits he possesses—have all come from his learning experiences at home, on the streets, in school, on the playground, at the movies, on the radio, and in what he has read, heard and seen, v It is the function of health instruction to extend these learning expe- riences of the prospective teacher, to help him to supplement and scrutinize them, and to give further orientation to enable him to exemplify good health habits, think scientifically about health problems and adapt health instruc- tion to the total situation in which he as a teacher may find himself. I. Formal Instruction of Prospective Teachers While it may be wise to teach children health habits without full ex- planations of their bases, to begin the health instruction of adolescents or adults with hygiene, in its literal sense, is like building a house upon sand. Sound hygiene rests upon an understanding of the structure and function of the human body, with some knowledge of its limitations and some idea of what may go wrong with it. Hygiene is, in a sense, the distillation of our wisdom and experience with our bodies. It grows out of what we know of anatomy, physiology, chemistry, nutrition, pathology, bacteriology, and other subjects. The student who takes the course in health instruction should have some reasonable knowledge of the fundamental sciences that underlie hygiene. His course in hygiene should supplement his basic knowledge and may have to provide something of what he lacks. The whole school program contributes to health education. A consider- able amount of the foundation on which the health instruction of the teacher-in-training will be established must be built through the courses he takes in chemistry, physics, biology, physiology, psychology, sociology, nutrition, home economics, physical education, bacteriology, and genetics. The teacher-to-be should participate in healthful living; he is significantly influenced by the lighting and ventilation and cleanliness of his quarters and of his classrooms, by his contacts with the health service and by the food served in his boarding house or dormitory or the school cafeteria. As an accompaniment of direct instruction each teacher-training institution should make some effort to inventory and coordinate these various con- tributions to health instruction through the faculty health council described at the beginning of this report. 25 A Basic Plan for Student Health and The important contributions of the basic sciences must be supplemented by formal instruction in health. Ideally, health education should be based, for any one student, on an analysis of his background, and should so supplement and extend it as to give him an adequate preparation for an understanding of personal, physical, mental and community hygiene, the detection of departures from normal health, and some familiarity with health materials and the methods of health instruction. Obviously, this cannot be done in a single course. A basic course in personal and community hygiene of not less than three semester hours should be required of all prospective teachers in their first or second year. While this course may be largely personal hygiene and may give considerable time to checking upon and extending fundamentals in the health field, it can and should have something of a professional point of view in consideration of the student as a prospective teacher. It cannot, however, fulfill its primary purpose in relation to the fundamental and factual basis for hygiene and, at the same time, do an adequate job with child growth and development, mental hygiene, dental hygiene, safety education, the detection of symptoms and abnormalities, and the materials and methods of health education, all in the space of fifty or fewer class hours. The good basic course should be freed of many of these respon- sibilities and should become the prerequisite of other courses, compulsory or voluntary, which would follow and would deal adequately with these topics. Separate instruction in child growth and development is recommended unless it can be shown that all prospective teachers are receiving sufficient familiarity with this material in other courses. In the light of published studies of teacher health, which show that emotional and nervous disorders come close to being occupational diseases among teachers, and in view of the accepted idea that every elementary teacher should have a familiarity with what is known as "the mental hygiene point of view,” it is recommended that separate instruction in mental hygiene be required for all who plan to teach. Such a course might well be given in the third or fourth college year, and should presuppose completion of basic courses in hygiene and psychology. Students should also receive instruction in detecting departures from desirable standards of heating, ventilating, seating, lighting, fire hazards and fire drills, being given adequate background of instruction as to the reasons for practice in these procedures. Motivation is an important aspect of health instruction, and health in- formation, however accurate, remains academic and sterile unless at some point it alters behavior. Given adequate preparation in the subject matter of health instruction, some familiarity with materials in the field, and the opportunity to see and participate in good health teaching in the laboratory school, the prospective teacher may not need a separate course in health education. But she does need a clear understanding of the nature of health education, and the ways in which it differs from the teaching of the more traditional school subjects. Health education in the grade levels where she is to teach should receive as extensive consideration as do the other elements of the curriculum in those grades. 