34*7/ BULLETIN OF THE EXTENSION DIVISION, INDIANA UNIVERSITY Entered as second-class mail matter, October 15, 1915, at the post-office at Bloom- ington, Indiana, under the Act of August 24, 1912. Published monthly by Indiana University, from the University Office, Bloomington, Indiana. Vol. VII BLOOMINGTON, INDIANA No. 7 Open Air Schools By Mrs. Avis Tarrant Burke Assistant, Public Welfare Service, Extension Division, Indiana University MARCH, 1922 Services of the Extension Division Extension Teaching Service Correspondence Study Class Instruction Indianapolis Extension Center Fort Wayne Extension Center Lectures and Music Programs Commencement Addresses Teachers' Institute Instruction Public Welfare Service Bureau of Parent-Teacher Associations Bureau of Child Welfare Play and Recreation Service Public Discussion Bureau — Package Libraries Club Programs and Outlines State High School Discussion League Reference Service Drama Service Visual Instruction Bureau — Loan of Lantern Slides Motion Pictures Loan of Picture Exhibits Welfare Exhibits General Welfare Service — Surveys and Investigations Community Centers Home Reading Courses Health Education Campaigns Information Service Publications LIBRARY OF CONGRESS RECEIVED DOCUMENTS D»V«34U» (2) Foreword This bulletin is published by the Extension Division of Indiana University as a part of its contribution to child health. The material included was gathered largely during five years of experience in teach- ing in an open air school. The information on open air schools in Indiana was furnished by persons in the local communities described. Special acknowledgment should be made to the following persons for their assistance in the preparation of this bulletin: Mr. Murray Auer- bach, executive secretary of the Indiana Tuberculosis Association; Mr. E. U. Graff, superintendent of schools, Indianapolis; Dr. William F. King, assistant secretary of the State Board of Health; Miss Mary E. Murphy, assistant director of the Elizabeth McCormick Memorial Fund, Chicago; Mr. Frank A. Manny, Boston, Mass.; Mrs. Ella Bagot Kehrerj Anderson; Miss Belle Roberts, teacher in open air school, Sunnyside, Oaklandon, Ind.; Miss Lillian Cannon, school nurse, South Bend; Miss Sara Redding, teacher in open air school, South Bend; Miss Julia E. Sullivan, teacher in open air room, Oliver School, South Bend; Miss Jane Hufford, executive of the Anti-Tuberculosis League, South Bend; Mr. L. C. Ward, superintendent of schools, Fort Wayne; Miss Jeanette E. Williams, principal of Theodore Potter School, Indianapolis; Miss Galvin, principal of Lucretia Mott School, Indianapolis; Miss Ima Black, McCoy School, Indianapolis; Miss Alma Hoss, teacher in open air room, School No. 9, Indianapolis; Miss Augusta Coburn, teacher of open air room, School No. 12, Indianapolis; Miss Green, principal of the James Whitcomb Riley School, Indianapolis; Miss Katherine B. Challman, teacher in open air room, Carpenter School, Evansville; Mr. L. P. Benezet, superintendent of schools, Evansville; Miss Turner, R. N. Boehne Camp, Evansville; Miss Naomi Blosser, public health nurse, Goshen; Miss Lila R. Powell, secretary of the Grant County Tubercu- losis Association; Miss Emma Borowski, teacher of open air school, South Manchester, Conn.; Miss Doris I. Osborn, teacher of School of Household Arts, South Manchester, Conn. (3) Contents The Open Air School Idea — Page History and Development 5 Method of Selection of Children 7 Building and Equipment 8 School Routine ' 10 Results 12 Follow-Up Work 13 Suggestions for Rural Communities 14 Open Air Schools in Indiana — Indianapolis 16 Fort Wayne 17 Evansville 18 South Bend 19 Goshen 20 Marion 20 Tuberculosis Camps 20 APPENDIX — Table of Ages, Heights, and Weights 22 Topics for Mothers' Meetings 25 Equipment 26 Bibliography 27 (4) The Open Air School Idea HISTORY AND DEVELOPMENT Most of us accept the fact that strength, vitality, and the power of resistance to disease are gained by a life in the open air. We have only to recall the stories of the feats of endurance performed by the Vikings of Northern Europe and by our own American Indians, as well as the exhibitions of strength and skill shown in the games of the ancient Greeks and Romans. We know that the latter were trained in open air gymnasia, and that teaching the youths out of doors was con- sidered both practicable and advisable. But the rapid growth of our economic and industrial system has forced people to work in factories and shops, and to live huddled together in tenements and crowded houses where there is little or no fresh air to be found. Its benefits are for- gotten or disregarded. Children suffer more from lack of pure air than do grown-ups. Figures show that fifty per cent of children living under adverse con- ditions become infected with tuberculosis before they are five years old, and many have the seeds of diseases which show malignant growth in later life. That these children are handicapped is evident as soon as they begin school, for the physically subnormal child is the backward one and the repeater. He makes nine per cent slower progress than the one having no defects. About the year 1904 the school authorities of Berlin, Germany, became aware that there was an unusually large number of children retarded in the grades of the public schools. Medical examination showed that these children were victims of some physical defect, — poor sight and hearing, tuberculosis, anaemia, malnutrition, diseased tonsils and adenoids, and chorea being the most common. The salutary effect of open air treatment for tuberculosis had long been known, and the idea of educating the minds of weakly children while curing their bodies was proposed and carried out. In a pine forest outside the city, in the suburb of Charlottenburg, a pavilion was erected, and one hundred and twenty tuberculous children were sent there for the experiment. They stayed all day, received three nourishing meals prepared on the premises, and had rest, play, and study hours. Three months later these children returned to their schools, completely cured. The news of the success of this school quickly spread to other coun- tries, including our own. The first open air school in the United States was in Providence, R.I. An abandoned schoolhouse was used, and only tuberculous children were admitted. About the same time, New York City also established a similar school for tuberculous children on an unused ferry-boat. The treatment and results in both schools were identical with those obtained at Charlottenburg. Now the idea has grown and been adapted so that not only tuberculous children, but (5) 6 Bulletin of the Extension Division those who are frail from malnutrition or any sort of physical defect are considered candidates for an open air school. At least one of these schools is maintained in nearly every large city in our country. In Boston, the law provides that each new school building shall contain one open window room. Unfortunately, the number of open air schools It is fun to study in the open air when one is warm and comfortable. (Courtesy of F. C. Huyck and Sons, Albany, N.Y.) is much too small to accommodate all the children who would benefit