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The Crown recognised his contributions with a knighthood in 1955.
The British Paediatric Association created the James Spence Medal, which is made awarded annually since 1960 for "outstanding contributionsto the advancement or clarification of paediatric knowledge."<ref name="spence">{{REFjournal
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==Death==
Spence had an extended illness which led to his death at age 62 on 26 May 1954.<ref>{{REFjournal