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48
HANDICAPPED CHILDREN
Handicapped Children of Pre-School Age
Children arc notified to the Child Health Section of the Health Department as soon as a handicap has
been identified. These notifications come from the maternity hospital following a child's birth, from medical
officers in the child health clinics, health visitors, paediatricians and from workers in the Social Services
Department.
A Handicapped Children's Register is maintained centrally at Brent House and during 1972 with the
appointment of a Senior Medical Officer in the Schools Health Section it was possible to extend and co-ordinate
the supervision of these children more fully.
A medical examination is carried out after reports from all those concerned with the child's care
have been obtained. The needs of the child are assessed and a programme of further care arranged. Many
of these children are admitted to the day nursery for some hours a day, others to the special nursery attached
to one of Brent Special Schools. Arrangements to ensure physiotherapy and speech therapy may be necessary
and the support of the Social Services Department or voluntary organisations may be required.
Regular re-appraisal of the needs of these children is necessary and reviews are carried out yearly or
more often as required to ensure the changing factors in the child's physical, mental and social progress are
assessed and alterations to the programme of care are made where needed.
Close contact is maintained with the School Psychological Service and plans for future schooling,
either in special schools or in ordinary schools with supportive care are made.
Handicapped Children in Day Nurseries
Brent is fortunate to have 13 day nurseries. It was always the policy when these nurseries were under
the care of the Health Department to integrate a certain number of handicapped children into each day
nursery. This provided an opportunity for these children to experience normal play and social activities with
other children and thus reduced the developmental delay that could occur. Handicapped children are often
unable to mix normally for play with other children in the pre-school years as their handicap may confine
them to their homes.
When the Social Services Department took over the administration of the day nurseries, this policy was
continued and extended and interpreted literally for the care of all handicaps.
During 1972 there were 88 handicapped children in the 13 day nurseries. These children were usually
admitted for a limited number of hours each day, not spending the full day there unless for other reasons
whole time care is required. Each nursery may accept up to five children, usually with different handicaps. The
staff in day nurseries are now well experienced in the care and management of the different handicaps. Speech
therapists visit the day nursery to give both treatment to individual children and assistance and advice to
nursery staff in the stimulation of speech and language. Physiotherapists also visit the nurseries and give advice
on the care and management of the physically handicapped.
It is interesting to record the wide variety of handicaps admitted to the day nurseries (Table 30).
It will be noted that the number of children who have delay in speech and language development
without evidence of any other handicap is fairly high. This problem is a common one in Brent where social
and cultural deprivation often combines to retard development in speech and language skills. Immigrant
children have additional problems because of their differing cultural patterns.
Considerable help to remedy this handicap can be given to these children by admission to the day
nursery where speech and language development can be actively stimulated by the staff at the nursery. It is
in this respect that speech therapists have much to offer in their contact with the day nurseries.
With the increase in the establishment of speech therapists in 1972, it had been possible for them to
undertake regular nursery visits. They are able to help the day nursery staff extend their knowledge of
language development so that some structuring of the language environment in the day nurseries can be
assisted.
The development of satisfactory communication ability before starting school is basic to the child's
opportunity of benefiting from education being offered. If speech and language understanding are retarded
this can remain an educational handicap for the child which he may never fully recover from during his
school life.
As an advisory service to the Social Services Department, medical officers visit the day nurseries
regularly and supervise the general health of all the children in the nursery as well as assessing the progress
of the handicapped children placed there.