26 Health Education in Teacher-Training Institutions II. Health Instruction Through Student Teaching Those who teach hygiene and health education courses should supervise or be in close touch with the health education program of the training schools in order that there will be more effective coordination between the college classroom and practice. Such instructors ought to be well qualified teachers of children and should be ready and willing to conduct demon- strations of such teaching in the practice school. The training school should have a highly developed health program in order that the student may see and participate in good health teaching and sound health practices in operation. In addition, he should have an opportunity to work in a regular public school program under field condi- tions and under the supervision of one of the college staff in order that he may get real experience in schools as they are. These two types of school situations should give him a sound understanding of what the best practices are and how he may adapt such practices to the improvement of the school or classroom where he will later find himself the regular teacher. By implication and by all modern interpretations of the term, any broad ftealth program includes mental health, which cannot be dissociated from physical well-being. At one state teachers’ college in Illinois a project is developing which involves the child guidance clinic on the campus, the Illinois Institute for Juvenile Research, the Education Department and the Training Department and thus shows some promise along the lines of an improved mental hygiene point of view for prospective teachers. This project illustrates a type of student contact with practical professional work in the field of health which may be developed in other areas as well as in mental hygiene. By means of a series of seminars conducted simultaneously on three age or grade levels—early elementary, later elementary, and high school—with a member of the staff of the Institute ki charge, case studies from the child guidance clinic were studied in such a way as to allow students to learn how problem cases are analyzed and to observe some of the results from such analyses as well as consequent remedial prescriptions. Students were encouraged to ask questions about other cases in which they had an interest. On the basis of further experience, it seemed wise to require all fresh- man students who expect to teach to attend orientation seminars where they are acquainted with the mental hygiene and child guidance movements in general and are given a brief history of the work of the Institute for Juvenile Research. Sophomore students see cases presented, with diagnostic procedures, plus suggested treatment and results, with an opportunity for discussion. In a third phase, the students of the senior college continue to work with the child guidance clinic as they prepare case studies of students encountered in their own classrooms in student teaching. III. Preparing Teachers to Detect Symptoms or Abnormalities in Children Training which enables the teacher to detect successfully the symptoms or abnormalities for which children should be referred to nurses, dentists or physicians is tremendously important from the standpoint of general educa- tion. Such training properly places the emphasis upon the individual child. 27 A Basic Plan for Student Health and It is predicated upon a belief in the essential worth and value of each personality. If the child is to succeed to the fullest extent in school—either in academic attainment or in the acquisition of those physical skills that are desirable for the particular child—he must be a healthy child. To that end his physical limitations should be recognized early and where possible measures taken to correct them. Where correction is not possible, measures should be taken to lessen to the fullest degree possible the extent of the handicap and to modify the instructional program for the individual so that the educational process will be as meaningful as possible. Ability to recog- nize symptoms of illness and abnormalities of the individual child is fun- damental to any program of general education which attempts to recognize and provide for individual differences. The basic instruction having as its end the ability to recognize symptoms and abnormalities should be incorporated in the courses of instruction in health education and in the observation and practice teaching required as a part of teacher preparation as set forth in Sections I and II. Such instruc- tion should be given at the place best suited for a complete presentation of the program. This may be the teacher-training institution itself, provided suitable facilities are available or can be set up. It may be nearby clinics or institutions which are adequately equipped; or it may be a combination of teacher-training institutions and nearby clinics. The organization and development of this work should be such that proper emphasis is placed upon acquisition of skill in recognizing signs and symptoms of the common communicable diseases as well as the recog- nition of abnormalities. Provision should be made for training in certain areas: 1. A general presentation of the subject with special attention to the relation of mind and body and of the hampering effect of physical dis- abilities upon the individual child and upon all concerned. 