by them. In 1914 there were one million tuberculous children in the United States, of whom fifteen hundred were in open air schools. There were sixty open air schools, so that one may easily see that the number of open air schools is entirely inadequate for the tuberculous children Open Air Schools 7 in our country, to say nothing of the great army of the non-tuberculous who need just this sort of school. The small number of schools is accounted for by the fact that school boards do not feel justified in incurring the expense of an open air school. In most cases where these schools have been established, the initial expense of equipment and cost of maintenance for a period of time has been borne by societies or private individuals. After the ex- perimental stage, such schools have, in some cases, been taken over by the school authorities, but in others they are still conducted wholly or in part with private funds. The feeding of the children is undoubtedly the greatest item of ex- pense, and while they improve faster when fed at school, such a plan is not necessary. Experiment has shown that a group of children in a schoolroom with windows open, and without school feeding, show better physical condition than a similar group in a room heated and ventilated by the uncertain and inadequate (tho expensive) systems with which we are familiar. With the above experiment in mind, some schools maintain open window rooms, in which the windows are thrown wide open and the children continue in regular session, studying and reciting while wearing their out-door wraps. From the most superficial observation of the results of these open air schools, we are compelled to admit that out-of-door air is beyond question the best for the human body, and we must seek for the reason. That the body may perform its functions, a radiation of bodily heat is necessary. This is accomplished best in fresh air, cool, moving, and moderately dry. It is almost impossible, even with a thoroly tested and well-recommended ventilating system, to maintain ideal conditions in our overcrowded schoolrooms. Instead, we find in them a varying amount of heat and moisture, and a harmful quantity of carbon dioxide and accompanying impurities given off by skin and garments, doubt- fully clean. Fresh out-of-door air usually has the proper degree of coolness and dryness for bodily health, as well as motion enough to carry away impurities. In speaking of the need of out-of-door air for the human being, Dr. Fletcher B. Dresslar in his excellent book, School Hygiene, points out this fact: "The human organism developed in open air, and its physiological processes were adjusted through countless ages to conditions there prevailing. Man today is adjusted to normal pure air such as we find in the open country and unless he is fur- nished with an atmosphere of approximately the same constituency as that prevailing in the open country he will suffer as a consequence." We have only to refer again to the experiments in open air schools to confirm the truth of Dr. Dresslar's statement. METHOD OF SELECTION OF CHILDREN Young children in the first six grades of school are those most benefited by an out-of-door program. Disease is not seated nor habit fixed, so that they respond more readily to treatment than do older chil- dren. Each child in school is thoroly examined by the medical inspector. His height and weight are compared with the normal height and weight Bulletin of the Extension Division A happy, cheerful spirit is the result of work and play in the open air. (Courtesy of Miss Jeanette Williams, principal of the Theodore Potter School, Indianapolis, Ind.) for that age; lungs, heart, and blood are tested; teeth, eyes, and ears are examined; and notice taken of general appearance. Record is made of facts discovered in order that future comparison may be possible. For obvious reasons the tuberculous children are segregated in a school of their own, while of the non-tuberculous, those needing treatment most are placed in another school. In any open air school, twenty-five pupils is the number best handled by one teacher. No law exists in this country which compels a child to attend an open air school, and permission from the parents must be obtained. The school nurse here plays an important part, in visiting the homes of the children, pre- senting the facts, and urging the need. BUILDING AND EQUIPMENT Since the movement first began there have been many types of open air school buildings. The first ones were chiefly makeshifts: un- used school buildings, roofs of schoolhouses, and balconies of hospitals. As a protection against the wind, these were fitted with canvas screens and roofs. Army tents and asbestos shacks were next used. In the last few years specially designed buildings have been erected. Par- ticular care is taken to have these with southern exposure, on well- drained ground, and in a pleasant locality. They are either the pavilion or two-floor type, some slightly heated and others with no heat except a stove for drying damp garments. The windows are either the slid- ing or pivot type, so as to insure as much air as possible. In some cases shutters are used to keep out direct sunlight and cutting wind; in others, muslin screens fitted to the windows perform the service. Open Air Schools 9 The adjustable desks and chairs are movable, preferably on plat- forms, so that the feet may be kept warm. Various devices are used to protect the children from the winter cold. Many schools use the Eskimo costume, originated by the Elizabeth McCormick Open Air School in Chicago. This consists of a loose coat with hood, trousers, and lumberman's boots. It permits great freedom of movement. Other schools find the sitting bag quite as convenient and comfortable. This is a canvas bag shaped so as to fit the chair and lined with a thick blanket. It is tied to the chair, and straps pass over the shoulder to hold up the back and front of the bag around the child. Another type of bag is one which opens in such a way that it may be used for either a sitting or a sleeping bag. It is fitted with a hood which can be drawn up over the head, and an extra piece at the bottom buttons up over the feet. In addition to the bags, "chasing shoes", similar to those used by invalids at Saranac Lake, are lent. The shoes are of sheepskin with the fleece turned inside. Soapstones, too, have been used. Any provision made by the schools is supplemented by the child's own winter garments, coat, sweater, mittens, and toque. As the rest period is an important part of the daily program, steamer chairs or folding cots are provided. Cots are the better, as a cramped position is avoidable. Blankets are furnished for use on the cots. Last, but not least, a tooth-brush is given each child. All of the articles described are marked with the owner's name or number and remain his property while he is in the school. When he Brushing the teeth is one of the health habits learned in an open air school. (Courtesy of Miss Julia E. Sullivan, Oliver School, South Bend, Ind.) 10 Bulletin of the Extension Division withdraws, the equipment is thoroly fumigated and ready for another child. In or near each open air