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These findings caused Dr. Brimblecombe and his associates to ask some searching questions about the usefulness of the services then being offered to such families, and also to inquire into the adequacy of those who render these services, as well as the appropriateness of their professional training. He continues in his report as follows:

The answers to these questions were not reassuring. The services provided clearly failed in many respects to meet the expressed needs of families with handicapped children. It was decided to experiment by providing a different type of resource aimed to achieve -the following:-

1. "More than words and talk; it must be genuine and show itself in action." Only in this way could the relationship between the family and the professional begin to measure up to what we sought to achieve.

2. A service which enabled families to achieve the skills, self-reliance and confidence: a) To provide for their own needs b) To assist them to know what services to seek and obtain when faced with problems beyond their own capabilities. (Brimblecombe, 1978)

Certainly this points up very forcefully the broad opportunities social workers have to participate in a program of early intervention alongside a broad array of such other specialists as pediatricians, developmental psychologists, teachers, nurses, and the practitioners in occupational, speech, and physiotherapies. Again I quote from Dr. Brimblecombe's report:

From the start, one member of the center became the named person who would be responsible for ensuring that the needs of that particular family were met. This person irrespective of his discipline would be responsible for ensuring that the three main aims of our project were achieved for the particular family: (1) that the family fully understood the nature of their child's handicap; (2) that they were enabled to learn the skills and achieve the confidence to help their child achieve his full potential; (3) that they received all the family support that they needed. Once the total needs of the child have been identified, a treatment plan is made in full discussion with the parents and also with the single member of staff (irrespective of discipline) who will work directly with them. From then on, the treatment is carried out at home by the parents supported by regular home visits by the member of staff responsible. Where problems arise the particular member of staff and the parents can at any time obtain expert advice from the particular professional in whose discipline the difficulty lies. At the same time, a close relationship develops between the member of staff and the family. The family is provided with a confidante who will at all times be available when needed.

In addition the Center itself is available for family support. It is open every day and night throughout the year. The child can come whenever the parents wish and for periods which they themselves select, for the day, for the night, for weekends or for longer periods depending upon the needs. Most parents decide to have a regular arrangement so that they know in advance that their child will spend two regular days a week at the Center or alternate weekends. They also know that they can call upon us for help at any time in an emergency. .. No one wears uniforms; the atmosphere is informal. Children and parents come and go, both for a day and for short term residential care as their own family needs require. Parents are key members of the policy committee which has been formed to decide further developments in the service. (Brimblecombe, 1978)

Let me re-emphasize: this brief account of Dr. Brimblecombe's work in Devon is presented here as a shining example of what ought to but generally does not yet exist in England.

Marked exceptions to the general neglect of the earliest years of the child with developmental disabilities exist elsewhere as well, some of them, of course, in California. Indeed, it was our close acquaintance with the Developmental Center at the Children's Hospital of Los Angeles which first directed my husband's and my attention to the importance of early intervention.

The Retarded Infant Services in New York City pioneered in the early 1960s and the United Cerebral Palsy Associations maintained at about the same time some striking demonstration programs of work with families on behalf of children multiply handicapped to a most severe degree. The American Academy of Pediatrics in recent years has begun to push early screening programs to discover children with handicaps at the earliest possible age. But in New Zealand such a nationwide screening program has been going on for at least twenty years through a cooperative scheme of public and private resources.

South America, overall, is extremely backward in social services in general and services to developmentally disabled children in particular. Yet 15 years ago, in Montevideo, Uruguay, Eloisa de Lorenzo, an educator and psychologist, persuaded the University Hospital to start a program of early intervention for high risk children, with a strong research component. At about the same time, over in Buenos Aires we visited the clinic of Lydia de Coriat, a neurologist, and saw her developmental program for infants with Down's syndrome and for those having neurological disorders, a program with strong parent participation which was years ahead of what could be found in most university hospitals in our country at the time. A key member of Dr. Coriat's team was an early childhood educator who worked with parents and their infants both at the clinic and in their homes.