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velopments are recorded. When part-time psychiatrists are used, they may undertake some direct treatment.

Although the case workers and the psychiatric consultant are not in residence at our home, they do not dissociate themselves from the resident group and the staff. They are part of the home and work through it.

Throughout the treatment it is recognized that a concept gained through the understanding and skill of a case worker must be lived through "in experience" if the child is to be able to relinquish old feelings and begin to assimilate new ways of behaving. The The child's ability to reenact earlier life experience and have it handled in a constructive way by adults and other children in the residence is essential to a sound treatment program.

The residential group

Study and treatment homes vary in size, and in the age, composition and basis for their groupings. The Evanston home includes two buildings, housing 34 children between 6 and 16 years of age. They are in groups of 8 to 12, with a trained housemother and housefather. Part-time university students living at the home come to represent big brothers and sisters. Boys and girls have separate living quarters, but are free to mix for dining, recreation, and other activities. Dormitory space is gradually being broken down into single and double rooms.

Planning so that the group has constructive elements is as important to effective study and treatment as is good case-work interviewing. In the last few years of practice many principles have emerged on which such a group must be based. Some of these still need further testing.

Our experience shows that the following principles are of first importance: (1) In making up a group, developmental rather than chronological age is more important.

(2) The group setting and what it means to live in it should be interpreted to each child as an important step in the group treatment. Group treatment, though, can precede, accompany, or succeed individual treatment.

(3) The sooner accurate therapeutic

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goals are fixed, the more effective the initial and subsequent handling of the child in the group.

(4) The child, if possible, should also have a therapeutic goal.

(5) The greater the difference in disturbed behavior patterns of the individuals, the more active the adult must be in the group situation.

(6) The group is a substitute sibling setting and positive relationships

should be stressed. Individual needs

should determine choice of roommates, dining table grouping, recreation groups, and so forth. Unwise use of competition can be injurious.

(7) The adult must be trained to observe group cross-currents, to understand their effect on individual children,

to predict the impact of new children, and to transfer children who prove to be consistently injurious to others in the group.

(8) Children vary in the emotional use they make of adults, and this use may change from day to day.

(9) The child who desires to remain. in the group must adjust some of his personal way of living to the mores of the group. Initially he may repress some attitudes and express others.

(10) What is permissive can be extended in those groups for which children are chosen with the foreknowledge that they will modify their aggression. (11) Certain disturbances do not "live well" together, whereas other disturbances depend on a social group for treatment.

(12) A "group" equilibrium must be maintained. Conflicts are important

but should not be continuous. Constructive leadership in the group should be stimulated.

The community and the home

The community setting must be taken into account for the way in which it influences the program of the group residence. If the community schools are to be used along with the churches, recreational and other resources, then that fact must be taken into consideration before the child is admitted, for the residence can treat only as much disturbed behavior as the neighborhood will tolerate. Schools frequently will tolerate as much disturbance as they

are prepared for ahead of admission and no more. Similarly, the group, or children in the group, cannot be precipitated into neighborhood groups. One must know in advance how the community resource can be related to the child's needs.

Thus, a residence which depends on community resources may have to modify its program somewhat, but, it gains in being able to draw upon the coterie of specialists so indispensable in treating disturbed children: psychiatrists and psychologists; medical specialists; educational tutors; and persons on the staff of referring agencies, hospitals, clinics, churches, and other resources.

As far as possible, the residence should integrate its own children with neighborhood children as they show readiness and capacity for it. Resident children should be able to bring in community friends. Adolescent girls and boys should be permitted to invite their "dates" to the residence. Mixed group parties should be used when children can utilize the experience.

The staff, likewise, should have community ties. For instance, the staff of the Evanston Home participates in parent-teacher groups, the Council of Social Agencies, youth councils," and other local groups. Characteristics of personnel

A resident program is dependent upon a staff of persons with specific qualifications.

The Evanston program, which provides for 32 children, draws upon a staff that includes the following: a director, secretary, three full-time housemothers, a house father, two assisting housemothers, and several university students who receive room and board in return for 16 hours a week in recreational activities. A handyman, cook, and serving assistant are also on the paid staff. Additional help comes from the community on a voluntary basis: a men's group gives shop instruction; a women's group instructs in cooking; and Northwestern University students assist the staff in art, music, drama, and craft activities.

The psychiatrist, through case conference and review attended by the resi dent staff, indirectly influences the treatment atmosphere of the residence.

Staff efforts are integrated so that a consistent treatment of the specific child is followed.