schoolroom, accommodation can be given for serving the one or more nourishing meals which the children enjoy each day. In some instances a cottage near by has been utilized, domestic science rooms have been used, and in not a few cases, the meals have been sent to the children from school lunch counters. School authorities must also provide properly equipped and heated toilet and washrooms. SCHOOL ROUTINE Since increased health for those attending is the purpose of an open air school, the whole curriculum is arranged with that in view. In both types of school, for the tuberculous and the non-tuberculous, the program is much the same, except that in the case of the former the children are of necessity more closely watched by the medical in- spector and they are instructed in methods of preventing the spread of their disease. The day begins at about 8 o'clock with a breakfast of milk and cereal; then follows school work, interrupted by recreation periods until 12. At that time the children wash their faces and hands, clean their finger-nails and prepare for the noon meal. The following menus are typical of the dinners served to the open air school children in South Manchester, Conn. Monday Tuesday Meat loaf Baked omelet Baked potatoes Creamed potatoes Peas Scalloped corn Corn bread and butter Wheat bread and butter Tapioca cream Peaches (home canned) Milk Milk Thursday Wednesday ■off Scalloped ham and potatoes , T71 , , , j i . . Lettuce and dressing Wheat bread and butter _ . . . , , .. Graham bread and butter Gingerbread and cream Milk Apple sauce Milk Friday Monday Scalloped haddock Goldenrod eggs on toast Mashed potatoes Mashed potatoes Corn bread and butter Graham bread and butter Cottage pudding and lemon sauce Chocolate bread pudding Milk Milk These meals are planned to give both the greatest variety and nourish- ment possible. In June, 1921, the cost per capita for the noon meal and the breakfast of cereal and milk (or cocoa and crackers) was eighteen cents. After dinner the children brush their teeth, under Open Air Schools 11 direction, and rest on the cots for an hour. Absolute quiet is the rule, and many children really sleep. At about 2 o'clock, school work is again resumed until 3:30 when a light supper is served, after which the children go to their homes. As a consequence of this program, the child receives but one meal at home. This should be a light lunch at the regular supper hour. Each day the school nurse visits the children, and at stated inter- vals the doctor makes inspection. He re-examines each child in order to determine the improvement and to decide whether or not he may take up the work in the regular schoolroom. (It is generally best for Eest in the open air gives strength and refreshment to mind and body. (Courtesy of Miss Emma Borowski, Open Air School, South Manchester, Conn.) a child to remain in an open air school for a whole year.) Each week the children are weighed and a gain is eagerly looked for. Lessons in cleanliness of body and teeth, in the importance of fresh air at all times, of exercise of the whole body, of deep breathing, all receive practical demonstration at some time of the day. If it is pos- sible for shower baths to be given at the school, so much the better. The children love them. Instruction in handwork and gardening may be given and is much enjoyed. It can easily be seen that the scheme is capable of endless variation and can be adapted to any sort of condition. 12 Bulletin of the Extension Division Work in the school garden is an enjoyable and healthful exercise. RESULTS No comment is needed as to the results obtained from the treat- ment of tuberculous children in the open air. They are too well known. But what is to be said of those other children suffering from malnutri- tion, anaemia, chorea, lack of appetite, indigestion, neuralgia, nervous- ness, chest pains, headaches, heart trouble, impaired nutrition, relaxed skin and muscles, and chronic fatigue? Reports from various schools all tell the same story. From seventy-five to ninety per cent of such children attending open air schools show improvement. The regular routine, with fresh air and nourishing food, brings about in the pupils an almost immediate visible result. The eyes brighten, the step becomes elastic, headaches disappear, studies and play are entered into with more vigor, and the whole mental and physical tone is raised. Gain is made in weight — from one-fourth to one-half pound each week. The blood gains in hemoglobin, showing a higher type of activity in the whole body. Teachers say that "snuffling" disappears, the children have few colds, and never does a contagious disease "go thru" a room. Nervous- ness grows less and in time vanishes. Best of all, as the child improves in health, his school work becomes better, and instead of being a "re- tarded pupil" he finds himself abreast of those in his grade. He is happy and contented, likes his school, and is much more tractable. Other unexpected results follow which are none the less quite valuable. What cares the open air school child if it rains or blows or snows? Experience has shown him how to take care of himself so that he can enjoy his work under any conditions. Suppose at dinner food is served that he has never eaten before. Experience again has taught that all food served at school is good and appetizing, and that one can learn to like what has previously been disliked. Her mother says that Hattie never ate potatoes before she attended the open air school, and that now she cannot give her enough. John's mother can hardly be- lieve that he drinks nearly a pint of milk at school each day. Knives Open Air Schools 13 and forks are handled with the same ease as a spoon, and Paul dis- covers that even tho he is only six years old he can keep his food on his plate and eat as quietly and politely as his teacher. Lizzie has found out that people do not shout for food, but instead say quietly, "Mary, please pass the bread", or "I should like the butter, please." In some schools the pupils take great pride in setting the table and in serving the meal correctly and decently. The influence of the open air school extends to the homes of the children. From listening to their talk, parents gradually come to realize that their duty is not done with merely getting John and Mary up in time for school. Their food must be nourishing and given at regular intervals, their clothing hygienic, their sleeping hours of suf- ficient length, and their rest undisturbed. Parents begin to study their children and think of things never noticed before. FOLLOW UP WORK That all the good accomplished in an open air school is greatly diminished by lack of cooperation in the home is shown by the fact that most schools record a loss in weight in the children from Friday to Monday. The "Monday cold" caused by lack of fresh air in the homes is also common. One of the most important parts of the work may be called the "education of the parent". We have already men- tioned the fact of the child's influence in the home. But it is useless ■ : : :; ::: ; . ;; ; |: Singing, as a means of developing the lungs, is an important part of the open air school daily program. (Courtesy