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Children 'at risk' of or with handicapping conditions—The aim has been to detect
handicaps as early as possible, so that training which will help the child to make the best
use of his residual assets can be given at the most favourable time of development when
skills would normally be acquired and to see that the child is not lost sight of for any
reason; to assist parents to keep the child in the community as long as possible and also
to advise in advance on the child's needs for special care for education. In order to do this,
a register of handicapped or potentially handicapped children has been set up in each
division. Babies are considered to be at risk of developing a handicap by reason of adverse
factors occurring during pregnancy, labour or the puerperium. The register is compiled
from information provided on the form of discharge report made available by the Council
to domiciliary midwives and hospital maternity units and from information about children
born with congenital handicaps provided since 1964 on the form of notification of birth.
In each division the register is scrutinised at regular intervals by a senior medical officer
so that the children's progress and development may be kept under continuous review
and the offer of help made at the earliest possible time.
Some 90 per cent. of infants born in the county are seen in child welfare clinics in their
first year of life and clinic medical officers thus have the opportunity to screen babies
for congenital handicaps. In 1957 training of medical officers in screening tests of the
hearing of babies and young children began and all medical officers soon had the opportunity
of studying these techniques. Every centre was equipped with the 'Stycar' hearing
testing set devised by Dr. Mary Sheridan, Ministry of Health. Medical officers train health
visitors not only to refer babies known to be at risk but also to carry out screening tests
at the centre. All children suspected of deafness are referred to the divisional otologist.
The youngest child for whom a hearing aid and auditory training have so far been prescribed
was four months of age.
Detection of children suffering from phenylketonuria—Since 1960 babies' urine has been
tested as a routine to detect those with phenylketonuria—a rare inborn error of metabolism
which can lead to mental defect—and from this screening test four cases have been found.
One of these was a boy who, although tested with phenistix at the age of 32 days with an
apparently negative result, was found over a year later to be suffering from phenylketonuria.
The boy was admitted to hospital where several further phenistix tests were carried out in
the ward with only faint results or none at all, but a more 'pronounced result was obtained
after meals. Following this experience, wherever possible the test for urine is done an hour
or so after a feed.
Day accommodation for children
Day nurseries are provided for children under five whose home circumstances are
detrimental to health or whose mothers have to go out to work, priority being given on
health and economic grounds. In recent years places have been set aside for children
whose physical or mental development might be advanced in the care of the nursery and
through mixing with children not suffering from a handicap.
Since 1961 a number of special units for the admission of severely subnormal children
have been provided in nine day nurseries. In addition, young deaf children may be admitted
up to a maximum of 15 hours a week. In each case no charge is made except for meals or
refreshment taken. Otherwise charges for admission have continued to be made but have
remained abatable according to means. To an increasing extent nursery staff have become
involved in co-operating with other workers on the social problems of some of the families
using the nurseries.
The number of children minded by voluntarily registered child-minders has doubled
since the end of 1949. Comparable increases have occurred in the number of private day
nurseries and in the number of children that can be minded by child-minders registered
under the Nurseries and Child-Minders Regulation Act, 1948.
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