The director of the residence is frequently used as a guiding person by the resident staff, case workers, and the community. Such a person should be trained in social work, psychiatry, education, or medicine. The author's own background of group work, psychiatric case work, and professional social work training has helped him understand the application of case work and group therapy in the treatment of disturbed children, and has also helped him to integrate function, plant, program, personnel, and finances in building and implementing this type of service for children. A sustaining leadership, rather than an authoritative personality, is desirable in a director.

The substitute parents must be mature adults whose own emotional patterns are recognized and have value in terms of the child's reacting behavior. Their interaction with the child must be carefully watched. The housemother and housefather must be able to observe behavior objectively, and to participate in psychiatric consultations, reaching with the others a diagnosis and treatment plan. They must then be able to react to the child's daily behavior in relation to this framework of diagnostic and treatment dynamics. Some of this ability will be brought to the job; some will be gained through training.

These substitute parents should be able to give warmth and dispense firmness in relation to the needs of the different children. They should also have the ability to handle objectively and constructively for the child such behavior as cursing, threats, projected blame, destructiveness, stealing, and the gamut of irregularities that are associated with disturbed children.

Each of the houseparents at the Evanston home is college-trained. One has an advanced degree in education. All have had graduate training in case work, or group work of various kinds. Such training is helpful but the basic need is a mature, flexible person who can respond to children's behavior on the basis of a professional plan.

All others of the staff, paid or volunteer, must be persons mature enough to contribute to the total treatment atmos

phere. The cook, for example, should not only be a good cook, but also some one who enjoys children and is ready to accept some disturbance from them.

Program

The program of a study and treatment home is not a "mass" program, but in so far as feasible, it is broken down. to meet individual needs. Reliance must not be placed on a mass dormitory, a large dining table, and large group activities, for not many children will be reached in such a setting. A basic framework is necessary, but it must have flexibility.

Our differentiated program provides play and construction materials as a means of draining anxiety and restoring self-confidence in different ways. A woodwork shop, indoor and outdoor cal and "jive" music, sewing equipment, athletic equipment, art supplies, classiand the like are provided for varied activities.

Each child has his room or part of a shared room and keeps with him, besides his clothing, his own books and toys and the many objects that go with growing up. Children like to "putter" a bit with their own possessions in their own room

before retiring. Clothing is individual; mail is personal. Throughout all their experiences the youngsters feel that they, as individuals, count. They are made to feel proud of their "home," and they make social attachments within it and within the community. They come back to visit with pleasure.

A happy group, a minimum of rules,

and a constructive use of adults-these together provide a constructive matrix for treating disturbed youngsters. Within this matrix we try not only to eliminate symptoms, but to do away with the inner need for the symptom.

In sum, it should be recognized that the study and treatment home for disturbed children is a new tool. It needs testing under various conditions and with many children before exact values can be proposed scientifically. have, however, learned this much.

We

1. The study home cannot stand alone. It must be interlocked with the use of the child's own home, foster home, institutions, and other community services depending on the changing needs of the child.

2. There are no quick "cures" except for very mild or recent disturbances or those related to specific environment.

3. An institution cannot be made into a study home by a mere change of title. but only by meeting the requirements listed earlier in this discussion.

4. This specialized service which may seem prohibitively expensive is not so when the alternative is considered, that

is, the expense of foster home replacements for many, to say nothing of the cost of later maintaining the most seriously disturbed children in hospitals. or paying later, in more ways than one, the cost of a neurotic and delinquent adult in the community.

The study and treatment home provides a testing ground by which we can come to a better understanding of disturbed children and their treatment. With each child who is served our knowledge is expanded and deepened. This understanding of the child, obtained in a controlled setting, provides a sounder base for diagnostic and treatment formulation, treatment testing. and actual treatment progress than could be obtained for some children in any other way.

Treatment some progress, in inold, a 9-year-old who came to the stances, is markedly accelerated. HarEvanston Home 2 years ago, provides a notable example. He had buried a cat alive and dropped another into an incinerator. He beat other children. He tore his clothes in rags. He set fires. He played truant and he ran away. He showed marked reading and mathematical retardation. He was given to constant enuresis and periodic soiling. He was unable to accept limitations. All in all, he had 13 symptoms.

Today, Harold is being prepared for care in a foster home. In that short time, he has gained sufficient internal integration to be able to behave acceptably in all his social relations.

If a qualitative change of this kind can be accomplished on a quantitative basis-that is, if such a change for the better can be brought about for more youngsters like Harold and if it holds under test-then, study and treatment homes will have won acceptance as a new tool in social work with disturbed children.

Reprints available in about 5 weeks

STATE ACTION FOR CHILDREN

S

IGNIFICANT GAINS in behalf

of children are shown by action of 1947 State legislatures. The following summary, though incomplete, covers proposals that benefit children which were included in the legislation recommendations sent to the States by the Council of State Governments for consideration in 1947. Several of these proposals are in line with recommendations made by the National Commission on Children and Youth in its action program of 1947 and 1948.