of Miss Belle Roberts, Open Air School, Sunnyside, Oak- landon, Ind.) 14 Bulletin of the Extension Division for him to urge having the windows open at night if his mother is unconvinced of its necessity, or is superstitious about night air. The school nurse and the teacher can here render an important service. The homes must be visited and interest aroused. The teacher can impress upon the parent that, if permanent and speedy benefit is to be gained by attendance at an open air school, there are several things the child must do. He must eat healthful meals, especially breakfasts, instead of the all-too-common cup of coffee and piece of pie. Because coffee contains unwholesome properties, the open air school child must drink milk. Thus his body will grow and gain strength of bone and muscle. If he is hungry between meals, a piece of bread and butter (an excellent food) will satisfy him, and candy should be eaten only directly after dinner or supper. The open air school child must retire early, preferably in a cot by himself. The room must be well ventilated, the window open at top and bottom. Visiting the homes of the open air school children is so very important that the teacher might well be excused from schoolroom duty a few hours each week in order that she might increase the efficiency of the school in the home. Home visiting may be supplemented by a Mothers' Club composed of the mothers of the open air school children. The club meetings should be conducted according to parliamentary law, held at regular intervals, and kept educational in character; the program may include a talk on some health problem, such as ventilation of the home, care of young children, diseases of children, care of the teeth, etc. Tea and wafers, served after the discussion, aid greatly in promoting a social at- mosphere, and in adding to the popularity of the meetings. SUGGESTIONS FOR RURAL COMMUNITIES We are accustomed to think that country children are more healthy than city children. But is this true? Dr. James A. Nydegger, surgeon of the United States Public Health Service, as a result of his investi- gations brought to light (1915) the following facts: that children afflicted with tuberculosis are almost four times as numerous in the ■ country as in the city; that eye defects in country school children are four times as numerous as in city school children, ear defects more than five times as numerous, enlarged tonsils four times as prevalent, and curvature of the spine twenty times more prevalent. Dr. Nydegger also asserts that from sixty-five per cent to seventy per cent of the children in the United States are in country schools. Dr. Mabel Carney, professor in Columbia University, in reporting (1921) on her investigations does not make the difference in health between country and city children quite so great as does Dr. Nydegger. She discovers the country children suffering from similar handicaps, and in addition from defective teeth and malnutrition. She says that the country child has one-half the health protection that the city child has. In the light of these facts, and with the knowledge of the great benefit of fresh air to the physically unfit, comes the question, why not the open air school, and its attendant advantages in the country? But Open Air Schools 15 in a school of nine or fourteen children it is not possible to give the three or six frail ones a separate school with equipment. Like a flash conies the solution of the problem, If good for some, why not good for all? However, the thoughtful person understanding conditions in most rural districts realizes that the problem of the health of our country- children will not be solved by advocating offhand that every school be an open air school. What is the message of the open air school for the rural community? Each district can apply the information gained by experience in the cities to itself. The school authorities can begin by abolishing the ill-fitting desks and seats, the common drinking-cup, and a hand - towel. The employment of the school or public health nurse comes next. She may be paid either by public or private agencies, or both. Working with her, there should be the school physician, who makes examination in the schools and suggests care and treatment when necessary. Milk feeding and school lunches for the undernourished would follow quickly. Finally, we may hope that parents, fully aroused to the importance of their children's health, will insist upon getting rid of bad heating and imperfect ventilation and eventually open all the schoolroom windows wide. Then we shall have every rural school an open air school and every country child given a fair chance for health and a life of usefulness. Open air school children like to entertain their mothers and friends with little plays, — even Mother Goose rhymes may be used. (Courtesy of Miss Emma Borowski, Open Air School, South Manches- ter, Conn.) Open Air Schools in Indiana As is true of most states in our country, open air schools, or open window rooms, are maintained in several of the larger and some of the smaller towns in Indiana. INDIANAPOLIS The Theodore Potter Fresh Air School, on the Technical High School grounds, was established in October, 1914. The building has two schoolrooms, two restrooms, kitchen, dining-room, and office. About fifty children, predisposed to tuberculosis, attend. They receive two nourishing meals a day, and take a rest on cots in the afternoon. These pupils are under the daily supervision of the school nurse. They are weighed each month; and where the gain is unsatisfactory, reasons in each individual case are sought, and remedied as far as possible. 1 At the Lucretia Mott School (No. 3), there are two open window rooms in which are about fifty-five ansemic and undernourished chil- dren. The rooms are heated, the windows thrown open, and the chil- dren wearing their out-of-door wraps, supplemented by blanket suits, continue the work of their different grades 3, 4, 5, 6, 7, 8. All of these children receive a lunch in the morning, and those who do not care to return home at noon eat their dinner at the school. This is a well-balanced nourishing meal prepared on the premises especially for the open window room children. The rooms, started in 1913, have been in session longer than any other open window rooms in the city. Ap- proximately four hundred children have attended during the nine years. Two open window rooms for ansemic children were begun in the Robert Dale Owen School (No. 12) in 1917. The rooms are heated, and the children, looking like little Eskimos in blanket coats and trous- ers, do the work of the regular schoolroom. There are six grades and two teachers. Monthly weight charts are kept with great interest on the part of teachers and pupils. A muslin window room for anaemic colored children is provided in the McCoy School. This room was started in February, 1917, and since that time sixty-five children have attended. Last year (1920-21) ten pupils were discharged as normal in health. The open window room in School No. 9 was begun in September, 1921. This is a mixed class of thirty-five fifth grade children, not all 1 It is expected that a new