News and Notes
Handicapped Children and the Education Act, 1944 Section 33 of the Education Act, 1944, enacts that: The Minister shall make regulations defining the several categories of pupils requiring special educational treatment and making provision as to the special methods appropriate for the education of pupils of each category.
_On April 13th, 1945, these Regulations were issued in Uraft and?concerning as they do every type of handi? capped child?they should be closely studied by all who are interested in the Mental Health of the nation, whether . educationalists, doctors, social workers, health JSitors or ordinary citizens with a sense of obligation ?wards those who are disabled in mind or body.
In the Regulations the categories of pupils requiring .Pecial educational treatment are enumerated as follows: 5”nd, and Partially Blind, Deaf and Partially Deaf, Helicate, Diabetic, Educationally Subnormal, Epileptic, ^aladjusted, Physically Handicapped, and pupils Uttering from Speech Defect.
In the case “f fhe blind, deaf, physically handicapped, ePilept;_- antj aphasic, it is provided that the special ^ethods of education shall be applied in Special Schools, th *n case children who are epileptic or blind, “at these shall be boarding-schools. The other categories (including the educationally subnormal) may be uucated in an ordinary school if the special educational featment afforded thereby is satisfactory and if the presence of the child concerned is not detrimental to the ^?terests of the other pupils. Where these conditions are ?t Present, Special School education must be provided. Section 8(2) (d) of the Act, includes amongst the other duties of Local Education Authorities that of paying regard:
” … to the expediency of securing the provision of boarding accommodation, either in boarding schools or otherwise, for pupils for whom education as boarders is considered by their Parents and by the authority to be desirable.’’’’ , The Draft Regulations enact that to be approved, a ?arding home used by an Authority for handicapped Pupils, must provide accommodation for not fewer than unless the Minister sanctions a smaller number, of u boarding-out method is used instead, inspection 1 the foster home must be made before admission of the rst pupils, during the first month of residence, and thereafter at least once a term. Not more than three handicapped pupils must be boarded out with any one foster parent.
Part V of the Regulations deals with Institutions for Further Education and Training of Disabled Persons. Special reference is made here to the needs of the blind and partially sighted, the deaf and partially deaf, the epileptic and the physically handicapped.
No specific mention is made of the mentally handicapped, but we understand that this category will be included in the groups dealt with under the Disabled Persons (Employment) Act, if such special provision appears to be needed in any case.
Part VI is concerned with the School Medical Service, Conduct of Medical Examinations and Inspections, etc., and the final Section deals with payment of Grants for services coming within the scope of the Regulations. In an explanatory Circular (No. 41) issued at the same time as the Draft Regulations and which should be read with them, it is stated that a pamphlet dealing in some detail with the whole subject of special educational treatment will be issued shortly by the Ministry. The publication of this pamphlet will be awaited with interest and we shall hope to refer to it again in our next issue.
Handicapped Children Advisory Committee In February, 1945, the Minister of Education announced the appointment of an Advisory Committee to advise him on ” such matters relating to children requiring special educational treatment as he may submit to them or as they may consider require investigation The members of the Committee are as follows:
Mr. F. Messer, M.P. for Tottenham South. Professor J. M. Mackintosh, Dean of the London School of Hygiene & Tropical Medicine. Dr A. A. E. Newth, Senior School Medical Officer, Nottingham.
Mr. E. W. Woodhead, Director of Education, Kent. To assist the Committee in considering any specific question under review, it is the intention of the Minister ” to appoint as additional members, persons possessing special knowledge and experience of the particular category of handicapped children concerned Special Education?Boarding or Day School ? Under Section 8(2) (d) of the new Education Act, Local Authorities are required to pay regard ” to the expediency of securing the provision of boarding accommodation either in boarding schools or otherwise, for pupils for whom education as boarders is considered by their parents and by the authority to be desirable The question as to the advantages or disadvantages of the Boarding School (as compared with the Day School) is therefore one of great moment, particularly in relation to handicapped children in whose education it is likely to play an increasingly frequent part.
In the Report of the Principal School Medical Officer for Newcastle-on-Tyne, for 1943, there is an interesting testimony to the value of the Residential School for mentally defective children given by the Head Mistress of the Bolam Street Girls’ Special School, evacuated as a unit to Close House, Wylam, Northumberland, for 3years.
Miss Hickman’s general conclusion is given as follows: ” My experience of Boarding School training for mentally defective children during the 3J years I spent running the residential school at Close House, is that it is very much more successful than the day school, since it extends the scope for training to include social as well as scholastic training. The children all learned to fit into the community life of the school as useful members in a greater or lesser degree according to their relative mentality. Behaviour difficulties were eased. The response in classroom work was therefore readier and more sustained. The children worked to the full extent of their various limited mentalities, showing an interest in their own educational progress.”