2. General features to be observed in physical examinations, general appearance, behavior, gait, carriage, evidence of nutritional deficiencies, signs of fatigue, the influence of heredity, the mechanism of growth and the factors which influence it, types of build, methods of weighing and measuring, and the meaning and limitations of height and weight tables and averages. 3. The control of communicable diseases, including their methods of transmission and early characteristics. 4. Behavior characteristics, including social and emotional phenomena which indicate physical and mental maladjustment. 5. Description of the development and eruption of teeth, causes of decay and methods for examination of the teeth. Knowledge of the normal and recognition of departure therefrom with respect to occlusions, caries and recession of the gums. (A special committee of the Illinois State Dental Society, under the chairmanship of Dr. L. H. Johnson, has prepared an excellent Outline on Dental Health Education. Copies are available to teacher training institutions upon request to the Illinois Department of Public Health.) 6. Speech which deviates from the normal so that it interferes with satis- factory social, educational and economic relationships. 28 Health Education in Teacher-Training Institutions 7. Anatomy and physiology of the eye, especially the visible parts; theory of accommodation and causes of myopia, hyperopia and astigmatism; effects of eye strain; explanation of Snellen letters and of the effects of lenses on vision; diseases of lids, conjunctiva, cornea and lachrymal apparatus. 8. Anatomy and relationship of the nose, throat and ear; what to see and methods of examination. Diseases of the nose, throat and ear; causes of deaf- ness ; and methods of testing hearing. 9. Anatomy and physiology of lymphatic glands and thyroid gland. 10. Common deformities of chest, back and extremities, with their causes. Instruction should be given at a time in the student’s training when he is familiar with the normal child and its development. Probably the last year of the student’s course is the best time to instruct him in abnormalities and symptoms. This training should be much more than the conventional classroom in- struction of the lecture-textbook type. Adequate provision should be made for classroom demonstrations, some of which may consist of members of the class being examined by the supervisor and perhaps by other members of the class. It should be reinforced by the use of visual aids, such as appropriate motion pictures and slides which will illustrate more clearly the nature of the symptoms and the abnormalities which are being pointed out. Utilization should also be made of experts who may be available to give lectures upon their specialties. Such experts would include orthopedists, pediatricians, psychiatrists, eye, ear, nose, and throat specialists, dentists* speech pathologists and orthopedic nurses. Provision should also be made during the course of instruction for at- tendance at demonstration clinics such as the orthopedic clinics which are conducted throughout the State by the Division of Services for Crippled Children. Here an opportunity will be afforded prospective teachers to observe skilled physicians and nurses in the process of conducting actual examina- tions of children with various types of orthopedic defects. It should also be possible to arrange for attendance at speech, hearing and dental clinics where opportunity would be provided to determine the process of making examinations of this type. Other possibilities include arrangements for visits to general and mental hospitals and student health centers, offices of private physicians, dentists, public health clinics, offices of the Tuberculosis Association, and home visits with public health nurses and orthopedic nurses of the Division of Services for Crippled Children. Experiences should include observation of a complete physical examination of the child, observation of the methods used to diagnose auditory, visual, cardiac, speech, dental, and orthopedic defects as well as tuberculosis, epilepsy, malnutrition and other such conditions. Trainees should be acquainted with State provisions for special classes for physically handi- capped, those with defective vision, and the hard of hearing, and if possible, visit such classes in operation. Medical instruction for this type of training can be provided through lectures given by the medical officer of the teacher training institution and by lectures and demonstrations given by specialists who may be invited to the campus for the purpose. In this latter case arrangements may be made for special demonstration clinics to be held by such specialists. 