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53
developing physical or mental defects and of those deemed handicapped.
The register is designed to arrange for the supervision of
those specially liable infants where an abnormal pregnancy,
delivery or puerperium has been noted or when deviation from the
normal is observed. The register enables therapeutic or remedial
measures to be applied, thus preventing or modifying gross defects.
The initial information about the children is obtained from birth
notifications, Paediatric Departments of hospitals, general practitioners,
midwives, health visitors and clinic doctors. The completeness
of the register has been achieved only through the
co-operation of all concerned.
When a handicap is confirmed closer liaison is established with
all those concerned with the child's future, i.e. the hospital
specialists, education officers, head teachers of ordinary or special
schools, or superintendents of hospital schools.
There is also a continuous exchange of information with the
Children's Officer about those children in care who are physically
or mentally handicapped. The health visitors, who are trained to
recognize the social and medical symptoms of deprivation and
distress, advise about children who are under stress and request
that they be placed on the Observation Register. The Children's
Department is contacted whenever it is felt that the child should
be received into care. The Children's Department is also notified
whenever a child in care is placed on the Handicap and Observation
Register. Whenever necessary advice is given to child care
officers on the most appropriate placing for physically or mentally
handicapped children.
There is exchange of information with the Welfare Department
about those who have been ascertained as blind or partially
sighted so that arrangements can be made for suitable placing in
Sunshine Homes when required. Every handicapped or potentially
handicapped child is individually assessed before the age of five
years when a decision is reached with regard to its future education
and those concerned in this care, i.e. paediatricians, psychiatrists,
surgeons, education officers, etc., are often asked for advice
before a placement at school or in a training centre is offered.
There is close co-operation with the Inner London Education
Authority's Medical Adviser and his psychological medicine team.
The following tables give some statistical information about
this work including details of the number of children on the handicap
and observation register in relation to the child population
under 5 years of age. It will be noticed that, whereas the majority
of those put on the register in the first year of life are being kept
under observation, about two-thirds of the children in the 3-4
years age group who are still on the Register have been assessed
as handicapped.