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FAMILIES WITH SPECIAL DIFFICULTIES
During the year it was felt that a review should be made of families with special
difficulties. I deliberately avoid the term problem families as this has come to have a
meaning which is somewhat derogatory and by implication the parents are held to be
at fault. As this is so often not the case I feel disinclined to use any expression which
infers that it is. I prefer to think of these families as suffering from a social illness which
is perhaps no more due to their own fault than physical and mental illness are the fault
of those who suffer from them.
Following a discussion with the health visitors it was agreed that about 54 families
in Dagenham should be classified as families with special difficulties. It was found
possible to divide these into three groups, based on a points system worked out in the
London County Council. On this system 10 families scored less than 5 points and were
regarded as slightly affected, 26 families scored 5—10 points and were more severely
affected, while 18 were seriously affected. In order to give an indication of some of the
difficulties involved I give below an account of a family with whom the health visitor
might be trying desperately to cope. It is important in our dealings with these families
that we should disclose no information which may embarrass them and thus interfere
with the relationship we try to achieve with them. For this reason I have not described
any one family but have used information about a number of families and joined it to
form one whole.
The family consists of father, mother and six children. They live in a three bedroomed
house. The ages of the children range from 16 years to 18 months. The
father is a labourer and a good workman (when he feels well enough to work) and the
mother is backward because of limited intellectual development; she can read a little
but cannot write. The eldest child (aged 16 years) is away in a mental defiicency hospital
and the next child (aged 14 years) is at a residential school for maladjusted children.
When we visited one day at 11.30 a.m., the youngest child was sitting in his pram,
wet and dirty, with a crust of bread in his hand which he was trying to eat, and pus
dripping from his ear. The two children of school age were at school, the 5-year-old
having just recovered from measles. The 4-year-old rushed out of our sight as we
entered the living room (he had been nervous of people since he had whooping cough).
The hearth was empty although the living room was hot and stuffy. Dirty clothes were
scattered about (mainly in the scullery) and the living room was extremely dirty. Upstairs
the paraffin lamp in the front bedroom was still alight and the curtains drawn.
The bedclothes were filthy and inadequate, the beds urine stained (all the children are
bedwetters) and by the noise which came from under the bed it appeared that the 4-yearold
had taken refuge there.
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