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55
Assessment and Parent Counselling
Parent counselling and support for the family with a young
mentally handicapped child has until now been carried out by the
Health Visitor. This policy was adopted because in the majority of
cases the problems encountered were not unlike those in a family
with "normal" children, and with these the Health Visitor deals in
the day-to-day course of her work. Moreover, a number of these
children belong to either established or "borderline" problem
families and the Health Visitor is already deeply involved,
especially when co-ordination with other statutory (Children's
Dept., Probation Service) or voluntary (N.S.P.C.C.) agency is called
for. Where there is an overt mental illness or a clear mental health
problem, the M.W.O. takes over the supervision of the case before
the usual date, i.e. the child's 5th birthday.
The clinical assessment is carried out by the Senior Medical
Officer at the child's home as soon as practicable and often as a
matter of some urgency. A home visit has many advantages with
the child and the family being examined in the natural setting.
Much thought has been given to establishing an Assessment Centre,
but no concrete steps have as yet been taken in this direction. The
geographical problems mentioned before may be the overriding
difficulty. The scarcity of clinical accommodation available would
also have to be overcome.
Link with Hospital Paediatrician Service
The Borough is well served by the paediatric in-patient and
out-patient facilities. In practice, every mentally handicapped child
has been seen by the paediatrician at some stage of his development.
The proximity of London teaching hospitals resulted in many
children being referred to such hospital for a "second opinion"
and the newly established Assessment Centre (Newcomen) at Guy's,
which is easily accessible by rail, is being increasingly used by the
local paediatricians. A two-way exchange of information, clinical
and social, between the local and London hospitals and the Medical
Officer of Health is now well established.
Clinical Types of Subnormality
The table below gives grouping by diagnosis of young subnormal
children:—