Theodore Potter open air school will be ready for occu- pancy in September, 1922. The plans have been very carefully worked out for the health, comfort, and convenience of all concerned in the daily routine of the school. Open air schools in about a dozen cities in the Middle West were visited, and many of the good features, and none of the objectionable ones, of these schools have been incor- porated into the plans for the new building. There will be provision made for one hundred children. It is hoped that future years will see -three more such schools in other parts of the city. (16) Open Air Schools 17 in need of special medical attention. Of the twenty-five children who were underweight, all but one has gained somewhat in weight, and two have gained nine pounds from September to February. In the James Whitcomb Riley School (No. 43) is a heated (60°) muslin window room which has been in session four years. Of the thirty-eight children attending some are ansemic and undernourished, but most of them are in normal health, having been assigned to the room because of the request of parents. With the exception of a few children admitted to the room because of vacancies occasioned by chil- dren moving out of the district, the same children have remained in the room for the four years, progressing each year in school work. No medical attention besides that given to other children in the James Whitcomb Riley School is given these particular children, but they do receive a hot lunch during the cold weather, cocoa or soup, with crack- ers. Because of the departmental system, these children will return to the regular schoolrooms next year It is hoped that other parents will realize the opportunity for their children, that the room may not be discontinued. FORT WAYNE From September, 1916, to June, 1921, an open air school was sup- ported in Fort Wayne, the school board and the Tuberculosis League dividing the work. In September, 1921, the school board assumed en- tire control. The open air school was discontinued and, instead, two open window rooms for anaemic children, and those disposed to tubercu- losis were begun. Sixty-two children are enrolled. The school physi- Holiday seasons give variation to the regular school routine. (Courtesy of Miss Belle Roberts, Open Air School, Sunnyside, Oak- landon, Ind.) 2—21027 18 Bulletin of the Extension Division The story hour is one of the pleasantest times in the day. (Courtesy of Miss Julia E. Sullivan, Oliver School, South Bend, Ind.) cians and nurse look after the physical welfare of these children. It is intended that in the near future two or three more open window rooms will be in session, thus giving one such room at least to the four dif- ferent parts of the city. EVANSVILLE This city has an open window room for each school building. The one for the Henry Roosa School is in a portable building near the school. It was begun in April, 1921, and accommodates thirteen children suf- fering from anfemia and a predisposition to tuberculosis. The improve- ment in weight has been satisfactory and last year (1921) two children were discharged as normal in health. Near the Delaware School is also a portable building for the open window room. The room, accommodating twenty-two pupils, was opened in September, 1921, for children showing a tendency to tuberculosis. At the morning lunch, milk is supplied free to these children. If they bring food from home for the noon meal, the teacher can heat it on the stove furnished as a part of the school equipment. There is a regular rest period. Cots are used. Last year six children were dis- charged as normal in health. The Carpenter School started an open window room for anaemic and pre-tuberculous children in March, 1921. Twenty-four children have been enrolled since the opening, and in October six were discharged as cured. A lunch of one pint of milk and three graham crackers is served each child each half-day. The lunch is followed by one half- hour rest period. In the Fulton School is an open window room, begun in September, 1921, and accommodating twenty-one anaemic, pre-tuberculous children. They also have a milk lunch and have gained in weight, an average of Open Air Schools 19 1 1/7 pounds. As is the case with the children in the other open win- dow rooms in Evansville, these children are under the care of the school physicians and nurse. In the Centennial School, the open window room was begun in January, 1920. This was the first to be started in the city. The ail- ments of the seventeen children attending are anaemia and tendency to tuberculosis. They are given milk at the school, and show an average gain of one pound a month. Stanley Hall School has its open window room. This was opened in September, 1920, for children predisposed to tuberculosis. In the year 1920-21 fourteen children, a large number, were discharged as normal in health. The children in the open window room at the Emma Roach School are suffering from anaemia, pre-tuberculosis, adenoids, and infected ton- sils. The room was started in September, 1921, with an enrollment of thirteen. As is true of the other open window room children in the city, they have a lunch of milk and crackers each day. SOUTH BEND The first open window room in this city was begun in the Wash- ington School in September, 1918. The total enrollment since the time of opening is 136. These children were recommended for the room by the school physician, because they were anaemic, undernourished, and inclined to tuberculosis. The pupils have two nourishing meals a day, at 10 a.m. and at 12:15, as well as a lunch at 3:15. There is a two- hour rest period after the noon meal. Temperatures are taken twice each week, and the children are weighed once a month. The improve- ment in many cases is rapid, and some children gain a great deal in weight, two pounds being reported as the average each month. The new Oliver School (1922) has two open window rooms, partly heated. The suite consists of the large classrooms, storeroom, kitchen, and restroom. The health of the forty undernourished, pre-tuberculous children is carefully supervised by the school physician and nurse who are aided in their efforts by an expert dietitian hired by the school board. The children rest each day on what is known as the Dardenol- ney. Because of the cold winds blowing from the marshes of St. Joseph County, it was found impossible to keep the children warm on the cots generally in use in open air schools. To remedy this, it was suggested that the children sleep on the floor and the Dardenolney was evolved. This is a felt, canvas-covered pad, with flaps which tie over the child, who retains his Eskimo suit while taking the rest. The Dardenolney is very light, can easily be rolled up and stowed away and has been found most satisfactory for the purpose' for which it was designed. The program followed each day is the same as that of the Washington School. ■ ; ! I V \'\ If 20 Bulletin of the Extension Division M Children thrive in the fresh air and sunshine of winter, just as they do in the fresh air and sunshine of summer. (Courtesy of Miss Naomi Blosser, Public Health Nurse, Goshen, Ind.) GOSHEN The underweight, undernourished, anaemic, and