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Handicapped and Observation Register
Work continued on the build-up of the handicapped and observation register, with
increasing exchange of information between the Department and hospitals and general
practitioners. The objects of the register are:-
(i) to follow up those children who are "at risk" of developing a handicap because
of genetic, pre-natal or post-natal history so that there is early warning
of a handicap developing.
(ii) to ensure care and attention for the handicapped child and his family.
(iii) to obtain statistical information to help the Department with its routine work
and to assist medical research.
Notification of these children is received from a number of sources, including the
birth notification, the discharge notice from the hospital or domiciliary midwife, the
health visitor, hospital reports and general practitioners.
The term "At Risk" is used normally to describe a baby whom the midwife, general
practitioner, obstetrician or hospital consultant considers may acquire a handicap mainly
because of unusual circumstances pertaining prior to, at the time of, or soon after birth.
These children are medically examined at six monthly intervals and are removed either on
transfer to the handicapped section of the register, or completely if they can walk, talk
and are otherwise developmentally normal. The "at risk" section of the register contained
the names of 4,054 children at 31 December 1968.
A handicapped child may be defined as one who suffers from any continuing disability
of body, intellect or personality which is likely to interfere with his normal growth,
development and capacity to learn. Some handicaps are recognisable at birth; for example,
an obvious anatomical abnormality. Others, such as deafness, blindness, metabolic disorders
etc., must be deliberately looked for and discovered as quickly as possible. During
1968 the number of babies notified as congenitally malformed was 80. The number of
handicapped children on the register at 31 December 1968 was 632. (See also the report
on the School Health Service).
We are particularly fortunate in Southwark to have a comprehensive assessment
centre for multiple handicapped children at Guy's Hospital. This centre, which is known
as the "Newcomen Clinic" has been designed to supplement existing services, and is
concerned with young children from the age of six months when the possibility of
handicaps is usually first raised, and when there is a need to assess, advise and help
families. It also deals with specific cases where specialist services and knowledge are
required. Among cases which are dealt with are suspected visual and auditory defects,
delayed or disordered development, gross physical handicap and obscure problems of
assessment and management.
Southwark bears 50 per cent of the cost of a specialist's services and, in addition,
provides a health visitor for the necessary follow-up with children and families from
Southwark.
Special follow-up sessions are held at one or two of the child health centres where
the Senior Medical Officer for maternity and child health services, who is in close touch
with the work of the Newcomen Clinic, is able to see the children referred by the centre.
If specialist medical advice is needed for any child seen under this follow-up scheme, an
immediate appointment is made for further attention at the Newcomen Clinic.
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