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were due to the basic underlying interests and
research position of the directors and staff. Where
the main interests of the Centre were on vision, as
for instance when the Centre or Clinic was closely
involved with optometry, then visual difficulties
were most closely looked at, and the remedial
programme put forward was one that involved a
good deal of visuo-motor and gross motor training,
with some language, but not as intensive a
language programme as it would be if the basic
emphasis of the Clinic or Centre was on language
disorder. I am quite sure that because of the
selection of children for referral to particular
Centres, many of the children going to any one of
them would have primarily a visual or an auditory
difficulty, but in some cases I observed children
who, it seemed to me, were being considered
primarily from a visual, or a gross motor
standpoint, who appeared to have really quite
strong though subtle language difficulties and
vice-versa. I am not suggesting that there was any
exclusion of other disciplines—far from it—but
because of a declared interest in one particular
aspect of development the emphasis went that way.
I was therefore impressed when I discovered at
the University of Houston, where I had the
opportunity to visit the Department of Optometry,
that optometrists are working with the speech
therapists and language pathologists from the
Language Department and with the lecturers in
Special Education and Learning Disabilities,
co-operating in helping children in the Reading
Clinic, each contributing equally their special skills
in diagnosis and remediation.
'Most Assessment Centres and Institutions had
a great deal in common, however, except for the
Institutes for the Achievement of Human Potential
in Philadelphia. Treatment here, of specially
selected children, is based on theories derived
from the work of neurologists such as the late
Dr Temple Fay, elaborated by the directors.
The remedial treatment suggested by the Institutes
is challenged by very many special educationists,
paediatricians and other medical personnel in the
United States. Recently the Journal of the
American Medical Association has published two
articles, one describing experimental work using
the treatment with groups of children, and how
they compared later with a control group, and the
other criticising the basic neurological postulates.
Until the Institutes produce some really carefully
controlled experimental data to support their
claims, or allow an outside body to do so, very
few special educationists will accept the remedial
techniques in their entirety. Nevertheless, I was
grateful to Dr Delacato for allowing me to visit
the Institutes and to observe assessment and
discussion sessions in order to inform myself
better about the Institutes' approach; occasionally
parents of handicapped children in Hounslow
who have read about the Institutes' methods ask
me for information on this subject.
'To turn now to the ordinary schools in the
public school systems I visited, both of these
systems were probably untypical, in that both were
in comparatively new and fast-growing areas—
Hoffman Estates, a new suburb of Chicago, and
Prince George's County in Maryland, the county
surrounding Washington DC on its eastern and
south-eastern side, to which an enormous
migration of white people from Washington is
taking place. Both are fairly middle class, and
there is plenty of interest in education. Dr Jeanne
McCarthy, the Director of Special Education at
Hoffman Estates, has a Federal grant for an
exploration of the best use of special provision
for children with learning difficulties in the
ordinary school, especially reading difficulties.
She has a staff of two psychologists, two
educational diagnosticians, some resource room
teachers and others to carry out this work.
Dr McCarthy believes that the size of the
population of school children with learning
difficulties is potentially so great that specialist
teaching and psychological staff alone will not be
able to tackle it, and that the class room teacher
could manage a larger amount of remedial help
for individual children if the learning problems
were clearly diagnosed for her (it is usually a 'her'
in the elementary school) and she was shown by
the specialist teachers how the remediation could
be carried out and helped to take over some of
this, with constant support and advice, suitable
teaching materials, etc.
'In Prince George's County, Dr Gilbert
Schiffman, a former optometrist with good
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