- Email: [email protected]
MENTALLY HANDICAPPED CHILDREN AND THEIR FAMILIES
1227 MENTALLY HANDICAPPED CHILDREN AND THEIR FAMILIES
VOLUNTARY organisations, backed by parents, have lately had considerable success in bringing the needs oi mentally handicapped children to public notice, and paediatricians, psychiatrists, psychologists, and teachers are taking an increasing interest in them. The latest group to survey the problem is a working party of doctors and psychologists from the South East Metropolitan region, under the chairmanship of Dr. Duncan Leys. In a carefully thought-out report1 they stress the burden that a mentally handicapped child places on the whole family. Normal siblings are sometimes anxious, lack drive, and make poor progress at school when a handicapped child claims too much of the mother’s time, energy, and often affection; and families need support from the time when the child is first found to be backward, through the growing years, until residential treatment can be considered. Counselling clinics, run by either a psediatric department or local-authority service, are welcomed by parents, though sometimes the family doctor prefers to give this continued service. But advice is not enough: there must also be practical help. More nurseries and training-centres are needed so that all children over five can spend part of each day outside their homes. But even before they are four, these children can be difficult to manage owing to their overactivity and lack of understanding, and it would ease the strain for the family if some of them could go to a centre earlier. Already some children are placed in hospitals because it is recognised that they are imposing a strain on their family; and the working party consider that " there is a need not for a contraction but for an expansion of residential care." A minority of these children are physically helpless, and need full nursing care. The report recommends that they should be nursed in pasdiatric wards rather than in large hospitals for the mentally subnormal. Many children with severe physical and mental handicaps are waiting for admission to hospital, and the provision for them is grossly inadequate. Their number may grow, as more children with such conditions as hydrocephalus and severe brain damage survive. The report suggests that many are unlikely to live long, but without full statistics we cannot be certain of this and plans must be made for a full span of life. Some of these children prove to have more intelligence than expected: their environment should allow for progress and be as stimulating as possible. Are beds in paediatric wards, with the emphasis on nursing care in bed, necessarily the right place for them ? Units are needed where the children are dressed for the whole of the day, put in a play-room, or taken out in prams. The working party are doubtful of the benefit of large hospitals for the mentally subnormal. But a large hospital can be a sheltered village community with a shop, gardens, laundry, school, and factory, where a severely handicapped child can grow up as far as possible and remain for all his adult life. Many more handicapped children are active and healthy and do not need nursing care, and the working party suggest that they should be looked after in small homes or hostels where they could receive suitable education and training. This arrangement has been tried suc1. Needs of Mentally Handicapped Children: a report of a working party set up by the Paediatric Society of the South East Metropolitan Board, published by the South East Metropolitan Regional Hospital Board, the National Spastics Society, and the National Society for Mentally Handicapped Children. Copies (2s. 6d.) are available from the N.S.M.H.C., 125, High Holborn, London, W.C.1.
cessfully by some hospitals for the mentally subnormal and by private bodies. The opportunity was not taken under the new Mental Health Act of transferring the care of these children from the health authorities to the education authorities, but there seems to be a case for providing resident schools which they could attend during termtime, returning to their own homes for the holidays. In this way, the child and his family would not lose contact, and the child would not feel that he was being " put away " by his family. When he reached school-leaving age his capabilities and the possibility of employment would be reassessed, and he would not automatically be transferred to a hospital for adults. More research into the best methods of training and educating these children is needed, and the working party draw attention to recent work on learning difficulties in cerebral-palsied and deaf children, and to the value of play in nursery-schools. At present, even though training in hospitals for the mentally subnormal is adequate, it is not unknown for a patient who has spent most of his school life in a hospital to be able to hold down a wageearning job in adult life. Psychologists are showing an interest in training severely subnormal adults to do simple factory work. With more suitable and skilled methods of education, emotional security, and opportunities to develop their personalities, many more of these children might later make a useful contribution to the community. BIRTHDAY HONOURS
OF the honours conferred last week on doctors (see p. 1232) the K.C.B. to which Dr. G. E. Godber is appointed will be especially welcomed. Before he became chief medical officer to the Ministry of Health in 1960, Dr. Godber’s work as deputy c.M.o. was highly valued not only within but also without the Ministry; and in his present post he has evinced a constructively thoughtful turn of mind which is strengthening the heart of the National Health Service. In the Services, Surgeon ViceAdmiral W. R. S. Panckridge, medical director-general of the Navy, is appointed K.B.E. Knighthood is conferred on Mr. H. C. Colville, of Melbourne, president of the Australian Medical Association; on Dr. C. G. McDonald, who has long been a force in the affairs both of the University of Sydney and of the Royal Australasian College of Physicians, of which he is a former president; and on Dr. T. F. Fox, editor of The Lancet. At least two esteemed allies of the profession are included in the List. Sir Charles Harington, now appointed K.B.E., has been director of the National Institute for Medical Research since 1942. He largely gave up his own scientific work to organise the transfer of the Institute from Hampstead to the more commodious buildings at Mill Hill; and under his wise leadership the repute of this centre has increased out of all proportion to its growth in size. Prof. J. T. Randall, who is created a knight, has proved a staunch friend of medicine and medical workers in many ways, and notably through his directorship of the Medical Research Council’s biophysics research unit. Lord BRAIN has been appointed chairman of the advisory committee on distinction awards in succession to Lord Moran, who has held this office since the inception of the National Health Service. Dr. F. PARKES WEBER, consulting physician to the German Hospital in London and senior fellow of the Royal College of Physicians, died on June 2. He was in his 100th year.