Improvement in physical health and habits was to be expected, but it is noted that this was accompanied by an increase in self-reliance and independence, both on the part of the neglected and of the over-protected child, and by the birth of a new self-respect.
” With favourable conditions for washing, and access to proper clothing, the children became very aware of their appearance. I found them demanding proper clothing from their parents where once they were content with any cast off or handed down unsuitable garment. A feeling of self-respect grew in the girls, especially as they felt themselves useful and able to do their school work. Combined with this was the ever present example of the teachers. The older girls copied the staff. The younger girls copied the older girls. In time, the appearance of the children improved considerably.” It is true that these happy results were not achieved without unwonted strain and self-sacrifice on the part of the teaching staff, but they, too, gained something of solid value, because by living in close daily contact with their children in the capacity of friends and helpers, and not of teachers only, a feeling of mutual understanding was engendered which greatly helped the classroom approach.
The following brief record of an individual child illustrates more vividly than any generalizations, the happiness and fullness of life which wartime experiment could bring?and alas, which its ending could so tragically take away.
J. A. Age 9 years, 9 months. At time of evacuation: pale, thin, undersized. Signs of rickets in bones of legs. Dull, lethargic, unhappy, slouching carriage. Scholastic attainments: practically nil. After 15 months at Close House: bright, happy, full of ready laughter. Active and full of movement. Carriage more erect, flesh with a healthy glow. Body well covered though not fat. Physical health satisfactory. No illnesses. Scholastic attainments: Making steady and sustained progress in the 3 R’s. Learned to knit and do a little sewing. Able to wash and dress herself, make her own bed and do simple jobs. Every sign that this child will progress satisfactorily.
After 3 months at home. Again dirty and neglected. Acquired that dull, lethargic look. Slouching and listless. Pale and often unhappy. Frequent septic sores and abscesses through sickness or other reasons. Class Work: Progress has not been maintained. Is unlikely to carry out the promise showed at Close House under present home conditions.
It is, however, encouraging to learn that the majority of evacuated pupils now back at Bolam Street School, show a higher standard of educational attainment, behaviour and social adjustment than that shown by their schoolfellows who stayed at home. Moreover, many of the girls now in employment, have taken their place satisfactorily in the community and have maintained the improvement resulting from their residential school experience.
An Experiment in Special Education
The Chesterfield Education Committee have recently issued a report on their scheme for combining an Open Air School with provision for psycho-therapeutic treatment of maladjusted children?an experiment owing much of its inspiration in the initial stages to the late Dr H. G. Stead in his capacity as Chief Education Officer to the Borough. The Scheme now includes three types of provision?Brambling House Open Air School, Brambling House Children’s Centre, and Holly House Hostel.
The object of the promoters was, it is stated in the Report, ” to combine the physical, intellectual and psychological approaches to children’s problems … to do away with the usual distinction between the delinquent, the nervous, the retarded and the ill child, and to regard all sorts of varied conditions such as nervousness, chronic headaches, stealing, rheumatic pains, temper tantrums, bed-wetting, shyness, asthma, lassitude, school failure, etc., merely as symptoms that something is wrong with the child; and to pursue investigations along these lines simultaneously to discover whether that ‘ something ‘ is physical, intellectual, emotional or, as is so often the case, a combination of all three.”
The accommodation at Brambling House Open Air School provides for 125 children with a staff consisting of the Headmaster and five assistants. Children are received from schools under the Chesterfield Authority as well as from outside Authorities through the local Hostel for maladjusted children. The purpose of the School is remedial, and although a small minority are likely to stay there throughout the whole of their school life, the greater number return to ordinary schools when their mental and physical health is established. The majority of the children admitted are physically defective, and although some are poorly adjusted socially, they are able to co-operate with the teacher in creating a stable class room atmosphere. Into this group it is found that the over-shy or educationally handicapped children receiving psycho-therapeutic treatment at the Centre, are easily absorbed, but experience has shown that the “noisy, misbehaving, unco-operative’ children can be dealt with successfully only if their numbers are kept down to about three in a class of 25. In the free atmosphere of the school, teachers and children learn to know each other, and through staff meetings difficulties are discussed and efforts are made to find a solution to difficult individual problemsCareful records are kept on each child, and there is 3 clo?e partnership between the School Doctor, the teaching staff and the therapists. Co-operation of the parents is ensured by providing frequent opportunities for their visiting the school, and by home visits paid by the Child Psycho-therapist and the Health Visitors.
