/— .£ fir ^5 No. 71 LB 3485 .08 Copy 1 OPEN AIR SCHOOLS LEONARD P. AYRES, A.M., Ph.D. ASSOCIATE DIRECTOR, DEPARTMENT OF CHILD HYGIENE, RUSSELL SAGE FOUNDATION Reprinted from The Proceedings of the Albany ioio Meeting of the Committee on the Prevention of Tuberculosis of the New York State Charities Aid Association DEPARTMENT OF CHILD HYGIENE RUSSELL SAGE FOUNDATION 1 Madison Avenue, New York City i isk&e SEP 3 , 1M« Open Air Schools LEONARD P. AYRES, A.M., Ph.D. ASSOCIATE DIRECTOR, DEPARTMENT OF CHILD HYGIENE, RUSSELL SAGE FOUNDATION In the year 1904 there were in Charlottenburg, a suburb of Berlin, a large number of backward children who were about to be removed from the ordinary elementary schools to special classes. An examination showed that many of these children were physically debilitated owing to anemia, various ailments in incipient stages and to the results of more serious diseases from which some of them were convalescing. This circum- stance offered an ideal opportunity for the co-operation of the educator and the school physician and to meet the need a new type of school was devised. This was the open air recovery school in which sick children were cured and taught at the same time. Such a new departure in school administration could not long remain unnoticed, and in 1908 the London County Council published a description of this educational innovation together with an account of the first English school of the new type. It is from this report that the present descriptions are largely taken. A suitable place for the new school was chosen in a large pine forest on the outskirts of the town. Plain sheds were erected which sheltered the children during the rainy weather. But in the main the school was kept in the open air. Specially skilled teachers were put in charge and no teacher had more than twenty-five pupils. The children reached the school about eight o'clock in the morning. Upon their arrival they received a bowl of soup and a slice of bread and butter. Classes commenced at eight o'clock with an interval of five minutes after every half hour of teaching. Instruction was reduced to the most necessary subjects and never given for more than two consecutive hours. 3 At ten o'clock the children received one or two glasses of milk and another slice of bread and butter. After this they played about, performed gymnastic exercises, did manual work and read. Dinner was served at half past twelve and after dinner the children rested or slept for two hours. At three o'clock there were some classes and at four milk, rye bread and jam were distributed. The rest of the afternoon was devoted to informal instruction and play. At seven o'clock came the last meal of the day and then the children returned home. After the first few weeks a great improvement in the condition of the children was shown by their better appetite, attention and general temperament. Among 107 children suffering from anemia, scrofula, heart trouble and pulmonary diseases 74 were totally cured or greatly improved in the three months the school remained open. On the average they gained half a pound each week during the entire period. Many of them in- creased eight or ten pounds during the three months and some of them as much as eighteen pounds. These physical changes for the better were gratify- Kept up ing but hardly surprising. But what did come as a With distinct surprise was the fact that these children did Classes not fall behind in their school studies. On the contrary, although they devoted less than half as much time to the regular subjects as the children in the ordinary elementary schools, they had no trouble in keeping up with their classes. When they returned to take their regular places in the ordinary schools it was found that instead of having lost they had gained and were ahead rather than behind their former companions. Since the establishment of the first Charlottenburg school the plant has been enlarged and similar work has been carried on each year since. Moreover, other schools of the same sort are being organized all over Germany, and there has yet to be recorded a single case of disappointment, failure or abandon- ment of work once begun. The fame of the German schools soon spread to England and in 1907 the London County Council decided to try a similar experiment. They opened their school at Bostall Wood in the outskirts of the great city. The children who were chosen for the experiment were of the type familiar to those who have much contact with city schools of the congested districts. They were thin, pinched, pale and wasted and showed in every case signs of physical enfeeblement. They were children who had been unable to keep pace with the other children of the school and usually attended irregularly and were incapable of con- tinued mental or physical exertion. A NEW USE FOR A ROOF An open air school "room" in Chicago The school was kept open for thirteen weeks. Much the same plan with respect to teaching, food, rest and play was followed as has already been described in the case of the Charlottenburg school. Despite numerous difficulties a notable success was achieved. The general improvement of the children was great and in some instances remarkable. The beneficial effects of the open air life were shown by their improved color and ani- mated demeanor. They were better and more full of spirits at the end of the^school term than at the beginning. They moved more briskly Jand their intellects were keener. On the average they gained half a pound apiece during each week they attended school. Lbs go 79 7* 77 76 75 13 72 71 70 69 6S WEEKS 123 ^5 67 g 9 10 / / / 4b, 7 ^^^M CHART I.