pre-tuberculous chil- dren are cared for in this town by means of an open air room. This room was started in the fall of 1921 with a capacity of eighteen chil- dren. The children show satisfactory gain in weight and improvement in school work. The nurse reports that mothers in many cases are fol- lowing at home suggestions made at school for the improvement of the health of the children. MARION Provision for two open window rooms accommodating fifty children has been made in the plans for a new school building which will be ready for occupancy in September, 1922. TUBERCULOSIS CAMPS As may be expected, open air schools are maintained in connection with tuberculosis sanatoria. At Sunnyside, Oaklandon, the school was organized in September, 1918, under the supervision of the county superintendent of schools, for those children having tuberculosis in an active form, or who had been directly exposed to it in their families. The school has seats for twenty children who are being led on the road to health by a carefully planned program of fresh air, rest, and nourishing food. Of the one hundred and four children enrolled since opening, sixty-eight have been discharged as normal in health. Open Air Schools 21 At Boehne Camp, Evansville, is also an open air school for tuber- culous children. The fourteen children attending receive the same kind of careful supervision by nurse and physician as do the children at Sunnyside. The authorities are well pleased with the rate of improve- ment. The records of all the schools described show that in some places in Indiana much is being done for the frail, undernourished child. What a fine thing it would be, if all the school systems in our state would give to the physically subnormal child an opportunity to return to health by means of fresh air, rest, and nourishing food! Appendix TABLE OF AGES, HEIGHTS, AND WEIGHTS 1 The following table of heights and weights of children is taken from the weighing and measuring test card issued by the Children's Bureau, Department of Labor, United States of America: Age Be YS Girls Height, Inches i Weight, Pounds Height, Inches i Weight, Pounds 6 43.8 45.7 47.8 49.7 51.7 53.3 55.1 57.2 59.9 62.3 65.0 45.2 49.1 53.9 59.2 65.3 70.2 76.9 84.8 94.9 107.1 121.0 43.4 45.5 47.6 49.4 51.3 53.4 55.9 58.2 59.9 61.1 61.6 43.3 7 47.5 8 52.0 9 57.1 10 62.4 11 68.8 12 13 14 78.3 88.7 98.4 15 16 106.1 112.0 "Approximate equivalents of decimal fractions of a pound in ounces — 0.1, iy 2 ; 0.2, 3; 0.3, 4V 2 ; 0.4, 6; 0.5, 8; 0.6, 9%; 0.7, 11; 0.8, 12%; 0.9, 14; 1.0, 16. "A variation of from 1 to 2 pounds from the averages given in the table above should not be considered abnormal." This table will be of value to the teacher desirous of discovering those of the children in her care who are undernourished. Dr. William R. P. Emerson and Dr. Thomas D. Wood, both nationally known au- thorities on the subject of nutrition, agree that "Children habitually seven per cent or more underweight for their height are not only under- nourished but malnourished, retarded in both height and weight from one to four years." Thus the girl of fourteen years — 59.9 (normal height) — 22 lbs. underweight is 22.4 per cent underweight, a truly alarming condition. These tables of heights and weights prepared by Dr. Thomas D. Wood may be fovrnd to be more valuable than the foregoing one. These give the variations in height for the different ages of girls and boys and the corresponding variation in weight. For instance, a girl of six years, 39 inches in height, should weigh 35 pounds. If she is 42 inches in height, she should, according to the following table, weigh 41 pounds. 1 The complete table of weights and measures from which this material is taken may be procured from the Children's Bureau, Department of Labor, United States of America. (22) Open Air Schools HEIGHT AND WEIGHT TABLE FOR GIRLS 23 Height. Inches 5 Yrs 6 Yrs 7 Yrs 8 Yrs 9 Yrs 10 Yrs 11 Yrs 12 Yrs 13 Yrs 14 Yrs 15 Yrs 16 Yrs 17 Yrs 18 Yrs 39 34 36 38 40 42 44 46 48 35 37 39 41 42 45 47 48 49 51 53 36 38 40 42 43 45 47 49 50 52 54 56 59 62 43 44 46 48 50 51 53 55 57 60 63 66 68 49 51 52 54 56 58 61 64 67 69 72 76 53 55 57 59 62 65 68 70 73 77 81 85 89 56 58 60 63 66 6S 71 74 78 82 86 90 94 99 104 109 61 64 67 69 72 75 79 83 87 91 95 101 106 111 115 117 119 70 73 76 SO 84 88 93 97 102 107 112 117 119 121 124 126 129 77 81 85 89 94 99 104 109 113 118 120 199 126 12S 131 134 138 86 90 95 100 106 111 115 119 122 124 127 130 133 136 140 145 91 96 102 108 113 117 120 123 126 128 132 135 138 142 147 98 104 109 114 118 121 124 127 129 133 136 139 143 148 40 41... 42... 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 106 111 115 119 122 125 128 130 61 62 63 64 65 66 67 68 69 137 70 71 144 72 149 1 24 Bulletin of the Extension Division HEIGHT AND WEIGHT TABLE FOR BOYS Height, Inches 5 Yrs 6 Yrs 7 Yrs 8 Yrs 9 Yrs 10 Yrs 11 Yrs 12 Yrs 13 Yrs 14 Yrs 15 Yrs 16 Yrs 17 Yrs 18 Yrs 39 40 41 42 43 44 45 46 35 37 39 41 43 45 47 48 36 38 40 42 44 46 47 49 51 53 55 37 39 41 43 45 46 48 50 52 54 56 58 60 62 44 46 47 48 50 52 55 57 59 61 63 66 69 49 51 53 55 58 60 62 64 67 70 73 77 54 56 58 60 63 65 68 71 74 78 81 84 87 91 57 59 61 64 67 69 72 75 79 82 85 88 92 95 100 105 62 65 68 70 73 76 80 83 86 89 93 97 102 107 113 71 74 77 81 84 87 90 94 99 104 109 115 120 125 130 134 138 78 82 85 88 92 97 102 106 111 117 122 126 130 135 139 142 147 152 157 162 86 90 94 99 104 109 114 118 123 127 132 136 140 144 149 154 159 164 169 174 91 96 101 106 111 115 119 124 128 133 137 141 145 150 155 160 165 170 175 97 102 108 113 117 120 125 129 134 138 142 146 151 156 161 166 171 176 47.... 48... 49. . . . 50. . . 51 52 53... 54 55 56 57 58 59 60 61 110 62 116 63 119 64 122 65 126 66 130 67 135 68 139 69 143 70 147 71 152 72 157 73 162 74 167 75 172 76 177 About What a GIRL Should Gain Each Month. Age 5 to 8 6 oz. 8 to 11 8oz. 11 to 14 12 oz. Age 14 to 16 8oz. 16 to 18 4oz. About What a BOY Should Gain Each Month. Age 5 to 8 6oz. 8 to 12 8oz. Age 12to'16 16 oz. 16 to 18 Soz. Weight and measures should be taken without shoes, and in only the usual indoor clothes. Open Air Schools 25 TOPICS FOR MOTHERS' MEETINGS The topics below are suggested as suitable for open air school mothers' meetings. It is desirable that these subjects be presented with special reference to the open air school child. 1. The open air school idea. 2. Care of the teeth. 3. Care of the eyes. 4. Home nursing and care of the sick. 5. Tuberculosis — the care and cure of the patient in the home. 6. Tonsils and adenoids and their relation to health. 7. Home ventilation. 8. Principles of a well-balanced, nutritional diet. 9. Preparation of food in the home. 10. Milk. 11. Hygiene and proper clothing for the child. 12. Discipline and management of children. 13. The child and the moving picture. 14. Birds, wild flowers, and other out-of-door interests. 