COLUMBIA LIBRARIES OFFSITE HEALTH SCIENCES STANDARD i RECAP HX64072720 RD701 M22 The permanent letter ^^^^_, ,^,^P^rr,w^«. rriE rnKMANENT BETTER- MENT OF THE CRIPPLED CHILD BY DOUGLAS C. McMURTRIE PD 70I ±122 COLLEGE OF PHYSICIANS AND SURGEONS LIBRARY Digitized by the Internet Archive in 2010 with funding from Open Knowledge Commons http://www.archive.org/details/permanentbettermOOmcmu The Permanent Betterment of the Crippled Child An essay on the operation of the non- residential system of education and care, the social principles involved, and the restoration of crippled children to places as useful members of the community. An account of the work of the Associ- ation for the Aid of Crippled Children. By DOUGLAS C. McMURTRIE New York 1911 Author G. MAY 3 11 912 Copyright, 1911, by Douglas C. McMurtreb DOOCLAS C. MCMUSTBIS NKW TOHK ClTT THE PERMANENT BETTERMENT OF THE CRIPPLED CHILD The best type of modern philanthropy and the wisest supporters of charitable work are more and more insistently demanding per- manent results in place of temporary allevi- ation. The real value of any work may, therefore, be well measured by the final results it accomplishes. The relative emphasis placed on the various phases of work is also of the highest importance. What are the essential needs of the crippled child can best be judged by his average cir- cumstances. In most instances when crippled children first come under care they have been largely neglected. Even if wilhng their fam- ihes have probably been unable properly to care for them. In some instances they may have had a certain degree of medical care, but even in such cases the social and educational considerations will have been almost wholly neglected. As a person's point of view is to a great extent conditioned by his en^^ronment, so the attitude of the crippled child is determined by his erperience. Shut-in., neglected, de- prived of any educational advantages, unable to eura^e in a::y form of acti^'ity and enduring an existence devoid of any fun or play — the crippled child's attitude may well be one of hopelessness and discouragement. And this point of view seems to be \-eri-6ed repeatedly. He sees his sister start daily for the public school, he sees his brother play in the street during the afternoon and the other members of the family all d-iinz their part in the house- hold duties. Ana all these are things which the crippled child cannot do and sees no hope of Q.jing. This attitude is a diSicuIt one to overcome and there is but one way to do it. That is by piers'jnal infuenoe and sympathy — by intimate wr,rl^ of the hnest sort. By patient effort of this kind, however, it is possible to restore the child's self-respect and to recreate within him, at it were, a hopeful spirit of self-con- fidence. By proper training more and more of his abihties are revealed to him and there is aroused ambition which is, after all, the main- spring ofj and incentive to, all effective en- deavor. After this metamorpliosi.s is effected — and it can be effected by tbe right kind of effort — it is amazing what the crippled child can accomphsh. He is far from the complete wreck we may have thought him. In the first place, we find he has an active mentahty fully as Adgorous as in a child whose limbs are straight and strong. His progress in school, when he is pro%dded with educational facilities, is astonishingly rapid, for, being free from most of the diverting distractions of childhood, the appHcation to his one acti\'ity is all the more intense. In many other ways the cripple who is started in the right direction CAdnces unexpected abilities. Several institutions have basebaU teams which put up an excellent game, another has a brass band, others have organized drill, and in almost all classes and homes the chil- dren engage in regular play and games. The eventual aim, however, must always be to render the crippled child seK-supporting. As the deformity is only local in one part of the body, lea^dng the remaining members and faculties active, with properly selected trade instruction the cripple can be rendered inde- pendent. Consider the transformation — turning a hopeless, discouraged cripple into a hopeful, ambitious and self-respecting citizen. Could any change be more complete and more highly to be desired. Yet this result is being accom- phshed again and again. Such a change may be pointed to as an exam- ple of real and permanent betterment. And all that needs to be done is to assist the child in overcoming the special handicaps imposed by his deformity and make avail- able to him the ad^'antages which every child in right and justice should have. In many cases, by proper methods of medical and surgical care, a complete cure can be effected thus disposing of the entire problem. In practically every case definite improvement can be effected and further harm forestalled. In cases requiring constant treatment and nursing, care in a resident hospital or home is demanded. But there is a great class of crippled children whose deformity is less acute and who need less frequent attention. The members of this class do not and will not receive hospital treatment in the present state of provision for such requirements. The result is that such children remain at home without advantages of any kind and are, of course, unable to attend school. Briefly stated, these children can be excellently