A BASIC PLAN FOR 
HEALTH EDUCATION 
AND THE 
SCHOOL HEALTH PROGRAM 
Issued Jointly by 
VERNON L. NIC KELL, Superintendent 
Office of Public Instruction 
ROLAND R. CROSS, M.D., Director 
Department of Public Health 
FRANK G. THOMPSON, Director 
Department of Registration and Education 
PRINTED IN JULY, 1944, BY AUTHORITY OF THE 
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 Student Health and 
Health Education in Teacher-Training Insti- 
tutions. STATE OF ILLINOIS 
DWIGHT H. GREEN, Governor 
a basic plan for 
HEALTH EDUCATION 
AND THE 
SCHOOL HEALTH PROGRAM 
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 LNICKELL 
Superintendent of Public Instruction 
FRANK 0. THOMPSON 
Director of the Department of Registration and Education 
CLAIR E. TURNER, Dr.P.H., Consultant 
■ 248 
68077) 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 
Underlying Principles Relating to Administration, Educational Pro- 
cedures and Cooperative Relationships 10 
Specific Objectives 17 
The Organization of the Student Day in the Interest of Mental and 
Physical Health 26 
A Healthful School Environment 38 
School Health Services 48 
The Health of the Teacher and Other School Employees 65 
In-Service Training in Health and Health Education for Teachers . . 71 
List of Committee Members 74 Foreword . . . 
This report comes to you from three agencies of your State Government, 
and represents the work of the committees listed herein. It was prepared for 
the use of local communities in planning their own programs of school health 
and health education. It is believed that local planning committees like those 
suggested on another page will find this document to be of such nature, 
scope, and detail as to form a helpful framework within which the program 
for the individual county or community may be built. This report is a guide 
and not a graded course of study. 
Effective programs and curricula are best prepared at the local level 
with the participation of the health personnel and teachers concerned. This 
report recognizes the school health program as an important element in a 
community-wide program of health education. It presupposes the cooperation 
of local official and voluntary health agencies. Insofar as possible, staff 
members of the three State agencies concerned and the members of the 
continuing Illinois Joint Committee on School Health and its Liaison Com- 
mittee will assist in the development of local programs. The five State 
Teachers Colleges and Normal Universities and the University of Illinois 
will gladly assist schools in their respective areas when possible. 
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 State 
agencies concerned, and may be addressed to the Joint Committee’s Chair- 
man. 
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 knowledges, 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 estab- 
lishment of such teacher-pupil relationships as make a safe and sanitary 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 physical 
education program are the protection and improvement of health; the de- 
velopment 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 Health Education 
Suggested Organization tor Program Planning 
The school health program of each school system and the health educa- 
tion program in each community must be developed locally. This report is 
prepared primarily for the use of local planning committees. The following 
suggestions describe desirable procedures in organizing and conducting the 
school health and health education program: 
I. The Community Health Committee or Council. 
Steps toward increasingly effective community organization for health 
education have already been taken spontaneously and independently 
by many widely separated communities in Illinois and in the Nation. The 
initiative has come variously from school systems, public health de- 
partments, private health agencies, or interested non-professional civic 
leaders. The basic plan toward which the experience of such communi- 
ties seems to point is the development of a permanent Community 
Health Committee, or City or County Health Council, which carries 
on a continuing cooperative study and gives impetus to the program. 
With the guidance of the school administration and the health officer 
such a committee or council, composed of representatives of all in- 
terested groups in the area, including the medical and dental pro- 
fessions, may go far toward ensuring the continued growth of the 
school and community health program. Many areas find it possible to 
appoint one individual to coordinate health education activities along 
lines discussed in the report under the section on School and Health 
Department Relationships. 
II. The Health Committee or Council of the School System (Curriculum 
Committee). 
It is hoped that each local Illinois school system, city or county, will 
plan, through appropriate committee organization, its own detailed 
school health program and health education curriculum. Such a com- 
mittee, under the leadership of the school superintendent, should have 
a membership representing principals, supervisors, teachers, and health 
specialists, including in the latter group the full-time local health 
officer if there is one, and other health specialists from the health 
department in areas where the health department furnishes school health 
services. Representatives of other cooperating agencies may also serve 
effectively. The local program needs to be planned with locally desired 
adaptations, and with an amount of detail which cannot be included in 
the basic plan proposed in this publication. This publication does not 
undertake to set forth a graded program of health instruction nor 
detailed methods of procedure. 
III. The Health Committee of the Individual School. 
In addition to the central program-planning or curriculum committee, 
it may be desirable for each school to have a staff health committee. 
In the secondary school, student participation will also be desirable. 
This committee in the individual school will be concerned with the 
implementation of the local curriculum to make sure that plans are 
effectively carried out, that undesirable duplication is avoided, and that 
continuous progress is made. 
8 and the School Health Program 
9 A Basic Plan for Health Education 
Underlying Principles Relating to Administration, 
Educational Procedures and Cooperative 
Relationships 
The Place of the Health Program in the Program of General Educa- 
tion—The Key Position of the Classroom Teacher in Health Educa- 
tion—Teacher-Supervision and Guidance in Health Education— 
Relationship of Health Instruction to Other School Experiences— 
Relationship of School Health Education to Community Health 
Education—Implementation of the Program Through the Health 
Committee or Council—School a?7d Health Department Relation- 
ships. 
I. The Place of the Health Program in the Program of 
General Education 
The education of the child is designed to enable him to make the most 
of his natural physical and mental endowments throughout life so that he 
may have the maximum capacity to enjoy life and to serve usefully his family, 
society, and himself. 
Since his use of other attainments is conditioned by the state of his health, 
those factors which tend to secure each child’s own optimum degree of health 
are fundamental components of his preparation for life. These factors embrace 
school health services, instruction and training in the methods of healthful 
living. These factors are complementary to each other and inseparable from 
the child’s general education, into which they should be integrated. 
The prime objective of all school health activities will have been attained 
when each child who leaves school is as nearly as possible a perfect individual 
in the complete biological sense. Such perfection includes the anatomical and 
physiological development of the body and the mind in relation to the 
environment. This perfection cannot be profitably contemplated as being 
limited to the school years solely. What happened before the child began his 
schooling and what is to happen after he has finished it are constant con- 
siderations. Indeed no consideration in the life of the child may be excluded 
as irrelevant or even unimportant. 
The component objectives of all school health services and school health 
education are: 
To inspire the child with a desire to be well and happy; 
To convey to the child a public and personal health ideal, designed to 
ensure for him the continuation throughout life of wholesome and ef- 
fective living, physical and mental; 
To educate the child, according to a definite plan, in the cultivation of 
those habits of living which will promote his present and his future 
health; 
To impart health knowledge and attitudes to the child so that he 
will make intelligent health decisions; 
10 and the School Health Program 
To develop in the child a scientific attitude toward health matters, 
and an understanding of the scientific approach to health problems; 
To maintain adequate sanitation in the school, the home and the 
community; 
To protect the child against communicable and preventable diseases 
and avoidable physical defects by providing effective public health con- 
trol measures, both individual and social, throughout the school and the 
community; 
To bring each child up to his own optimal level of health; 
To extend the school health program into the home by obtaining fam- 
ily and community support for the program; 
To discover early any physical defects the child may have, secure 
their correction to the extent that they are remediable, and assist the child 
to adapt himself to any residual handicap; 
To provide healthful school living for the child; 
To relate the school health program to the health program in the 
community so that it may deal with real, current and practical problems; 
To organize effectively not only the program of direct health instruc- 
tion but the equally important indirect learning experiences of the child 
in the field of health. 
II. The Key Position of the Classroom Teacher in Health Education 
Clearly the key person in the school health program is the classroom 
teacher. It is the teacher who will implement any principles of health educa- 
tion which the local school and public health administrators may develop. It is 
she who sets the classroom pattern and carries the burden of the instruction. 
Upon her rests largely the final responsibility for the success or failure of any 
proposal for school health education. Unless she undeistands and accepts her 
responsibility in the program, the efforts of administrators and supervisors 
will go for naught 
The leaders of the teaching profession are deeply conscious of the need 
for more adequate school health programs. They have long held health a 
cardinal principle of education, and they recognize that the school should 
be the most important single organized social agency for the accomplishment 
of the health educational purposes here envisioned. Admittedly many teachers 
are already overburdened with a multiplicity of tasks. Seldom is subject mat- 
ter subtracted from the school offerings; school programs are built rather 
by addition to the already crowded requirements. Under these circumstances 
it may be necessary to see that such teachers’ loads are lightened, if the 
teachers are to participate effectively in a school health program. In most 
cases, however, teachers can and will find time to work on the health pro- 
gram if they are convinced of its worth. They need, of course, to be health 
conscious themselves and to be just as much concerned with the physical de- 
velopment of the children as with their mental achievement. They need 
particularly to realize that health cannot profitably be taught simply as a 
skill subject: it is rather a mode of life. 
11 A Basic Plan for Health Education 
The elementary and secondary school teacher should: 
Understand growth and development of children (physical, mental, 
emotional and social) ; 
Understand the materials and methods of health education, both as 
to direct instruction and as to indirect learning experiences; 
Have a basic understanding of the philosophy and methods of teaching 
physical education, and know what physical education can contribute to 
the education of the child; 
Be able to recognize as early as possible, and cope with, any deviation 
from the normal mental, physical, and emotional development in children; 
Have basic training in first aid and safety; 
Understand the health problems and resources of the community; 
Be an example of one who lives by recognized beneficial health habits. 
III. Teacher-Supervision and Guidance in Health Education 
The organization of an ideal program of health education in a school 
system requires a coordinating, directing head who will have the respon- 
sibility of supervision. In school systems in which there is no health educator, 
coordinator, or director who is responsible for the supervision of health teach- 
ing, the responsibility for supervision of this phase of the program falls to 
the supervisory authority. In addition, the teacher has a right to expect help 
from the school physician and nurse in understanding the individual child. 
Among the educational principles that need to be kept constantly in mind 
in the teaching of health, the following* may be cited as fundamental: 
In health education, as in character education, special consideration 
needs to be given to the child’s indirect learning experiences that take 
place not only in the school but also in the home and in the community. (In 
the school these will involve such things as the actual school health serv- 
ices, the sanitation of the school, the lunch period, the organization of the 
day and the entire program of healthful school living.) 
The child should think of health as a matter of conduct, not as a subject 
of instruction, for health knowledge is only a guide for healthful living. 
In the field of health, as in other areas, repetition, accompanied by satis- 
faction, is necessary for the most effective formation of habits and for the 
maintenance of these habits at each grade level. 
Emphasis is placed upon what to do, not upon what not to do. (The 
teaching is positive, not negative.) 
Children are commended for success. 
Particular care is taken not to hold the child responsible for the improve- 
ment of conditions over which, for some such reason as lack of family co- 
operation, he has no control. 
The teacher helps the child to sec that the ultimate reward of health 
practices will be found in growth, in improved physical accomplishment, and 
in other concrete evidences of health rather than in school records as such. 
‘Adapted from Principles of Health Education, C. E. Turner, pp. 70-77, Second edition, 
1939, D. C. Heath and Company. 
12 and the School Health Program 
For young children, interest in growth is the best single incentive toward 
the improvement of health behavior. 
The tendency of children to imitate those whom they admire is so strong 
that it may be used as a force in developing health behavior. 
The distribution of emphasis will vary to meet the actual needs of different 
classes, as reflected by the observable health practices of the students and by 
the medical and dental reports of their physical conditions. 
The result of the child’s experiences in developing health habits should 
be pleasurable, no matter what his present physical shortcomings may be. 
Unhappy mental states are to be avoided. 
IV. Relationship of Health Instruction to Other School Experiences 
An organized and adequate program of direct health instruction and of 
indirect learning experiences should be planned fo reach all students at all 
levels of education in the entire primary and secondary school program. 
In addition, the teacher and the school should attempt to correlate health 
teaching with the other courses in the curriculum that have a real bearing 
on health. For example, health and physical education are closely related. 
Physical education provides an incentive for health; it is an important aid 
in attaining health; and it is in some degree a measure of the quality of 
health. 
On the basis of actually pertinent subject matter, correlation in a wide 
variety of other courses will support the specialized health instruction and 
help the child to apply health facts to life situations. Valuable opportunities 
for such correlations will be found, for instance, in the teaching of general 
science, biology, chemistry, social science, and home economics. 
Another valid type of correlation, designed to lend interest to the learning 
of fundamental skills, may be achieved by using health facts, experiences, or 
situations in courses such as reading, language, arithmetic and handwork. 
It is important that each teacher who touches health at all should know 
what health subject matter is being taught in other classes or grades; and that 
all the school employees should work together to see that the child’s indirect 
health learning, so far as it is within the influence of the school, is in 
accord with his direct instruction in the hygiene course and in the related 
courses. 
V. Relationship of School Health Education to Community 
Health Education 
The achievement for each child of his own optimum health depends, as has 
been brought out, upon his whole way of life, and not only upon his expe- 
riences during that portion of the day that he spends, during about 180 days 
of the year, under school supervision. If there is to be a carry-over, into the 
home and into the community, of the health knowledge and health prac- 
tices acquired at school, it would seem that there must be some sort of 
correlation between school health education, parent education and general 
community-wide health education. 
13 A Basic Plan for Health Education 
Where townships, municipalities, or counties maintain fulltime official 
local health departments, the fulltime medical health officer, who has special 
training in public health, plans his department’s program of community health 
education on the basis of scientific data as to the most pressing health needs 
of the area. 
But many communities in Illinois, especially rural communities, are without 
this kind of well-rounded fulltime official local health service. In such areas 
the school that wishes to conduct a functional health education program will 
need to determine for itself, on the basis of statistical information and guid- 
ance that State and Federal health agencies may make available, the most 
significant child health problems and community health problems of the 
locality. Although the school will obviously not be able to accomplish alone 
the solution of all these problems, the school may quite properly, as the com- 
munity’s ranking educational institution, take the lead in making the needs 
known. # 
The school will do well to plan its own graded health education projects, 
and study units, both in specialized courses and through correlation, around 
recognized local needs. The methods and content of instruction should be 
based on the natural interests of the children and the cultural pattern and 
needs of the community. Such a functional school health education program, 
using the problem-solving technic, will make further gains by being kept 
flexible enough to dovetail with community health education projects, whether 
the latter are initiated by the school or by voluntary or official community 
health agencies. Where necessary, such projects may very well be initiated 
by the school, for it is evident that adult health education is an important 
parallel to the health education of the child. 
Different features of the broad program may make greater or less appeal 
to a given community at a given time. It would seem best to aim at those 
features of the program for which public sentiment is prepared, meanwhile 
cultivating the soil for the next feature to be planted. A community in 
which several adolescent children have died unnecessarily of tuberculosis may 
be ripe for the tuberculosis prevention feature of its school and community 
health program, and yet may need considerable further education before 
being ready to appropriate money for other needed health activities in the 
schools. Responsible citizens, whether teachers or parents, can guide the 
evolution of their school and community health program more effectively 
if they know the whole outline of the complete program. 
It is indeed fortunate that there are paths of community cooperation 
open to the school that wishes to use them. Among the various kinds of 
non-governmental agencies with which the school may effectively develop 
cooperative working relationships in regard to the community health educa- 
tion program are the Parent-Teacher Association, the local Medical Society, 
the local Dental Society, the local chapter of the American Red Cross, the 
Tuberculosis Association, the Ministerial Association, the Farm and Home 
Bureaus, the Chamber of Commerce, the newspaper, the radio station and 
service clubs. If the community is in need of more adequate official public 
health service than it has, the interest and cooperation of these groups would 
unquestionably help to bring about the establishment of the required fulltime 
local health department. To be expected as an important by-product of co- 
14 and the School Health Program 
operation with various civic groups and institutions, of course, is the de- 
velopment of better community understanding of the school program. The 
school and community should work together. 
VI. Implementation of the Program Through the Health 
Committee or Council 
As has already been pointed out in the section on Suggested Organization 
for Program Planning at the beginning of this report, one of the best ways 
for implementing an adequate school health program is the effective func- 
tioning of both school and community health committees or councils. Or- 
ganized according to democratic principles with complete representation 
from all groups concerned, such councils may prove invaluable in stimulating, 
molding and sustaining health programs which adequately meet the specific 
needs of the individual local area. 
VII. School and Health Department Relationships 
There are a number of methods by which successful joint programs have 
been developed locally between school administrators and public health 
administrators. Whatever method is used, the key to its successful operation 
lies in the careful definition of the functions and lines of authority of each 
agency, and of the specific functions of the various types of personnel in 
each agency. A school superintendent and a health officer may have perfect 
agreement between themselves as to the respective functions in the school 
health program of their two organizations, but they must not overlook the 
fact that their staff members must also know just what they are to do, and have 
their individual functions outlined. It is the job of the school superintendent 
and the local health officer to coordinate the respective functions of their 
staff members with respect to the school health program. 
It should be clearly understood that each agency retains administrative 
control of its own activities. Everything which goes on in the schools must be 
in accordance with school administrative policies. There should be no reason- 
able excuse for either the health department or any private agency to enter a 
school with a program which runs counter to the educational policies of the 
school administration. For example, if a nurse or other health specialist teaches 
classes in the school, she should possess the same teaching qualifications and 
be subject to the same kind of supervision as the other teachers. When doc- 
tors, dentists and nurses are supplied by the health department, it is expected 
that the health department decides on their qualifications, and supervises the 
technical aspects of their work. The school system decides on the profes- 
sional qualifications and teaching methods of all who teach. When serving a 
school each individual should adhere to the school regulations exactly as if 
he were employed by the school. 
