So easy to pass by (1978)

Anyone can have a mentally handicapped child, even the most eminent professor. And in Britain today, about 50,000 mentally handicapped people live in accommodation provided by the health service. They get help from a caring team that includes doctors, nurses, and many other health professionals. because they're physically handicapped because they don't appear to respond. People think you can do nothing with them. Whereas in fact, you can probably do more with this time a child than on some of the other boards where they appear to be much brighter. It's a matter of getting the child to accept you, not you accept the child. If they accept you and respond to you, you you are 50% along the way. You're getting there. Can you get someone on the green? Good boy, Michael. This is Timmy. Timmy Anderson. Timmy likes books. Likes to read. He likes to be read, too. But he doesn't turn the pages himself unless you really encourage him to. Go on, Timmy. Right over. Come on. Let's turn over. Come on. Oh, look, Timmy. Come on, Paul. Come on, Paul. You're doing well. Keep your feet in there now. Keep your feet in there, Paul. Forward, back, forward. To get Roy to smile, I think would be lovely, wouldn't it, Roy? But trying to get Roy to hold the ball and squeeze it himself difficult. He can grip. If he could grip, maybe he could grip a spoon. If he can grip a spoon, then he can feed himself. [Applause] This hospital has been George's home since he was 5 years old. He's now 37. He has a sister who calls to see him every 2 or 3 months. He's quite defiant at times, but he can manage to wash and dress himself now. There is evidence that public attitudes are changing and very much more sympathetic to the integration of of handicapped members in society. In the in the 1930s, of course, the idea was that they should be all put away in large institutions in isolated parts of the country. And that's one of the problems. We we still have the the legacy of that era. Plug George. Good boy. Cold water. Hot water. Take the flannel. George. Uh. George is always able to wash himself, but in fact, he could never connect the individual skills. um he could squeeze a flannel or put water in a sink, but he would never actually wash himself as such. So, what we hope to do is to be able to gather all these little skills together, hoping that in the end he'll be able to wash himself completely without anybody helping him or prompting him to do it. The advantages of the child development center are that it enables us to look very carefully at very young children with possible handicaps and therefore to ensure that all the facilities required for helping the children and bringing their up to their best potential are made available at an early stage. Very sweet child actually. Yes. Yes. You're a good girl. Let's have your head. happy about. Let's have a the basic aim of the center is to do what I've already said but with a in a in a way a different slant in that it is I think truly a comprehensive assessment because it involves other important professionals like psychologists and speech therapists and physiootherapists and community nurses and others all of whom have a contribution to make to the management of a child and helping the child and its Emily, should in fact we identify a handicap at all. Good girl. Better. She's holding it. Better forward. The parents are vital because that's a good half an hour, 3/4 of an hour once or twice a week with a physio isn't the answer. The answer is that the the physio shows the parents or whoever's looking after the child how to handle the child, how to get more normal movement from the child. That's the way. That's a good way. That's the way. That's a good way. She's so pleased when she does. Yes. And then slowly slowly down. It has to become part of life. So that when you're dressing them, when you're feeding them, whatever you're doing, you're doing it in the correct manner so that the child is not in an abnormal position, is not using abnormal tone to do movements, but everything is as normal as is possible. You know that little girl Charlotte that I was telling you about? Oh, yes. Thank you. Um, I wondered if you could go and see her Got a few problems with feeding. Sure. What sort of problems? Well, I've got her sitting position and everything all right, but um her mother's having problems getting her off a liquid diet onto a normal diet. Is she cooperative? Yes, she is. She's much more, but um we've got very poor head control and virtually no trunk control. So, in fact, I gave her a ring. Have you mentioned at all? Yes, I have. And I've said that perhaps, you know, you'd have some more ideas. So, okay, she's I sort of dovetail in between that of a health visitor and a social worker Jenny in the sense that I do obviously have an overlap of roles because I'm a community nursing officer. I like to be involved in seeing the parents away from their home in sort of a more formal surrounding so that they can link where I fit in as much as anything else. We're on the way to Mading Road to see a little boy called Brian. He's three. He's very profoundly multiply handicapped. Um, and his mother's had tremendous management problems in getting him to feed correctly to drink from a cup and also problems of constipation which because of his handicap are quite common in children. Well, we've been working on a feeding program with mother for some weeks now. And we've now got him so that he will in fact eat from a spoon and drink quite nicely from a specially designed cup so that she can now manage in fact to get him to drink without having to suck because sucking is rather a poor reflex action for him. Steady. It's very difficult in fact to try and come to terms with anything like this with Brian because he is so difficult and has been so difficult. He wanted to suck all the way through, but Pat's had to work very hard and put up with a lot of Brian screaming and resisting any attempt to feed from a spoon since it's obviously easier for him to feed from from a bottle. Yes. Yes. And put them all in the fridge. Well, I got very frustrated in the end because I thought I was banging my head against the brick wall, you know, because I never seemed to be able