pro- vided for by a comprehensif^e system of \'is- iting nursing, by transporting the children back and forth from their homes to the special classes which are pro\4ded for them by the public school system, and by surgical care at the clinics and dispensaries. It is this sort of work that is being carried on by the Association for the Aid of Crippled Children, which in this way is caring for over a hundred deformed children. With these principles, the nurses are able to perform seem- ing miracles, for the hopeless, discouraged little mites of humanity are changed into bright ambitious boys and girls, looking for- ward to the day when they can learn a useful trade and occupy a definite niche in the com- munity. The nurses ride with the children to and from school each day and \'isit them in their homes. The home work, however, is always 8 with the view of supplementing rather than supplanting care from the parents. They first endeavor to enlist the mother's interest in sending her crippled child to school and they then try to fortify this interest by intelli- gent direction and sympathetic encouragement. Oftentimes the mother has been doing very little for the child, but this is more frequently due to ignorance and inability rather than to intentional neglect. Conditions have often rendered the situation very difficult and the burden of the small cripple in the family has seemed the additional straw which was fatal to the back of the proverbial camel. When the nurse, however, shows the mother what can be done and demonstrates by prac- tical example that it is as easy to give the child proper, as it is to give improper, care, conditions are materially altered. The effort is always to have normal needs supphed through the medium of the family, so that the home ties may be preserved un- broken and the child's respect for his parents may remain unimpaired. When the mother is absolutely unable to supply the needs of the child, the nurse is ready with the required assistance; but it is always given where possi- ble through the medium of the family, so that the child may not come to look for the simplest elements of existence from outsiders. Nothing is more cruel than the situation of a child who has lost respect for his own father and mother. There is a great deal of influence which the nurse can exert directly upon their little crip- pled charges. In riding to and from school with the children in the omnibuses each day, the nurse is able to inculcate principles of politeness, honesty and cleanliness. The trans- formation which can be accomplished in a few weeks with a bus load of children is astonishing. The general aim of the work is to make the position of the child just as normal as possible. This attitude is further emphasized by the fact that the children attend regular public schools just as do their healthier brothers and sisters. This attendance often marks the realization of a long-cherished dream. In keeping with this general idea of healthy activity, the Association believes that clinical work and nursing should be excluded from the schools in which the children spend the major- ity of their time, and as the children belong 10 to the class which needs only clinical treatment, it is felt that this may as well be given in a hospital. With most of children, however, the necessity for such attention is fairly in- frequent. In a general analysis of the work of the Association it will be seen that the children are really doled out very little charity in the old sense of "almsgiving." As members of the community they are entitled to their education as a right and not as a charity, and the aim of the Association has been to stimu- late the provision of such education by the proper authorities, and then to make it possible for the children to avail themselves of their natural birthright. The children have been receiving support and some type of care at home. The Associa- tion merely endeavors to supplement and improve this care by intelUgent instruction and sympathetic influence. In short, it enables the children to avail themselves of opportu- nities which are at hand but which are just beyond their unaided reach. Such work is free from the charge of being temporary relief only. The instruction of the 11 families in the elements of proper care and the influence exerted upon the mothers accomphsh permanent results — results which are effective long after the child passes from the care of the Association. Starting the child on its educa- tional career accomphshes results which are cumulative in their effect as he progresses. The crippled child has great possibilities; for, with but a little intelligently directed assistance to overcome the special handicaps imposed up)on him by his deformity, he can be given the chance to succeed through his own efforts. What the Association does want to do is to guarantee to crippled children the chance to make good themselves and to give to them the square deal of equal opportunity. COLUMBIA UNIVERSITY LIBRARIES This book is due on the date indicated below, or at the expiration of a definite period after the date of borrowing, as provided by the rules of the Library or by special arrange- ment with the Librarian in charge. DATE BORROWED DATE DUE DATE BORROWED DATE DUE '■'■(l**!^ fr PUf. 1 RD701 7^' U22 'rie COLU^''Bl^'oMVFRSlTY LIBRARIES (tisLstx) RD701W22C.1 _„,.. 2002-^50-02