Difficulties sometimes arise in separating the educational functions of 
physicians and the health functions of teachers. The physician provides health 
guidance for the individual child. This should he an educational experience 
for the child. The teacher is primarily concerned with health problems which 
do not need medical or dental attention. She deals with accepted standards 
of individual conduct or principles of health behavior. Most of her instruction 
15 A Basic Plan for Health Education 
involves groups of children and for this type of program she is especially 
trained. In matters regarding medical or dental supervision, a specialist should 
function, but in matters of health teaching, that other trained specialist, 
the teacher, should function. Let cooperation bridge the gaps of preparation. 
Good administration will allow the educational specialist and health specialist 
to work together, each respecting the professional status, skill and activities 
of the other. 
There is no single best plan for the coordination of agencies in the health 
program in the school. Local factors and available personnel influence all 
plans. What will work in one city or one system may not work in another. 
Successful coordinated programs are sometimes based upon informal personal 
relationships between the administrative heads of the cooperating agencies. 
They are sometimes based upon rather informal committee organization, 
including the agencies and professions concerned, and sometimes upon the 
organization of a more formal school health council. It is suggested that 
where a school health council is organized, the schools should be represented 
by administrators, supervisors and teachers, and the health department by 
the health officer, community health educators and public health nurses. Other 
participating agencies should, of course, be .represented also. 
As the cooperative activities succeed, and increase in scope, the pro- 
gram may reach the point of requiring some one person to devote full time 
to drawing the activities together and seeing that the entire undertaking 
moves cohesively toward the general goal. Sometimes this is done by an 
individual representing one of the participating agencies, with the endorsement 
of all the other groups. 
Some Illinois health officers have on their local health department staffs, 
as health education specialists, persons who have had training in education 
as well as in public health, and who would accordingly be particularly well 
qualified to assist in the development of a coordinated school and community 
program of health education. If the local health department has no such 
staff member, it may prove feasible for the local school authorities and 
health authorities to employ such a person jointly, as coordinator. 
16 and the School Health Program 
Specific Objectives 
I. Examinations and Observations for Determining Health Status— 
II. Specific Disease Control—III. Physiology—IV. Dental Health— 
V. Care of the Eyes, Ears, Nose, Nails, Skin and Hair—VI. Clothing 
—VII. Harmful Substances—VIII. The Importance and Care of 
Food—IX. Rest, Relaxation and Sleep—X, Physical Education, Ex- 
ercise and Body Mechanics—XI. Sanitation—XII. Safety—XIII. 
Character, Personality and Social Adjustment—XIV. School En- 
vironment—XV. Community Health Services. 
In presenting the following list of specific objectives of a school health 
program it is clearly recognized that the list may well be impractically long 
and repetitious; that some of the items are almost too trivial to mention; 
that other items are so sweeping in scope that their realization may be im- 
possible; that certain items may not be advisably considered in the case of 
certain individual children and that grade placement of the material is best 
performed by the local school system. 
In an adequate school health program which extends into the home, it is 
suggested that each child should realize the following objectives: 
I. 
1. Experience routine health examinations made with explanation of the 
need for examination and interpretation of the findings. 
2. Be examined specifically for rheumatic involvement and cardiac dis- 
ability from time to time between routine health examinations—es- 
pecially in connection with the athletic program. 
3. Receive vision tests, hearing tests, speech tests and dental check-ups as 
often as necessary. 
4. Receive routine haemoglobin estimations, erythrocyte counts and urine 
examinations. 
5. Be examined specifically for psychological disorders. 
6. Be observed for the development of the common posture defects, it 
being assumed that major orthopedic defects have been corrected insofar 
as possible. 
7. Be measured for growth (weight, height and body build) as often as 
may be desirable between routine health examinations (children should 
be weighed monthly in elementary schools). 
8. Be tuberculin tested at suitable intervals and x-rayed if necessary. 
9. Be followed up to insure treatment of any pathological condition found. 
II. 
10. Be instructed not only in general health terms but also in the specific 
characteristics of certain diseases, particularly tuberculosis, syphilis, 
other infections, infestations, nutritional deficiencies, endocrine dis- 
orders, heart disease, cancer and renal disease. 
17 A Basic Plan for Health Education 
11. Be immunized against diphtheria and smallpox. 
12. Be immunized against certain other specific diseases in accordance with 
individual or community needs such as pertussis, tetanus and typhoid 
fever. 
13. Be protected by group control methods against certain other diseases 
such as cancer, malaria, hookworm, pinworms, tapeworm, ascariasis, 
amoebiasis, fungus infection, scabies, pediculosis, trichinosis, respira- 
tory infections, brucellosis, shigellosis, salmonellosis and meningococcus 
infection. 
III. 
14. Learn the basic facts concerning the functioning of the body as a 
whole and of its parts. 
IV. 
15. Brush his teeth and gums in an approved manner at least twice a day 
using his own toothbrush of proper size, shape and stiffness. 
16. Refrain from biting or breaking hard substances with the teeth, from 
putting inappropriate articles such as pencils in the mouth, and from 
interchanging candy, gum, fruit, or any other edibles. 
17. Cooperate with parents and school in going to the dentist twice a year. 
18. Chew all food thoroughly and eat daily some food which requires vig- 
orous chewing. 
19. Refrain from thumb or finger sucking. 
20. Refrain from resting cheek on hand. 
21. Refrain from biting thumb, lip and cheek. 
22. Restrict the sugar intake. 
V. 
23. Read or work only in a light of sufficient intensity, without shadows or 
glare. 
24. Avoid reading on moving vehicles or while lying down. 
25. Hold his book or work in the correct position and at the correct 
„ distance from the eyes (approximately 16 inches). 
26. Select books with large print and unglazed paper whenever possible. 
27. Rest the eyes occasionally by closing them or looking at distant objects. 
28. Refrain from looking at the sun or bright lights. 
29. Wear colored glasses or visors for protection when needed (especially 
at sea, on the snow, in the sun). 
30. Avoid rubbing the eyes or using them needlessly when tired or strained. 
31. Go to motion pictures only in moderation. 
32. Wash the ears carefully. 
33. Refrain from putting anything into the ears. 
34. Refrain from striking a person’s ear or shouting into it. 
35. Protect the ears when diving or swimming. 
18 and the School Health Program 
36. Carry a clean handkerchief (or tissues) every day. 
37. Use his own handkerchief and blow his nose gently without closing the 
nostrils. 
38. Keep the fingers away from the nose and refrain from putting any- 
thing into the nose. 
39. Breathe through the nose with the mouth closed. 
40. Cover the mouth with handkerchief when sneezing or coughing. 
41. Use a well modulated speaking voice and avoid straining the voice in 
yelling. 
42. Wash the hands thoroughly with warm water and soap before eating 
or handling food, after toilet and whenever play or occupation indicates. 
43. Take an all-over cleansing bath with warm water and soap at least 
twice a week and bathe daily those parts of the body that perspire 
freely and are involved in the discharge of body wastes. 
44. Use his own clean towel and washcloth, 
45. Use a mild soap and rinse and dry the skin thoroughly to prevent 
chapping. 
46. Keep the fingernails trimmed and clean, 
47. Push back the cuticle and avoid picking it to prevent hangnails. 
48. Refrain from biting the nails. 
49. Avoid continued irritation of any parts of the skin. 
50. Keep the hands from the face and avoid squeezing or picking at pimples. 
51. Brush and comb the hair daily. 
52. Use one’s own brush and comb, and keep them clean. 
53. Wash or shampoo the hair frequently and dry the hair before going 
out of doors. 
VI. 
54. Depend more upon intelligent reasoning than upon bodily sensations 
in determining the amount and kind of clothing to wear so that it will 
be properly adapted to occupation, changes in weather, seasons and 
temperatures (both indoors and outdoors). 
55. Wear proper night clothing. 
56. Remove wraps and rubbers when indoors and avoid water-proofed 
materials for constant wear. 
57. Remove damp clothing as soon as possible and wear extra wraps to 
prevent chilling after exercise. 
58. Avoid tight clothing, including shoes and hats. 
59. Put on clean underclothes and stockings at least twice a week, prefer- 
ably after a bath. 
60. Keep all clothing as clean as possible. 
61. Assume responsibility for airing, brushing and polishing items of 
clothing. 
62. Select healthful clothing when buying for himself. 
19 A Basic Plan for Health Education 
VII. 
63. Study the effects of alcohol and narcotics in accordance with the Illinois 
school law and avoid alcoholic beverages, narcotics and tobacco. 
64. Avoid habit forming drugs, unless prescribed by a physician. 
65. Avoid patent medicines, unless prescribed-by a physician. 
66. Avoid tea and coffee during the growing period. 
VIII. 
67. Learn the signs of good nutrition. 
68. Learn to like all foods necessary for health and growth, including milk 
and dairy products, vegetables, fruits, whole grain or enriched cereals 
and breads, meats, fish, poultry and eggs. 
69. Learn to choose and eat an adequate breakfast, lunch and dinner daily. 
70. Learn to take sufficient time (at least 30 minutes) to eat his meals. 
71. Avoid eating between meals, or, if necessary, eat only suitable foods. 
72. Avoid the use of sweets except at mealtime and then in moderate 
amounts. 
73. Learn to eat meals at regular intervals and avoid the "no breakfast” 
habit. 
74. Eat meals in a pleasant environment. 
75. Learn to drink a sufficient amount of water daily. 
76. Learn table etiquette. 
77. Learn the relation of food to healthy growth, resistance to fatigue, at- 
tractive appearance, physical well being, maintenance and function of 
the body. 
78. Learn the food needs of the body, what happens to food in the body, 
the basic food groups and what each of these groups contributes. 
79. Learn how to plan for himself and his family a balanced breakfast, 
lunch and dinner in relation to cost, available foods, and racial food 
habits. 
80. Learn how to prepare food to make it palatable and’ attractive and to 
conserve its nutritive value. 
81. Learn how to buy food economically and to get the most value for the 
money expended. n 
82. Learn about food production and preservation. 
83. Appreciate the value of food sanitation. 
84. Appreciate dangers of food fads and fallacies. 
85. Learn the effects of food deficiencies upon the body. 
86. Learn about care of food in the home. 
87. Drink only that milk which has been pasteurized and properly stored 
and kept covered and in a refrigerator or similar cool, sanitary place 
of storage. 
88. Cook all pork thoroughly to avoid transmittal of trichinosis. 
89. Keep perishable or cooked foods in a refrigerator or similar cool, 
sanitary place. 
20 and the School Health Program 
90. Refrain from exchanging food or handling another’s food unnecessarily. 
91. Wash or peel fruit and vegetables if they are to be eaten without being 
cooked. 
92. Scald dishes and eating utensils after they have been washed and allow 
them to air-dry. 
93. Store clean dishes and eating utensils in a fly-proof and dust-proof 
cupboard or container. 
IX. 
94. Understand the importance of sleep and rest in securing and maintain- 
ing optimum health and efficiency. 
95. Plan the day to provide a balanced program of rest and work, including 
adequate fime for recreation. 
96. Avoid undue fatigue. 
97. Practice relaxation at definite times during the day, such as before and 
after meals and before bedtime. 
98. Go to bed early enough to secure sufficient sleep to be refreshed and 
ready for the day’s activity. 
99. Avoid habitual sacrifice of sleep for movies, social activities or radio 
programs. 
100. Sleep alone if possible and in a well ventilated, dark, quiet room. 
101. Adjust bed clothing in accordance with weather. 
X. 
102. Participate regularly when in good health in the physical education activi- 
ties offered by the school, such as daily total body activities (out of 
doors if the weather permits) of sufficient intensity and the amount to 
promote the optimum development of organic and muscular vigor, 
and growth. 
103. Acquire reasonable proficiency in the fundamental skills necessary for 
safe participation in aquatics; combatives; individual, dual and team 
sports; track and field; self-testing activities; and gymnastics, includ- 
ing tumbling apparatus and rhythms. 
104. Practice good body mechanics at all times. (Correct body mechanics is 
important for maintaining the correct mechanical correlations of the 
various systems of the body with special reference to the skeletal, 
muscular and visceral systems and their neurological associations. The 
good teacher will expect good body posture in the student’s daily 
activities, especially sitting, standing and walking. This is not to be 
interpreted as a stilted pose, but rather as essential use of the body in 
varied activities.) 
105. Understand and appreciate the values and importance of exercise (play) 
in one’s daily life. (Exercise is one means of conserving the optimum 
level of organic and muscular efficiency. The desire to become fit and 
maintain this fitness must be developed. The desire for maintaining 
physical fitness should be stimulated by the recognition that good nu- 
trition, adequate sleep, good medical and dental care, and emotional 
21 A Basic Plan for Health Education 
stability are factors of actual or probably greater importance. Exercise 
can be made to maintain and develop desirable traits of courage, loyal- 
ty, fair play and cooperation. It can be a means of using one’s leisure 
time in a wholesome manner and of securing better social adjustment 
through team sports.) 
106. Use exercise (play) as a means of self-expression for developing self- 
confidence, better social adjustment (physical, social and mental poise) 
by mastery of activities suitable to one’s age and capacity. (Exercise is 
a socially accepted medium for the expression of one’s urges, desires, 
drives and emotions as well as a medium for developing desirable traits 
of courage, loyalty, cooperation and fair play.) 
XL 
107. Drink water that is obtained from a safe source of supply and dis- 
tributed in a system or manner which does not permit contamination to 
enter the water. 
108. Boil or chemically disinfect drinking water, the sanitary quality of 
which is at all doubtful. 
109. Use his individual drinking cup or glass and refrain from dipping the 
drinking cup or glass into the drinking water container. 
110. Dispose of body wastes in such a manner that flies, rodents and other 
animals cannot have access to them. 
111. Place household waste and garbage in appropriate containers for later 
removal by a scavenger or for disposal by burning or burial. 
112. Keep home, yard and premises dean and dispose of trash in a proper 
manner. 
113. Keep window screens and screen doors in effective condition and closed 
to exclude flies, mosquitoes and other disease bearing insects. 
114. Destroy insects and their breeding places. 
115. Prevent accumulations of litter or trash which might encourage infesta- 
tion of premises with rats or mice. 
116. Eliminate rats and mice by use of traps or other methods not harmful 
to human beings, birds and domestic animals. 
117. Regulate ventilation of rooms so that an adequate supply of fresh air 
is available. 
118. Clean shoes on door mat before entering home, school or other building. 
119- Dust furniture and floors with mop or doth which picks up dust instead 
of dispersing it into the air. 
120. Change bed linens with necessary frequence and after the departure of 
overnight guests. 
XII* 
121. Learn the extent of injuries and fatalities which occur yearly. 
122. Realize that a majority of accidents can be prevented. 
• A detailed list of safety precautions is available from the National Safety Council, 20 N. 
Wacker Drive, Chicago 6, Illinois, and other agencies. 
22 and the School Health Program 
123. Learn the cause of and avoid accidents in the home, such as falls, burns, 
fires, poisoning, electrical shocks and asphyxiation. 
124. Learn the cause of and avoid automobile accidents, such as those oc- 
casioned by violating traffic regulations, stealing rides, getting on or 
off moving vehicles and careless pedestrian habits. 
125. Learn the cause of and avoid accidents while playing, such as those 
occasioned by the improper handling of fireworks and firearms or taking 
unnecessary risks while swimming, boating, coasting, or skating. 
126. Learn and practice the rules of safe conduct in the use of school 
buildings, gymnasiums, playgrounds and athletic fields. 
127. Learn and develop habits of safe conduct in occupational areas in which 
pupils frequently participate in addition to attending school. 
128. Learn safe ways of meeting the common hazards associated with the 
occupations in which a majority of the pupils are likely to be associated 
with in adult life. 
129. Develop habits and attitudes which will enable the individual to meet 
situations of daily life with the least possible risk, exposure and danger. 
130. Develop coordination, alertness, strength and agility as a means of 
avoiding accidents. 
131. Learn the value of cooperation for the protection of all. 
132. Learn and realize the futility of taking unnecessary risks involving 
added chances for accidents. 
133- Develop wholesome attitudes in regard to risk, safe practices, and safety 
rules and regulations. 
134. Develop a respectful and wholesome attitude toward persons charged 
with the duty of providing and maintaining safe working and living 
conditions. 
135. Gain experience in numerous safety practices. 
136. Create, develop and maintain an active interest in the protection of 
life and property in the community, 
137. Develop a sense of responsibility for the safety of others in all situations. 
138. Learn the theory and practice of first aid. 
139. Learn.to apply the scientific knowledge gained in school subjects for 
the safety welfare of the individual and the group. 
140. Assist in developing safe conditions for work and play as an important 
part of community life. 
XIII. 
141. Exercise curiosity concerning the world about him. 
142. Concentrate on whatever he is doing and complete his task successfully, 
reasonably often. 
143. Develop increasing initiative in work and play. 
144. Develop increasing independence and ability to solve his own problems. 
145. Meet difficulties and disappointments squarely. 
146. Cultivate a habit of cheerful calm and poise, controlling himself in 
anger, fear or other strong emotions. 
23 A Basic Plan for Health Education 
147. Develop a sense of responsibility for the happiness and well-being of 
others. 