29 A Basic Plan for Student Health and Supervision of student teaching naturally should be given by members of the instructional staff of the teacher training institution. Such personnel is well trained in this aspect of the school program. In addition, arrangements should be made for the medical officer or nurses of the health center of the teacher training institution to supervise the work of the cadet teachers in this area. Obviously the most feasible plan of providing supervised practice in de- tecting these symptoms and conditions is in the laboratory school where, fol- lowing the preliminary instruction, the teacher will have an opportunity to work with children in a classroom situation. Arrangements might also be made for the student to work in the student health center under the super- vision of the health nurse and school physician. Consideration of these aspects of health education should receive definite recognition as an important aspect of student teaching. The cadet teacher should be required to assume as much responsibility for the health aspects of her classroom work as she does for the instructional plans which she makes. She should formulate definite plans for checking the physical condition of the children in the class or classes she conducts. These plans should be reviewed, discussed, and approved by the supervising teacher. They should then be put into effect and the supervising teacher should carefully evaluate this phase of the student teaching just as she does any other part of the cadet’s work. Her evaluation should include constructive criticism and the student teacher should have the opportunity, also, to watch the master teacher demonstrate the necessary technique. This phase of the student teaching should include regular conferences at which time the cadet teacher has an opportunity to ask questions and have them answered and the master teacher has an oppor- tunity to make suggestions to the cadet. Additional opportunity for practice under supervision can be provided through making it possible for the cadet teacher to work for a period of time with the public health nurse on her school visits; to work with the school physician, local physician or dentist during his examination; to work with field workers of the Division of Services for Crippled Children at their clinics or on home visits; and for a time to assume responsibility for indi- vidual study of one or two children and evaluation of these studies with qual- ified medical personnel. 30 Health Education in Teacher-Training Institutions In-Service Training in Health and Health Education for Teachers Supervision and Consultation—Summer Health Education Work- shops—Extension Courses—Short Institutes—Reading Circles— Visitations—The School Health Committee. I. Policies Many teachers have not had the privilege of recent health education prep- aration. Everyone is aware of the tremendous load the teacher carries. It is with the hope of providing guidance that in-service training is suggested as one method of better equipping the teachers for the important task ahead. Teachers undoubtedly will welcome effective, practical help from those who have something to give. In-service training provides such an opportunity. Community conditions and needs, parent-school relationships, health status, immediate and contributing environmental factors, the previous training of teachers and other factors must all be considered. II. Desirable Procedures In-service Health Education Through Supervision and Consultation This means that direct help will be given to the teachers "omthe-job” by those who are particularly well qualified. This assistance will be highly in- dividualized. 1. Direct aid from a well-qualified supervisor of health education is an ideal method of in-service training where it is available. 2. Health consultants, such as doctors, dentists, public health nurses, nutritionists, and home advisers, may be of great assistance in the training of teachers in almost all phases of the school health program. 3. Conferences of teachers with nurses, engineers or other qualified persons concerning environmental problems are worthwhile. 4. Meetings where teachers (both large and small groups) and health consultants discuss suitable health activities and health materials are profitable. Health councils with teacher, student, parent, and health consultant membership have been formed to good advantage in some schools. 5. Conferences between the nurse and teacher provide an excellent opportunity for the teacher to learn more about individual children and about the health problems of her school. Whenever possible, time for this conference should be provided in the teacher’s schedule. 6. Doctor, dentist, and nurse examination of students with teacher and parents present provide an excellent opportunity for establishing desirable health attitudes and developing additional health knowledge. A teacher also learns about her pupils through being present when such health examinations are performed. 31 A Basic Plan for Student Health and A workshop is not a lecture class. It is a plan devised to help each participant arrive at solutions of particular problems or at better understand- ings of felt or discovered needs. In a workshop, where teachers are free from the pressure of three or four courses, all of which require extensive reading and term papers, they have time to plan related, adaptable, timely outlines which serve as a basis for the direction the curriculum will take for their own students. The particular problem or problems to be attacked in the workshop should be determined through cooperative planning between the participants, consultants and other resource people. The following suggested procedures for developing workshops may be helpful: 1. It is desirable that the initiation of the program should come from a local group of teachers under the leadership of (a) the local school administrator (the county or city superintendent of schools or the village principal) or (b) the county or city health officer. 2. The permission of the local board of education, in whose area the workshop is to be organized, should be obtained for the use of build- ings and grounds. 