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OBSERVATION AND HANDICAP REGISTER
A Handicap and Observation Register is being maintained in the Health Department, to
ensure the follow-up of children who may be "at risk" of developing a handicap or who have a
known handicap.
The register is compiled from three main sources of information:-
(i) iBirth notification card - handicaps visible at birth.
(ii) Babies "at risk" - included in discharge reports (of mothers and babies) from maternity
hospitals and the domiciliary midwifery service.
(iii) Known handicaps - compiled from:-
(a) hospital social workers, general practitioners, clinic medical officers
and health visitors,
(b) hospital reports and reports of other investigations including vision
tests,
(c) parents,
(d) school and clinic examinations.
The register is kept in a central card index system, and records are reviewed by the
Principal Medical Officer (Maternity and Child Welfare) or the Principal Medical Officer (School
Health), at regular intervals. A duplicate of each index card on the central register is kept at the
child's welfare centre or school. In child welfare centres the clinic doctor records the child's
initial medical examination and subsequent developmental examinations made on review dates.
If the baby has not been brought to the centre for the initial examination by the time it is
three months old, the health visitor visits and reports to the clinic doctor who then decides what
action should be taken. If the child has not attended the centre by the age of six months, the centre
doctor either contacts the general practitioner by telephone, or requests the central office to write
to the general practitioner or hospital for a medical report.
The Health Department's scheme for the continued follow-up of children on the register
provides for a full developmental examination at or about six months, nine months, one year,
eighteen months and two years. A reminder is sent in advance to each child welfare centre and day
nursery. The medical report is then sent to the central office after each examination for review by
the Principal Medical Officer. The child's name remains on the register until the doctor is satisfied
that the child is walking and talking normally.
Children on the register who fail to attend the centre for screening are visited at home by
the health visitor. Her report of the child's progress is recorded for the information of the centre
doctor who may then decide if further action is necessary.
Babies with a known handicap are also considered to be "at risk" because handicaps are
often multiple, and these babies too are screened at the appropriate intervals.
All doctors and health visitors working in the child welfare service of Camden have had
the opportunity to attend one or two meetings at which the Borough's scheme for the compilation
and review of a comprehensive Handicap and Observation Register was explained and discussed.
These meetings were addressed by Dr. Dorothy F.Egan, who acts as the Health Department's consultant
in maternity and child welfare and who has played a leading part nationally in the reorientation
of thought and action on the lines described above.
COMMUNITY SERVICES FOR THE HANDICAPPED CHILD
The Handicap and Observation Register is kept under regular review by the Principal
Medical Officers so that the needs of handicapped children for community services - for recreation,
training and special education - may be planned in advance. Supportive services may enable the
child to remain in his family, by relieving his parents of some of the strain, and short-term hospital
care may enable them to take a holiday. If a child is admitted to a day nursery, special unit or to
school, his medical records are sent with him, so that follow-up medical examinations may be continued.