15. Home gardens. Package libraries on any of the above subjects will be sent free of charge to anyone addressing request to the Bureau of Public Discus- sion, Extension Division, Indiana University, Bloomington, Ind. 26 Bulletin of the Extension Division EQUIPMENT Equipment for the open air school child may be obtained at the following places: Eskimo suits — Marshall Field and Co., Chicago, 111. Elizabeth McCormick Memorial Fund, 315 Plymouth Court, Chi- cago, 111. Sitting bags 2 — F. C. Huyck and Son, Albany, N.Y. Sleeping bags 2 — F. C. Huyck and Son, Albany, N.Y. Cots— These can be ordered thru any furniture dealer. Blankets — Regular folding army cots with army blanket can be obtained from any army store. These may also be bought at any large department store or mail- order house. Sheep-skin shoes — These can usually be ordered thru a shoe dealer. Adjustable desks — These can be ordered from any firm dealing in school furniture. Platform for desk — Platforms can be made by any carpenter or school janitor and the desks screwed to them. Tooth-brushes — The children can furnish these or they can be bought at wholesale from drygoods or drug store. Orange sticks or tooth picks for cleaning the finger nails may be secured at a nominal cost. This bag used for each purpose. Open Air Schools 27 BIBLIOGRAPHY Ayres, L. P. Open Air Schools. An account of the history and prog- ress of the movement in our own and other countries. Ayres, L. P. Laggards in Our Schools. Parallel drawn between chil- dren who are repeating the grade and those having physical defects. Ayres, L. P. Open Air Schools, in Cyclopaedia of Education. Paul Munro (Ed.). Short account of the history, administrative expense incurred, and need for these schools. Baker, S. Josephine. Open Air Classes in Public Schools of New York City during 1919, in Bulletin of Department of Health of City of New York, Oct., 1920. Account of the "follow-up work" especially Barrows, Franklin W. Open Window Schools in Buffalo, in Fourth In- ternational Congress on School Hygiene Transactions, Vol. 2, 1913. Report of the experiment in Buffalo, daily routine, and results. Bryan, James E. The Anaemic Pupil, in National Education Association Bulletin, 1915. Discussion of treatment in open window rooms and its beneficial effect on the anaemic child. Bryant, L. S. Is Your Child Hungry? in Good Housekeeping, Oct., 1919. Difference is shown between plenty of food and plenty of nourish- ing food; importance of the nutritious school lunch. Bryant, L. S. School Feeding. Excellent work giving information about school feeding in different European countries and our own; rea- sons for malnutrition in children and treatment of same by means of proper food. Clark, Talliferro. Physical Care of Rural School Children, in National Education Association Bulletin, 1916. A plea for medical inspec- tion in the country schools. Curtis, E. W. Outdoor Schools in Pedagogical Seminary, Vol. 16, 1909. Description of open air schools in Charlottenburg and other parts of Germany, in England, and in United States at Providence and Boston. Cornell, Walter S. Health and Medical Inspection of School Children. A book every teacher should read. Pages 115-128, The Open Air School; pages 155-173, Ventilation; pages 479-503, Nutrition, espe- cially applicable to subjects discussed in this bulletin. Dresslar, Fletcher B. School Hygiene. An excellent book for teachers. Chap. X, The Need of Pure Air; Chap. XI, Ventilation; Chap. XII, Open Air Schools; Chap. XIII, Heating of Schoolrooms; and Chap. XIV, Humidity in the Schoolroom, especially recommended. Dresslar, Fletcher B. Open Air Schools. Bulletin of Department of Interior, Bureau of Education, 1916, No. 23. Excellent history and review of the whole subject of open air schools in our own and foreign countries. Edmondson, Edna H. Feeding Children at School. Bulletin of the Ex- tension Division, Indiana University. Information concerning the methods employed in different parts of Indiana, and a description of suitable and nourishing food to be served in well-balanced menus. 28 Bulletin of the Extension Division Emerson, William R. P. Scales, a Tape Measure, and Conservation, in New Republic, June 29, 1918. Excellent article on identification and treatment of malnutrition. Emerson, William R. P. Health, the School Child, in Bulletin of the United States Department of Labor, No. 60. Discussion of nutri- tion classes and clinics, pages 238-247. Fisher, Dorothy C. A Peep into the Educational Future, in The Out- look, Sept. 22, 1915. Contrast shown between children living on a farm and in modern city home. Description of the open air school of the future where each child has an appointed task. Foerste, August F. Open Air Schools, in Monthly Bulletin of Ohio State Board of Health, Mar., 1912. Comparison of number of chil- dren actually attending open air schools with those who should attend. Hadler, Hazel. Open Air Schools for Normal Children, in Century, Nov., 1915. Entertaining account of the importance and extent of the open air school movement. Hetherington, Mrs. Clark W. Demonstration Play School of University of California, in National Education Association Bulletin, 1916. Description of school where children learn to work by playing. Holmes, George J. Result of Open Air Treatment in Public Schools of Newark, N.J., in Fourth International Congress on School Hygiene Transactions, Vol. 2, 1913. Account of progress and results of the open air schools for tuberculous and anaemic children. Hutchinson, Woods. Fresh Air in School and Elsewhere, in Indiana State Teachers' Association Proceedings, 1911. Argument for fresh air at all times for growing children. Keyes, Harold B. Effect of Outdoor and Indoor School Life on Physical and Mental Condition of Children, in Fourth International Congress of School Hygiene Transactions, Vol. 2, 1913. Record of an experi- ment conducted in Horace Mann School with two groups of children as nearly alike as possible, one group working indoors, the other outdoors. Kingsley, Sherman C. Open Air Crusaders, 1910, 1913. Full particu- lars of the pioneer in open air schools, the Elizabeth McCormick Open Air School. Kingsley, Sherman C. Open Air and Open Window Rooms, in Edu- cational Hygiene. L. W. Rapeer (Ed.). Chap. XV deals with im- portance of fresh air in treatment of tuberculosis. Kingsley, Sherman C. (See F. B. Dresslar, Open Air Schools.) Knopf, T. A. Open Air Schools, in Fifteenth International Congress on Hygiene and Demography. Plea for prevention and cure of tuber- culosis in childhood and for open air schools for all children. Koch, Felix J. Going to School on the Roof, in Journal of Outdoor Life, Oct., 1915. Interesting account of an open air school in Cincinnati. Koch, Harry I. A Real Open Air School, in Town Development, Apr., 1916. History of the experiment in Allentown, Pa. Open Air Schools i 29 Johnson, George Woodruff. Effects of School Life on the Health of Children, in North American Review, June, 1906. Discussion of the various diseases, especially those of the nervous system, resulting from pressure of school work on children thruout the grades. Lasher, G. S. Safeguarding Rural Children, in Fourth International Congress on School Hygiene Transactions, Vol. 2, 1913. Excellent lecture giving recommendations for improvement in rural schools and describing methods employed by state of Michigan for raising the standard of education. Lee, F. S. Fresh Air, in Popular Science Monthly, Apr., 1914. Excel- lent scientific article