The Children’s Centre, attached to the School, is staffed by a psychiatrist, a Child Psycho-therapist (holding the Diploma of the Institute of Child Psychology) and by one or more part-time Educational Psychologists. Children from schools outside the Borough are admitted *or treatment on payment of a fee.
Of the 347 cases referred during the five years under reveiw, 85 have also attended the Open-Air School, and of these 37 have made a satisfactory adjustment. The close connection between the School and the Centre is found to have many advantages. By means of it, time secured for continued treatment as part of the school routine, and a child is educated with normal delicate children under specially selected conditions but without his acquiring the label of ” difficult ” or ” maladjusted Holly House Hostel?the third, and most recent constituent of this Scheme?was opened in 1943, and Up to April, 1944, 27 children had passed through it, ?f whom 12 were from Chesterfield and 15 from outside areas. Whilst at the Hostel, 13 children in need of residential treatment, attended Brambling House School ar>d Centre, 3 attended the Centre and continued tn. attendance at an ordinary Elementary School. 9 children were received as ” Care and Protection ” cases aWaiting foster-home placement or receiving treatment to make them fit for this.
The cost per week, including education and treatment at the Centre, has worked out at ?2 10s., and the expenditure has been regarded by the Ministry of Education as ehgible for grant.
The staff consists of a Warden and House Mother parried couple), an Assistant Matron, and a General Assistant with one daily non-resident cleaner. Weekly Visits are paid by the Child Psychotherapist. The life of the Hostel has been too short to justify any adequate discussion of results, but the Report draws attention to certain conclusions which it considers can be legitimately arrived at, from the year’s work. Some of the children admitted from outside areas have been jound to be unsuitable cases, in view of the fact that the Hostel is intended as a place in which children stay |or a limited period only and then, after the necessary treatment, can return to their own homes. No useful Purpose is therefore served by admitting childien whose home conditions are bad, unless there is either an assured Prospect of improvement, or of a suitable foster-home which should be secured before treatment is begun. In the main, the Hostel should bs reserved, it is considered ‘apart from its function as an emergency home for children awaiting foster-home placement) for ” seriously disturbed children from reasonably normal backgrounds who need intensive residential psychotherapeutic treatment after which they can return home.
This Report is particulaily interesting, in view of the development of such provision contemplated in the Education Act, 1944, and it can be commended to all who are interested in the handicapped or maladjusted child.
Society of Mental Nurses
This Society is a new comer into the list of organizations interested in Mental Health. Its Chairman is Miss Gunn, Matron of St. Bernard’s L.C.C. Hospital, ^outhall, Middlesex. Miss Payne, Matron of Clavbury L-C.C. Hospital, Woodford Bridge, Essex, is its Vicechairman, and Miss Griffith, Mill Hill Hospital, is its Hon. Secretary. Membership is open to nurses holding the final certificate of the General Nursing Council or of the Royal Medico-Psychological Association, in mental nursing or mental deficiency nursing, and the objects are to promote the interests and the professional standards of mental nurses, to secure for it greater recognition on the part of the whole nursing service, and to provide opportunities for discussion and study of matters affecting duties and responsibilities. The question of training is also one to which the Society proposes to devote close attention.
Anyone interested is invited to communicate with the Hon. Secretary at Mill Hill Hospital, London, N.W.7.
The Board of Control
Since our last issue two new appointments have been made to the Board of Control, necessitated by the retirements of the Chairman, Sir Laurence Brock, and of a Senior Commissioner, the late Sir Hubert Bond. As successor to Sir Laurence, the Minister of Health has appointed Mr. Percy Barter, a Principal Assistant Secretary in the Ministry since 1940, and Secretary of the Board from 1930 to 1939. Mr. Barter’s appointment as a Senior Commissioner has also been approved by the King.
As a Senior Commissioner to take the place of Sir Hubert Bond, the King has approved the appointment of Dr The Hon. Walter Symington Maclay, Medical Superintendent of Mill Hill Emergency Hospital.
Children on Remand
The question of the referral of children for psychological examination at Child Guidance Clinics by Juvenile Courts was considered by a recent Committee set up by the Home Office to enquire into the provision of Remand Homes made by the London County Council.* The principle reference in the Report was made in Para. 43, where the following statement occurs: We gather that psychological reports are asked for rather freely?we are not altogether satisfied that they are not asked for too freely. In so far as they are really necessary for a decision on the case, we think arrangements should be made for the examinations to take place on the premises of the Juvenile Court or in its immediate vicinity.’”
