How Can Your Community Plan for Strengthen Research Into Child Life, 96 Will You Help? 16 July. Emery, Margaret A.: For Children Who Need Foster Care, Enochs, Elisabeth Shirley: Act of Congress Authorizes Interna- For Health, Education, and Welfare of For Our Children's Future, 112 Jan. Book reviews by, 15 July, 95 Dec., 127 Fenske, Virginia: State Protects Children Living Away Goodwin, Robert C.: Youth and the Employment Service, 114 Feb. THE CHILD Volume 12, July 1947 to June 1948 Krakow, Samuel: A Foster Child Needs His Own Parents, When a School Child Is in Trouble, 82 Lenroot, Katharine F.: The American Scene as a Background Children's Bureau Has Thirty-fifth An- For Every Child a Fair Chance, 144 Mar. Welfare Workers, 48 Sept. We Meet Again With Our Latin-Amer- We Need to Know More About Europe's Luck, Juanita: Make Way for Youth, 93 Dec. That Youth May Be Served, 50 Oct. Homemaker Service Helps to Preserve Mayo, Leonard W.: Book review by, 47 Sept. Homes for Unmarried Mothers Develop Perry, Mary Bishop: California Youth Committee Studies Peters, Ann: Book review by, 95 Dec. Van Horn, A. L.: Book review by, 61 Oct. Warburton, Amber Arthun: Harlan County Plans for Its Boys and Whitridge, John, Jr.: Toward Better Care for Rural Mothers, 204068 52 vol. 12 U. S. GOVERNMENT PRINTING OFFICE: 1952 MEDICAL-SOCIAL WORKER HELPS If the mother demands special attention for the child in the clinic, or is critical of the hospital's methods, every BLIND BABIES TO GET GOOD START effort is made to meet her demands in RUTH M. BUTLER, Medical-Social Worker, Massachusetts Eye and Ear Infirmary, Boston F A BLIND CHILD is to grow up to be an acceptable member of his family, of his neighborhood, and of his community, he needs mother love and a secure place in his home even more than other children do. And a first step in helping a blind baby toward a happy and useful future is to help to relieve emotional or other strains on his mother. This may mean that the medicalsocial worker in a program for meeting the needs of blind children is at one time arranging hospitalization; at another, raising funds for housekeeping service when the mother is unable to attend to her home duties; or trying to place the blind child in a foster-family home; or seeking a nursery school that will accept him. But basically it means that the worker, in trying to relieve family strains, is not only providing services for the child but is helping to strengthen the tie between the mother and the child, which may be weakened even to the breaking point by his blindness. After a doctor diagnoses blindness in one of our baby patients, almost always the mother needs help in facing the facts and in seeing them in perspective. We try to give her this help, for unless she is able to acknowledge, both intellectually and emotionally, the fact that her baby is blind, and unless she is able to realize that his blindness is only one factor in his life, she will be unable to give him the care he should have, in the sense of fulfilling the needs of his personality. No attempt is made to hurry the mother in adjusting herself to the difficulties she must face from now on, nor to minimize them. Instead, the case worker gives the mother continued opportunities to talk freely about her Paper given at the National Conference on the Blind Preschool Child, March 13-15 at New York. feelings and to tell of the disappointment, anxiety, and frustration she is suffering because her child cannot see. The mother, and the father too, may at first refuse to believe that their baby is blind; and if they still refuse to believe it after a reasonable amount of explanation, the case worker may ask In developing a program to meet the needs of blind preschool children under medical care at the Massachusetts Eye and Ear Infirmary, the social-service staff has been guided by the following principles: 1. Each blind child is an individual; his particular needs should be studied, and services offered accordingly. 2. If the blind child is to make a satisfactory adjustment to his handicap, the attitude of his parents, particularly of his mother, must be recognized. 3. The blind child will find his greatest sense of security in his own home, where he has his place in the family group. 4. All community services that are useful to the seeing child, such as convalescent care, foster-home care, child-guidance clinics, and nursery-school programs, should also be available to the blind child. 5. The mother of a blind child should be offered practical assistance in training the blind; such assistance should be timed according to the mother's ability to use it. 6. Further research and study is needed: (1) To provide norms regarding the development of the young blind child and (2) to determine what can help us most in understanding his emotional growth and in finding ways of treating his problem. the doctor to explain his diagnosis to them again. She does this so that the parents will feel that it is natural for them to have many questions and doubts about their child's condition and that they have every right to discuss the situation thoroughly. If they wish to seek additional medical opinions the worker encourages them in this, so that they can feel that they have made every possible effort to give the child the best medical care. order that she may know that the hospital has an interest in her as an individual. At this time the father may be more articulate concerning the diagnosis than the mother, and he is likely to ask the case worker questions to which she can give factual answers. While the worker is discussing the diagnosis with the parents, she observes the mother's emotional reactions and