— INCREASE IN WEIGHT OF KATHLEEN, BOSTALL WOOD OPEN AIR SCHOOL Note decrease during eighth week when she was absent Two cases may be shown in detail as typical. A little girl named Kathleen entered the school during the second week. She weighed a trifle more than sixty-eight pounds. The heavy line on the diagram shows how her weight increased during the following weeks. In the next week she weighed more than sixty-nine pounds, then nearly seventy-three, then seventy-five, then seventy-six, and in the seventh week seventy-seven pounds. During the following week she was absent and her continuous record of gain became during that week one of loss. When she Lbs. WEEKS 1 23 IJ- 5 673 9 10 ^3 hi to 39 % OS = \ 1 \ CHART II.-1NCREASE IN WE1UH 1 OF ARTHUR. BOS1ALL WOOD OPEN AIR SCHOOL Note decrease during sixth week when he was absent returned she had lost a pound, but during the following week when she was again in attendance at the school she made this up and gained nearly three pounds more. This reflects in a graphic way the beneficial results of the life at the open air school, but the evidence becomes thoroughly convincing when we find the same story repeated in many other cases. One of the very little boys was named Arthur. When he entered the school he weighed just a little more than thirty-nine pounds. During the first week there was little if any gain. During the second week he gained almost two pounds and during the third week four more. This weight he maintained for one week and then was absent for a week. During that week of absence he lost more than half of what he had gained during the previous five weeks, but on his return he began, first slowly and then rapidly, to make up the lost ground. That these are not isolated cases is shown by what happened in another English outdoor school — the one maintained by the city of Bradford. The wonderful story of the results secured in the Bostall Wood school spread throughout England and not only have more and larger schools been organized by the city of London, but a number have been started in other cities. One of the most thoroughly successful and well equipped was that opened in 1908 by the city of Bradford. Here about forty children were cared for during nine weeks. They were de- scribed as "very poorly developed," "delicate," "neglected looking," "anemic" and "scrofulous." The general plan of the school did not differ greatly from that of the previ- Value of ous ones. The children were simply given pure air, Good Food good food, wholesome surroundings and common and Air sense school work. The results were similar to those secured in Berlin and London. The diagram shows the average increase in weight during the nine weeks the school was open. It amounts on the average to nearly half a pound per week per child. The broad solid line shows how it kept steadily climbing upward as week after week passed. It also shows how the average weight of the entire class of forty children dropped off when the school was closed in the last week in October. Perhaps the city of Bradford in England has done more real scientific social work than has any other English city. They have a curious and unique way there of judging educational processes in terms of their results instead of by guesswork and oratory. The school authorities of Bradford approached the ORDER FORM 1 910. DoUBLEDAY, PAGE & COMPANY I 33 _I 37 East Sixteenth Street, New York City, N. Y. Gentlemen: Enclosed with this find $ for which please send me copies of OPEN AIR SCHOOLS, by Ayres at $1.20 each plus 12 cents for postage. Name Street, Number City, State Copies sent on approval if desired. problem of measuring the results of the outdoor school on this same scientific basis. While they recorded each week the aver- age gain in weight of the children in the outdoor school they also LBS Al/fc SEPTEMBER OCTOBER NOVEMBER Sc :hoc »1 c: -03€ >d 3 2 1. < ,'' -* -* *► * + + * * + + + * * <* > * ** *** CHART III.