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21
the Summer term, her place has been taken by a qualified audiometrician,
Mrs. Marshall.
For additional Statistical details, see Appendix B, Page 59.
CHILD GUIDANCE CLINIC
I am grateful to Dr. C. Crosse, Consultant Psychiatrist,
South West Metropolitan Regional Hospital Board, for the
following report:—
It is refreshing to report that our efforts over the past few years to improve
team work and co-ordination at the clinic are now producing dividends.
Nearly all cases referred are subjected to a multidisciplinary scrutiny before
decisions of diagnosis and treatment are made. In the final analysis one
often has available data from the educational psychologist, school head,
social worker and day unit staff. All aspects of the child's problems are thus
comprehensively covered whether the exercise is one of diagnosis or treatment.
One of the most common ploys in the management of emotional disturb
bance .in children is the manipulation of environment and one should emphasise
here that the stronger the levers the more effective the manipulation.
Having acquired through the skills of the psychologist and social worker a
deep investment in the family and school environment, we are in a position
to discharge effectively the clinical recommendation made at the time of
referral. The clinic may be seen as just one part of a total service matrix in
which other social agencies, hospital departments, family doctors and
schools, have some common involvement with the family in attendance. The
real fruits of this pattern of service is the awareness of the clinic staff of
the considerable resources at hand, thus negating that nagging sense of
impotency so often felt in clinics detached from the local professional
community.
Our day hospital unit continues to prosper and it is being more and
more used for observation and treatment. Disturbed children are, by the very
nature of their disability, severely crippled in their social relationships, and
the warm therapeutic groups so ably supported by the day unit staff go a
long way to restore the social confidence of these children/These remarks
have particular application to children who are either excluded from school
or are too sick to attend. Since the staff are fully aware of the dangers of
institutionalisation there is a constant drive to return their charges to their
rightful environment and long term attendance is discouraged. Although
school attendance of the so called school refusal child is soon reinstated
we do not lose sight of the fact that a child is not just a name on a school
register and that factors underlying his school refusal should be fully understood
before demands for his return are made. Experience of the day unit over
the past two years has shown that it is an indispensable part of a busy child