148. Have wholesome relationships with children of the opposite sex. 
149. Possess feelings of being wanted, of being needed and of belonging. 
150. Learn to adjust to hereditary characteristics over which he has no control. 
151. Learn to recognize and adjust to differences in functional health. 
152. Recognize and accept limitations in energy, endurance and native in- 
telligence and develop a constructive attitude toward such limitations. 
153. Capitalize on special abilities and capacities. 
154. Develop social relationships as a means to a happy adjustment in the 
daily routine of school and home life. 
155. Gain experience in adjusting to different types of personalities. 
156. Learn to give expression to his particular type of personality. 
157. Develop uses for leisure time along socially approved lines. 
158. Develop some form of creative self-expression. 
159. Learn good sportsmanship in all phases of school and home life as 
well as in physical and recreational activities. 
160. Learn the value of teamwork and cooperation. 
161. Learn to assume responsibility. 
162. Learn to control conflicts in thoughts and action. 
163. Learn how to assist in controlling home life to attain a happy situation. 
XIV. 
164. Experience a school environment in which: 
a. Teachers are secure and free from fears, worries, anxieties, appre- 
hensions and depressions. 
b. There are teachers of both sexes. 
c. A considerable number of teachers are happily married. 
d. The teachers are physically healthy. 
e. The teachers know and understand the significance of the health 
status of the child. 
f. The teachers understand that most emotional maladjustments have 
their bases in the experiences of childhood. 
g. The teachers understand that most of the difficulties encountered 
in the teaching of a given child are evidences of emotional disturb- 
ances which may be corrected by proper investigation and treatment. 
h. The physical, emotional and social development of the child at 
different age levels is understood. 
i. Adequate consideration is given to the problems of youth including 
sex hygiene. 
j. Parents are assisted in understanding the child’s personality develop- 
ment. 
k. Early deviation from normal behavior is recognized and the under- 
lying cause is sought. 
24 and the School Health Program 
l. Help with problems of personal adjustment may be obtained. 
m. Vocational guidance is available. 
n. Guidance is furnished in the selection of courses which will be 
both challenging and within the individual’s mental activity. 
o. Psychiatric help is accessible, preferably within the school itself. 
p. The teachers like children and are teaching because they wish to 
do so. 
XV. 
165. Appreciate the fact that community health services should include to 
the greatest extent practicable: 
a. The provision of a safe and ample water supply. 
b. The sanitary control of ’milk, meat and other foods. 
c. An adequate sewage and refuse disposal system. 
d. The supervision of housing sanitation. 
e. Measures for the control of all communicable diseases. 
f. Adequate hospital facilities for the care of the sick. 
g. Diagnostic laboratory facilities. 
h. Extensive public health nursing services. 
i. A program of child hygiene; including prenatal, infant and pre- 
school services. 
j. A program of school hygiene; including physical, dental and mental 
examinations, medical inspections and corrections of defects. 
k. A program of industrial hygiene. 
l. The sanitary supervision of recreational facilities. 
m. A program of health education in all its phases and among all age 
groups. 
n. A comprehensive system of vital statistical records. 
o. Activities which help to establish a healthy mental situation. 
p. The establishment of competent official health organizations and the 
enactment of laws and regulations necessary for the enforcement 
of all community health measures. 
166. Appreciate the personal utilization of all the community health services 
enumerated above. 
167. Learn to exercise a personal interest and effort in the establishment and 
maintenance of such community health services. 
25 A Basic Plan for Health Education 
The Organization of the Student Day in the 
Interest of Mental and Physical Health 
The Administrator’s Responsibility—The Teacher’s Responsibility— 
The Parent’s Responsibility—The Student’s Responsibility—The 
Community’s Responsibility. 
I. General Introduction 
In order to achieve a functional program of healthful living, it is essen- 
tial to consider very carefully the organization of the student day. Little is 
gained from the acquisition of health knowledge and the provision for health 
examinations and services unless the child has an opportunity to live health- 
fully. Intelligent living requires the cooperation of the school, home, com- 
munity and the student himself. The mental and emotional stability of teachers 
and students which is necessary for proper pupil-teacher adjustment is directly 
influenced by the attitudes of the school board, the administrator, and the 
community. Basic elements in such a plan are: 
1. A guidance system to aid individual pupils. 
2. Provision for a balanced program of work, physical activity, relaxa- 
tion, rest, and recreation. 
3. Home and school contact adequate for understanding and adjusting 
individual health problems. 
II. The Administrator’s Responsibility 
Specific Recommendations 
1. Class periods should vary in length depending upon the age of the 
pupils, the character of the class activity and the emotional stability of the 
teacher and the class. For a six-year-old engaged in close intensive work a ten 
to fifteen-minute period should be the maximum. If the work is less con- 
centrated a longer period is possible without injury. An increase of a few 
minutes in each grade thereafter may be made for average children. Where 
some freedom to move about is allowed, there is less likelihood that children 
will suffer from strain. 
From the standpoint of physical and mental health, the modern curriculum 
which recognizes children’s normal interests and activities is a tremendous 
improvement over the restrictive program of earlier days. When the school 
day consists of many short and unrelated class periods, the frequent adjust- 
ments required of the pupil are a source of strain. The school in which 
pupils at many grade levels study from eight to ten different subjects daily is 
an example of this situation. Fewer and longer class periods would provide a 
more healthful day. 
2. Factors that seem more significant than size of the class are the range 
of ability in the class, the type of work being done, the ability and experience 
of the teacher and her skill in adapting the work to the individual pupil. 
Ideally, the primary teacher should not have more than twenty-five pupils. 
The less capable pupil in a large class will be submerged, with all the ensuing 
26 and the School Health Program 
personality difficulties, unless the teacher adjusts his requirements. The more 
capable student needs to have demands made upon his best efforts. Teachers 
cannot hope to have all pupils achieve in equal amounts and with equal suc- 
cess if their physical and mental well-being are to be considered. There must 
be individual guidance and the class should be small enough to permit it. 
On the other hand, the class should not be so small that group activity and 
experience are impossible, a situation that is found in the very small rural 
school. 
3. There is little significance to be attached to the sequence in which 
classes are arranged in the daily program. The notion that arithmetic, for 
example, is the most difficult subject and should therefore come the first 
hour of the day when pupils are supposedly most efficient is not supported 
by scientific study. No one subject can be said to be most difficult. Subjects 
vary in difficulty among pupils and not all pupils do their best work early 
in the school day. A good principle to follow is that the arrangement of 
school work should provide variety of activity to relieve physical tension and 
mental boredom. It is generally agreed that a rich and varied day’s program 
will not cause undue strain or physical fatigue. 
4. The length of the school day must be adjusted to the age level of 
children. The arrangement of the daily program of the child is the joint 
responsibility of the parents, the school, and the community. In general, the 
length of the school day should range from a minimum of 240 minutes for 
Grade I to a maximum of 360 minutes for high schools, including recreatory 
periods. Recreatory periods should be such as to provide healthful activities 
for the child. The practical difficulty of dismissing children in the lower grades 
earlier must be recognized and met. Unless younger children can safely go 
home unattended by older pupils or parents, supervision must be provided 
during the interval until all are dismissed. 
Children need supervision on the playground at all times. If no better 
plan can be devised, the younger children should be dismissed from formal 
school work and provided with materials of the creative and constructive play 
types. A corner in the school room which can be given semi-privacy is an 
acceptable play space where younger children may use such materials in re- 
laxing and satisfying activity. Parents of younger children should understand 
why a shorter day is needed at that age level. At any age level, the school day 
should be made as short as is consistent with adequate instruction. 
For high school students, a school day of six hours should be ample for 
basic classwork including minimum preparations, essential library reading, 
and laboratory periods. To require a longer day is to endanger the physical 
well-being of the student regardless of his ability and ambition. 
Some home study may be desirable, especially in the last two years of high 
school, to enable the student to develop self-direction and responsibility for 
independent work. Until other social agencies are ready to offer opportunities 
needed for youth in their all-around development, the school may well 
continue to dominate the student’s time. 
5. One hundred percent attendance at school has been unduly emphasized. 
Remuneration on the basis of average daily attendance is responsible in part 
for this. When a child is ill, he should be kept at home, or be sent home if 
illness occurs at school. Common colds and infections can be partially con- 
27 A Basic Plan for Health Education 
trolled, at least, if parents and teachers cooperate in excluding ill children from 
school. Less school time is lost when pupils stay at home and in bed with 
their colds than when they bring their colds to school. If children were not 
penalized with make-up work immediately after bona-fide illness fewer of 
them would attend school when really sick. 
Feigned illness, on the other hand, may be a pupil’s means of escaping an 
unpleasant situation at school. The distinction which must be drawn between 
safeguarding the health of children and coddling them is difficult in many 
instances. Too much stress cannot be laid on the value of good working rela- 
tionships among pupils, teachers, and parents in meeting problems of attend- 
ance. The school nurse can render invaluable assistance in these matters. It is 
agreed that extra assistance must be given to teachers when there are extra 
make-up loads. This responsibility lies with the administrator. 
The teacher likewise should remain at home when she is ill. School admin- 
istrators should work out a plan whereby a substitute may be provided to 
relieve the ill teacher for a reasonable period of time without loss of salary. 
6. Provision should be made in the school day for social and emotional 
growth. Time should be allotted during the day for social contacts between 
secondary school boys and girls. 
7. Time should be provided in the school day for parent-teacher and 
student-teacher conferences and such conferences should be included in the 
reckoning of the teacher load. 
8. Information about a student who has been through an unusual or un- 
foreseen experience should be disseminated to all of his teachers and his 
schedule should be adjusted temporarily to meet the situation. 
9. Periods of relaxation should be planned for the group as well as for 
the individual. Provision should be made in the school day for a release from 
tension through participation in physical activity. Students should be taught 
how to relieve tension through muscular relaxation as well as through the 
medium of physical activity. 
10. Adequate time should be allotted between classes for students to go 
from one class to another. 
11. Marks and speed tests increase the pressure upon a student. They 
should be used as an educational technique to assist the student and con- 
dition him to meet such pressures. 
12. There should be some regulation of the extra-curricular activities of 
students in order to decrease the over-stimulation of some students and the 
lack of participation of others. 
13. Special adaptation of the school program should be made for under 
par and for handicapped children. 
14. Time should be allowed for proper toilet habits in the secondary as 
well as elementary schools. This should include adequate time for hand- 
washing after the toilet and before meals. Paper towels, hot water, and 
liquid soap should be provided. 
15. Children should be weighed and measured at regular intervals. 
Elementary school children should be weighed once a month and the height 
taken twice during the year. 
28 and the School Health Program 
The child’s rate of growth will vary according to his heredity and 
seasonal variations. Regular weighing gives the child, his parents, and his 
teacher an opportunity to watch his growth, thus acting as an incentive for 
the child to develop certain health habits. Such a program of weighing and 
measuring is an inexpensive means of screening out children who show no 
gain in weight for three or more months for referral to the physician. Cumu- 
lative growth increment charts (showing the amount of increase in the 
growth of the student) should be kept for every student to show the prog- 
ress in the development of the child. Student behavior patterns follow the 
physical growth of the child. 
A platform scale of the balance type is preferable since spring scales are 
not as accurate. The scale should be one which will stand moving without 
getting out of order and it should always be checked before using to make 
sure it is in balance. The graduations should be at least as fine as quarter 
pounds. 
Children should stand in the center of the scale and be weighed without 
shoes, coats, or sweaters. The weighing should be done at the same hour of 
the day since the weight varies considerably over the period of a day. 
16. Height measurements should be taken with shoes off, with heels to- 
gether and against an accurate scale or measuring tape attached to a flat sur- 
face. Measurements taken by the metal rod on a scale are not accurate. A 
leveling device (a chalk box will do) should be held at a right angle to the 
flat measuring surface to secure the right height and the data should be 
recorded to the nearest quarter inch. 
17. No child’s weight should be compared to an average iveight as such 
weight does not take into consideration that each child is a pattern unto him- 
self. 
18. Time should be allotted for adequate luncheon hours and sufficient 
supervision and guidance should be supplied. Students should be encouraged 
to eat more fruits, vegetables, eggs, milk, and dairy products. The practice 
of selecting "hot dogs”, chili, hamburgers, candy and commercial drinks 
should be discouraged. 
The purpose of the school lunch program is to improve the general 
health of school children and youth by providing simple nutritious foods 
at low cost with an opportunity for pupils to learn to eat foods that build 
health and by educating children to select balanced meals. Local school 
officials should recognize the school lunch program as an educational activity 
of the school and should assume administrative responsibility for organizing, 
operating, and maintaining the program. It may be administered by a 
trained director in cooperation with the health and home economics depart- 
ments in the school (in average size schools) ; or by the teacher or other 
trained person (in one room schools). 
The school lunch should be a total school program with all departments 
and teachers cooperating, equalizing responsibilities in order that no one 
department or group of pupils be exploited. It is essential to give students 
training in fundamental nutrition principles in order to have them under- 
stand the school lunch program. Home economics students in the secondary 
schools can be utilized as leaders in a school nutrition drive. An educational 
rather than an institutional management philosophy should permeate the 
29 A Basic Plan for Health Education 
school nutrition and luncheon program. It is a laboratory where all pupils 
may gain a variety of practical learning experiences related to agriculture, 
art, home economics, industrial arts, mathematics, science and other subjects. 
The lunch hour should be a regular period in the school day. In large 
systems, there should be several lunch hours such as (1) 11:15 a. m. to 12:00 
noon; (2) 12:00 to 12:45 p. m.; (3) 12:45 p. m. to 1:30 p. m. Thus 
students are allowed to eat leisurely during an unassigned period. This also 
relieves congestion. 
The period of eating should be supervised and students should be seated 
at tables of six or eight with one acting as hostess. No student should leave the 
table until the hostess has finished and dismisses the group. Soft victrola 
music, carefully selected, has been known to help students to eat more slowly. 
The school lunch should be operated on a sound financial basis. Schools 
should depend, as far as possible, upon the resources of their local community 
for the food necessary for the school lunch. Those selected to be responsible 
for preparation of food for school lunch should: (1) know and apply simple 
facts of nutrition in meal planning, (2) practice desirable standards of 
cleanliness of person, of storage, preparation and serving of food, (3) be 
able to prepare foods without loss of food values and serve them so they will 
appeal to the eye, (4) meet regulations of State and local health authorities 
governing the health of persons who handle food, (5) have a cooperative 
attitude toward all who assist with the program. 
Parents and other citizens can make valuable contributions through: (1) 
interpreting to the community the need and value of the school lunch, (2) 
sharing surplus food, (3) cooperating in garden and canning projects, (4) 
raising money to buy equipment, (5) recommending suitable help, (6) en- 
couraging pupils to patronize the school lunch, (7) donating services when- 
ever needed. 
The school lunch should be as distinct a department of its own as the 
Commercial or the Biology Departments and should be housed in rooms 
set aside for this purpose. (In small one room schools, a part of the room 
can be allocated to the preparation of lunch.) The location should provide 
adequate light, ventilation and sanitation. It should be easily accessible to 
pupils and for the delivery of food and the disposal of garbage. 
Windows and doors should be screened. Floors and working surfaces 
should be sanitary and easily cleaned. Adequate hot water and facilities for 
the sanitary care of dishes and equipment should be provided. Food should 
also be well protected from vermin and adequate refrigeration provided for 
perishable foods. 
19. The starting point of an adequate program of physical education in 
the elementary and secondary school should be a comprehensive health ex- 
amination. The school, home, and community should develop a functional 
health guidance program which will be concerned with the establishment of 
desirable habits and attitudes of rest, relaxation, sleep, diet, work, study, and 
recreation. Furthermore, since most adults show the same defects which they 
had as children, a vigorous follow-up program for the correction of all 
remediable defects should come after the health examination. 
Health is not the responsibility of one teacher, nor of one department 
alone. As one of the principles of education it should be given serious con- 
30 and the School Health Program 
sideration by all teachers. The program of physical education should be based 
on the individual needs of the pupils, and the recreational means and 
facilities of the community in so far as this is possible. This should be 
determined by studying the cumulative data of the health examination, and 
other data secured through the school and community activities of each one 
concerned. 
This assumes that those students who need special activity, modified 
activity, additional rest, or more activity, will receive it during school time, 
on every grade level. It is further recommended that greater use be made of 
music, both vocal and instrumental on all levels, in developing the various 
parts of the program. The emphasis should be on a graded curriculum which 
is broad and varied, and which meets the criteria established by the Office of 
the Superintendent of Public Instruction. Every attempt should be made to 
offer a wide range of activities over a period of years, so that every pupil will 
meet many challenges. 
Because of the many emotional, physical, and mental strains which the 
pupil continuously encounters, his activity needs must be carefully studied. 
Many students are already over-stimulated and need a better planned program 
of activity. Some are gainfully employed in a variety of areas after school hours 
and during week ends. This may result in additional strains on the pupil’s 
vitality and health, particularly if he attempts to continue with the usual units 
of academic subjects. All students physically capable of attending school for 
the school day should be able and required to participate in some type of 
physical activity adjusted to their capacity except in cases of recent illness or 
injury where extra rest is beneficial and recommended by a physician. In all 
cases, the physical education period of the student unable to participate in 
vigorous physical activity should be used as a health teaching period and the 
student should have modified activity or rest. To place the student unable to 
participate temporarily in activity in a study hall does not satisfy the need of 
the student. 
Students who are gainfully employed for a part of the day should not be 
excused from their physical education activity but should have their physical 
education program adjusted to their needs. Students who are working need 
an opportunity for social inter-action in a play medium and the release from 
tension that is gained from participation in physical activity. Adequate time 
should be allotted for dressing and undressing for physical education classes. 
