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development in children up to the age of five years and this is
especially important in relation to those children who are seldom
taken to any child health clinic. She often reports such cases to
the responsible medical officer who in turn initiates investigation
through the family doctor in the first instance. In some cases
reference to a special clinic for ascertainment is required.
When a handicap is confirmed, close liaison is established with
all those concerned with the child's future, including educationalists
at all levels and consultant medical specialists. While the usefulness
of the Handicap and Observation Register has not been
questioned, the criteria of choice and the method of follow-up of
all children included in these Registers in all parts of the country
have come under some professional criticism in the medical press.
As I have said above, the criteria for the selection of cases for
inclusion in the Register in our Department are quite strict; the
selection is carried out by a suitably qualified medical officer with
free communication and consultation at all levels and this has
resulted in our Register being most comprehensive. This, together
with an efficient follow-up scheme for all handicapped children in
Wandsworth, leaves no doubt in my mind that the value of the
Register is well established.
Inevitably a number of physically handicapped children are in
the care of the Children's Officer, and indeed some of the children
in care are considered to be at such risk of abnormal development
that they are placed under observation by reason of emotional
deprivation in early childhood. A constant exchange of information
about these children is therefore necessary and the liaison between
specialists, hospitals and the Children's Officer is often established
through the Health Department. Advice is often sought on suitable
placement of physically or mentally handicapped children in
care and requests are made to assess the needs of some of these
children. Symptoms of deprivation and neglect are often first
noticed by the health visitor and where it is felt that the child
should be received into the care of the Council, the Children's
Officer is informed.
There is also exchange of information with the Welfare Department
relating to the blind and partially-sighted and as the Handicap
and Observation Register is now being extended to embrace
children of school-age it is planned that particulars of children with
serious physical handicaps will be notified to the Chief Welfare
Officer just before the child leaves school so that further suitable
provision can be made, particularly with regard to the social
problems and needs of the handicapped. Close co-operation with
the Medical Adviser of the Inner London Education Authority is
established as soon as a handicap is diagnosed and always before
the child reaches school age. There is also close liaison between the
Greater London Boroughs and other authorities when handicapped
children change residence.