— SHOWING THE AVERAGE WEEKLY GAIN OR LOSS IN WEIGHT OF CHILDREN ATTENDING THE BRADFORD OPEN AIR RECOVERY SCHOOL The dotted line shows the average increase which takes place in case of children under ordinary conditions weighed each week an equal number of children from the same social classes who were in the regular schools. These children did not have the outdoor treatment. Their gain in weight is shown on the diagram by the dotted line. The difference be- IO tween the increase indicated by the dotted line and the lesser increase indicated by the solid line is an eloquent measure of the beneficial effects of the outdoor treatment. The credit and honor of initiating the first open air school in America belongs to Providence, Rhode Island. In January, 1908, the school authorities of that city remodeled one of their s »"9 March April May 3 3 3 © o o © cci © erf o, 1 t 79 .1 **\ 73 77 v« 1 C • i 1 76 • 1 i 75 t I . W 1 CF ART IV.- -HE MO GLO BIN IE =>IS P. UVI DEN CE OPE N A 1R ;ch OOL . A VER AGE FOR CLASS Note falling off during vacation school rooms so as to convert the ordinary four-sided room into one of three sides, leaving one entire side open to the air. In this room they began in the dead of winter to teach a class of children variously termed "anemic" or "pretubercular." The children wore their outdoor wraps, they sat in warm sitting- out bags and on cold days had warm soapstones at their feet. They were well fed and their school studies reduced in quantity but not in quality. The success of the experiment may well be judged by the re- sults of the hemoglobin tests among these children. For the information of the non-medical it may be explained that the red color in the blood is due to the presence in the red blood corpuscles of a chemical substance known as hemoglobin. This substance plays a very important part in carrying the oxygen from the air in the lungs to all the tissues of the body, and the proportion in which it is present in the blood is a valuable indicator of the degree of anemia present Hemoglo- and of the condition of the child's health. The nor- bin Tests mal percentage is 100. When the children entered the Providence school in January the average percentage was a little less than 74. Five months later in June it had increased until it was almost 84. During the summer vacation the school was closed. When the children returned in September the percentage had fallen almost to 74, but by January it had reached 79, and by June 84 once more. Six months after Providence began work an open air school for tubercular children was started in one of the Boston parks. There were forty-one children in that school and after the first summer's work it was found that there were twenty-three cases where the disease was either arrested or entirely cured. These twenty-three children were sent back to the regular schools and at last reports all but two of them were still enjoying good health. Five months later, in December of 1908, work was begun in New York. This latter instance is particularly interesting for two reasons: First, because the school was opened on an aban- doned ferry boat which shows what good use may be made of apparently useless localities even in the most congested cities. The second interesting feature is that this school was opened on the petition of the children themselves. They were the patients from one of the hospitals who were convalescing and who were being given open air treatment on the old ferry boat. One day these children got together and organized a strike. They told the doctor in charge that they wanted to have a school. The Board of Education at once offered to furnish them a teacher and school material and so the school was opened. Since that time three ferry boats and a roof have been pressed into service. In Chicago work was begun in a camp during the summer of 1909 and since that time very notable progress has been made both in open air schools and in cold air school rooms in that city. These were the only schools in Chicago which had no Christmas vacation last winter. The children simply refused to take a vacation. They demanded that they be allowed to go to school and the school authorities yielded to their demands. Hartford is doing very good work in a school in a tent and Pittsburgh is utilizing the balconies of one of its hospitals. In a number of other cities, notably Rochester, Washington, and Newark, there is now active agitation in favor of open- Growth ing these schools. Moreover, the school board of New In York City has voted to remodel twenty school rooms America so that the children may enjoy open air treatment, and work has already begun in some of them. Boston is planning to open such a room in each of its largest school houses, and there too the work is already under way. Only a few brief words can be devoted to the two most in- teresting problems of cost and need. The expense of beginning work in an open air school depends on local conditions almost exclusively. In this country the available experience points to a solution of administrative problems by a division of responsi- bility. In nearly every American open air