In general, the elementary school child should have from four to six hours 
of total body activity daily. This would, of course, include out-of-school 
play throughout the week as well as the program organized by the school. 
Such a program should be based on the daily period, and may be best 
met by a combined instructional participation period which is related to the 
various age levels of the pupils in the school. For example, a thirty-minute 
instructional physical education period may be scheduled for each pupil daily 
and the usual (minimum 15 minute) short recesses, twice a day, used as 
opportunities for play, with emphasis on the activities learned earlier. 
Much of learning should carry over into out-of-school play if activities 
suited to the needs, interests and capacities of the group are used. This will 
further be motivated if the program includes activities which the pupil enjoys 
doing, and in which he can experience some thrill of success quickly. The 
31 A Basic Plan for Health Education 
teacher’s task is to make participation in such total body activity an enjoyable 
and funful learning experience. 
A daily activity period of at least an hour should be the minimum re- 
quirement for the high school pupil, with considerable leeway in choice of 
activities during the junior and senior years. The daily period of activity 
should grow into a comprehensive program of intramural and recreational 
opportunities. Every attempt should be made to raise the level of skill on the 
part of each individual pupil in a number of worthwhile activities, so there 
will be some assurance that participation will be continued. The school can 
play a most important role, not only by careful selection of activities and good 
teaching, but also by providing many organized intramural and recreational 
opportunities. School activities should serve as a basis for stimulating 
interest and participation in community activities. The school recreational 
facilities should be open for community uses over the week ends and during 
the evening hours with proper supervision supplied by either the school or 
the community. 
The interscholastic program for the Boys’ and the Girls’ Athletic Asso- 
ciation and intramural activities should be enlarged by the addition of other 
worthwhile sports, and by the development of more teams in a sport so that 
the number of participants will be increased substantially in every school. This 
is the peak of the physical education program which, in turn, is supplemented 
by the intramural "laboratory” periods of participation. The school should 
supplement the recreational activities it offers by utilizing to its utmost, the 
facilities within the community. Community and school activities should be 
coordinated in order to offer students the widest use of all of the facilities in 
the community. 
Co-recreational activities should be included in the regular as well as the 
intramural and extra-curricular program. Physical activities offer a medium 
for the growing adolescent to make a good heterosexual adjustment. It helps 
the tomboy girl and the shy boy to be placed in a game situation where their 
attention is diverted from themselves toward a common goal. 
III. The Teacher’s Responsibility 
General Comments 
1. It is essential that the teacher understand the growtn and develop- 
ment of children and through sympathetic guidance and counsel assist each 
child to develop his individual capacities to the best of his ability and to 
become a well-integrated person. Teachers may be stimulated to understand 
each child as a developing personality by making a case study of one or 
two children with whom they have contact. 
2. Wholesome student-teacher relationships demand understanding on 
the part of the teacher of the growing child and his needs as exemplified by 
his behavior. The adjustment must be made most often by the adult to the 
child and not by the child to the adult. However, children must be taught 
as they mature to adjust to others. Good discipline is the result of good 
teacher-pupil adjustment. 
32 and the School Health Program 
Specific Recommendations 
1. Teacher qualifications 
Teachers should have the following specific qualifications: (1) be a 
well-integrated person (The emotional stability of the teacher has a direct 
effect upon the student with whom he comes in contact.) ; (2) like children 
and have a sympathetic understanding of them; (3) have good basic knowl- 
edge of child growth and development; mental, emotional, social and 
physical; (4) be free from prejudice; (5) have outside interests and satis- 
factions; (6) feel responsibility for knowing home and community conditions 
affecting the child and how to deal with them. 
2. Teacher’s role 
Teachers should recognize and know the potentialities of the individual 
child in relation to: (1) his personality adjustments; (2) his present mental 
level (with the aid of available tests and measurements) ; (3) his school 
experiences; (4) his home (parental attitudes, economic level and family 
composition) ; (5) his physical development, medical history, physical handi- 
caps and their effect on his social and emotional growth; (6) his outside in- 
terests and activities. 
Teachers should recognize signs of future maladjustments as well as al- 
ready present problems. They should recognize causes responsible for the 
problem and appreciate their extent and the need for help. The range of 
problems which should concern the teacher go from the shy withdrawn 
child who creates no classroom disturbance to the child who upsets classroom 
routine. 
Teachers should recognize their responsibility for the prevention of 
incipient problems and assume responsibility within their limits for aiding 
and correcting already existing problems which can be handled in the fol- 
lowing ways: (1) adjustment within the classroom, (2) conference with 
parents, (3) requesting aid of suitable agencies. (Teachers should be fur- 
nished with a list of available agencies.) 
3. Homework assignments 
a. In assigning homework, the teacher should consider the put-of-school 
needs of children, such as: (1) participation in family activities such as 
marketing and doing chores; (2) quiet restful companionship with members 
of the family ; (3) at least two hours per day in out-of-door play or recreatory 
occupations; (4) ten to twelve hours of rest, varying with the individual 
child; (5) lessons and practice in music, art and dancing; (6) club meetings 
and related activities as in 4-H Club and Scouts; (7) attending games; (8) 
earning spending money; (9) personal care, attention to clothing, matters of 
personal appearance. 
b. Conditions under which homework is done should be conducive to 
good study habits and good health habits. Ineffective results of study and 
unwholesome health habits may result from such conditions as: (1) poor 
lighting, heating, and ventilation; (2) unsuitable study table and chair with 
consequent bad posture; (3) frequent interruptions by other members of 
the family, the radio, telephone or other similar disturbances; (4) lack of 
reference materials; (5) lack of an organized plan for study at home; (6) 
procrastination and late hours for study; (7) unsuitable location for study; 
33 A Basic Plan for Health Education 
(8) lack of guidance and supervision, except by "volunteers” among the 
family who cause confusion and difficulty. (Parents should not be requested 
to assist the child with his homework assignments when the child has de- 
veloped a specific learning problem such as reading or arithmetic. If a child 
is more than a year retarded for his expected mental level and needs special- 
ized work, the parent is not the person to give it. This impairs the parent- 
child relationship.) 
c. Individual conditions will determine the nature ands extent of 
homework. Unless the conditions at home are known to be suitable, regular 
assignments for home study are undesirable. Necessary absence from school 
may make home study expedient for a brief period. If parents of elemen- 
tary school pupils insist on homework, let it be reading or handwork related 
to the school work and supplementary to it. In general, homework assign- 
ments: 
(1) For primary and intermediate grades should not be prescribed. 
(2) For upper grades and junior high school levels should be supple- 
mentary related activities which are recreation to some degree. All basic 
work should be done at school under the supervision of the classroom 
teacher. 
(3) For high school students may well be supplementary well-chosen 
reading, or creative activities related to some school work. All possible basic 
work should be done during school hours and at school. The extra- 
class activity program at this level should not crowd basic preparation into 
homework assignments. 
(4) At no grade level should the attempt be made to force the slow- 
learning child to keep pace with his mentally more capable classmate. Such a 
course imperils both the physical and mental well-being of the student. 
(5) Whenever homework is a part of the child’s program, the school 
administration has the responsibility for preventing too many and too heavy 
assignments at one time and for the development of a program of home study. 
d. Make-up work assignments due to absence 
(1) The student who has returned to school after an absence due to 
illness should not have his daily schedule overloaded with make-up work. 
Ample time should be allowed for the make-up work and the teacher should 
recognize the student’s impaired health condition. 
(2) When students should really remain at home, they should not be 
coerced to attend school due to make-up work being made more difficult than 
regular class assignments. Likewise, administrators should recognize the fact 
that when extra homework assignments are given, the teacher’s tasks are 
increased and she should be given added assistance. 
4. Examinations 
a. The length of the examination period should vary with the age of the 
pupil and the character of the examination. When much weight is attached to 
a single test it becomes a source of emotional strain and physical disturb- 
ance, particularly among the very pupils who should be protected from such 
conditions. A momentous final, by which failure or success in passing to a 
higher grade level is determined, should be discouraged. Too much em- 
34 and the School Health Program 
phasis on memorization, which is involved in an over-emphasized final, is 
open to question, both from the pedagogical standpoint and that of health. 
It is recommended that; 
(1) In primary grades, examinations be limited to ten minutes and be 
given frequently, as a class exercise. 
(2) In middle and upper grades, frequent objective tests using perhaps 
ten minutes, and less frequent tests of thirty minutes’ duration be used. 
(3) On high school levels, examinations, final and others, should be 
limited to a maximum of two hours, and in most courses should be of 
shorter duration. It is especially important that the several examinations to be 
taken by any one student be scattered over a period of two or more days. 
Concentration of examinations, particularly finals, in the same day is not 
desirable at any school level. 
(4) Students should be helped to appreciate the educational values of 
examinations. 
5. Pupil observation 
The importance of observation of pupils by the teacher to detect illness has 
already been pointed out. 
6. Planned relaxation 
Because of the variation in age, course of study, physique, physical 
stamina and length of school study periods, it is impossible to outline any 
systematic routine relaxation periods. These should be graded as is the 
educational system itself. 
The solution is to rely upon teachers who have been adequately trained 
in health routines and health education by the teacher training institutions to 
appraise’properly the needs of the class and to make the needed adjustments, 
either through practical application of techniques or through recommendations 
to the home. 
IV. The Parents’ Responsibility 
General Comments 
Parents should understand the work that is being done in the school 
and should make an effort to coordinate the work of the home and the school 
in the interest of the best growth and development of the child. The pri- 
mary responsibility for the intelligent organization of the student’s day 
rests upon the parent. Wise parents who need help should seek the counsel 
and assistance of the teacher who has had the benefit of training in the 
growth and development of children. Parents should seek to control the 
social pressures that are exerted on the child. Parents should see that a 
functional Parent-Teacher organization is set up in the school and that 
there is an opportunity for parents, teachers, and children to exchange ideas 
and coordinate all of their efforts in an educational program. Through adult 
education, parents should be taught to know and assume responsibility that 
is obligated by parenthood instead of forcing it onto the school system and 
other organizations and individuals. 
35 A Basic Plan for Health Education 
Specific Recommendations 
1. Parents should assume the responsibility for planning a well budgeted 
day with their children. The child’s activities and work should be balanced 
against his energy and capacity. 
2. Parents should pay particular attention to the need of the child for 
adequate rest and sleep. A regular and early bedtime hour is essential. 
3. It is necessary for all children to have adequate and leisurely meals. 
4. Some time should be provided for out-of-door activity. 
5. Home duties should be budgeted in direct relationship to the energy 
demands made upon the student. 
6. Extra demands on the child’s energy such as music lessons should 
be taken into consideration. 
7. Study hours should be planned and be free from interruption. 
8. Time should be provided for the high school girl for personal 
grooming. 
9. Time should be allotted for family relationships. 
10. Every child should have some free time to pursue his own hobbies 
or to do whatever he may choose within the limits of approved social 
behavior. 
11. Time should be provided for the care of the personal self. 
12. Time should be provided for participation in community activities. 
13. Parents should be at home or be responsible for the after-school time 
of their children. 
14. Parents should help the child to avoid excessive emotional stim- 
ulation from sources such as radio programs, movies, bad parental-conduct, 
harsh discipline, over-indulgence, and extra-curricular activities. 
15. It is the parents’ responsibility to plan relaxation periods for the 
child and eliminate any of the above health hazards if they are present. 
16. Parents should recognize the limitations of their children as well 
as their abilities and not force the children into situations with which they 
are unable to cope. 
V. The Student’s Responsibility 
As the student grows into adulthood, he should assume more and more 
his own responsibility for intelligent living and should gain in the ability 
to make intelligent health decisions. He should also seek to develop within 
himself a desire to live intelligently. Likewise, he should develop within 
himself an understanding and acceptance of himself as an individual with 
his capacities and limitations and an understanding of the role that he is 
to play in life. 
Each student, as he approaches adulthood, should increase his ability to 
budget his own time and energy and limit his own activities. Students, as 
they mature, must learn to limit the social pressures made upon them by their 
peer group and set up their own standards of living. They should increase 
their ability in self-discipline in direct proportion to their age. Older students 
36 and the School Health Program 
should recognize the fact that their behavior has a tremendous influence upon 
the younger child and that by living intelligently, the older student directly 
influences the attitude and behavior of the younger children in regard to wise 
health and safety habits. 
VI. The Community’s Responsibility 
The work of the school, home, and community should be coordinated 
in the interest of the child and his welfare. The community should seek to 
control the social pressures on the student in order to decrease the over- 
stimulation of the individual. The community should also be informed about 
the activities in the school and feel free to call upon the educational institu- 
tion for help. The community should, likewise, provide assistance to the 
school and the home in so far as health services, social welfare, and child 
guidance are concerned. Provision should be made in the high school student’s 
day for community service of some kind. 
37 A Basic Plan for Heaith Education 
A Healthful School Environment 
Values and Objectives—Items of a Healthful School Environment— 
Deficiencies—Suggestions for Assisting Achievement—Discussion 
of Items Affecting a Healthful Environment (Water Supply, Toilets 
and Waste-Disposal Facilities, Hand-Washing and Shower-Bath 
Facilities, Lighting and Interior Decoration, Heating and Ventila- 
tion, Seating, Screening, General Building Arrangement, Main- 
tenance and Fire Safety, Construction of School Buildings, Food- 
Handling Facilities, Flay grounds'). 
The Goal 
Every School with a Healthful Environment 
and 
Suitable Health Instruction in a Safe, Sanitary School Building 
with 
Adequate Indoor and Outdoor Play Space 
I. Values and Objectives 
Healthful surroundings for our schools have a two-fold purpose. Pri- 
marily, good health and personal safety of students and teachers are essential 
for proper physical, mental, and social development of our school children; 
secondarily, as a result of healthful school environment, the home life of the 
entire community may be greatly improved through indirect effect on parental 
education. Principles of good sanitation, such as the proper location and 
construction of wells and toilet facilities, sanitary handling of food and 
milk, safe dishwashing procedures, and good lighting, heating, and venti- 
lating practices, all serve as desirable examples upon which the community 
may pattern its home environment. This is important in later years as the 
students attain adulthood in the community. 
Unsafe drinking water at school may be responsible for serious illness 
as well as minor intestinal upsets, ordinarily not recognized as being water- 
borne. Improper lighting, with resultant eye strain, may greatly retard student 
progress. Malodorous toilets with obscene writing and caricatures, besides 
offending the aesthetic sense, have an unfavorable influence on moral develop- 
ment. Playground equipment is too often chosen only with the object of 
providing exercise and fun, little or no thought being given to the desired 
physical-education objectives of body poise, agility, skill, and certain social 
needs of some students, attainable through properly supervised team play. 
Some playground equipment may be of such design as to create definite 
hazards to personal safety of the users. 
Efforts of school officials and civic organizations to correct malnutrition 
among school children by the establishment of hot-lunch programs are com- 
mendable. Proper equipment should be provided and food should be pre- 
pared and served in accordance with approved sanitary practice. These and 
38 and the School Health Program 
other items of school environment materially affect the physical, mental, 
and moral well-being of both students and teachers. 
II. Items of a Healthful School Environment 
Items which should be given consideration in a study of a healthful school 
environment are as follows: 
1. Water supply. 
2. Toilets and waste-disposal facilities. 
3. Hand-washing and shower-bath facilities. 
4. Lighting and interior decoration. 
5. Heating and ventilation. 
6. Seating. 
7. Screening. 
8. General building arrangement, maintenance, and fire safety. 
9. Food-handling facilities. 
10. Playgrounds. 
This report contains a brief discussion of each of the items listed above, 
which may be helpful as a guide in the study of individual school needs. 
Technical details are omitted because the inclusion of such details would 
necessarily require a voluminous presentation. Bulletins giving information 
on some of the items are now available for free distribution from the Office 
of the Superintendent of Public Instruction and the Illinois Department of 
Public Health which furnish technical details and minimum specifications 
to guide procurement of proper facilities. Technically trained and experi- 
enced personnel are also available from various State and local health and 
educational organizations to furnish free consultation and assistance in 
planning improvements. 
It should be appreciated that the order in which these items appear above 
is not necessarily the order of their relative importance. This order may be 
expected to vary with the individual school conditions; however, it is gen- 
erally conceded that the first two items, water-supply and toilet facilities, 
should receive prime consideration. Screening is always desirable, especially 
so where malaria is prevalent and Anopheles mosquitoes are numerous. 
Proper lighting should usually be placed high in the order of attainment. 
It is suggested that school officials should study each school individually with 
respect to school-environment needs and prepare an orderly plan for attain- 
ment of needed improvements. 
III. Deficiencies 
Previous to the current war effort the Illinois Department of Public 
Health, through its sanitary engineers, had inspected the sanitary facilities 
at 7,000 of the State’s public schools. Analysis of the inspection data showed 
that 88 percent of the water-supply facilities were defective and 54 percent 
of the school toilets were insanitary. Detailed data on deficiencies of heat- 
ing, lighting, ventilation and similar items have not been compiled but from 
representative observations, there is ample evidence to substantiate the belief 
that there exists a wide-spread deficiency of some of the other factors 
essential to a healthful school environment. There is need for expansion and 
39 A Basic Plan for Health Education 
modernization of Illinois school statutes concerning minimum physical facili- 
ties, and it is recommended that the Department of Registration and Educa- 
tion, the Department of Public Health, and the Office of the Superintendent 
of Public Instruction give further consideration to the need for moderniza- 
tion of school laws. There is now adequate legislation governing facilities for 
special aid schools and high schools. While there is need for legislation to 
require all other schools to provide at least a minimum of facilities in accord- 
ance with standards as prepared by the State Superintendent of Public In- 
struction, and provision of this legal requirement should be very helpful, 
statutory action alone is not enough to assure complete attainment of an 
ideal school environment. A comprehensive program of education and pro- 
motion is necessary, in which school and health officials throughout the 
State will cooperate and coordinate their efforts toward this objective. Such 
a program should include the active participation of all education and health 
officials of the State, cities, and counties. 