3. A nearby teachers college, liberal arts college, or university may be requested to furnish instruction and assistance, as may suitable rep- resentatives of the State or local health departments and other quali- fied persons. 4. Wherever possible, the workshop should operate in such a way that the teacher will receive some form of academic credit for the work. Teachers who do not desire credit, and who are willing to work without the credit incentive, should not be excluded from participation, 5. The daily program should be flexible to permit efficient use of time so that needed visitations, excursions, and inspections can be made. 6. Whenever possible, the workshop should be run continuously, that is, from one day to the next, rather than be called once each week for a series of meetings. Continuous and fulltime work on a workshop problem promotes efficiency and continuity of work. This would suggest that the best workshops can probably be organized during vacation periods. The length of time the workshop is to run will depend upon the amount of credit to be given. Summer Health Education Workshops Extension Courses Whenever possible, extension courses should be organized around group needs. The following areas need consideration: nutrition, physical education, personal and community hygiene, growth and development, and techniques for recognizing departures from normal health. Short Institutes (Held Locally) on School Health or Health Education Such institutes would help teachers to see the great possibilities in health education. Plans for various kinds of activities, suggested procedures, discus- 32 Health Education in Teacher-Training Institutions sion of scientifically sound books, and scientific data presented in a dynamic, challenging fashion, might well be offered. At a meeting of this type, held on a regular institute day as now provided in each county, qualified speakers might discuss such topics as; 1. The teacher’s health and grooming in relation to successful teach- ing. 2. Nutrition and learning. 3. Recognition of departures from normal health. 4. The danger of false emphasis on perfect attendance. 5. The local, county and State health departments and their relation to the school. A series of appropriate motion pictures on health subjects might also be shown. In-service Training Through Teacher’s Reading Circles or Through Making Health Education Materials Available to Teachers ' The local county and State departments of public health provide excellent education aids of many kinds. The school health committee, or some teacher in the school, should feel responsible for securing as much help as possible from these departments. Perhaps a committee composed of representatives from several schools in a county could be set up to evaluate material available from many sources. Visitations to Other Communities, Health Centers and Clinics Alert teachers welcome the opportunity of visiting other areas where ef- fective work is being carried on. Such visitation should provide not only an opportunity for discussion between the visitors and those concerned with the plan that is being studied, but it should also include a report to fellow teachers at home about what was observed. At the beginning of this report suggestions were made for the organiza- tion of a committee in the school system to develop specific plans and cur- ricula in health education. Participation in the work of such a program plan- ning committee is a highly educational process for those teachers who par- ticipate. School Health Committee Illinois Joint Committee on School Health Developed with the approval of GOVERNOR DWIGHT H. GREEN and organized October 29, 1943, under the leadership of ROLAND R. CROSS, M.D., Chairman, Director of the Department of Public Health VERNON L. NICKELL, Superintendent of Public Instruction FRANK G. THOMPSON, Director of the Department of Registration and Education with the consultant services of CLAIR E. TURNER, A.M., Ed.M., D.Sc., Dr.P.H., Professor of Public Health, Massachusetts Institute of Technology, Cambridge. 33 A Basic Plan for Student Health and Agencies and Representatives on the Joint and Liaison Committees Agencies Representatives State Department of Public Health *Dr. Allan J. McLaughlin, Medical Admin- istrative Consultant. *Mrs. Leona East, Chief, Division of Public Health Instruction, Springfield. *Dr. Howard W. Lundy, Division of Public Health Instruction, Springfield. Mr. B. K. Richardson, Senior Administrative Officer, Springfield. State Office of Public Instruction *Mr. Ray O. Duncan, Director of Health and Physical Education, Springfield. State Department of Registration and Education *Mr. Elmer P. Hitter, Coordinator, Teachers College Division, Springfield. Illinois State Normal University Dr. R. W. Fairchild, President, Normal. *Dr. Rose Parker, Director of Special Educa- tion, Normal. Southern Illinois Normal University.... Dr. Bruce W. Merwin, Acting President, Car- bondale. £Dr. Roscoe Pulliam, President, Carbondale. *Dr. Marie Hinrichs, Professor of Physiology and Health Education, Carbondale. Northern Illinois State Teachers College Dr. Karl L. Adams, President, DeKalb. *Mr. O. M. Chute, Director of Training, DeKalb. *Dr. Charles E. Howell, Professor of Social Science, DeKalb. Eastern Illinois State Teachers College. . Dr. Robert G. Buzzard, President, Charleston. *Dr. Harold M. Cavins, Associate Professor of Hygiene, Charleston. Western Illinois State Teachers College Dr. F. A. Beu, President, Macomb. *Dr. Fred H. Currens, Dean of the Faculty, Macomb. University of Illinois Dr. A. C. Willard, President, Urbana. *Dr. George T. Stafford, Professor of Phys- ical Education, Urbana. Agricultural Extension Service, University of Illinois Miss Fannie Brooks, R.N., Health Education Specialist, Urbana. Illinois Commission for Handicapped Children *Mr. Lawrence J. Linck, Executive Director, 211 West Wacker Drive, Chicago. Institute for Juvenile Research, State Department of Public Welfare Dr. Richard L. Jenkins, Acting Superintend- ent, 907 South Wolcott Avenue, Chicago. Dr. Paul L. Schroeder, Former Superintend- ent, 907 South Wolcott Avenue, Chicago. County Superintendent of Schools Mr. Ruel Hall, Kankakee. * Member of Liaison Committee. } Deceased, March 27. 