One of the recommendations of the Council of State Governments was that the official State crippled children's agency be held exclusively responsible for evaluating the need of a child for service under the State program and for determining whether a child is to be accepted for care. To this end, the council recommended that State laws requiring court action before a crippled child can be accepted for service under the State crippled children's program be repealed.

In its 1947 legislation, California eliminated its court action procedure. This action came as a climax of many years' effort.

Under the new law eligibility for care under the crippled children's program will be determined by the county agency designated by the county board of supervisors to administer the program for handicapped children.

By this action, California reduced to 12 the number of States that operate their crippled children's program with the court action procedure. Originally 14 States required such court action. Indiana eliminated this type of procedure about 8 years ago. The city of New York-but not the State of New York-dropped its court action for care of crippled children in 1945. Missouri has a bill pending that will be considered when the legislature reconvenes in January.

The 12 States still operating under legal requirements for court action are: Florida, Iowa, Kansas, Kentucky, Michigan, Missouri, New York (except New

York City), Ohio, Oklahoma, Tennessee, Texas, and Wisconsin.

Revision of adoption laws

During the 1947 sessions of their State legislatures, two States-Arkansas and North Carolina-passed new adoption laws.

Fifteen States amended their adoption laws. They are: Connecticut, Florida, Iowa, Maryland, Michigan, Minnesota, Montana, Nevada, New Hampshire, North Dakota, Pennsylvania, Puerto Rico, Texas, Vermont, and Washington.

A preliminary review of the laws enacted indicates that many of the changes made were in accord with "Essentials

for employment or strengthened existing 16-year laws in line with the recommendation in "Building the Future for Children and Youth."

In its 1947 session, Alabama passed an act with a basic 16-year minimum age for employment, thereby becoming the eighteenth State having such a law. Also, Alabama reduced from 48 to 40 the number of hours a child under 16 may work each week.

In Missouri a child-labor bill setting a 16-year minimum age was introduced in the spring of 1947. This bill is still pending and is slated for consideration. when the Missouri legislature continues. its session in January 1948.

Two States in 1947 enacted laws rais

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during school hours. This State has long had a 16-year minimum age for most employment.

On June 30, 1947, the Illinois law, setting a basic minimum age of 16 years, became effective.

In preparation for its next session, the Maryland legislature provided for the appointment of a commission of 11 members to determine whether the child-labor law should be revised. This commission will report its findings to the Governor and Legislative Council by September 1, 1948, in preparation for the 1948 session.

In three States, protection against child labor was strengthened by passage of good compulsory school attendance laws. These States were Maryland, Michigan, and Tennessee. The acts passed eliminated or tightened exemptions under which children may leave school before they are 16 years of age.

Closely allied with this legislation are laws for State licensing of hospitals by State departments of health. Nine States and the District of Columbia had such laws prior to 1947. Twenty-three States and Alaska passed legislation in 1947. Two more States and Hawaii probably have adequate authority to license hospitals without additional legislation.

School lunch act

Based upon incomplete returns, 19 State legislatures took action in 1947 relative to provisions of the National School Lunch Act. Abstracts of action

by States compiled by the U. S. Office

of Education show:

Arizona provided for a nonprofit school-lunch program. (Ch. 98.)

Arkansas authorized the acceptance of Federal funds for the school-lunch program, provided for its administration by the State Board of Education,

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received from the Federal Government for use in connection with the schoollunch program, and appropriated $90.000 for its administration of said program. (Ch. 305.)

lowa appropriated from generai fund $8,000 to meet deficiencies in the school-lunch program. (S. B. 460, enacted.)

Kansas provided for the establishment, maintenance, operation, and expansion of nonprofit school-lunch program. (S. B. 102, enacted.)

Louisiana appropriated $300,000 for its free-lunch program. (H. B. 7, enacted.)

Maine provided for acceptance of the National School Lunch Act and set up the necessary legal authority for the State to accept such funds as are made available by the Federal Government and to administer the distribution and expenditure of those funds. (Ch. 127.)

Maine also passed a law requiring physical examination of all persons employed in school, including employees engaged in the preparation of school lunch. (Ch. 367.)

Mississippi appropriated $64,750 for defraying expenses incurred by the State department in the administration of the National School Lunch Act for the fiscal biennium beginning July 1. 1946 and ending June 30, 1948. (H. B. 71, 1947 extra session.) (Enacted.)

