Review of organization for the care of handicapped children

Book Reviews Review of Organization for t h e Care of H a n d i c a p p e d Children. Report of the Committee on..Nationa], S t a t e and Local Organization for the Handicapped. White House Conference on Child H e a l t h ~nd Protection. Century Company, New York, 1932, p. 432. The importance of h a v i n g available adequate h e a l t h services to all physically, mentally, and socially h a n d i c a p p e d children in America a n d t h e close interrelationship of h e a l t h and w e l f a r e services are strongly emphasized in the very interesting report of the Committee on National, S t a t e a n d Local O r g a n i z a t i o n for the H a n d i c a p p e d compiled u n d e r the able c h a i r m a n s h i p of 1V[rs. K a t e Burr Johnson, S u p e r i n t e n d e n t of the New J e r s e y State Home for Girls. Summarizing its views on welfare, health and education of the handicapped child, the Committee states t h a t ~ n o program for the care of handicapped children can ignore education and health. Every county or locality should have a b o a r d of welfare, a board of health~ a n d a b e a r d of education, the three serving the same political unit. The three s h o u i d b e so related and their work so integrated t h a t the full service of each will be available for all handicapped children. No o n e service should undertake work falling in the province of the others except in general as a temporary expedient.' ' And as regards nursing and social services, the Committee is of the opinion that both services " a r e needed in every local area, and whichever service first enters the field should make i t a part of its daily program to educate the community to the need of the other service. Nursing service and social service are complements of each other and in no sense rivals i n dealing with the ills of humanity. ' ' A sub-committee of the general committee which has been concerned with the history and administration of local public units, has come to the conclusion t h a t the county is generally the most practicable unit for the administration ef child care. The Committee felt t h a t ~ t h e majority of the problems of handicapped children require study and treatment b y a n agency which is close a t hand. To be effective, service must b~ immediately available in the neighborhood of the trouble. Only through such close at h a n d service as can be given by a county agency can an early discovery of the case be assured, with home treatment whenever possible, and the development of preventive m e a s u r e s . " Above these local units for health and welfare is the state which '~ has a distinct responsibility to see t h a t all its children are protected, given proper support, care, and education, and are provided with opportunity so t h a t each may develop to his fullest capacity. I n meeting this responsibility states are brought into relationship with the federal government on the one hand and local governmental bodies and private child earing agencies on the other. I t is essential, therefore, t h a t every state have a central authority through which these relationships may b e maintained. ' ' The Committee which considered direct care to handicapped children f e l t t h a t " e v e r y state should accept its responsibility for handicapped children by setting up efficient machinery for their proper care, either through the establishment of a pro129

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gram of direct care by the state itself or through the stimulation of local agencies, public and private, supervised by the s t a t e . " From the standpoint of the medical practitioner, the following points in the program of the Committee on Dh:ect Care are of special interest: 1. ~ E v e r y state should definitely accept responsibility for institutional care of the t r a i n i n g school type for mentally defective and mentally ill children; for the establishment of mental clinics for early diagnosis and treatment in sections where such facilities would be otherwise unavailable, for the establishment of central registration and parole from state institutions, an educational program t h a t will stimulate local communities, special day school classes and adequate supervision, to develop a protective program for .the mentally handicapped child not requiring institutional care. ' ' 2. ~'Every state should accept responsibility for the physically handicapped (the deaf, the blind, the crippled) and provide special clinics; a stimulation of special classes in local day schools; statutory authorization of home teachers when neees-~ sary; arrd, if proved necessary, state hospital schools which, in the larger states, shall be developed on a regional basis and shall be equipped with social service and vocational t r a i n i n g . " The findings of the Committee on Organization for the Care of Handicapped Children are epitomized i~ the Children's Charter promulgated by the White House Conference on Child Itealth and P~'oteetion. The charter states t h a t in order to make everywhere available minimum protections of the health a n d welfare of children, there should be a district, county, or community organization for health, education, and welfare, with full-time officials, ?oordinating with a state-wide program which will be responsive to a na~ion-wide service of general information, statistics, and scientific research. This should include: (a) Trained, full-time p u n i c health oificials, with public health nurses, sanitary inspection, and laboratory workers (b) Available hospital beds (c) Full-time public welfare service for, the relief, aid, and guidance of children in special need due to poverty, misfortune, or behavior difficulties, and for the protection of children from abuse, neglect, exploitation, or moral hazard. WILLIAM

J. ELDIS.