IV. Suggestions for Assisting Achievement 
Herewith are listed suggestions for the organization and execution of a 
program through which the attainment of healthful school environment may 
be assisted: 
1. Wide publicity should be given to the values of healthful school 
environment and to the existing deficiencies. 
2. Local school and health officials should be encouraged to hold 
local meetings and secure the support and cooperation of interested indi- 
viduals and civic organizations. , 
3. The General Assembly should be requested to strengthen the laws 
governing school sanitation and to make provisions enabling the school 
to meet these new standards. 
4. County superintendents of schools should be encouraged to hold 
local meetings with boards of directors and boards of education for the 
purpose of promoting needed school improvements, stressing particularly 
the items controlling school environment. 
5. A group of schools in a given area may be encouraged to engage in 
competition in various activities relating to a healthful school environment. 
6. The Office of the Superintendent of Public Instruction should be 
requested to consider the preparation of a school health appraisal form, 
to be used in the recognition of schools, pertaining to school-environment 
facilities. 
7. The program of teachers’ institutes should frequently include infor- 
mation and suggestions for the improvement of school environment. 
8. Nontechnical bulletins presenting pertinent information on the 
school-environment problem should be prepared for general distribution 
to all school and health department personnel as well as to other inter- 
ested persons. 
9. Technical bulletins should be provided in fields not now adequately 
covered. 
40 and the School Health Program 
10. All possible encouragement should be given to promote the 
establishment of adequate local health departments, including the full-time 
services of properly trained and experienced personnel. Such individuals 
should possess tact and promotional ability as well as thorough technical 
preparation. All of these qualifications are essential for providing the 
necessary guidance and technical assistance to local school officials. 
11. Teachers should be encouraged to use inspections of school facili- 
ties by visiting officials as class demonstrations. The collection of samples 
of water for analyses, and inspection of school wells, toilets, and food- 
handling facilities, accompanied by tactful explanations from the inspect- 
ing health official, as he proceeds with his work, can be of extreme edu- 
cational value. 
V. Discussion of Items Affecting a Healthful 
School Environment 
Water Supply 
Most of the rural and small community schools utilize wells as a source of water 
supply and the majority of these wells have defects which subject the water to con- 
tamination. Although some of the defects are minor, many of them are serious (such 
as the location of non-water-tight sewer and drain lines in the near vicinity of wells) 
and could result in water-borne illness. Many such dangerous situations have been 
occasioned by the installation of indoor toilets in old school buildings. School wells 
are often located near the entrance to the schools, and inside toilets when added are 
generally placed in the cloak rooms, which are usually in the front part of the building 
structures. Under these conditions, drain lines from the toilets are commonly laid in 
close proximity to the wells and unless certain precautions are taken to construct sewer 
lines of assuredly watertight materials, there is grave danger that sewage from leaking 
joints in these drain lines may contaminate the water supply. 
Some few schools have no water supply. In certain areas it has been found diffi- 
cult to develop ground water sources, the geologic formations being such that an 
inadequate or highly mineralized and unusable water is obtained. At some such schools, 
the teacher or older pupils have been required to transport water, generally in an un- 
covered bucket, from neighboring homes. This practice may easily subject the water to 
contamination in transit and the quantity provided is often inadequate for hand-washing 
and other school purposes beyond the bare essentials for satisfying thirst. 
In certain areas of Illinois where it is difficult to develop water from the ground, 
cisterns are utilized, rain water from the school-building roof being collected and 
stored in the cistern. Rain water from the roof is always subject to contamination by 
soot, dust, bird droppings and similar sources; and while it is possible to construct 
satisfactory sand filters to remove suspended material, such filters cannot be expected 
to remove dissolved organic matter and all contaminating bacteria. The final safety of 
the water, then, depends upon the use of chemicals such as chlorine. The proper 
maintenance of a cistern water supply requires extreme diligence and even when the 
best facilities are provided it is known that such maintenance is often lacking. Cisterns 
should not be used if any suitable form of ground water can be developed for schools. 
Certain areas of the State are underlain with limestone that is filled with open 
channels, cracks, and crevices which convey water and likewise pollution for great 
distances underground without purification. Wells penetrating such limestone forma- 
tions must always be regarded with suspicion, for much serious illness, including several 
notable typhoid fever epidemics, have been caused by water from such wells. To assure 
safety, water from these limestone wells should be either boiled or receive chemical 
treatment, such as chlorination, before use. Boiling, of course, with the necessary sub- 
sequent cooling, is decidedly inconvenient and cannot be expected to be performed at 
schools except under emergency conditions. Adequate chemical treatment of water 
obtained from wells equipped with hand pumps is largely dependent upon the personal 
element, and likewise cannot be expected to be continued for an indefinite time. Where 
wells are equipped with power-pump installations, automatic chlorine machines can 
41 A Basic Plan for Health Education 
be purchased which will provide satisfactory disinfection of the water with a minimum 
of attention. 
Use of the common drinking cup is often observed at schools where drinking 
fountains are not employed. Glasses, tin cans, soft drink bottles, and similar con- 
tainers should not be left at the well pump where they may be thoughtlessly used in 
common by the students. 
Urban schools employing water obtained from public water supplies have available 
a source of water under pressure that is, almost without exception, of safe quality and 
adequate in quantity. Public water supplies in Illinois have been subjected, for many 
years, to a rigorous program of inspections by sanitary engineers of the Illinois 
Department of Public Health, and most municipalities have cooperated admirably in 
this program of providing safe public water supplies. However, even though most 
urban schools employ, as a source, water from public supplies which is reasonably safe, 
it is often dispensed through drinking fountains of the unguarded vertical-bubbler 
type which permits lip drinking and the retention of bacterial contamination so intro- 
duced. Sanitary drinking fountains of the inclined-jet type equipped with guards to 
prevent lip drinking are reasonably satisfactory and, while many schools in recent years 
have installed such drinking fountains, there yet exist many that are of the improper 
type. There is need for school instruction in the proper use of drinking fountains. 
Installation of other improperly designed plumbing fixtures makes possible back- 
siphonage of contamination into the water-supply lines at times when water pressure 
may drop, which can occur on any water system. Hand-washing lavatories equipped 
with water faucets, the discharge outlets of which are located below the top of the 
wash bowl, are subject to submergence by contaminated water in the bowl, and 
under such conditions, if a partial vacuum exists in the water lines, occasioned 
by a drop in the water pressure, contamination can be drawn directly into the 
water pipes. Similar conditions can exist on improperly designed toilets and other 
plumbing installations. Most manufacturers of plumbing equipment have cooperated 
admirably in recent years in recognition of this public-health problem, and are now 
producing plumbing fixtures and equipment which prevent the possibility of back- 
siphonage occurrences. However, improper fixtures are still made and sold. All new 
plumbing fixtures, when purchased, should be specified as of a type approved by the 
proper health authority. 
Schools located in small cities and villages not provided with public-water-supply 
facilities usually employ private-water-supply sources similar to those of rural schools, 
and many of these school water supplies are improperly located and constructed. 
While such schools usually have electric power available and have frequently devel- 
oped water-pressure systems, the water obtained from wells, cisterns, and similar 
sources is often found to be impure. Many schools likewise have improperly designed 
drinking fountains and plumbing fixtures. 
The ideal situation for all schools, whether urban or rural, is the utilization of 
some sort of pressure water supply, for this makes possible the use of inside water- 
flush toilets, sanitary drinking fountains, and adequate hand-washing facilities. 
Any school having access to a public water supply should employ it in preference 
to the development of a separate water source. Schools beyond the reach of public 
water-supply facilities can provide private water supplies by the use of electric or 
gasoline power. 
All private school water-supply sources should be checked by bacteriological 
analyses at least once annually, and more frequently if the water is of doubtful 
sanitary quality. 
Toilets and Waste-Disposal Facilities 
The community sanitation program conducted through the Federal Works Progress 
Administration in recent years has been responsible for considerable improvement 
in the sanitary status of outdoor toilets at schools. However, survey data show that 
more than one-half of Illinois’ schools still have insanitary toilet facilities. The majority 
of rural schools and many small urban schools still employ outdoor-type toilets. From 
a strictly public-health standpoint such outdoor toilets can be located and constructed 
satisfactorily but, from the aesthetic, moral, and educational standpoints, inside toilets 
are desirable for all schools. Outdoor toilets are often neglected and the interiors of the 
structures are frequently unclean. Outdoor toilets, when used, should be properly 
42 and the School Health Program 
located at distances somewhat remote from the school building, but such location 
makes their use inconvenient during inclement weather. Students frequently defer 
using these toilets, to their own physical detriment, because of the remote location or 
filthy condition. Teachers should exercise proper supervision over the use of outdoor 
toilets to eliminate certain undesirable practices, including obscene writing and carica- 
tures on the toilet walls. 
There has been developed in recent years a so-called "septic toilet” produced as a 
manufactured unit which can be installed inside school buildings and which gives 
reasonably satisfactory inside toilet convenience. This toilet operates without water 
pressure, although about one bucket of water per day is added manually through each 
seat opening. These toilets, if provided with the minimum maintenance necessary, are 
reasonably free from objectionable odors. The septic toilet is preferable to the 
chemical toilet. 
A few chemical toilet installations still remain in Illinois schools. Their con- 
struction is similar to the septic toilet mentioned above, and when properly maintained, 
the chemical toilet can be reasonably satisfactory. However, because the proper main- 
tenance involves periodic removal of material from the toilet tank and recharging 
with chemical, such maintenance is usually neglected and obnoxious conditions fre- 
quently result. 
Large urban and some of the larger rural schools have water-flush-type toilets 
with discharge of sewage into a municipal sewer system or to some type of school 
sewage-disposal system. Design of sewage-treatment facilities is highly technical, and 
engineering assistance is desirable. 
Illinois law requires that plans for sewerage installations serving fifteen persons 
or more shall be submitted to the State Sanitary Water Board for review and issuance 
of a permit before any contracts are let or construction work started. 
The ideal school toilet facilities consist of inside water-flush toilets located in clean, 
adequately heated, well lighted, and ventilated rooms. 
Hand-Washing and Shower-Bath Facilities 
Equipment to permit pupils to wash their hands is essential for proper cleanli- 
ness and is necessary to the teaching of good personal hygiene. A common water bucket 
with wash bench and basin can be satisfactory in the smaller schools if kept clean and 
under proper supervision. However, a water dipper, essential to the use of such meager 
equipment, should never be used as a common drinking cup. Adequacy of such 
equipment depends largely on proper supervision by the teacher. Common towels 
have been almost completely eliminated and use of paper towels is quite universal. 
The teaching of students to wash their hands after use of toilets should be a major 
educational objective, and hand-washing facilities should be located adjacent to 
toilets. However, this is ordinarily not feasible when outside toilet facilities are 
provided. Hand-washing lavatories, with water available under pressure, accompanied 
by paper towels and liquid soap dispensers, installed in close proximity to inside 
toilet facilities, make the ideal installation. 
Bathing facilities are ordinarily found in Illinois schools only in conjunction with 
athletic or physical education programs, and usually in the larger schools. Most ele- 
mentary and rural schools do not have bathing facilities. There is wide need for pro- 
viding shower-bath facilities at all schools and the development and adoption of pro- 
grams to encourage daily bathing of all pupils. Existing shower-bath facilities are rea- 
sonably well-designed and maintained, with the exception of control of athlete’s foot, 
which item should receive extensive study and greater attention. The practical diffi- 
culty of providing hot and cold water under pressure at all rural schools is recog- 
nized as a principal obstacle in the universal adoption of daily school bathing programs. 
Lighting and Interior Decoration 
Satisfactory natural light within school rooms is dependent upon proper building 
construction and seating arrangement, including sufficient window area and proper 
window shades. However, regardless of good building design, natural light only 
cannot give perfect lighting at all times and some form of artificial light is necessary 
on dark days. While some rural schools are equipped with electricity, the majority of 
43 A Basic Plan for Health Education 
rural schools do not, as yet, have access to electric power, although schools almost 
universally install electricity when it is available. While some good gasoline lights 
are available, when provided, they are not often used, except under extremely dark 
conditions, because of the inconvenience. School officials should study the possibilities 
of obtaining more adequate natural light by installing additional windows and by 
removing trees that may interfere with natural lighting. 
In general, electric lights provide the only entirely satisfactory source of artificial 
light. The rural electrification program of recent years has improved lighting facilities 
at schools, but it is still far from universal. Continuation of the electrification program 
is expected after the war. 
Electricity makes artificial light always available with the flick of a switch, and 
teachers readily take advantage of this convenience by extensive use to satisfy any 
deficiency of natural light. Howevg:, many schools with electric lights do not have 
the best fixtures to give proper light intensity and distribution. There is opportunity 
for considerable improvement in existing school lighting through modernization of 
electric light facilities. 
Color engineering and the entire field of interior decoration offer much that 
promises to improve school environment. Dark, oily floors and dull, gray walls, so 
commonly found in many schools, absorb light and do not produce an inviting or 
attractive learning environment. 
Heating and Ventilation 
Heating in the majority of schools, both urban and rural, is reasonably satisfactory. 
The larger schools are equipped, almost without exception, with modern furnaces which 
either employ steam radiators or deliver warm air through a system of ducts. One-room 
schools generally have stoves of the jacket type which ordinarily provide satisfactory 
heating except in very cold weather. 
Ventilation is not always adequate as the facilities now exist. Window boards or 
shields should be provided when window ventilation is improper, and dampers on fresh 
air inlets should be kept in good order to assure proper control. Such fresh air inlets 
are usually arranged in conjunction with the heating system, and when these inlet 
dampers are not in proper working order an attempt to obtain good ventilation results 
in a draft on the floor. 
Adequate humidity control is generally lacking and, while equipment is fre- 
quently provided to add some moisture to the air when the heating system is operated, 
experience indicates that during the heating season the humidity is usually too low. 
On the other hand, in the early fall and late spring when heating is not employed, high 
natural temperatures may prevail and, likewise, humidity above the comfort zone 
frequently exists. High room temperatures, especially when accompanied by high 
humidity, so common in the Mississippi Valley, are not conducive to concentration and 
study by either pupils or teacher. With the increasing use of air-conditioning equip- 
ment it appears that the installation of modern air-conditioning facilities at schools 
is warranted, and the future should see wide application at Illinois schools. 
Seating 
Movable and adjustable seats are preferred. The seat should be on a swivel which 
permits turning through a horizontal plane of at least 30° to the right or to the left. 
If nonadjustable seats are used, provision should be made for variation in the size of 
pupils. The seats should, of course, be kept in good condition. 
The aisles between rows should be at least eighteen inches and the aisles between 
rows and walls should be at least twenty-four inches wide. There should be at least 
six to eight feet between the front row of seats and the front wall. Unused seats and 
desks should be removed from the room. The seats should be placed to take advantage 
of the best lighting (at an angle of 20° from the windows and as close to the windows 
as possible). Single seating is required by law. 
The pupil should sit well back, so that his lower back is comfortably supported by 
the back of the chair. He should sit with his spine erect, and his head and upper body 
should be in good balance with both feet on the floor. Correct sitting posture may 
be impossible in a poorly designed chair. 
44 and the School Health Program 
Screening 
Window and door screens not coarser than sixteen mesh should be installed on all 
Illinois schools to exclude flies and mosquitoes. Besides the public-health hazard of 
disease transmission by flies and mosquitoes, these insects may be of considerable 
annoyance to both teachers and pupils during class periods. Good housekeeping today 
stipulates the screening of homes. The screening of schools should then be prac- 
ticed if for no other reason than to teach this item of good housekeeping. 
General Building Arrangement, Maintenance, and Fire Safety 
Condition of school buildings throughout the State, in general, is good. Although 
there are a considerable number of old school buildings remaining in use, for the most 
part these have been modernized by providing new floors, movable and adjustable 
seats, book shelves, storage cupboards, and light-tinted walls. Much more attention 
should be given to providing adequate storage space in the original construction of 
school buildings, as well as when older buildings are remodeled. Some one-room rural 
schools still retain the old window arrangement where windows are located on opposite 
sides of the room, although the majority of these have been provided with means of 
masking the lower portion of one set of windows. Cross-lighting and seating arrange- 
ments requiring pupils to face the light should be eliminated in all cases. 
The type and condition of the floors in the school building is directly related to 
the health, comfort and safety of the student. The types of floors that are apparently 
giving the most satisfactory service in schools throughout the State are hard maple, 
terrazzo, asphalt tile, rubber tile and battleship linoleum. For years linseed oil and 
paraffin base oils were used on maple floors but with poor results because they not 
only created additional fire hazards but also turned the floor dark and unsightly. 
However, today there are many types of penetrating floor seals that if properly 
applied make a splendid looking floor and also provide a durable finish. 