1944. 34 Health Education in Teacher-Training Institutions Agencies Representatives Illinois Association of School Boards.... Mr. Robert M. Cole, Executive Director, First National Bank Building, Springfield. Illinois City Superintendents’ Association Mr. H. B. Black, President; Superintendent of Schools, Mattoon. Illinois Congress of Parents and Teachers Mrs. Everett F. Butler, State Health Chair- man, Box 192, Alton. Illinois Dietetic Association Miss Marie Dohm, Chairman, Community Education Section; Nutritionist, Cook County Public Health Unit, 737 South Wolcott Avenue, Chicago. Illinois Education Association Mr. Irving F. Pearson, Executive Secretary, 100 East Edwards Street, Springfield. §Mr. Lester R. Grimm, Research Director, 100 East Edwards Street, Springfield. Illinois High School Principals’ Association Mr. Lyman K. Davis, Principal, Springfield High School. Illinois Home Economics Association. . . Dr. Adelaide Spohn, Nutritionist, Elizabeth McCormick Memorial Fund, 848 North Dearborn Street, Chicago. Illinois Physical Education Association. . *Dr. C. O. Jackson, Professor of Physical Edu- cation, University of Illinois, Urbana. Illinois Public Health Association Dr. E. A. Piszczek, Secretary; Director, Cook County Public Health Unit, 737 South Wol- cott Avenue, Chicago. Illinois State Dental Society Dr. Lloyd C. Blackman, 702 Professional Building, Elgin. Dr. L. H. Johnson, 304 West Armstrong Street, Peoria. Illinois State Medical Society Dr. James H. Hutton, State Board of Public Health Advisors, 30 North Michigan Blvd., Chicago. Illinois State Nurses Association Miss Sarah Daily, R.N., President, 8 South Michigan Avenue, Chicago. Illinois Statewide Public Health Committee Mrs. Guy A. Tawney, Co-Chairman, 502 West Main Street, Urbana. Illinois Tuberculosis Association Mr. W. P. Shahan, Executive Secretary, First National Bank Building, Springfield. Chicago Board of Education Dr. William H. Johnson, Superintendent of Schools, Chicago. *Mr. A. H. Pritzlaff, Director of Physical Edu- cation, Chicago. Chicago Board of Health Dr. Herman N. Bundesen, President, 54 West Hubbard Street, Chicago. U. S. Public Health Service Advisor: DR. MAYHEW DERRYBERRY, Chief, Field Activities in Health Education, Washington, D. C. * Member of Liaison Committee. § Chairman of Liaison Committee. 35 A Basic Plan for Student Health and Membership of Subcommittees Ex-officio Members of All Subcommittees Mr. O. R. Barkdoll, Assistant Director of Health and Physical Education, Office of the Illinois Superintendent of Public Instruction, Centennial Building, Springfield. *Mr. Ray O. Duncan, Director of Health and Physical Education, Office of the Illinois Superintendent of Public Instruction, Centennial Building, Springfield. *Mrs. Leona East, Chief, Division of Public Health Instruction, Illinois Department of Public Health, Capitol, Springfield. *Mr. Elmer P. Hitter, Coordinator, Division of Teachers’ Colleges, Illinois Depart ment of Registration and Education, Springfield. Mr. Foster Keagle, Assistant Director of Health and Physical Education, Office of the Illinois Superintendent of Public Instruction, Centennial Building, Springfield. *Dr. Howard W. Lundy, Division of Public Health Instruction, Illinois Department of Public Health, 408 E. Monroe Street, Springfield. *Dr, Allan J. McLaughlin, Medical Administrative Consultant, Illinois Department of Public Health, Capitol, Springfield, Mr. B. K. Richardson, Senior Administrative Officer, Illinois Department of Public Health, Capitol, Springfield. Miss Elsa Schneider, Assistant Director of Health and Physical Education, Office of the Illinois Superintendent of Public Instruction, Centennial Building, Springfield. SUBCOMMITTEES ON THE SCHOOL HEALTH PROGRAM IN PRIMARY AND SECONDARY SCHOOLS Underlying Principles Relating to Administration, Educational Procedures, and Cooperative Relationships. CHAIRMAN: Mr, R. V. Jordan, City Superintendent of Elementary Schools, Centralia. MEMBERS: *Mr. Ray O. Duncan, Director of Health and Physical Education, Office of the Illinois Superintendent of Public Instruction, Centennial Building, Springfield. *Mrs. Leona East, Chief, Division of Public Health Instruction, Illinois Department of Public Health, Capitol, Springfield. Dr. E. H. Mellon, City Superintendent of Elementary and High Schools, 601 West John Street, Champaign. Dr. Sumner M. Miller, Commissioner of Health of the City of Peoria, and Peoria County Defense Zone Health Officer, City Hall, Peoria. Specific Objectives. CHAIRMAN: Dr. Parker Dooley, Assistant Professor of Pediatrics, University of Chicago, 950 East 59th Street, Chicago. MEMBERS; Dr. R. V. Brokaw, Chief, Division of Cancer Control, Illinois Department of Public Health, 505 South Fifth Street, Champaign. Miss Maude B. Carson, R.N., Chief, Division of Public Health Nursing, Illinois Department of Public Health, 216Va East Monroe Street, Springfield. Mr. Carl Gross, Principal Sanitary Engineer in Charge of Sewage and Stream Pollu- tion, Division of Sanitary Engineering, Illinois Department of Public Health, Cap- itol, Springfield. * Member of Liaison Committee. 