to get any further ahead with it. We had these continuous screaming sessions with the feeding and that and you know we persevered for a long time and it just meant we'd got to persevere that little bit further along the line with it and now it's paid off. There we are. Now don't come forward too far. All right. Oh, good shot. Wipe my own mouth. Yeah. when children are difficult, particularly like Brian who screams and cries all night. Mom can't just shut the door and say, "That's it." So, she has to get this this feeling out of her system. She needs to know if she's doing right. She needs a bolt hold. She needs somebody who's going to come along and say, "Look, okay, you know, all right, we'll we'll help you out. Don't panic. Don't worry." Because she's there with it the majority of the time because nobody will take it away from her. She feels guilty because it's her child. It's something she's produced. It's something that she's got to come to terms with and she's got to get other people to accept it and other people's comprehension of the problems is almost nil. There comes a time when obviously residential care has to be considered. Say when parents are becoming frail and old. But the trend now unfortunately is that even then that such people should be contained in the community if you like in substitute home situations for as long as possible. looking worse. And then of course there is the percentage of handicapped people who are really very severely handicapped indeed and are totally dependent on care staff in all of their needs. And at the present time such people are still admitted to so-called hospital service. Another one. All of the work that we do here, whether it be table apparatus or passing the ball or sand and water therapy, it's all a visual thing. They need to follow an example by seeing it. And if they will not make eye contact with the the trainer or the nurse, then obviously they can't be expected to imitate the action that's being demonstrated to them. Therefore, this is very very important. A number of them are very withdrawn and this is the first basis to make a relationship to establish eye contact. The two are tied up together. If you can make a relationship with the resident, then they will make eye contact and they will want as a result of the relationship, they will want to please you by copying hopefully copying what you're demonstrating to them. You do it this time. You do it this time. I have two. These are my eyes and I see you. This is my chin that move to my legs to take a walk. Good girl. [Music] A lot of mentally handicapped children have a very good sense of rhythm in fact and they all love music and there's a lot of music therapy goes on basically linking music with movement I either them moving themselves or somebody helping them to move. Can you sing a song? Can you save your He's gone outside. They are happy. Lots of people think they're not, but they are in their own way. They don't know any other kind of life. So, they're happy and content the way they are. [Music] Get some more. Sarah again. [Music] [Applause] Most children have got behavioral problems somewhere. Uh we seek them out and we try to um you know, to fight that. I mean, sort of help them to get over it. Good boy. If you haven't had a smile out of them all week and then suddenly somebody smiles, it makes you happy just to think that they have. Yeah. Wait a minute. Wait a minute. First, physical handicaps can be minimized with the help of physiootherapists. Speech handicaps can be minimized with the help of a speech therapist and educational games psychologists will come in on this angle. The school should come in on this angle and together as a group get together and build up a program for each child and everyone chipping in and you'll find the child will progress tremendously. The fork put them on the put them on the table. Here's the fork. Now give them a good mix up. All right. Now, you better do some for Rita. We want one more bowl, son. Handicap people can integrate very well into the community and very often fulfill useful work in society, provided they're given the right sort of background educationally and and the help in in learning to live and self-help skills and so on. How much does that make? How many is that now? Six. Yes. Two more. That's right. Yes. It's quite a good program. My children watch Swap Shop. Do they? Yes. Jeremy was going to ring up Swap Shop and ask if he could swap his sister. Oh, Jill. He was. Oh, Jill. Tell you what, you saying that you can swap not. Yeah, if you could ring up and swap yours. That's lovely when you all see the flower. Sandy, do you think you could pass the um Oh, one of the bags. It doesn't matter which one. It's funny really. People still think we lock them away and they are quite amazed when they learn that we help them to obtain a degree of independence. Just a little bit higher. Hand up. Up. Look up. We're getting George to follow these cotton reels with his eyes and to get an understanding of mobility of the of the arms to use his arms. He's not very keen to put his arm right up in the air. So, we're com comprising the two activities. Hand down, George. Down. Oh, yeah. Yeah. That's it. Hand up, George. Right up. Don't tease. And down. Yeah. Yeah. Give the string to Georgie. Give it to Georgie. Hand up. Georgie. Georgie. Up. Good boy. Yes. And down. Up and down. Three. Michael. Three. Three. Michael. Three. When he first came up here, everything went into his mouth. Everything. And the thing is it's trying to hold his concentration and get him to do, you know, by saying one, two, three. The purpose is trying to get him the exercise of putting them through the holes. And you've had some success. Oh gosh. Yes. He never did. He never did anything. He he he just sat there and masturbated. kept pulling at his shirt and u self mutilation all the time continually and uh now with perseverance I think he he's actually he's doing something constructive you know which is really super Michael one two three and as you can see his hands they're they're fine he's not Morgan put the fork on the plate. [Music] Good. Thank you. There you are. Put orange in the cup. That look hot. Good. Put water. Good. [Music] Michael, give the