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101
the Opportunity Classes in Tottenham subserve such a function for
the younger maladjusted children as educational backwardness is an
almost invariable symptom in such cases.
An attempt is being made in the field of prevention at the infant
welfare clinics by non-specialist medical staff. In addition there is no
doubt that additional sessions are required for actual treatment of
pre-school children by a psychiatrist.
While it is not my province to comment on the organisation and
working of the Child Guidance Centres in Tottenham and Hornsey,
the following comments by Dr. C. Phillips, the visiting psychiatrist,
are of special interest:—
"On the subject of delinquency and psychological illness in children,
the contribution that bad parenthood makes towards this social
problem is, in my opinion, paramount here. There is a good deal
that is unknown of this subject, but two things are outstanding:
(1) There is a partial, and quite often complete, failure of the parents,
particularly the mother in the earliest years, to adapt to the child's
needs, so that the aggressive and destructive impulses present in small
children do not become moderated as in healthy persons and may, in
fact, be stimulated to the point where the child's personality is destroyed
by them. (2) The parents, however, commonly have an unconscious
participation in the child's delinquent acts, that is, to put it crudely,
they get a quiet, perhaps not even realised, satisfaction at the antisocial
behaviour. The children work off some old scores for the
parents. Parents are commonly not aware of this, but one comes up
against this powerful motive in parents when there is an attempt to
give advice or deal with the child. One is quite frequently met with the
overtly expressed desire of the parents to co-operate in every possible
way, but they often manage to find some "reason" for not doing the
one thing that has been recommended. This is not because of original
wickedness on the part of the parents but because they, themselves,
so commonly have a similar character structure because of their own
childhood experiences.
This leads us to a consideration of what we might begin to do about
these widespread problems. It surely follows that we must attempt to
get, as an important goal for the community, a generation of healthy
children so that we may, in the distant future, get a generation of healthy
adults. I am pleased to report that a start has been made, on a necessarily
small scale. In October, 1955, a weekly psychiatric clinic was
started in this Area, in which difficulties of children under five could
be investigated and dealt with. We have been given a considerable
amount of freedom as to how this may be organised, and the present
arrangement is that the visiting psychiatrist and each of the medical
officers who are working in the schools and maternity and child welfare
services, hold a joint clinic session for this purpose, so that their combined
knowledge is at the service of the family, and each kind of doctor
can have some worthwhile contact with the knowledge and experience
of the other related field of work. For the most part, emphasis is on
seeing children between the ages of a few months and about three years
in order that the earliest developmental processes can be studied, and