contrasting fresh air with bad air. Lobel, Jacob. (See Baker, S. Josephine.) Lord, Mabel Delano. Anaemic Children in Open Air School, in The Survey, Apr. 22, 1911. Description of summer school for anaemic children at Castle Island, Boston. Lusk, Graham. Nutrition of Adolescence, in Bulletin of Department of Labor, Children's Bureau, No. 60. Discussion of elements in food necessary for growth and development of the child. Mangold, George B. Problems of Child Welfare. Part II, Chap. Ill, Tubercular and Anaemic Children, especially recommended. Manny, Frank A. A Scale for Marking Nutrition, in School and So- ciety, Jan. 22, 1916. Article giving full and valuable information about grading children in regard to nutrition. Manny, Frank A. Defective Nutrition and the Standard of Living, in The Survey, Mar. 30, 1918. The results of study of school children in Grammercy District in New York showing undernourishment to be the result of ignorance and poverty. Marcus, Leopold. Open Air Classes in the Public Schools, in Monthly Bulletin of the Department of Health, City of New York, June, 1921. Complete description of this work for the year, kinds of children admitted, results, follow-up work, plans for the next year. McDonald, Robert A. F. Open Air Schools, in Adjustment of School Organization to Population Groups. Chap. IX excellent on open air school idea. Nydegger, James A. What are we going to do about it? in American City, Sept., 1919. Argument showing that the health handicap of the child in the country school is greater than that of the child in the city school. Perrin, H. Ambrose. Open Air Schooling, in American City, Mar., 1918. Description of open air school in Jacksonville, 111. Richards, Byron V. The Schoolroom Window, in Fourth International Congress of School Hygiene Transactions, Vol. 2, 1913. Article ad- vocating a schoolroom window that can be opened. Roach, Walter M. Vitalizing School Children, in Fourth International Congress of School Hygiene Transactions, Vol. 2, 1913. Record of tests made in Philadelphia with two groups of third grade children, one studying indoors, one outdoors, and neither group fed at school. 30 Bulletin of the Extension Division Robertson, Charles. Open Air School in Scientific Pedagogy, in Fourth International Congress of School Hygiene Transactions, Vol. 2, 1913. Discussion of results of open air schools and description of open air schools in Buenos Aires. Sargeant, E. Shepley. What's in a Pagoda? in New Republic, Apr. 1, 1916. Story of the Phoebe Ann Thorne model open air school for normal children at Bryn Mawr, Pa. Spencer, Mrs. Anna G. Fresh Air School, in Delineator, Oct., 1911. Article written in popular style on activities of open air school children. Talbot, W. P. Physical Basis of Attention, in Bulletin of National Edu- cation Association, 1908. Excellent argument in favor of medical inspection and treatment for all children and especially the back- ward ones. Tefft, Burton S. Rural School Hygiene in Michigan, in Fourth Inter- national Congress on School Hygiene Transactions, Vol. 2, 1913. Lecture telling of investigations of school conditions revealing great need for medical inspection in country schools. Todd, J. B. Cloth Window Open Air Schools, in School and Society, Aug. 28, 1915. Account favoring screening the windows of the schoolroom with cloth. Tupper, Harriet. Need of Fresh Air Classes in Public Schools, in Na- tional Education Association. Bulletin, 1916. Article showing need of the anaemic child for large amount of fresh air. Upton, Mrs. S. M. H. Open Air Schools, in Teachers' College Record, May, 1914. Interesting review of open air schools giving contribu- tion each has made to the progress of the movement. Van Pelt, John O. Architecture of Open Air Schools, in Fourth Inter- national Congress on School Hygiene Transactions, Vol. 2, 1913. Explanation of different types of construction of open air schools, and their relation to the health and comfort of the children. Vidal. Antoine. (See Robertson, Charles.) Warren, B. S. Open Air Schools for Prevention and Cure of Tubercu- losis among Children, in U.S. Public Health Bulletin, No. 58, Oct., 1912. Bulletin giving information about location, equipment of buildings with plan of St. Louis open air school, and selection and treatment of children with records to be kept. Watt, William E. Open Air. Excellent book emphasizing the need of fresh air, especially in the schoolroom, and showing also that much of ill health of school children, and consequent loss of time in school, is caused by breathing bad air the greater part of the day. Watt, William E. Making Children Resistant to Fatigue and Disease, in Indiana State Teachers' Association Proceedings, 1911. L. T. Turpin (Ed.). Lecture demonstrating importance of fresh air and rest in daily working program as a means of combating and elim- inating fatigue. Wellman, Mabel T. (See Edmondson, Edna H.) Open Air Schools 31 Wile, Ira C. Cost of Educating the Underfed, in School and Society, Dec. 30, 1916. Parallel drawn between the malnourished child and the retarded one in the schools. Wood, Alice D. Building up the Malnourished Child, in The Public Health Nurse, Dec, 1921. Description of the handling of the prob- lem in the Chicago schools, particular attention given to reasons for malnutrition quoted from Dr. Emerson. Wood, Thomas D. Health Examinations and the School Nurse, in Bul- letin of Department of Labor, Children's Bureau, No. 60. Article on importance of observation and examination of school children as a cure and prevention of disease. Wood, Harry W T arren. General Science — A Bibliography for General Science Teachers, Bulletin of Extension Division, Indiana Univer- sity. On pages 11-19 are described several books containing infor- mation on subjects mentioned in this bulletin. Woodruff, Ogden. Fresh Air Schools in New York City,— A Compara- tive Study, in Fourth International Congress on School Hygiene Transactions, Vol. 2, 1913. Comprehensive comparison of children in the different open air schools in regard to height, weight, hemo- globin, with and without school feeding, from homes of poverty and comfort. The Open Air School Movement in Indiana. Issued by the Indiana State Board of Health cooperating with the Indiana Society for the Pre- vention of Tuberculosis. Description of the aims and purposes of open air schools, and accounts of these schools in Indiana. Open Air Schools. Bulletin of the Russell Sage Foundation, Division of Education. Bulletin chiefly interesting for its la^|e number of ex- cellent pictures of various open air schools in U.M. First Report of Open Air School Committee, Civic Club of Allegheny County, Pittsburgh, Pa, History and report of open air school for anamiic and frail children in Pittsburgh, with facsimiles of pupils' health card and some letters written by the pupils about the open air school. The Country Child's Handicap, in The Literary Digest, Aug. 21, 1921. Comments on article by Mable Carney in the New York Tribune in which she asserts that the country child suffers both physically and mentally from untrained and underpaid teachers. LIBRARY OF CONGRESS 021 331 337 P i LIBRARY OF CONGRESS • 021 331 Hollinger Corp.