36 Health Education in Teacher-Training Institutions Dr. Leslie W. Irwin, Professor of Physical Education, University High School, Uni- versity of Chicago, Chicago. Dr. L. H. Johnson, Illinois State Dental Society, 304 West Armstrong Street, Peoria. Miss Leone Pazourek, Nutrition Consultant, Division of Maternal and Child Hy- giene, Illinois Department of Public Health, 212 West Monroe Street, Springfield. *Professor George T. Stafford, Department of Physical Education, University of Illinois, Urbana. Miss Louise Sullivan, Health Education Director, Joliet Grade Schools, 909 Oneida Street, Joliet. Healthful School Environment. CHAIRMAN: Mr. H. A. Spafford, Principal Sanitary Engineer in Charge of Water, Division of Sanitary Engineering, Illinois Department of Public Health, Capitol, Springfield. MEMBERS: Mr. Robert Cole, Executive Director, Illinois Association of School Boards, First National Bank Building, Springfield. *Dr. Fred H. Currens, Dean of the Faculty, Western Illinois State Teachers College, Macomb. Mr. Harry E. Haughey, Superintendent of Buildings, Springfield Public Schools, * Springfield Board of Education, 206 East Adams Street, Springfield. Mr. Otis Keeler, Assistant to Superintendent of Public Instruction, Office of Illinois Superintendent of Public Instruction, Centennial Building, Springfield. Mr. Lewis V. Morgan, DuPage County Superintendent of Schools, Wheaton. Dr. B. L. Smith, Assistant City Superintendent of Schools, Alton. School Health Services. CHAIRMAN: Dr. Hugo V. Hullerman, Chief, Division of Maternal and Child Hygiene, Illinois Department of Public Health, 212 West Monroe Street, Springfield. MEMBERS: Dr. Arlington Ailes, Director of the Hygienic Institute, and LaSalle County Defense Zone Health Officer, LaSalle. Miss Alice E. Dalbey, R.N., Springfield School Nurse, 1205 South Second Street, Springfield. Dr. Moreland Emerson, Chief, Division of Public Health Dentistry, Illinois Depart- ment of Public Health, 220 Reisch Building, Springfield. Mr. Ray Graham, Director of Education of Exceptional Children, Office of the Illinois Superintendent of Public Instruction, Centennial Building, Springfield. Dr. Richard L. Jenkins, Institute for Juvenile Research, 907 South Wolcott Avenue, Chicago. Mr. Foster Keagle, Assistant Director of Health and Physical Education, Office of the Illinois Superintendent of Public Instruction, Centennial Building, Springfield. Mr. Lawrence J. Linck, Executive Director, Illinois Commission for Handicapped Children, 211 West Wacker Drive, Chicago; and Director, Division of Services for Crippled Children, University of Illinois, 1105 South Sixth Street, Springfield. Dr. D. E. Lindstrom, Professor of Rural Sociology, Department of Agricultural Economics, University of Illinois, College of Agriculture, Urbana. Mr. George S. Olsen, Superintendent and Principal of the Lyons Township High School, La Grange. Dr. Paul L. Schroeder, Institute for Juvenile Research, 907 South Wolcott Avenue, Chicago. Dr. Howard J. Shaughnessy, Chief, Division of Laboratories, Illinois Department of Public Health, 1800 West Fillmore Street, Chicago. Mr. Edward H. Stulljcen, Principal, Montefiore Special School, 655 West Fourteenth Street, Chicago. * Member of Liaison Committee. 37 A Basic Plan for Student Health and Organization of the Student Day in the Interest of the Mental and Physical Health of the Pupil CHAIRMAN: Miss Iris Boulton, Head of the Department of Physical Education for Girls, New Trier Township High School, Winnetka. MEMBERS: Mr. O. R. Barkdoll, Assistant Director of Health and Physical Education, Office of the Illinois Superintendent of Public Instruction, Centennial Building, Springfield. Miss Mabel Bradham, Rural Critic, Department of Training, Eastern Illinois State Teachers College, 840 Sixth Street, Charleston. Mrs. Gordon Fillingham, Illinois Rural Education Committee, R. R. No. 2, Pontiac. Dr. Lee O. Frech, Pediatrician, Division of Maternal and Child Hygiene, Illinois Department of Public Health, 212 West Monroe Street, Springfield. Miss Rena Hodgen, Supervisor of Home Economics Education, Board for Vocational Education, Office of the Illinois Superintendent of Public Instruction, Centennial Building, Springfield. *Dr. C. O. Jackson, President, Illinois Physical Education Association, Professor of Physical Education, University of Illinois, Urbana. Dr. Richard L. Jenkins, Institute for Juvenile Research, 907 South Wolcott Avenue, Chicago. Dr. D. E. Lindstrom, Professor of Rural Sociology, Department of Agricultural Economics, University of Illinois, College of Agriculture, Urbana. Mr. Frank E. Oneal, Assistant to the State Superintendent of Public Instruction, Office of the Illinois Superintendent of Public Instruction, Centennial Building, Springfield. *Dr. Rose Parker, Director of the Division of Special Education, Illinois State Normal University, Normal. Miss Leone Pazourek, Nutrition Consultant, Division of Maternal and Child Hy- giene, Illinois Department of Public Health, 212 West Monroe Street, Springfield. Mr. Robert Ring, Assistant to the State Superintendent of Public Instruction, Office of the Illinois Superintendent of Public Instruction, Centennial Building, Springfield. Miss Susan Scully, Gompers School, 