Terrazzo floors are attractive, can be obtained in various colors and do not require 
as much maintenance as most other types of flooring. Application of a terrazzo seal 
after cleaning this type of floor makes it very easy to keep in first class condition and 
will prevent the floor from dusting. Asphalt tile and rubber tile floors can be recom- 
mended for any parts of the school building except where dampness is encountered, 
such as basements, or where the desks or equipment are fastened to the floor. With 
occasional scrubbing and regular waxing, an excellent looking as well as a durable 
floor is assured. Floor seals and wax should be purchased because they are suited to 
the local situation; no attempt to select a single type for the whole State should be made. 
Urban school buildings throughout the State are generally new or quite well- 
modernized, but some unmodernized school buildings do exist, where funds have not 
been made available for the construction of new buildings, and some of these still 
have dark walls with wide floor boards and poor window arrangement, but these are 
now the exception. 
Some overcrowding exists in urban schools, especially in certain heavily populated 
areas. This creates a difficult problem in many localities which may be solved by 
adequate building programs. 
Good housekeeping at school is important not only because of its direct relationship 
with the health and safety of students but because of the influence it may have upon the 
attendance of all concerned. Responsibility for the prevention of untidiness should be 
the concern of all members of the staff rather than that of the custodian alone. Not 
enough attention is paid to this subject and the general housekeeping standards can 
be greatly improved in many school systems. 
Fire safety at schools throughout the State Is reasonably well-provided for, as 
evidenced by the long record of no disastrous school fires with loss of life. Old school 
buildings, both urban and rural, which still exist have been universally provided with 
doors that swing outward and equipped with panic bolts, as required by law; 
a second entrance has been provided, although this emergency exit door is frequently 
found locked during the school day. Schools are reasonably well-equipped with fire 
extinguishers, and the larger schools with water pressure have fire hose. Occasionally 
such fire-hose installations have become too old to be serviceable. Fire drills should 
be regularly practiced and fire escape doors should not be locked during the school day. 
45 A Basic Plan for Health Education 
Construction of School Buildings 
When new school buildings are constructed, the plans should be developed with 
full appreciation of modern school function. The first principle of any school plant 
is to provide facilities for learning. The functional planning of school buildings is 
based on this principle. The architectural style should be secondary. Plans for new 
school buildings should be approved by the county superintendent in county schools, city 
building authorities in city schools and the Office of the Superintendent of Public 
Instruction. Further state-wide requirements are needed. 
Health is one of the cardinal objectives of education and should be considered in 
that position in the planning of school buildings. The provision of gymnasiums, lock- 
ers, and bathing facilities alone does not fulfill that obligation. Health is more than 
physical education. The building should be planned so that it may be built and 
maintained to create healthful living habits. 
Functional planning comprises more than the right number of rooms arranged 
economically in a general plan. Proper lighting, heating, and ventilating are health 
factors vital to the plan. The use of the proper materials for constructing the com- 
ponent parts of the building to provide a safe, sanitary, and easily maintained structure 
is as important as the proper placing of rooms. 
The elimination of basement areas in modern school houses for any use except 
mechanical equipment and storage is a step toward more healthful and sanitary build- 
ings. The location of toilet rooms, with facilities for hand-washing and drying, is far 
more important than the total number of toilet fixtures in the building. Making the 
facilities readily available will bring much greater use of them. Proper facilities and 
training in our public schools will create health habits which will be practiced long 
after details of specific courses are forgotten. 
Food Handling Facilities 
There is increasing recognition of the value of serving hot lunches at schools. 
The intention of those in charge of serving food at schools is commendable, where 
every attempt is made to serve nutritious meals in the most sanitary manner within the 
limits of the equipment available. Persons in charge are usually those who have had 
either training in home economics or who apply the best-known practice of home 
housekeeping methods; and, in general, extreme cleanliness is exercised. While the 
attention given to sanitation in preparing and handling foods at schools is on a higher 
level than the present-day food handling in commercial restaurants and other public 
eating places in the State, there are some general deficiencies observed in school food- 
handling procedure. Instruction in food sanitation should be provided for all food 
handlers. Some items which should be checked in the handling of foods in schools 
are food-handling and food-serving facilities, dishwashing methods, health of those 
handling and preparing foods, refrigeration, storage of food and utensils, and avail- 
ability and use of pasteurized milk. 
Although the prime object of good sanitation in the serving of food at schools 
is to protect the health of the pupils and teachers, a very important indirect objective 
is the education of pupils in the proper methods of food preparation, storage, dish- 
washing and similar subjects in order that such items may be placed in practice at the 
home and throughout the community. Whenever food is served at schools, the facilities 
provided and procedures employed should be the best known to nutritional and sanitary 
science. Children who bring their lunches should have a suitable place in which 
to eat them. 
Playgrounds 
While most schools, both urban and rural, in Illinois, have some type of play- 
ground equipment, as a general observation there has been a tendency to provide 
heavy, expensive equipment such as swings, slides and giant strides, and once the 
equipment has been supplied, too little thought has often been given to the super- 
vision of the students while using it or to teaching them how to acquire new skills 
on it. Heavy playground equipment is not essential, although there may be no 
objection to some such equipment if it is wisely chosen and instruction is supplied, 
in addition to ball diamonds, volleyball and basketball courts, and other facilities which 
permit supervised team play. The acceptance of playground equipment standards as 
46 and the School Health Program 
set forth by the Office of the Superintendent of Public Instruction, the National 
Recreation Association and the American Playground Association is recommended. 
All-weather playgrounds of adequate size should be provided so that play periods 
will not be affected by rain, snow or excessive dust. Adequate consideration should be 
given to the type of surface provided as this is extremely important. Cinders are not 
desirable. Adequate drainage should likewise be given attention by the proper school 
authorities. In order to minimize the opportunities for accidents to the younger children 
while on the playground, some separation of the students on the basis of age is desirable. 
47 A Basic Plan for Health Education 
School Health Services 
Health Examinations (Scope; number of students examined per 
hour; presence of parent, nurse and teacher; the role of the teacher; 
vision testing; testing hearing; testing speech; dental examina- 
tions; examinations in the office of the private physician; referrals 
between routine examinations; examinations just before entering 
school; examinations for athletes; pre-employment work certificates) 
—Procedures for Follow-Up After Health Examinations (At the 
school; the use of clinics; special classes; provision for handicapped 
children; nurse-teacher conferences; evaluation)—Health Records 
—Communicable Disease Control (Communicable disease chart; 
the tuberculosis program; teacher observation; procedures for ex- 
clusion; procedures for re-admision; immunization program; epi- 
demics)—Safety and First Aid. 
I. Introduction 
School health services encompass a broad field and represent a tremen- 
dously important part of the school health program. They provide some of 
the most vital health experiences of the pupil—experiences which directly 
affect his health and which shape his knowledge, attitude, and health prac- 
tices. Health services are particularly important in shaping pupil attitude 
toward health. Teachers and principals must know what the health services 
are in order that they may cooperate effectively with those who render school 
health services, and make use of these services in the educational program. 
The teacher needs to know what each of the health specialists does for the 
child, what the specialist does for the teacher, and what is expected of the 
teacher. The medical, dental, and nursing professions, and the rest of the 
community should also know what the school health services are. 
II. Health Examinations 
General Discussion of the Physical Education Law 
Prescribing Health Examinations in All Schools 
The Illinois Revised Statutes, 1943, Chapter 122, Section 523.4 state: 
"As soon as practicable physical examinations as prescribed by the Superin- 
tendent of Public Instruction with the advice and aid of the Department of 
Public Health shall be required of all pupils in the public elementary and 
secondary schools except as hereinafter provided immediately prior to or 
upon their entrance into the first grade, and not less than every fourth year 
thereafter. Additional health examinations of pupils may be required when 
deemed necessary by the school authorities. 
"Such examinations shall be made by physicians and dentists licensed to 
practice in the State. Cumulative records of such examinations shall be kept 
by the school authorities.” Exceptions to the law are specified. 
Such examinations may discover abnormalities and be an educational 
health experience for the parents and child. Local school authorities, health 
48 and the School Health Program 
department personnel, doctors, and dentists will, of course, be guided by 
and comply with the standards and regulations established by the Superin- 
tendent of Public Instruction. Such standards and regulations usually repre- 
sent minimum satisfactory conditions, whereas many communities can main- 
tain, and all communities should strive for, higher standards than those set 
in minimum regulations. It is recommended that local school authorities, 
local health authorities, and local medical and dental professions coop- 
eratively plan and carry out a health examination program, not merely to 
comply with the law, but in order to bring to the children and the com- 
munity the greatest benefits possible. 
The Scope of the Health Examination 
The examination should be broad enough dn scope to discover all 
abnormalities which can be detected by observation, and should include: 
(1) a careful physical examination and a careful history, with tests for vision, 
hearing and speech (which may be done by teacher or nurse) ; (2) a con- 
sideration of those subjective and behavior problems called to the examiner’s 
attention by the teacher, nurse, or parent; and (3) the presentation to the 
parent of a practical amount of health information by the examiner at the 
time of the examination. 
The evaluation of all findings should be summarized by the examiner. 
If there are definite abnormalities needing correction, these should be called 
to the attention of the parent, and some means used to motivate the parent 
to consult the family physician for verification and correction, or for extend- 
ing the scope of the examination if needed. School health examiners should 
take as much time as is practical to make the examination interesting and 
educational to the child, teacher, and parent; and the entire procedure should 
be a pleasant health experience which should influence the child and parent 
to demand good medical care and motivate them to more healthful living. 
Detailed individualized education is probably not a primary objective on the 
part of the physician. However, he should take time to explain the implica- 
tions of deafness or serious defects, and to answer all questions. In group 
programs it may at times be desirable to talk to the group or class as a whole 
on important or prevalent defects or problems. 
It is recommended that the child be stripped to the waist,* with the shoes 
off. The pupil should be examined from head to foot, including the genitals 
in the boys. A reasonable degree of privacy and segregation for the examiner, 
the patient, and the parent is essential if best results are to be obtained. 
Privacy is easy to obtain in a physician’s office; it is sometimes difficult in a 
one-room school. With sufficient privacy, a stethoscope, otoscope, nasal spec- 
ulum, tongue depressor, and a good light, and with the child stripped before 
him the examiner can observe the expression, mannerism, alertness, skin 
texture and muscle firmness, as well as physical defects. He gives considera- 
tion to the history, subjective symptoms, and behavior. 
The Number of Students Examined per Hour 
It should be obvious that an examination of the scope mentioned above 
cannot be made in a minute and the mother and the patient dismissed with 
* A garment or robe should be worn by the older girls. 
49 A Basic Plan for Health Education 
an encouraging pat on the back; nor can a one-minute meeting with parent 
and child be expected to influence future health practices favorably; neither 
can the parent be expected to hold such an examination in very high respect. 
In general, it is recommended that an average of from ten to fifteen min- 
utes per child be allowed as the period during which the parent and child 
are with the examiner, exclusive of the time necessary for vision, hearing and 
speech testing, weighing and measuring, and time consumed in other routine 
preparatory work. Notes should be made at the time. If more than six 
examinations per hour are scheduled, all parties concerned should clearly 
understand that some valuable features of a health examination are being 
sacrificed. 
Presence of Parent, Nurse and Teacher at the Examination 
The parent should be present at the examination if possible. Exceptions 
might be made in some programs, such as examinations of athletes and work 
examinations. A nurse should be present. She can do the recording and later 
can intelligently discuss and review cases with the teacher and parent. The 
teacher may or may not be present depending upon the age and sex of the 
child, the familiarity of the teacher with the program, and the cooperation 
which has been developed between the physician, nurse and teacher for future 
handling of problems. There is greater need for the teacher to be present 
when a child who is known to have health problems is under examination, 
because of the intimate knowledge she has about the child. Her big job is 
before and after the examination, although presence at the examination should 
be used to increase her knowledge of the routine of the examination, and to 
increase her ability to discover defects. Of course, the defects or conditions 
found should be reported to her in most instances. 
The Role of the Teacher in Preparing the Class for the Health 
Examination, and at the Time of the Examination 
The teacher should have an intelligent attitude toward health and toward 
the whole procedure of health education and examination. If she does, the 
children will not fear the examination; indeed they will be eager and inter- 
ested. If she doesn’t have this attitude, poor results can be expected, even 
when the program is otherwise fairly good. 
Aside from the psychological approach to the examination, the teacher, 
with the help of the nurse, should have time to prepare her pupils otherwise. 
She is expected to perform the screening tests of vision, hearing and speech, to 
weigh and measure students, to note absences and their causes, to note be- 
havior problems, to note other abnormalities, to make observations for con- 
tagion and other illnesses, and to record corrections. The teacher is the 
key person in the health teaching and child health guidance program. If 
she performs her part well, the class will be ready for the examination with 
much valuable information available to the examiner. The teacher should 
see that her pupils report promptly and in orderly fashion for the health 
examinations. 
50 and the School Health Program 
Plans for vision testing should be worked out cooperatively by the 
local school authorities, local health departments, and perhaps other agencies. 
The Illuminated Snellen and Astigmatic Eye Charts serve well for the 
discovery of cases of near-sighted or mixed vision, but many children who 
are far-sighted will be detected by other observations by the teacher, such 
as frowning, indisposition to study, and straining. Teachers can be trained 
to give vision tests and experience has shown that they may be relied upon to 
perform the tests accurately.* 
Plans for Vision Testing 
Hearing testing should be included in physical examination programs. If 
a child has an unrecognized loss of hearing his work at school is affected, he 
may be unnecessarily handicapped outside of school, and his chances of 
satisfactory adjustments are impaired. 
The approved method of testing hearing is by a group test with the audio- 
meter, followed by individual testing with the Puretone audiometer for 
selected pupils. It is recommended that the type of testing programs to be 
used be determined jointly by the local school and health authorities and 
medical societies. 
Plans for Testing Hearing 
Plans for Testing Speech 
Simple screening tests for the more obvious defects of speech are avail- 
able through such organizations as the American Speech Correction Asso- 
ciation. They may be used effectively by teachers or nurses to discover children 
handicapped by defective speech and to facilitate referral to treatment sources. 
Speech defects are serious handicapping conditions and should not be ignored. 
Plans for Dental Examinations 
Every child should have a dental examination by a dentist at least once 
a year. An x-ray examination should be made wherever feasible to fulfill the 
requirements of a comprehensive dental examination. 
Local dental groups in cooperation with school authorities should decide 
where dental examinations are to be held—whether in the schools or in the 
offices of private practitioners. Studies have shown that as complete corrections 
can be secured by an educational program through which all of the children 
go to the office of the private dentist, or the dental clinic, as by a program 
where examinations are made in school. The examinations by the dentists 
should comply with the standards established by the Division of Public 
Health Dentistry of the Illinois Department of Public Health. 
Health Examinations in the Physician’s Private Office 
Experience has shown that promotional work by health personnel, educa- 
tors, and others tends to motivate a large percentage of people to take their 
children to their own physicians for routine physical examinations. It is 
* Solving School Health Problems, Dorothy B. Nyswander, p. 194, 1942, The Commonwealth 
Fund, New York. 
51 A Basic Plan for Health Education 
possible that the response will be even better as an eventual result of the 
enactment of the Illinois law requiring physical examinations for school 
children. 
If the examination is to be made by the family physician he should be 
well informed regarding the objectives of the school health program. He 
should record his findings on the health record card furnished by the school 
in order that the; examinations may be reported and carried out in a uniform 
manner. 
The main advantages of this plan for pupil health examinations are: 
1. That it accomplishes the objective of getting the pupil under the 
supervision of the family physician by one direct move. 
2. That it retains the valued individual physician-patient relationship. 
3. That it maintains or develops the sense of parental responsibility 
for such services. 
The main disadvantages are: 
1. That lack of uniformity often occurs in the findings and the 
reporting of these findings. 
2. That there is a tendency of certain pupils to complain of illness 
in the hope that the family physician will be sympathetic and willing to 
request that the pupil be excused from the usual physical education 
activities required by law. 
3. That there is usually a tendency to under-emphasize health educa- 
tional possibilities. 
Much thought and experimentation are needed in exploring the pos- 
sibilities of this plan because it should prove very effective if the weaknesses 
could be eliminated. 
It is recommended that the local health authority, the local school authority, 
and the local medical and dental professions cooperatively work out for each 
county or other suitable jurisdiction a plan which will accomplish the desired 
results. 
Referrals for Examination Between Routine Class Examinations 
Selected children will need examinations between the scheduled examina- 
tions which the Jaw requires "not less than every fourth year.” In most 
cases the teacher will initiate the action which will ultimately result in the 
selection of a given child for non-routine examinations. The teacher should 
have the benefit of consultation with a public health nurse and the two 
should then work together in selecting pupils for reference to a physician or 
dentist. The closer the cooperative relationship between the teacher and nurse, 
the better will be the results obtained. 
Plans for the Examination of Pupils Prior to Enrolling in School 
It is suggested that emphasis be placed on pre-school examination during 
the summer months just prior to the admission to kindergarten or first grade. 
Whatever record forms are used for the examination of children in school 
should also be used for pre-school children. 
52 and the School Health Program 
Examinations for Athletes 
All candidates for the school athletic teams should be examined by a 
doctor of medicine. The physician should state that the pupil is or is not 
physically fit to take part in the designated sports. If the pupil is unfit for 
the designated sports, the physician should indicate the activities in which 
he might safely engage. The physician’s statement should indicate on stand- 
ard forms how completely the pupil was examined. 
