View report page

Child Guidance Service
The Borough is served by two Child Guidance Centres - at Lordship Lane, Tottenham and at
Tetherdown, Muswell Hill. Dr. Nina Meyer is consultant psychiatrist and medical director at Lordship
Lane, and Dr. K.A. Graf at Tetherdown. Miss Gwen Kidgell is senior educational psychologist with
overall responsibility for the administration of the child guidance and school psychological services.
The staff of the service also includes two full-time and one part-time educational psychologists, three
part-time psychotherapists, four part-time psychiatric social workers, two part-time social workers
and six clerical assistants who between them work the equivalent hours of five full-time officers.
Dr. Meyer reports as follows on the work at Lordship Lane:-
"How to make the best use of the resources available for help for the disturbed child has been
the chief concern of this Clinic during the past year. Perhaps because of increasing awareness of
disturbance and its consequences, and the beneficial results of timely help, the number of referrals
have increased greatly — the present average is 4 — 5 a week, over 200 new referrals a year. From
1st January 1968 to 29th February 1968, 54 cases have been referred compared with 35 in the same period
of 1967.
Preventive psychiatry as with all preventive medicine is, we feel, the most economic way of using
our resources. The Clinic therefore, is tending to the approach of the Child Health Department and is
dealing with childhood disturbance from birth to school leaving age, giving priority to the very young
child. We hope in this way to modify patterns of disturbed reaction between mother and child before
they are firmly established.
Much malaise of the young infant stems from the mother's disturbance, of which depression is a
frequent feature. To give help to the mother together with suggestions for the well being of her infant
is often dramatically rewarding. Managing the anxieties of the very young mother is another rewarding
measure. Two such mothers referred to the Clinic were under fourteen. Early discussion when making
decisions for these girls might have been helpful in averting the later disturbance for which they were
eventually referred.
With the aim of using early psychiatric help to the greatest advantage, discussion groups this
year have included Health Visitors, Nursery Matrons and Assistant Medical Officers. For the first time
it is proposed to include a group of School Welfare Officers, since enlarging the scope of school welfare
has been found to be a great help in averting delinquency and school refusal.
The end result of such interactions at home and at school can be seen in the frequent gravity
of the problems with which older children are referred for psychiatric help — attempted suicide (3),
exclusion from school for dangerous violence (5). inability to go out of the house because of intense
fear of the outside world (4), truanting (6).
Together with preventive work aimed at the emotional aspects of disturbance, there has been in
this Clinic an increasing awareness of the part played by unrecognised physical causes in many symptoms
referred to the Psychiatrist; for example, pica, the eating of abnormal substances — dirt, sand or grit,
has been frequently found associated with anaemia, behaviour problems in epileptic children have on
occasion responded to change in medication which has affected metabolism. A child referred for hysterical
symptoms was found to be suffering from hypoglycemia; abdominal pain with no organic cause, has
responded to a non-purgative regime aimed at dealing with constipation. The agreement of the Hospital
Management Committee to prescribing by the present writer has been of great assistance.
The enthusiastic co-operation of co-workers in the field of Child Health, Child Care Officers.
Probation Officers. School Welfare Officers. Nursery Matrons, Health Visitors, and our own Assistant
Medical Officers, has greatly helped us; our team continues unchanged in personnel, but matured by
another year of rich clinical experience."
Dr. Graf reports as follows on the year's work at Tetherdown:-
"This is my third report as Medical Director of the Tetherdown Child Guidance Centre, which was
established at the time of the reorganisation of the London Boroughs. We can justly claim that this
was a further year full of activity for the team of experts who have been co-operating and pooling their
experience in the interest of the referred children and their parents and elders. The problems on which
we are consulted are becoming increasingly more complex. The old pattern of family cohesion and
parental authority has been loosened and modified by contemporary social trends, the increasing influence
81