drink to David. Yes. Good. Thank you for Yes. Put orange in the cup. Stop. Now water. Good. That's it. Give the drink to Morgan. Morgan, what did you say? Right. Thank you. Drink for Michael. Good. If we can help them to cope with our community nurses and our psychologists and our speech therapists and other provisions of the state, if we can help them to cope in maintaining their children at at home, then so much the better. Stop. Good. The team is important because each person has a specific skill that's necessary in the care of that child. Whether it's physio or whether it's the health visitor for the the whole family as as part of we are sort of specialist for an individual child. She is there for the whole family. Well, in fact, as a health visitor, I get contact with all babies on the 11th day after they've been born. Our responsibility is to take them on at that point. And so in fact every baby crosses my path. Now the problem with being a health visitor is that one has a general nursing training midwiffrey training. But in terms of specialist babies and their special problems such as a down syndrome baby uh the one that I in fact refer to Jenny was the first one I'd ever had contact with. So I had no skills and previous knowledge to fall back on. I need the relationship that I have with Annette because she may pick up something that I might miss. And the same as I need to relate to her what I'm doing so she can continue that moral support to the family when she's visiting. I think got quite a special relationship with a particular family we share and it was quite important to the mother particularly that I carried on at the level of counseling and supporting and also of course I do have um quite wide ranging knowledge of skills about small children and that one's general knowledge is important in relating to the handicapped child and I would communicate with Jenny and we'd say the same things this was terribly important um the mothers need that security of knowing that all the professionals are saying the same things. Rachel's five. She's quite a profoundly handicapped child. Mentally, physically, she's quite normal. She's a lovely looking little girl, but she has severe behavior disorder. Some of it's linked to her language difficulties. Her ability and comprehension is very good, but language, she can't communicate properly. And so we're working on a program of trying to get her to recognize speech is an important part of development. When you see children like Rachel who scream and throw temper tantrums, it's fine to cope with them in hospital or in schools, but actually trying to cope at home when you've got the washing to do and there's someone at the door and the other children are wanting attention and Rachel seizes that moment to be the most difficult or when you have in fact got visitors who just have no comprehension of what mental handicap can be. That's what's most difficult to cope with at home. Jenny, when I was see you. Have you been a good girl? Have you been a good girl? Oh, yes. Yes. She goes too often, Jenny. And I'm never going to get her dry that way. The way she's going. You give her one drink and she's going about three or four times just on that one drink. Still the same frequency. Yeah. Right. Well, I think she had a urine test when she was with us for a period of short-term care. So I think the best thing we can do now is the toilet training program that we gave you where that describes on it the observation chart. Okay. I want you to keep that for me for 3 days. Do this for about 3 days so we get some idea of what pattern is emerging and then make an appointment to see Dr. Wallace. Explain the problem to him. I in the meantime will write a report and send it off so that he knows in fact what's going on. Yeah. Presently we're going this thing. I've got something for you here. Come and have a look here. Of course, Jenny. Come and have a look. Look. [Music] Neil. Neil. He's a naughty boy. Go out. Soon. Presently. Angela will be here soon. You're going to be able to look at my new car, aren't you? Hey, look at my new car. Jenny's new car. You like my car, don't you? Hey, what have we got? Look, that's the object. And on the back are the words. Okay. What is it? Sink. Sink. What do you do at the sink? What? Wash your hands. Hands and face. Good girl. What else do we see in here? I know something else in here that Rachel does if she's a good girl. What's that? Clean your teeth. Do you clean your teeth? Yeah. Every day. Good girl. What else have we got? Oh, what's that? What do you do with that? It's dinner. Dinner. Dinner. Dinnery. And where's the other one? Good girl. Good girl. What else have we got? Oh, yes. What's that? Bed. bed. BB bed. What do you do when you go to bed? Faster sleep. You're getting tired, aren't you? You're getting tired. Give mommy a kiss. Then in something like this, you're dealing in a very personal way with the parents and particularly with mother and child. And that relationship is very strong. You've got to be seen to be caring and giving support without detracting from the mother's importance in the role. And I think if you can encourage her feelings of competence and the fact that she's not failing because she can't master a particular problem, that is something that's most important. She's the one who needs that support because she's there with the problem 24 hours of the day. Yeah. We go out to shops after there is hope for improvement and for minimizing the handicap but there is no cure for brain damage which has already been sustained. We can minimize the effects of the brain damage by providing treatment at an early stage. But we can never ever make perfectly normal children from those who are inherently mentally handicapped. [Music] There you are. In you go. There we are. See, you can hold it, can't you? There's a great hope for mentally handicapped children. I think they have special needs, but I think with the right teachers and with the right training, there is potential. Rachel, look at Jenny. Rachel, look at Jenny. Oh, we're getting close, aren't we? Oh, that was beautiful. [Music] Whoops. No smiling this time. Please do this yourself. I have to see you. This is my chin that [Music] makes nose. [Music]