The Committee also states that in their view it seems ” shocking that they (children and young persons) should be liable to be sent back to detention for another week, as they seem to be … merely because particular medical or psychological reports cannot conveniently be furnished on a particular day, or are more difficult to obtain if the boy or girl is released on bail The evidence on which these conclusions are based is not mentioned in the Report, but it would be most unfortunate if the recommendations here made were implemented.
In Para. 7 of the Report, on the character of the Remand Home, the latter is defined as: ” a place where children and young persons who, for one reason or another, are maladjusted to society or to their home environment, are received for a short time, and should be cared for in a way that will contribute to their physical and moral welfare.’’’’
In Para. 48 a description is given of the Committee’s opinion of the requirements of a good Remand Home. Inter alia it is recommended that ” the ruling characteristic of the home should be a civilized and civilizing atmosphere and accommodation should be such as ” to give the staff the right background of dignity and comfort to enable them to give the children, who usually * Report of Committee of Inquiry into L.C.C. Remand Homes. H.M. Stationery Office.
come from ill-regulated homes, a new idea of what a decent home might be In the light of these recommendations it is not easy to understand why a child should suffer harm through being detained a week or two in such an atmosphere, indeed one might confidently expect it to be beneficial.
Child Guidance Council
In the last quarter two new Child Guidance Clinics have been established and recognized by the Child Guidance Council, one in Dorset attached to the Herrison Hospital and one at the East Ham Memorial Hospital. Both were established to meet a growing demand for Child Guidance and both hope to expand and to be able to provide a full Child Guidance Service.
In West Sussex an interesting development is the establishment of a Child Guidance Committee which is a Standing Committee to the County Council; the terms of reference are to consider and advise the County Council on all matters relating to child psychiatry and the Child Guidance Service. The Committee consists of representatives of the Education Committee, the West Sussex (Combined) Probation Committee, the Visiting Committee of the Mental Hospital and the Midwives, Maternity and Child Welfare Committee of the County Council. A Child Guidance Service with fully staffed Child Guidance Clinics in three different centres is planned.
The Inter-clinic Committee of the Child Guidance Council has prepared a basic School Report Form which can be used as a model and has been circulated to all recognized Child Guidance Clinics.
It is not the experience of Child Guidance Clinics that cases are referred inappropriately by Juvenile Courts Magistrates. It would be disastrous if psychological examinations were to be carried out on the premises of the Juvenile Courts, or in its immediate vicinity; to do so would invalidate the findings of the examination and lead to the association in the child’s mind of the specialist’?”, interview with the Court proceedings or with punishment. Tt may be hoped that the Juvenile Court Justices and the Home Office who are requested to pay particular attention to recommendations in these paragraphs may seek some expert advice on the matter.
” Lord ” Memorial Essay Competition
The subject chosen by the Selection Committee of the National Council for Mental Hygiene for the 1944 Essay ^ Prize in connection with the Lord Memorial ? Competition (administered by the Council on behalf of the Society of the Crown of Our Lord) which is open to all certificated mental nurses of the rank of staff, charge, or chief charge in Mental Hospitals of the United Kingdom and Northern Ireland was: “The ^ Nurse’s part in helping the Newly Admitted Patient to settle down.” There were fifty-seven entries, and the successful candidates were as follows:
First Prize. ?3 3s. and a medal: Sister Alice M. Rose, of Mapperley Hospital, Nottingham. Second Prize. ?1 Is.: Staff Nurse James Ford Wright, i R.M.N, of Herrison Hospital, Dorchester. The winning essay is printed on pages 53 and 54 of this issue.
Teachers (Superannuation) Act, 1945 This Act, amending the Teachers (Superannuation) Act of 1925, will be particularly welcomed by Authorities and bodies concerned with the welfare of defectives, in that it removes a long-standing difficulty in the way of employing teachers for service in Occupation Centres for mentally defective children.
Such service (if full-time) will now count as contri- butory service for purposes of Superannuation, coming within the definitions in Section I (1) (e), viz. :? ” as a teacher of such kind as may be prescribed in a certified institution as defined by section seventy-one of the Mental Deficiency Act, 1913, or as teacher of such kind as may be prescribed employed by a local authority in the exercise of their functions under paragraph (cc) of section thirty of that Act “.
The paragraph in question will be found in the Mental Deficiency Act 1927,?Section 7(2) (i)?which added to the duties of Local Authorities that of providing training or occupation for defectives under supervision or guardianship.
fcKKA 1 U1V1 p. 58, col. 1, line 32, para, commencing “It is not the experience of Child Guidance Clinics” should follow col. 1, line 6.
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