Following an injury or an illness during the same season, the pupil should 
be re-examined before participating again. Examinations should be repeated 
each year, and approval for participation in one sport should not be transfer- 
table to a more strenuous sport. 
Examination of Children Leaving School and Requiring 
Work Certificates Before Employment 
The examination of children leaving school and requiring work certifi- 
cates should comply with principles evolved for health examinations generally 
and be similar to them in extent. The physician should know the type of 
activity into which the child expects to enter. The employer who employs a 
pupil with defects not incompatible with the job he is to take, but possibly 
incompatible with jobs to which he could be transferred, should also be ad- 
vised of the pupil’s physical condition. 
The pupil should be given as many tests, other than medical, as com- 
petent examiners are present to administer; such as intelligence, psychological, 
aptitude and placement examinations. From the results obtained, the pupil 
should be guided into work in which he may expect to be reasonably suc- 
cessful and work that will continue to be a challenge to him. If that type of 
work is not available to him, an attempt should be made to maintain or de- 
velop his interest and guide him into suitable lines of work through study 
in evening schools and similar activities, if at all possible. 
III. Recommended Procedures for Follow-up After 
Health Examinations 
All pupils, regardless of economic status, should have adequate medical 
and dental attention. The objectives of the follow-up program are: to 
inform the pupil, his parents, and interested faculty members of the findings 
of the examination and their implications; and to place every pupil under 
the supervision of a private physician and a private dentist, or to arrange for 
supervision by a clinic. 
Procedures in Following Up the Examinations Made by the 
School Physician at the School 
The most effective plan includes a health conference at the conclusion of 
the examination, at which time the physician discusses with the pupil the 
status of his health. It is often desirable that the parent be present at the 
examination. If defects are found, the pupil should be placed under the care 
of a physician, dentist or clinic. 
53 A Basic Plan for Health Education 
In each community the school or school system, and the local health de- 
partment having jurisdiction, should work out together a satisfactory system 
of follow-up. The system should be well understood by both of the agencies; 
should include adequate nurse-teacher cooperation with regard to individual 
cases; should make maximum use of services available from both the school 
and the health department to influence the family to have corrections made, 
or to assist family to do so; and should avoid useless and wasteful duplica- 
tion of effort. As a result of such working together, goals in school health 
can be achieved which will surpass expectations. 
The Use of Clinics 
The use of clinical facilities will, of course, vary according to the economic 
status of the individual pupils and the socio-economic resources of the various 
communities. 
In most communities there are, economically speaking, three groups of 
pupils to be considered: first, those who can afford to make use of the 
services of physicians and dentists; second, those who can pay in part for 
these services; and third, those who must have the necessary medical and 
dental work done without charge. 
Each group presents an entirely different problem to the school health 
service. The first group needs only the routine of informing pupil, parents, 
and physician or dentist, and a check-up to see that the defect has been 
remedied or is receiving treatment. For the second and third groups it is 
recommended that the school, health department, welfare department, and 
allied agencies examine their resources, and organize a system which will 
bring needy and marginal children under medical and dental care and make 
available to all, as needed, other related community services and facilities. 
One community has solved this problem on a city-wide basis through a 
connection with the city welfare department which makes home investiga- 
tions and keeps available a city-wide file of family economic information. On 
the basis of this information the various schools recommend partial pay- 
ment patients to panels of physicians and dentists. 
Some schools have set up service-club-sponsored health loan funds to 
help in such programs. The bill is paid from the fund at once, and the 
pupils or their parents repay the fund over a period of months, or the pupils 
work out the bill as student aid. 
In other instances no repayment is required, and the fund is not used 
on a loan basis. 
Other pupils found unable to pay for medical or dental services are re- 
ferred to a clinic. Regardless of economic status, school-wide clinics or sur- 
veys are carried on in many schools. These include tuberculosis case-finding 
(with x-rays), vision tests, hearing tests, vaccination against smallpox, in- 
oculation against diphtheria and nutritional guidance. All resources available 
in the community should be used in order to carry on an adequate and 
effective program. 
A special program is needed for children who for some health reason 
cannot be instructed in the regular school program. Most of the State serv- 
Standards and Policies for Special Classes 
54 and the School Health Program 
ices for aiding the handicapped have been set up on the basis of the "special 
class” approach. In the last five years the various State departments, and other 
agencies charged with administering this program, have been experimenting 
with a new approach. Handicapped pupils are encouraged to use the regular 
facilities as much as possible, with guidance and help from specialists and 
other workers in this field. The results of these experiments seem to indi- 
cate that much can be gained from making contacts for the handicapped as 
normal as possible. If these pupils are segregated in groups, and their handi- 
caps are emphasized, they tend to become "different,” and more conscious 
of the fact that they are "different” from other pupils. 
The following policies might well be adopted on a Statewide basis: 
1. Education and living for the handicapped should be made as 
normal as possible. 
2. Specialists should be available who can give extra attention to 
these pupils over and above the regular school program. 
3. Adequate equipment should be available. 
4. Arrangement should be made for special classes, special service, 
and home instruction where the regular program cannot be adapted to 
the handicapped pupil’s needs. 
State funds are available to pay for these services. Superintendents are 
urged to become acquainted with the opportunities for their schools which 
these special State funds offer, by consulting the State Superintendent of 
Public Instruction. 
General information concerning the resources of the State for handicapped 
children may be obtained from the Illinois Commission for Handicapped 
Children, an official State agency charged with responsibility for the over-all 
coordination, integration, stimulation, and promotion of more adequate serv- 
ices for all types of handicapped children. 
The Commission has no resources for rendering direct services, such as 
medical care, education, or vocational training or placement to individual 
handicapped children. These services are the responsibility of the several 
established departments of the State government. The Commission functions 
more particularly to stimulate all private and public efforts throughout the 
State in the care, treatment, education, and social adjustment of handicapped 
children and to coordinate such efforts with those of the State departments 
and offices into a unified and comprehensive program. 
The Commission’s office serves as a clearing house for information, 
advice, and technical consultative services to parents, school officials, health 
and social welfare workers, rehabilitation and placement workers, and others 
interested in the care, education, and social and vocational adjustment of 
handicapped children. 
The Program for Handicapped Children 
The Nurse-Teacher Conference 
Nurse-teacher conferences dealing with the health problems of in- 
dividual pupils or of the class should be arranged. Time for this conference 
should be allowed in the teacher’s schedule. All parts of the school health 
program, including the nurse-teacher conference, should be approved by the 
school administrator. 
55 A Basic Plan for Health Education 
Evaluation of the Follow-up Program 
The County Superintendent of Schools should request from each rural 
or other school system an annual summary of health records and corrections 
to show just how effective the follow-up program has been. The summary 
should also show the statistics on tuberculin testing, x-raying, smallpox 
vaccination, diphtheria inoculation and individual health conferences. From 
time to time special surveys should be made. 
IV. Health Records 
The Recommended Health Record Cards 
It is recommended that all Illinois schools use the following single 
standard "Examination and Health Record” card approved by the State 
Department of Public Health and the Office of the Superintendent of 
Public Instruction; 
SCHOOL HEALTH RECORD 
Pupil’s Name— 
_Sex— 
Physician— 
Parent's Name— 
Disease History (Yea or No) 
Chlckeppox 
Chorea 
Diphtheria 
Encephalitis 
Erysipelas 
German Measles 
Infantile Paralysis 
Malaria 
Meningitis 
Mumps 
Pneumonia 
Rheumatic Fever 
Scarlet Fever 
Smallpox 
Typhoid 
Tularemia 
Undulant Fever 
Whooping Cough 
Preventive Procedures (Year) 
Diphtheria Immunization 
Smallpox Vaccination 
Typhoid Vaccination 
Whooping Cough 
Scarlet Pever 
Tests: 
Schick poe □ neg □ 
Dick poe □ neg □ . 
Tuberculin poe □ neg □ 
Specify Test 
X-ray 
Corrections Following Examinations 
Year 
PHYSICAL EXAMINATION: 
Medical Examination: Date 
Nervous 
Poeture 
Nutrition 
Skin—Scalp 
4 
VUion 
Ears 
Hearing 
Noee 
Throat 
Thyroid 
Lymph Glande 
Heart 
Lunge 
Orthopedic 
Other findings 
Parent present 
Doctor's Signature 
Dental Examination; Date 
Ca Titles 
Malocclusion 
Gums 
Care needed 
Dentist » Signature 
Code: lx-Slight defect; 2x-Attention desired; 3x>Immedlate attention urged. 
56 and the School Health Program 
Grade 
Septeihber; Height 
" WHght 
October "* 
TVcember " 
January “ 
February; Height 
“ Weight 
March »» 
April “ 
May 
June: Height 
“ Weight 
Preschool First Second Third Fourth Fifth Slith Seventh Eighth 
WEIGHT AND HEIGHT RECORD—GRADE. 
TEACHER’S NOTES: (Absence due to colds, sore throats, headaches, vision, hearing, hygiene.) 
NURSE S NOTES* 
DOCTOR’S RECOMMENDATIONS: 
DIET HISTORY; 
NUTRITIONIST’S RECOMMENDATIONS: 
ILLINOIS STATE DEPARTMENT OP PUBLIC HEALTH 
In addition to the health record and examination form, it is recom- 
mended that a standard teacher’s "Health Record of Pupil” card be used by 
all schools in the State. The value of such a cumulative record kept by the 
teacher has been amply demonstrated in a number of communities and, when 
properly used, it becomes one of the fundamental activities of the school 
health service. 
A third type of form which is recommended for an adequate school 
health program is the "Annual Summary” card. Showing at a glance the 
health record for an individual child over a period of years, this form quickly 
orients the doctor, nurse or member of the school staff with regard to the 
student’s major health characteristics. 
57 A Basic Plan for Health Education 
ILLINOIS 
TEACHER’S RECORD OF PUPIL HEALTH 
Name. 
• Date of Birth: Month. 
• Day. 
19. 
Parent Address.. 
■O Hear- 
w Vision Test t j^g 
n M u! Audi- Teacher Notation 
< H SCHOOL Ht. Wt. Without With J_ 0„“ter on 
Crf <! Glasses Glasses m Score Pupil Health or Behavior 
O 0 s~g - 
R L R LDuR L 
SEMESTER RECORD 
QJ 
1 S PHYSICIAN’S RECOMMENDATIONS DATE NURSE’S COMMENT 
O Q 
DENTAL CODE:—D—DEFECT 
C—CORRECTED 
T—TREATMENT INSTITUTED 
N—TREATMENT NOT NEEDED 
ILLINOIS DEPARTMENT OF PUBLIC HEALTH 
58 AJNU IHt SCHOOL n E A TTT1P K O , K A M 
SEMESTER RECORD 
GRADES 
EYES 
Inflamed 
Eyes Water 
Styes, or Crusted Lids 
Eyes Crossed 
Rubs Eyes 
Blinks Frequently 
Squints Eyes 
Close or Far Reading 
EARS 
Failure in Hearing 
Discharge from Ears 
Earache 
Picking at Ears 
NOSE AND THROAT 
Persistent Nasal Discharge... 
Mouth Breathing 
Chronic Cough 
Frequent Colds 
Frequent Sore Throat 
BEHAVIOR 
Twitching 
Restless 
Listless 
Nervous 
Emotional 
Shy 
Uncooperative 
Quarrelsome 
Nail Biting 
Visits Toilet Unduly 
Speech Defect 
GENERAL CONDITION 
Lack of Color (Skin)..... 
Underweight—Thin 
Overweight—Fat 
Poor Posture 
Tires Easily 
Unhealthy Appearance 
Poor Muscular Coordination.. 
HEALTH HABITS 
Poor Sleep Habits 
Poor Food Habits 
Poor Hygiene 
PUPIL’S RECORD 
Number Days Absent 
Scholastic Standing 
General Health Condition 
n 
w 
> 
H 
in 
o 
a, 
a; 
O 
Uh 
* 
< 
S 
u 
w 
X 
u 
<n 
D 
CODE 
i Scholastic Standing ( 
General Health Condition) 
■E (Excellent)—G (Good )—F (Fair )—P (Poor ) A Basic Plan for Health Education 
TEACHER'S ANNUAL SUMMARY OF PUPIL HEALTH 
ILLINOIS 
Name Date of Birth 
Month 
Day 19. 
Parent Address. 
ANNUAL HEALTH RECORD 
Height Weight Vision Teeth Hear- 
Right Left mK 
GRADE 
YEAR 
Satisfactory 
Not 
Satisfactory 
Growth 
For 
School year 
Satisfactory 
Not 
Satisfactory 
Gain 
For 
School Year 
Satisfactory 
. Not 
Satisfactory 
Satisfactory 
. Not 
Satisfactory 
GOOD 
FAIR 
POOR 
GOOD 
FAIR 
POOR 
SCHOOL 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
11 
12 
GRADE 
DATE 
PARENT 
COOPERATION 
HOME 
ENVIRONMENT 
SOCIAL 
ENVIRONMENT 
TEACHER’S 
OR 
NURSE’S 
COMMENTS 
ILLINOIS DEPARTMENT OF PUBLIC HEALTH 
60 and the School Health Program 
GRADES 
I 2 3 4 5 6 7 8 9 10 11 12 
Normal 
Symptoms 
Physician Consulted... 
Results 
EYES 
Normal 
Symptoms 
Physician Consulted... 
Results .'. 
EARS 
NOSE AND 
THROAT 
Normal 
Symptoms 
Physician Consulted... 
Results 
BEHAVIOR 
Physical 
Mental 
Emotional 
Reactions 
GENERAL 
CONDITI ON 
Physique 
Stamina 
Appearance.. 
Disposition.. 
HEALTH 
HABITS 
Moral 
Cleanliness 
Physical Defects 
Mental Defect 
Progress Report 
NOTE:-Indicate Above by Check Mark; and byG-F-or-P 
SUMMARY 
Total Days Absent 
Scholastic Standing 
Scholastic Progress 
Health Progress 
General Health 
Code:—E(Excellent)—G(Good)—F(Fair)—P(Poor) Under Progress Report. 
61 A Basic Plan for Health Education 
The Use of the Health Record Cards 
The place where school health records are kept, their availability, and 
their transmission to the new school when the child changes location are 
matters that deserve special attention. 
One person in every school should be held responsible for the preserva- 
tion of the health records. It is strongly recommended that these records 
always be in custody of the school and available to the teacher, otherwise 
their value would be greatly limited. This may necessitate the keeping of 
duplicates, as a principal or nurse may desire the records for central filing. 
The forms should never be in the hands of the pupils, as they may contain 
confidential information. The teacher’s "Health Record of Pupil” cards 
should be kept in the teacher’s desk. The health forms should follow the 
student to a new school, including high school, as a part of his school record. 
They should be treated as confidential records. 
V. Procedures for Communicable Disease Control 
Wall charts concerning the administrative control of certain of the more 
common communicable diseases are available from the Illinois Department 
of Public Health and should be freely distributed throughout the schools of 
the State. 
The Tuberculosis Program 
It is recommended that the tuberculosis program in the schools be con- 
ducted in accordance with the following recommendations of the Division 
of Tuberculosis Control of the State Department of Public Health, and with 
whatever revisions or suggestions for tuberculosis control programs may 
be forthcoming from the Department in the future. 
It is a recognized fact that very little actual active tuberculosis will be discovered 
among grade school children by tuberculin testing surveys. It is therefore recommended 
that tuberculin surveys be confined to kindergarten or first grades and the high school 
years. First grade or kindergarten are recommended because if these children show 
positive reactions they have, in all probability, been exposed in their own homes. 
In certain areas where many children do not go beyond the eighth grade, it may be 
well to include the eighth grade in these surveys. No school program of this type should 
be undertaken unless funds are available to provide x-ray films of the chest for all the 
positive reactors, and personnel is available to visit the contacts of the positive 
reacting children. The child himself is only the means of gaining admission to the 
home to discover the causative case. The picture changes somewhat by the time the 
high school age group is reached. In this age group, morbidity begins to increase 
and a percentage of cases may be expected in high schools surveyed. But again pro- 
vision should be made for check-up on home contacts. It is not advisable to do, or 
urge to be done, a school tuberculin testing survey merely for the sake of tuberculin 
testing or for the production of reports and records. 
It is understood that any program undertaken in schools should be preceded by 
educational work which may include talks and motion picture showings to Parent- 
Teacher Associations and high school students. It is felt that teachers, parents and 
students should know what a tuberculin test is, and the purpose of the test. 
Naturally, the homes of all positive reactors in any school program, whether 
confined to kindergarten or first grade, or including high school, should be kept under 
observation. Reactors themselves should be x-rayed and re-checked annually there- 
after by x-ray. It is not necessary to repeat the tuberculin test in the case of the 
positive reactors. Doubtful reactors should be re-tested. A search should be made 
for the possible source case, and the contact with such case should be broken. 
62 and the School Health Program 
Teacher Observation 
A sick child should not be in school. It is important to detect the child 
who is ill, particularly a child who is ill with a communicabe disease, at the 
earliest possible moment. For the detection of such illness the primary 
responsibiity must rest upon the teacher, working under the leadership of, 
and according to principles developed with, the medical and nursing service. 
At the beginning of a school year or school term, and in the presence of 
cases of disease, the observation of the child’s departure from normal health 
should be made with particular care. This is true for the teacher in the sec- 
ondary school as well as in the elementary school. Too much time is likely 
to be spent in re-admitting students to school after illness, and insufficient 
time in screening out children who are coming down with an ailment. 