judges her ability to understand the doctor's direct statement. The worker also studies the ways in which the mother either expresses or disguises her feelings about blindness and notes her responses to the case worker's own serv ices. The worker thus picks up clues to the mother's psychological make-up. and in this way determines how she can make her services most useful. Case worker ready to help The case worker offers no direct advice at this time. She tries to give the mother a sense of her complete interest and sympathy, and definitely tries to gain her confidence by accepting the mother's attitude without comment even if it includes great hostility to the child. The worker points out that it take some time before the mother may can feel differently. She shows that she is aware of the many difficulties the child's condition presents and suggests' that the mother come to her to discuss. any disturbing situations. As the mother begins to accept the fact that the child is blind, the case worker stands ready to help her, but only as the mother herself decides that she needs help. Several months may pass before the case worker gives the mother any service other than the opportunity to express her feelings. Sometimes a mother is able to accept the blindness of her child with a minimum of emotional reaction. Such a mother is usually aware of the difficulties met in caring for the child, and she turns rather soon to the case worker for suggestions regarding toys, feeding, and ways of stimulating the child in socialization. Mrs. A, aged 40, is an example of this type of mother. She was very much disturbed about her baby's blindness, and doubted her ability to care for him. The doctor had therefore referred her to the case worker when the baby, Donnie, our patient, was 6 months old. The A's had six other children and the family relationships were excellent; Donnie had been fully accepted in the family group. Mother's efforts successful The case worker showed appreciation of the fine care Mrs. A was already giving Donnie, and showed that she realized that Donnie's progress was largely due to his mother's efforts. She encouraged the mother to continue. his training in the sound way in which she had started, and told her she could consult the worker from time to time if problems came up. When Donnie was almost 18 months old and could no longer be considered a baby, Mrs. A came to the hospital and told the case worker that her mother and other relatives were criti cizing her for her methods of letting Donnie develop independence; for example, letting him experiment in walking, even though he would fall. At this time Mrs. A was invited to attend a week-long educational program for mothers of blind preschool children-a summer school project. Here she found that her methods of caring for Donnie were approved by the experts at the school. As a result she was able to be more firm after she went home in holding to her own ideas even though her relatives criticized her. The case worker suggested that a home nursery-school teacher might help Mrs. A with Donnie's training and give her instruction. Mrs. A readily accepted this service. Mrs. A, as is usual with mothers who may be considered to be making a rather good adjustment, is aware of her own problems and of the resources she can use to meet them. A mother who is antagonistic toward her blind child is easier to help than one who is overprotective. Regardless of how extreme the mother's antagonism may be, the case worker shows willingness to help her in any plan that seems to offer a chance that the mother may develop her latent feelings of love for her baby. If the mother requests that the baby be placed in an institution, the case worker discusses this possibility from the point of view of its meaning to the mother and the child, and in regard to the best place to send him and the length of time that she wishes him to be away from home. One mother who requested that her baby be placed in an institution is Mrs. M. She is 24 years old, is not entirely happy in her marital relationship, and has three children under 3 years of age. When the middle child, Jean, our patient, was 8 months old, the doctor referred Mrs. M to the case worker. During the first few months after the case worker was in contact with her, Mrs. M did not discuss Jean at all and did not seem to realize that the child was blind. She was giving the child only inadequate care, physically and emotionally, and the child was much under par physically. Mrs. M became pregnant, and soon berelieved of the care of Jean, giving as gan to demand aggressively that she be her reason that she should have less responsibility during pregnancy. It was evident to the case worker that Mrs. M was strongly antagonistic to the blind child. Since Mrs. M seemed to be unable to care properly for Jean, and since the economic status of the family was low, the case worker began to make plans to remove the child from the home. Child-placing agency finds foster home Great difficulty was encountered in finding a foster home that would accept a blind child. After months of effort, in which 18 different agencies were applied to, a child-placing agency finally arranged care for the child in a foster home. The child-placing agency accepted responsibility for a long-time case-work service to prepare the mother to assume responsibility for Jean when her return home was recommended. Jean has now been in the foster home for a year. A home nursery-school teacher visits her weekly to help the foster mother in training her. Her physical progress has been truly remarkable, and she has made some gains, but slowly, in general accomplishment. |