school the cost for teachers' salaries, added equipment, etc., is met by the Board of Education, while the expense for food and clothing is de- frayed by hospitals, charitable organizations and societies for the prevention and cure of tuberculosis. In the foreign schools the expense for food amounts to about sixteen cents per day for each child. For this sum four meals are provided. It would be impossible to furnish these meals for such a low price in America. In this country the cost for two meals per day for each child seems to be in the neighborhood of twenty cents, while three meals cost about thirty cents. Figures from Germany, England, Sweden and seven American cities indicate that in the average city school system the children who are in need of such treatment as that afforded by the open air schools constitute from three to five per cent, of the entire school membership. This means that Albany, for example, should have open air schools in sufficient numbers to care for three hundred children, while New York City needs accommoda- tions for twenty thousand. When such figures as these are mentioned the objection of expense looms high at once. But it must not be forgotten when we are considering expense that a thousand children of school age die each year of tuberculosis in New York City. On the average they have each had about six years of schooling for which the city has paid about $250. This means a quarter of a million dollars loss each year in the The Cost great city in money expended on educating children who die of tuberculosis before growing up. A quarter of a million dollars a year spent in open air schools designed to pre- vent this frightful waste would go far toward meeting the entire expense. But the matter of expense and preventable money loss are not the most important phases of the problem of the open air school. Compute as we will we can never arrive at an estimate in dollars and cents of the value of wrecked hopes and ruined homes. I do not believe that the ultimate banishment of the great white plague is destined to be the most notable and far reaching result of this world-wide crusade for saner and more wholesome living in which we are all engaged. Neither do I believe that the open air school is to win its most notable victories merely as a factor in the fight against tuber- culosis. The open air school will take its place in the history of edu- cation as marking one long step toward that school system of the future in which the child will not have to be either feeble minded or delinquent or truant or tuberculous in order to enjoy the best and fullest sorts of educational opportunity. OPEN AIR SCHOOLS BY LEONARD P. AYRES, A. M., Ph. D. Associate Director, Department of Child Hygiene, Russell Sage Foundation; Co-Author of Medical Inspection of Schools; Author of Laggards in Our Schools, etc. The first book in any language devoted to the new type of schools in which sick and ailing children are made healthy and vigorous and at the same time make better progress in their lessons than normal children in ordinary schools. Profusely and beautifully illustrated. Doubleday, Page & Co., New York Price $1.20 (postage 12c.) Russell Sage Foundation Publications MEDICAL INSPECTION OF SCHOOLS BY LUTHER HALSEY GULICK, M. D. Director of Physical Training of the New York Public Schools; and LEONARD P. AYRES, A. M„ Ph. D. Formerly General Superintendent of Schools for Porto Rico "Lucidly exhaustive and admirably arranged." — The Nation. "A notable contribution both to medicine and to school administration." — Erie Dispatch. "An important contribution to the cause of Education." — Journal of Edu- cation. Third Edition. Price, postpaid, $1.00 LAGGARDS IN OUR "SCHOOLS A Study of Retardation and Elimination in City School Systems BY LEONARD P. AYRES, A. M., Ph. D. Formerly General Superintendent of Schools for Porto Rico; Co-Author of Medical Inspection of Schools, Author of Open Air Schools. "Mr. Ayres has given life to his figures and character to his diagrams." — ■ American Industries. "Such a book, at once readable and scholarly, scientific and popular, critical and constructive, is typical of the best in educational literature." — The Independent. "It is the most important specific study of school conditions that has been made by any one." — Journal of Education. Third Edition. Price, postpaid, $1.50. In lots of six, $1.00 each, postpaid THE WIDER USE OF THE SCHOOL PLANT BY CLARENCE ARTHUR PERRY A volume of 350 pages with 32 illustrations describing fully the use of the school plant for such activities as Vacation Schools, Public Lectures, Social Centres, Evening Schools, etc. Such features as social betterment, administration, cost, and organization are fully treated. Price, postpaid, $1.25 CHARITIES PUBLICATION COMMITTEE 105 East 22d Street, New York City, N. Y. LIBRARY OF CONGRESS 029 501 137 3 3^5 fa LIBRARY OF r nil Hollinger Corp. ¥ T a IT