Procedures for Exclusion 
1. The teacher should notify the principal of suspected cases of 
communicable disease. 
2. The principal should issue an exclusion order. Exclusion is the 
responsibility of the school authorities, but the procedures followed can 
include the use of the public health nurse or school physician, with or 
without review by the principal in individual cases, providing that the 
relationship and responsibility of the public health nurse or school phys- 
ician is definitely understood. Exclusion should not await the decision of 
the public health nurse or the physician if this would result in continued 
contact between well students and suspected cases of illness. 
3. The excluded pupil should be sent home with a notification to 
the parents as to the reason for exclusion, and a report should be made 
to the health department in cases of suspected communicable diseases. 
Such reporting is the responsibility of the school principal. 
4. A sick pupil, particularly in the younger age group, should not 
be sent home alone, but should be accompanied by another individual, 
or the parents should be notified and the pupil held until the parent or 
another responsible person calls for him. However, when sick pupils are 
held at the school, proper isolation should be established. If a young child 
who is sick is sent home, there should be assurance that some member 
of his family is at home to receive him or that other responsible persons 
will be in charge of the pupil after he leaves the school. 
5. Whether the excluded student walks to his home or uses some 
other form of transportation should depend upon the degree of illness. 
Assurance should be obtained that he will go directly home. 
6. Exclusion depends upon suspected illness and symptoms; not 
upon a diagnosis. 
It is fundamental that a child should not return to school if he is likely 
to infect others. It is not always easy to determine when a child has 
ceased to disseminate virulent organisms. 
If the State or local health department regulations specify the condi- 
tions under which a child should be isolated, these should be followed. For 
Procedures for Readmission 
63 A Basic Plan for Health Education 
quarantinable diseases release and re-admission to school frequently depend 
upon a physician’s certificate. 
There are many conditions such as impetigo, scabies, chickenpox, 
measles and colds, in which current practice in many areas has permittee! the 
re-admission of pupils without a physician’s certificate. The recommenda- 
tions for re-admission of the State Department of Public Health should be 
followed. 
The Immunization Program 
1. Each local area should establish an immunization program ac- 
cording to local needs. Smallpox and diphtheria immunizations should 
be carried out in every community, and typhoid immunizations performed 
where needed after due consultation with the local health department. 
2. A standardized immunization technique should be adopted, 
based upon the immunization recommendations of the State Depart- 
ment of Public Health. 
Procedures Recommended in Case of Epidemics 
1. With respect to epidemics, school authorities should follow the 
recommendations of State and local health agencies which are officially 
charged with the responsibility for communicable disease control. Schools 
‘should not be closed except upon advice of the local health officer. 
2. During an epidemic local health authorities should make a special 
effort to acquaint school authorities and personnel with all of the pro- 
cedures to be followed and with the reasons for such procedures. 
VI. Safety and First Aid 
School boards are liable for school accidents where there is evidence of 
neglect on the part of school officials. It would be desirable to have all school 
accidents reported on a standard form to the county superintendent of 
schools. All school and playground equipment should be regularly in- 
spected. A planned safety program should be in operation in every school. 
One person in every school should be responsible for the administration 
of first aid in the absence of the nurse or physician. It may be the principal, 
the physical education teacher, or any interested person who has had 
special training in this field and is available at all times. Alternates should 
be appointed in advance. 
The first aid equipment need not be extensive. Standard equipment rec- 
ommended by the American Red Cross or the equivalent of that epuipment 
is satisfactory. A list of minimum equipment which will prove satisfactory 
for situations which frequently occur includes: tongue depressors, cotton, 
sterile gauze dressings with adhesive tape for application, gauze squares, ad- 
hesive tape, soda and water paste for burns, alcohol, green soap, scissors, 
boric acid, thermometer, ammonia and any standard form of antiseptic. 
64 and the School Health Program 
The Health of the Teacher and Other School Employees 
The Pre-employment Examination of Teachers and Other School 
Employees—The In-service Examination of Teachers and Other 
School Employees— School Employees and Communicable Diseases 
—Recommendations for Sick Leave of Teachers—Salary, Tenure 
and Retirement Benefits for Teachers—Group Health Insurance for 
Teachers—Other Items Affecting the Health of the Teacher. 
I. The Pre-Employment Examination of Teachers and 
Other School Employees 
No school employee or teacher who is not in good physical condition 
and free from communicable disease should be permitted to work in direct 
contact with the boys and girls of the State. No teacher should be granted 
a certificate for the first time, and no other school employee should be en- 
gaged for the first time, who does not submit a health certificate from a 
physician licensed to practice medicine in all of its branches in the State 
of Illinois. 
The law states that no teacher shall be certificated to teach in the 
schools of the State who is not in good health. Surely the examination pro- 
cedure is a good way to find out whether the teacher is in good health or 
not. The following examination form, which is used by the Illinois State 
Teachers’ Examining Board, is recommended to local school systems for 
use with all school employees: 
FORM H 
HEALTH EXAMINATION RECORD 
Illinois State Examining Board for Teachers’ Certificates 
TEACHERS’ EXAMINING BOARD 
Office of the Superintendent of Public Instruction 
Name 
Last First 
Middle 
Address. 
Married Single^ 
Widow ______ Sex Age. 
Height. 
_ Weight Color of Eyes. 
.Color of Hair, 
65 A Basic Plan for Health Education 
REPORT OF PHYSICAL EXAMINATION 
I. General Physical Condition: 
2. Vision (Near, ) Vision (Near ) Correctible to 
Right (Distance ) Left (Distance ) Right Left 
3. Hearing: Right. 
_ Left 
Nose and Throat. 
Case History. 
4. Vaccination_ 
Immunization: Diphtheria. 
Teeth Heart Blood Pressure: Systolic Diastolic. 
Pulse, 
Temperature. 
Scalp. 
_Skin 
5. Respiratory System, 
in home 
Thyroid. 
Superficial Glands. 
Any known or suspected tuberculosis 
Varicose Veins. 
Tuberculin Test. 
.When Given. 
Negative Positive. 
Result: 
If positive was X-ray taken. 
6. Kahn Test: Positive Negative. 
UrinalysisReaction 
Specific Gravity. 
Date Test was made: 
Albumen. 
Sugar Pus Blood Casts. 
7. Summary of Defects. 
To the Examining Physician: The objective of this health examination is 
to aid us in the certification of teachers who are physically fit to be asso- 
ciated with young people. We hope you will keep in mind the various 
diseases and defects that would endanger the health of the child in the 
classroom. 
I hereby certify that I have examined the above applicant and that the 
above is a complete and accurate record of such examination. 
Date of Examination. 
(Signed) 
.M.D. 
Illinois 
Note: It is recommended smallpox vaccination be made every five years. No 
certificate will be issued to any person who does not file with the State 
Teachers’ Examining Board a certificate of health properly certified to by a 
competent physician. 
To the Examining Physician: If applicant shows positive reaction to Kahn 
Test your recommendation as to whether disease is in a communicable stage 
or not is required. 
If Tuberculin test is positive X-ray must be required before your final rec- 
ommendation is made. 
Please give full description of any physical disability not herein included on 
reverse side of sheet. 
66 and the School Health Program 
II. The In-Service Examination of Teachers and Other 
School Employees 
In order to make the health program more effective, school boards 
should adopt a policy requiring teachers and other school employees to be 
re-examined at regular intervals. In the in-service examination program, the 
same form should be used as is shown on the preceding page. 
All infomation contained in the health examination of teachers and other 
school employees should be regarded as strictly confidential, and the detailed 
health records should remain in the custody of the examining physician. 
Each teacher and other school employee should present annually to the 
school board a certificate of physical fitness signed by a physician licensed in 
Illinois to practice medicine in all of its branches. The following form is 
recommended, item A being answered every year and item B every other 
year; 
HEALTH CERTIFICATE 
A. Report of General Physical Examination 
Date. 
I have today completed a general examination of : , 
including the items specified on Form H of the Illinois State Teachers’ Ex- 
amining Board, and find (him)* (her)* (not)* in good health and 
(free)* (not free)* from communicable disease. 
Signed, 
M.D. 
B. Report of chest x-ray examination {every second year) 
A (single) * (stereoscopic) * x-ray examination was made of the above 
named person on. 
date at. 
Signature. 
(For laboratory taking film.) 
Review of film: Active tuberculosis is (absent)* (present)* 
Roentgenologist and/or 
Tuberculosis Consultant. 
In cases of emergency, such as an epidemic, the teacher and other school 
employees should follow the same procedures as established for the pupils. 
Unusual situations may arise and school boards may require re-examinations 
at any time. In these cases, procedures should be established to meet a 
particular situation with the full knowledge of the teacher and the school 
board. In making a decision, school boards should be guided by the advice 
of a physician or health officer. 
It is suggested that where the employing board specifies the physician, the 
board should be expected to pay for the examination. If the employee, on the 
other hand, wishes to select his own physician, he should pay for the 
examination. It seems clear that the school board has legal authority to pre- 
vent school employees and teachers who are mentally unfit from remaining 
in contact with school children. It is recommended that precautionary meas- 
• Cross out words not applicable. 
67 A Basic Plan for Health Education 
ures and such examinations as are needed be carried out to see that such 
school employees and teachers no longer remain in service. 
III. School Employees and Communicable Diseases 
General 
Communicable diseases can be contracted by the school employee from 
the pupils and by the pupils from the employee. The employees are usually 
immune to the minor communicable childhood diseases because most adults 
have had them. Every employee should be immunized against diphtheria and 
should be vaccinated against smallpox every five years. 
School Employees and Tuberculosis 
1. Every school employee should present evidence of freedom from 
pulmonary tuberculosis before entering upon his duties, and every second 
year thereafter. One or more chest x-rays, interpreted by a qualified 
physician and found to reveal no evidence of active pulmonary tubercu- 
losis, should be considered as sufficient proof of freedom from tubercu- 
losis. 
2. X-rays of school employees should be taken by physicians, hos- 
pitals, clinics or sanatoria with adequate facilities to produce films of 
diagnostic quality. When, in the opinion of the interpreting physician, a 
film is not of proper quality, the laboratory that took the film or films 
should be asked to repeat the examination at no additional cost. 
3. X-rays of school employees should be interpreted by either a 
qualified roentgenologist or a qualified tuberculosis specialist. Roentge- 
nologists who are Diplomates or the American Board of Radiology prac- 
ticing in Illinois, Medical Directors of Illinois tuberculosis sanatoria, the 
Director of the Division of Tuberculosis Control of the Illinois Depart- 
ment of Public Health, and such other physicians as are designated by 
committees of the Illinois Chapter of the American Trudeau Society and 
the Illinois Chapter of the College of Chest Physicians, should be con- 
sidered properly qualified. 
4. The school board should arrange to make these examinations 
available to every employee at no cost. It should be considered a legitimate 
expenditure to use school tax funds for the examination of school per- 
sonnel to make sure that all are free from tuberculosis. It is suggested 
that where taxes are being collected for tuberculosis control under the 
Glackin Act,* the school board arrange for these examinations with 
the Sanatorium Board administering such tuberculosis funds. It is fur- 
thermore possible, in some instances, to get funds for these examinations 
from Tuberculosis Associations or other sources. 
5. The following procedures should be carried out with school em- 
ployees having tuberculosis: 
a. Any employee found to have active tuberculosis on the 
initial examination should not be permitted to render service until 
* Illinois Revised Statutes, Chapter 34, Section 164-175. 
68 and the School Health Program 
the disease has been properly treated and is called arrested in terms 
of the definition given by the National Tuberculosis Association. 
b. Any employee found to have active tuberculosis on a re- 
examination should be given a leave of absence, in accordance with 
the ruling of the board, for such a reasonable period of time as is 
ordinarily deemed necessary to arrest the disease. 
c. An employee who has had active tuberculosis, who has under- 
gone treatment and in whom the disease has become inactive and 
arrested, should be re-employed without discrimination other than 
that he or she have chest x-rays and such other examinations as 
often as are deemed necessary by a qualified tuberculosis physician. 
The cost of these additional examinations should be paid for by the 
individual. 
d. Employees who have had tuberculosis and in whom the 
disease is inactive should be recommended for new positions or pro 
motions without prejudice on this account. 
IV. Recommendations for Sick Leave of Teachers 
For the reason that salaries are low in most cases, the teacher feels that 
she cannot afford to remain away from her work with loss of pay. Conse- 
quently, if there is no sick leave with pay given by the school board, she will 
very often work when she is ill, endangering her own health, and in many 
cases, the health of her pupils. 
It would, therefore, seem advisable that boards give careful considera- 
tion to sick leave with pay. The general practice at the present time is to 
allow five to ten days per school year, cumulative to twenty days. In most 
cases, death in the immediate family is included in this allowance. 
V. Salary, Tenure and Retirement Benefits for Teachers 
Since the health of teachers is directly related to the amount of security 
provided for them and the compensation received, it is recommended: 
1. That school systems throughout the State adopt a salary schedule 
suitable to their size and income and guaranteeing an adequate standard 
of living for teachers. 
2. That the tenure law be recognized as making a contribution to the 
security of the teacher. 
3. That an adequate retirement plan be recognized as contributing to 
the welfare of the teacher and the school by providing opportunity for 
retirement because of disability, ill health, or advanced age. 
4. That the lay public be given sufficient information on salary and 
tax assessment variations throughout the State to insure public support of 
educational measures. 
5. That State aid be increased for districts not able at present to 
pay adequate salaries, and to improve educational programs and stand- 
ards. 
69 A Basic Plan for Health Education 
VI. Group Health Insurance for Teachers 
Teachers should be urged to consider the advantages of group health and 
accident insurance and a hospitalization plan. The final decision as to 
whether the teacher will or will not participate in any such insurance or 
plan should be left entirely up to the teacher. 
VII. Other Items Affecting the Health of the Teacher 
Housing and School Facilities 
The housing of teachers may be a rather serious problem, especially 
in rural areas and in congested suburban areas in this State. However, this 
is a local problem and must be left to the local community to solve. 
Special attention should be given to school heating and ventilation as 
well as proper lighting. Many teachers are forced to face the light while 
teaching. Adequate rest rooms at schools should be provided for the teachers. 
Extra-School Assignments 
In many schools the teacher has too heavy a teaching load. Extra duties 
are assigned to her such as dramatics, choral work, and club work. Most of 
these activities are very much worthwhile, and should be carried on in the 
school. However, they should not be the responsibility of only a few teachers. 
Unless there is a general plan throughout the school for distributing evenly 
this extra-curricular work, teachers should be compensated for such extra 
duties. The school board should call the attention of the public to the 
fact that the primary function of the teacher is to educate her pupils, and that 
demands by the community on the teacher’s time, energy and resources, which 
interfere with teaching, are to be discouraged. 
In-Service Study 
School boards should not require in-service studies to the extent that they 
may impair the health of the teacher. 
Opportunity to Work in the School Building 
at the End of the School Day 
The teacher should have the privilege of working in the school room 
at least thirty minutes after the close of school. 
Supervision 
It is recognized that the quality of supervision which teachers receive is 
related to their mental health. 
70 and the School Health Program 
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 
preparation. 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 oppor- 
tunity. 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 "on-the-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 ki-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 train- 
ing 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 de- 
sirable health attitudes and developing additional health knowledge. A 
teacher also learns about her pupils through being present when such 
health examinations are performed. 
71 A Basic Plan for Health Education 
A workshop is not a lecture class. It is a plan devised to help each par- 
ticipant arrive at solutions of particular problems or at better understandings 
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 buildings 
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 qualified 
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 prob- 
lem 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 
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. 
Extension Courses 
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, 
discussion of scientifically sound books, and scientific data presented in a 
dynamic, challenging fashion, might well be offered. 
72 and the School Health Program 
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 Teachers’ Reading Circles 
or Through Making Health Education Materials 
Available to Teachers 
The local county and State departments of public health provide ex- 
cellent educational 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. 
Alert teachers welcome the opportunity of visiting other areas where 
effective 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. 
Visitations to Other Communities, Health Centers and Clinics 
School Health Committee 
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 
planning committee is a highly educational process for those teachers who 
participate. 
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. 
73 A Basic Plan for Health Education 
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. 
I Deceased, March 27, 1944. 
74 and the School Health Program 
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. 
5 Chairman of Liaison Committee. 
75 A Basic Plan for Health Education 
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, 216V2 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. and the School Health Program 
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 Keaglh, 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. Stullken, Principal, Montefiore Special School, 655 West Fourteenth 
Street, Chicago. 
* Member of Liaison Committee. 
77 A Basic Plan for Health Education 
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. 
78 and the School Health Program 
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 
Student Health Service. 
CHAIRMAN; 
*Dr. Marie Hinrichs, Professor of Physiology and Hygiene, Head of Department, 
and College Physician, Southern Illinois Normal University, Carbondale.. 
MEMBERS: 
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, 216V2 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. 
Hygienic Regimen. 
CHAIRMAN: 6 
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 State Teachers College, DeKalb. 
Miss Leone Ware, R.N., Division of Public Health Nursing, Illinois Department 
of Public Health, 2l6Y2 East Monroe Street, Springfield. 
* Member of Liaison Committee. 
79 A Basic Plan for Health Ebucation 
Health Instruction. 
CHAIRMAN: 
*Dr, Harold M. Cavins, Associate Professor of Hygiene, Department of Biological Sci- 
ence, Eastern Illinois State Teachers College, Charleston. 
MEMBERS: 
*Professor 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. 
80