HANDICAPPED CHILDREN
By FRED MESSER, M.P.
FACILITIES for the education of handicapped children are still inadequate. It is difficult, of course, to provide special schools for sparsely-populated rural areas, for the number of children suffer- ing from physical or mental handicaps is small ; but even in some urban areas very little has been done. It is not possible to estimate, even approximately, the number of educable children who are not receiving education because of their condition, but an examination of the situation does show the need for more special schools and the provision of hospital schools. Blind and deaf children have probably received more attention than other types. Many blind people today are earning their living, some working in sheltered workshops and others in industry, and their ability to become wage-earners is the result of the attention and education they received in their youth.
Under the new Health Service Act there is provision for the setting up of hospital schools. The Regional Hospital Boards will provide the accommodation, and the local education authority the education. Some authorities had already set up hospital schools. Perhaps the largest number are in orthopaedic hospitals, where children suffering from disease or the result of accident become long-stay cases. An example of this type of work is to be seen at the Queen Mary's Hospital School, Carshalton, Surrey, which is run by the London County Council. It stands on 136 acres of land and has 1,o6o beds, although at present under 70o are occupied. The age-range is from birth to sixteen years, and the children are sent from all parts of London and some parts of Surrey. The nursing staff numbers 375, and the medical staff consists of twelve resident doctors in addition to part-time consultants. The children are divided into age-groups--nursery classes from two to five, infants from five to seven or eight, juniors from eight to eleven. At eleven they are able to sit for the entrance examination for the grammar- school type of secondary education. A wide variety of handicraft work is taught, including needlework, weaving, model-making, basketry, etc. ; and the staff consists of forty-five trained certificated teachers, and includes men and women graduates as well as Froebel and nursery-trained teachers.
The school has an excellent library of about 5,000 books, both fiction and non-fiction. The children who are able to move about change their own books at the library, and the books of bed-patients are changed by teachers. There is often ground for complaint in hospital schools that the patient is regarded as a " case " by the medical staff, and that the teacher is not given full opportunity to make the necessary arrangements for bedside tuition. At Carshalton, however, the ward sisters dovetail nursing duties into teaching time, 'and there is complete co-operation. Indeed, without effective team- work the school could not reach such a high standard. Those who are interested in educational systems would be able to see first-hand evidence of the success of the Dalton Plan, as the children are given a schedule to which they work and are able to use the rest of their time for subjects of their own choosing. But it is, of course, not only the teachers who contribute to the school's success. The medical staffs realise that there is therapeutic value in the concentration required in learning. Schoolwork keeps patients interested, and the pride of achievement helps to counteract the sense of inferiority which a physical handicap gives.
A crippled child may be suffering from poliomyelitis, tuberculosis of joint or bone, cerebral palsy or one of the various forms of paralysis ; and such children are often compelled to lie in bed for long periods, some of them in positions which make it very difficult for them to read and even more difficult to write. These difficulties, however, are overcome in ingenious ways, and at Carshalton one may see children lying full-length on their backs doing sums or writing by means of boards fixed above them. A child, especially when he is not a congenital case, experiences a period of frustration at the restriction of the freedom he once had, and the first duty of this teacher is to help him to adjust himself to his new life. During this period he is receiving medical treatment, and he will not be inclined to take kindly to lessons ; but later he comes to feel himself one of the school and accepts the teaching in the same way as his bed- fellows. The fact that they are all handicapped breeds a spirit of emulation.
Children, of course, soon become adjusted to changed circum- stances, and when the time comes, as it sometimes does, for the patients to work in a classroom in the school, what they have learned in bed is of very great use to them. They appear to make more rapid progress when they are able to sit in a chair in an ordinary class- room, although there are some who go through the whole of their school-life in bed. This does not mean that the bed-patients are unable to benefit by an academic education. There are many bed- patients who have passed the entrance examination to a secondary school ; some of them have obtained school-leaving certificates with exemption from matriculation and others taken the "Higher." Years ago it was expected that lame boys would earn their living by either shoe-making or tailoring, while girls would be trained in some form of needlework ; their opportunities in industry were re- stricted. Nowadays there is a very much wider field for the handi- capped child, largely because he has received a similar education to the normal child's. The view that children should be educated only if they are likely to earn their living is not accepted at Carshalton. It is believed that every child is entitled to the acquisition of know- ledge and to the training of the mind which will enable him to enjoy a fuller life, and the cultural side is not neglected. It is in a way saddening to see boys and girls playing musical instruments in bed. Some of the children show ability in drawing and painting. Drawing- boards are arranged in special positions for them and their models placed wherever they can see them ; though the freedom of their hands and arms is limited they are able to mix their colours. Many gadgets are arranged by the teachers, and a great deal depends on the teacher's ingenuity. In work of this type the staff must be per- mitted a great deal of latitude.
What is the future of these children ? They can be divided broadly into three groups—those who will be completely or nearly completely restored to normality, those who will be only partially restored and will always require some assistance and those who will be permanently handicapped and must always rely for their main- tenance on outside help. The first group will be able to enter industry in an ordinary way ; the second will find employment, through the medium of the Disabled Persons Act, either in industry or in sheltered employment, and the last group will have to rely on National Assistance. Even for those who will never be able to use their knowledge for the purpose of earning their living, Carshalton's training and education will not have been wasted, for they will have developed character, been taught an appreciation of beauty and found happiness in the discovery of individual abilities. Queen Mary's Hospital School will thus have made life a little more bear- able for those to whom fate has been unkind, and it is a pity that there are not many more schools like it.
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