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In 1970, 46 children were notified at birth as having congenital abnormalities compared with 48
in 1969. Of these 46, nine were abnormalities of the central nervous system or severe multiple
deformities, and six of them were still born or died shortly after birth; seven were cases of talipes,
and six suspected congenital dislocation of the hip. The remaining 24 children had abnormalities of
a minor nature and their names have subsequently been removed from the register.
For the identification of handicaps and the compilation of the register the Department depends
upon two main sources. The health visitor may suspect disorders and bring children forward to the
clinic doctor for developmental screening. As far as possible all children are screened at key ages and
those failing to make normal developmental progress in any sphere are referred for further observation
and investigation. The second source of information concerning handicapped children is the
hospital paediatrician or family doctor.
The regular follow up of handicapped children is undertaken by the clinic medical officers at child
health centres or day nurseries, by principal medical officers at special clinics for handicapped
children, or at hospital assessment centres.
During 1970,111 children were examined at special sessions by principal medical officers trained
in the diagnosis, care and management of handicapped children.
Sufficient time is allowed for full examination and assessment of the child's immediate needs
and as far as possible of his future requirements and potential. Placement may be recommended in a
special unit or day nursery in order to provide training by skilled staff and an opportunity for the child
to play and learn with others. Health visitors and social workers are encouraged to attend at the same
time as their families, and parent counselling on a long term basis is provided.
In the City of Westminster there are two district assessment centres in teaching hospitals. In both,
the consultant paediatrician is assisted by a principal medical officer from the local authority whose
duties are to undertake psychometric testing, and to arrange for the implementation of recommendations
for treatment, care, management and education in the home area. He acts as a co-ordinator,
and secures the co-operation of all concerned in bringing the necessary services together to meet the
needs of the whole family. At both these assessment centres ophthalmic, audiological, orthopaedic
and neurological investigation and treatment are available.
As will be seen from the statistics included in Table 34, page 81, the total number of children of
five and under on the handicap register is 363. Of this number 41 children under five received training
in special day units and a further 34 were placed in ordinary day nurseries; 12 were in residential
homes or long stay hospitals. Every child on the register on reaching the age of 4J had a special
medical examination to decide on the most suitable type of education. Of the 113 born in 1965
and 1966, eight were recommended for schools for the educationally subnormal, five for training
schools for the severely subnormal, 12 for other special schools (physically handicapped etc). But
a satisfactory finding was that 51 were recommended for admission to ordinary infant schools. In
many cases their handicaps, often retardation associated with emotional or environmental deprivation,
had been treated and overcome so that they could take their place satisfactorily and compete
with normal children.
The service for handicapped children has two main objectives. One is to provide the necessary
help to the child and his family from an early age so that he shall learn to live with the handicap, to
adjust to it and ultimately to become an independent member of the community. The other is to
prevent handicaps developing: to identify and treat deviations from the normal before all the
secondary disadvantages, emotional disturbance, educational failure and social maladjustment have
overwhelmed him and turned him into an unacceptable, unsuccessful, unhappy misfit.
(Statistics—Table 34, page 81).
DAY CARE OF CHILDREN UNDER 5 YEARS
Day Nurseries
The eight day nurseries again had a busy year. The need for places for children aged 1-5 years
continued, although the pressure for places for the under 1 -year olds was slightly less. Even mothers
in difficult circumstances seem to wish to keep their young babies with them, but the stresses
increase as the child gets older if they are living in overcrowded or shared homes, or need to work to
support themselves. Single parent families and socially deprived children constitute the majority of
those applying for admission. In some cases the mother needs to attend a day centre for psychiatric
treatment, or may be admitted to hospital for a short period.