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up. The Handicapped Child Unit ensures that appointments in hospitals are
regularly kept. In some cases of default an escort can be arranged.
If, in the course of observation, referrals to other specialists are thought
to be required, these are arranged with the co-operation of general practitioners
and paediatricians. Contrary to what occurs in many other parts of England,
children in Lambeth may often be attending three, four or sometimes five
hospitals. On several occasions, the Handicapped Child Unit was responsible
for establishing one "key paediatrician" taking the overall care of a particular
child whose parents were "shopping around" for better services.
D. PARENTAL GUIDANCE AND HELP
This service is very inadequate.
GENETIC COUNSELLING
This is more often offered to parents now than in previous years. It is
carried out by the paediatricians in charge, or by consultants, in one of the
legional genetic advisory centres. Some general practitioners prefer to carry
out their own genetic counselling; the advice of a geneticist is always available
to general practitioners.
To be effective, genetic counselling should be followed up by further
guidance of parents in order to clarify and reinforce the advice given. At
present we do not have this kind of parental counselling. Parents often have
wildly misleading impressions as to the cause and extent of their child's
handicap. They often are able to repeat correctly medical terms, but are unable
to relate its significance to the actual handicap and to the difficulty the child
is experiencing and, therefore, they are unable to assist the child in everyday
harmonious development. (This is confirmed by a survey carried out on
families of handicapped children in Lambeth; the result will be available shortly).
The guidance of parents with regard to the daily routine and care of the
handicapped child is not readily available. The reasons for this are manifold.
1. The parents of mentally handicapped children do not readily attend
Child Health Centres.
2. The Health Visitors are expert on handling and advising with regard
to "well children" but on the whole are not trained to give practical
help on handling the daily situation in which a mother caring for a
mentally handicapped child finds herself (e.g. feeding, changing
nappies, helping with motor progress, etc.).