12302 South State Street, Chicago. Dr. Paul L. Schroeder, Institute for Juvenile Research, 907 South Wolcott Avenue, Chicago. Mr. A. Edson Smith, Principal, Robinson Township High School, Robinson. ■The Health of the Teacher and Other School Employees. CHAIRMAN: Mr. Clarence D. Blair, St. Clair County Superintendent of Schools, Belleville. MEMBERS: Mr. Luther J. Black, Secretary of the Illinois State Teachers’ Examining Board, Office of the Illinois Superintendent of Public Instruction, Centennial Building, Springfield. Mrs. Everett F. Butler, State Health Chairman, Illinois Congress of Parents and Teachers, Box 192, Alton. Mr. Robert Cole, Executive Director, Illinois Association of School Boards, First National Bank Building, Springfield. §Mr. Lester R. Grimm, Research Director, Illinois Education Association, 100 East Edwards Street, Springfield. Dr. Richard L. Jenkins, Institute for Juvenile Research, 907 South Wolcott Avenue, Chicago. * Member of Liaison Committee. § Chairman of Liaison Committee. 38 Health Education in Teacher-Training Institutions Dr. Milton H. Kronenberg, Chief, Division of Industrial Hygiene, Illinois Depart- ment of Public Health, 1800 West Fillmore Street, Chicago. Dr. David F. Loewen, Medical Director and Superintendent, Macon County Tuber- culosis Sanatorium, 400 West Hay Street, Decatur. Dr. Paul L. Schroeder, Institute for Juvenile Research, 907 South Wolcott Avenue, Chicago. Miss Florence Wolfe, Science Teacher, Joliet Township High School and Junior College, Joliet. SUBCOMMITTEES ON THE HEALTH PROGRAM IN TEACHER TRAINING INSTITUTIONS CHAIRMAN: * Dr. Marie Hinrichs, Professor of Physiology and Hygiene, Head of Department, and College Physician, Southern Illinois Normal University, Carbondale. Mr. Luther J. Black, Secretary of the Illinois State Teachers’ Examining Board, Office of the Illinois Superintendent of Public Instruction, Centennial Building, Springfield. Dr. Richard F. Boyd, Chief, Division of Local Health Administration, Illinois De- partment of Public Health, 2I6V2 East Monroe Street, Springfield. Miss Rachel Jackson, R.N., Northern Illinois State Teachers College, DeKalb. Dr, Richard L. Jenkins, Institute for Juvenile Research, 907 South Wolcott Avenue, Chicago. Dr. Clifford Pearce, Western Illinois State Teachers College, Macomb. Dr. Paul L. Schroeder, Institute for Juvenile Research, 907 South Wolcott Avenue, Chicago. Dr. Olga Sirola, College Physician, Western Illinois State Teachers College, Macomb. Miss Mary E. Thompson, R.N., Eastern Illinois State Teachers College, Charleston. Miss Lucy K. Woody, Dean of Women, Southern Illinois Normal University, Car- bondale. Student Health Service. T . . Hygienic Regimen. CHAIRMAN: ° Dr. Olga Sirola, College Physician, Western Illinois State Teachers College, Macomb. CO-CHAIRMAN: Dr. C. E. Horton, Director of the Division of Health and Physical Education, Illinois State Normal University, Normal. MEMBERS: Mr. Cecil Brown, Student, Southern Illinois Normal University, Carbondale. Mr. E. G. Lentz, Dean of Men, Southern Illinois Normal University, Carbondale. Mr. J. C. McCaffrey, Division of Laboratories, Illinois Department of Public Health, 1800 W. Fillmore Street, Chicago. Miss Anna L. Simpson, Student, Northern Illinois J?tate Teachers College, DeKalb. Miss Leone Ware, R.N., Division of Public Health Nursing, Illinois Department of Public Health, East Monroe Street, Springfield. • Member of Liaison Committee. 39 A Basic Plan for Student Health Health Instruction. CHAIRMAN: *Dr. Harold M. Cavins, Associate Professor of Hygiene, Department of Biological Sci- ence Eastern Illinois State Teachers College, Charleston. MEMBERS: O. M. Chute, Director of Training, Northern Illinois State Teachers College, DeKalb. Miss Alice M. Heath, Director of Health Education, Peoria County Tuberculosis Association, 229 South Jefferson Avenue, Peoria. *Dr. Charles E. Howell, Professor of Social Science, Northern Illinois State Teachers College, DeKalb. Dr. L. H. Johnson, Illinois State Dental Society, 304 West Armstrong Street, Peoria. Miss Jayne Shover, Supervisor of Speech Rehabilitation, and Hearing Consultant, Division of Services for Crippled Children, University of Illinois, 1105 South Sixth Street, Springfield; and Illinois Commission for Handicapped Children. Dr. Walter Stevenson, Illinois Board of Public Health Advisors, 510 Maine Street, Quincy. In-Service Training. CHAIRMAN: Miss Elsa Schneider, Assistant Director of Health and Physical Education, Office of the Illinois Superintendent of Public Instruction, Centennial Building, Springfield. MEMBERS: Miss Miriam Anderson, Department of Physical Education, Northern Illinois State Teachers College, DeKalb. Dr. Karl Bleyl, Assistant Professor of Biological Science, Illinois State Normal University, Normal. *Professor O. M. Chute, Director of Training, Northern Illinois State Teachers College, DeKalb. Mrs. Bess D. Hale, Peoria Central High School, Peoria. Mr. Ernest M. Harshbarger, Champaign County Superintendent of Schools, Urbana. Dr. Bryan Heise, Director of Extension Service, Eastern Illinois State Teachers College, Charleston. *Dr. Charles E. Howell, Professor of Social Science, Northern Illinois State Teach- ers College, DeKalb. Mrs. Madeline Roessler, R.N., Cook County Public Health Unit, Cook County Bureau of Public Welfare, 737 South Wolcott Avenue, Chicago. Dr. E. K. Steinkopff, Chief, Division of Tuberculosis Control, Illinois Department of Public Health, 718 Reisch Building, Springfield. * Member of Liaison Committee. 40