VOLUNTARY organisations, backed by parents, have lately had considerable success in bringing the needs oi mentally handicapped children to public notice, and paediatricians, psychiatrists, psychologists, and teachers are taking an increasing interest in them. The latest group to survey the problem is a working party of doctors and psychologists from the South East Metropolitan region, under the chairmanship of Dr. Duncan Leys. In a carefully thought-out report1 they stress the burden that a mentally handicapped child places on the whole family. Normal siblings are sometimes anxious, lack drive, and make poor progress at school when a handicapped child claims too much of the mother’s time, energy, and often affection; and families need support from the time when the child is first found to be backward, through the growing years, until residential treatment can be considered. Counselling clinics, run by either a psediatric department or local-authority service, are welcomed by parents, though sometimes the family doctor prefers to give this continued service. But advice is not enough: there must also be practical help. More nurseries and training-centres are needed so that all children over five can spend part of each day outside their homes. But even before they are four, these children can be difficult to manage owing to their overactivity and lack of understanding, and it would ease the strain for the family if some of them could go to a centre earlier. Already some children are placed in hospitals because it is recognised that they are imposing a strain on their family; and the working party consider that " there is a need not for a contraction but for an expansion of residential care." A minority of these children are physically helpless, and need full nursing care. The report recommends that they should be nursed in pasdiatric wards rather than in large hospitals for the mentally subnormal. Many children with severe physical and mental handicaps are waiting for admission to hospital, and the provision for them is grossly inadequate. Their number may grow, as more children with such conditions as hydrocephalus and severe brain damage survive. The report suggests that many are unlikely to live long, but without full statistics we cannot be certain of this and plans must be made for a full span of life. Some of these children prove to have more intelligence than expected: their environment should allow for progress and be as stimulating as possible. Are beds in paediatric wards, with the emphasis on nursing care in bed, necessarily the right place for them ? Units are needed where the children are dressed for the whole of the day, put in a play-room, or taken out in prams. The working party are doubtful of the benefit of large hospitals for the mentally subnormal. But a large hospital can be a sheltered village community with a shop, gardens, laundry, school, and factory, where a severely handicapped child can grow up as far as possible and remain for all his adult life. Many more handicapped children are active and healthy and do not need nursing care, and the working party suggest that they should be looked after in small homes or hostels where they could receive suitable education and training. This arrangement has been tried suc1. Needs of Mentally Handicapped Children: a report of a working party set up by the Paediatric Society of the South East Metropolitan Board, published by the South East Metropolitan Regional Hospital Board, the National Spastics Society, and the National Society for Mentally Handicapped Children. Copies (2s. 6d.) are available from the N.S.M.H.C., 125, High Holborn, London, W.C.1.
cessfully by some hospitals for the mentally subnormal and by private bodies. The opportunity was not taken under the new Mental Health Act of transferring the care of these children from the health authorities to the education authorities, but there seems to be a case for providing resident schools which they could attend during termtime, returning to their own homes for the holidays. In this way, the child and his family would not lose contact, and the child would not feel that he was being " put away " by his family. When he reached school-leaving age his capabilities and the possibility of employment would be reassessed, and he would not automatically be transferred to a hospital for adults. More research into the best methods of training and educating these children is needed, and the working party draw attention to recent work on learning difficulties in cerebral-palsied and deaf children, and to the value of play in nursery-schools. At present, even though training in hospitals for the mentally subnormal is adequate, it is not unknown for a patient who has spent most of his school life in a hospital to be able to hold down a wageearning job in adult life. Psychologists are showing an interest in training severely subnormal adults to do simple factory work. With more suitable and skilled methods of education, emotional security, and opportunities to develop their personalities, many more of these children might later make a useful contribution to the community. BIRTHDAY HONOURS
OF the honours conferred last week on doctors (see p. 1232) the K.C.B. to which Dr. G. E. Godber is appointed will be especially welcomed. Before he became chief medical officer to the Ministry of Health in 1960, Dr. Godber’s work as deputy c.M.o. was highly valued not only within but also without the Ministry; and in his present post he has evinced a constructively thoughtful turn of mind which is strengthening the heart of the National Health Service. In the Services, Surgeon ViceAdmiral W. R. S. Panckridge, medical director-general of the Navy, is appointed K.B.E. Knighthood is conferred on Mr. H. C. Colville, of Melbourne, president of the Australian Medical Association; on Dr. C. G. McDonald, who has long been a force in the affairs both of the University of Sydney and of the Royal Australasian College of Physicians, of which he is a former president; and on Dr. T. F. Fox, editor of The Lancet. At least two esteemed allies of the profession are included in the List. Sir Charles Harington, now appointed K.B.E., has been director of the National Institute for Medical Research since 1942. He largely gave up his own scientific work to organise the transfer of the Institute from Hampstead to the more commodious buildings at Mill Hill; and under his wise leadership the repute of this centre has increased out of all proportion to its growth in size. Prof. J. T. Randall, who is created a knight, has proved a staunch friend of medicine and medical workers in many ways, and notably through his directorship of the Medical Research Council’s biophysics research unit. Lord BRAIN has been appointed chairman of the advisory committee on distinction awards in succession to Lord Moran, who has held this office since the inception of the National Health Service. Dr. F. PARKES WEBER, consulting physician to the German Hospital in London and senior fellow of the Royal College of Physicians, died on June 2. He was in his 100th year.