Mississippi also authorized acceptance of the provisions of the National School Lunch Act and designated the State Department of Education as the State agency for administration of the program. The State treasurer is designated as custodian of Federal funds. (H. B. 28, 1947 extra session.) acted.)

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Montana authorized the State Superintendent of Education to accept and administer Federal funds available under the Federal School Lunch Act, and appropriated from the common school equalization fund the sum of $20,000 for the biennium for administration of the said school-lunch program. (Ch. 282.)

Nevada provided for the establishment, maintenance, operation, and expansion of a nonprofit school-lunch program and the acceptance of the Federal School Lunch Act, and authorized a State appropriation of $18,500 for

the biennium beginning July 1, 1947. (S. 100, enacted.)

New Mexico provided for the establishment, maintenance, and expansion of the school-lunch program and acceptance of the Federal School Lunch Act. The State Board of Education is to administer this program, and is given $17,000 per annum for the next biennium for its administration. (Ch. 98.)

North Carolina authorized a bond issue for buildings other than schoolhouses, including teacherages, garages, and lunch rooms. (H. B. 679, enacted.)

North Dakota made appropriation for administration of the school-lunch program in H. B. 46 and 47 (enacted). House Bill 48 (enacted) provided enabling legislation for acceptance of the provisions of the Federal School Lunch Act.

Oregon authorized the State Superintendent of Education to employ a director of the school-lunch program and to accept the funds available under the provisions of the Federal School Lunch Act. (H. B. 191, enacted.)

Pennsylvania provided for the establishment, maintenance and operation of nonprofit lunch programs. (H. B. 333, enacted.) House Bill 1343, Appropriation Bill (enacted) appropriated $90,

000 for biennium for administration of school-lunch program.

Act 40 authorized all school districts to furnish food, including milk, to undernourished and poor school chil

dren.

Act 41 authorized nonprofit schoollunch programs in public schools.

Virginia appropriated $40,000 for the year 1946-47 and $40,000 for 194748 for its school-lunch program.

Washington authorized school directors of any district to establish, equip, and operate lunchrooms, provided the expenditures for food supplies shall not exceed the estimated revenue from the

sale of the lunches, Federal lunch aid,

Indian education fund lunch aid, other anticipated revenue to be received for that purpose by donation or otherwise, and cash balance during the preceding school year. (Ch. 31.)

Wyoming placed the administration of its school-lunch program in the State Department of Education. (Ch. 47.)

Enrichment of white flour and bread act

In 1947 Kansas and Oklahoma passed laws requiring the vitamin and mineral enrichment of white flour and white bread. Twenty-one States and two Territories now have such legislation. They are: Alabama, Arkansas, Georgia, Hawaii, Indiana, Kansas, Kentucky, Louisiana, Maine, Mississippi, New Hampshire, New Jersey, New York,

North Carolina, North Dakota, Oklahoma, Puerto Rico, South Carolina, South Dakota, Texas, Washington. West Virginia, and Wyoming.

Reprints available in about 5 weeks

Aware that a well-rounded lunch does much for health, 19 State legislatures took action on school-lunch programs.

New Bases for Eligibility in New York City Day-Care Centers

A child's own need, not the fact that his mother is employed, will be the basis of admission to public day-care centers in New York City under the new program of the Department of Welfare. This decision is in accord with the principle that the best type of care is in the child's own home. Children are to be accepted in the day-care centers only in those instances where it is impossible for them to be cared for properly at home, and only after consideration has been given to the possibilities of buttressing the home so that the child can be cared for there.

Determination of eligibility is to be made after study by the Department of Welfare to see whether admission to a day-care center would be in the best interests of the child. This will be done through a counselor attached to the center who will discuss the problem with the parent at the time application is made. A visit will be made to the home before a decision is made, with the help of the parent. Then, if the child is accepted, the counselor will maintain and the family. a close relationship between the center

Factors that will be taken into con

sideration will be the child's age, the receiving, and the total social and ecoamount and type of supervision he is nomic resources of the family, and in addition, what help other than the daycare service is available in the community. For instance, by drawing upon other services of the welfare department, or of other public and private agencies in the community, it may be possible for the child to be well cared for in his own home.

Heretofore, the day-care centers have accepted children primarily on the basis of the fact that their mothers were employed. The new program will not exclude the child of a working mother, but his need will be evaluated against other factors.

Three will be the minimum entrance age in the nursery groups. Two-yearolds will be eligible only in exceptional cases, a decision that is in line with the opinion of specialists that group living for such young children is by and large inadvisable.

Seventy-four of the ninety-four centers will be financed jointly by the city and the New York State Youth Commission, the remainder by the city alone. The Commission has allocated funds for a 3-month period of fact finding and experimentation. The centers it is helping to maintain are in high delinquency areas.

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