A School For Spastics

By KINGSLEY AMIS EVERY so often, hurrying down to the tobacconist's or the paper-shop. I catch sight of an ambulance drawn up outside a building in our street. Somebody is carrying a child up or down the stone steps, and occasionally a snit 11 figure can be glimpsed moving slowly and precariously in the rear, an adult holding its hand. Until recently, faithful to the middle-class non-staring tradition, I would allow myself a side- long glance to blunt my curiosity about the sort of kids they have at that spastic school place, and as soon as possible return to the eyes-front position. There are occasions, though, when staring, if properly followed up, is more humane and helpful than the employment of blinkers. The problem of sufferers from cerebral palsy is an occasion of this kind, and has recently attracted some attention in the national Press. It is hoped that a few non-technical remarks on the experience of a local Spastic Association may be of general interest and service.

Cerebral palsy, it seems generally agreed, is the result of physical damage to the brain at or about the time of birth. A great deal of time, money and energy must be expended on any given sufferer from the condition if he or she is to overcome its handicaps to any significant degree. The group who founded the Swansea and District Spastic Association in 1952—half a dozen parents of afflicted children—had no more time or money than might be expected in an area like Swansea. Energy, however, was their strong suit, and with it some money was raised. The Association was able to open a school for handicapped children (the first in Wales) in premises already secured. In April last year eight children began attending classes there under the teacher provided for handicapped children by the Education Authority. The Association's school, unusually fortunate in its staff, has made important progress since its foundation. Sixteen of the area's sixty-odd spastics (not all of these are of school age) now receive up to three hours' schooling daily. A second teacher has been provided, and the Association has engaged an assistant house-mother. The project has aroused wide' spread attention: observers from English as well as Welsh towns have visited the school, and letters asking for advice and help have been received from all parts of the world. 10 addition to the school itself, the Association has done much for the child too severely handicapped to leave home, has helped parents to obtain therapeutic aids, and has tried to construct some social life for spastics of all ages. Now that its purely educational tasks seem destined to pass under pub lie control, it will be free to take up other schemes. It already owns, thanks to a London benefactress, a large house on the outskirts of the town which should prove a highly satisfactory and attractive site for a Nursery Unit and Treatment Centre for under-fives, projected years ago but necessarily deferred until now.

Children suffering from cerebral palsy have other handicaps besides those of defective speech and movement. Some of them have apparently associated defects of hearing or vision; many are afflicted by dribbling; their power of concentration is often poor; since some have never been into a shop or out' side their home area, their experience of ordinary life can be severely limited; since some have (understandably) always been put first in the family, they can sometimes be selfish and unco-operative. In spite of all this and much else, the impression made on a casual visitor by the children at the Swansea school is one of great, indeed hardly surpassable, cheerfulness and activity. Many display extraordinary tenacity and courage in overcoming their physical disabilities. It would be hard to exaggerate the importance for the handicapped child —surrounded at home, perhaps, by normal brothers and sisters —of realising that he is far from being the only ' different ' ono in the world, that others may be even worse off, that something can be done for him and that he can do something for tiny

self, and for others too. No wonder, then, that he longs to return to school after week-ends and holidays.

Three typical cases are appended. Mary, a recent addition to the class, is twelve. Though slower to learn than some of the younger children, she is beginning to read and count. Her speech defect, besides causing tonal distortion, makes her sub- stitute d-sounds for j-sounds. and this hinders her reading. Her power of laughing, however, is unimpaired. Unlike some of her companions, she displays some lack of perseverance in her work, and although she can walk fairly well she prefers not to. She seems to realise that she and her classmates are different from other children, but, typically, talks freely of becoming a nurse when she grows up. Peter is seven. His gait is excellent, though control over the hands is poor. He is almost unable to speak, but he tries to make up for this by one of the most amiable, and least vacant, smiles one is likely to find anywhere. Recently he has been receiving speech therapy and is beginning to breathe out a few words: improve- Ment has begun. Margaret is ten, and bad no training of any kind until three years ago. She suffers from the athetoid type of cerebral palsy, characterised by excessive movement. Her Physical handicap is extreme, both in legs and arms, and her

speech is very defective. On the other hand she lias a keen

Intelligence. an excellent memory and a great desire to learn. Although her handwriting is naturally very poor, her spelling Is good, she can take dictation well and mathematically she is above the standard for normal children of her age. She may Well overcome her disadvantages to the extent achieved by an adult athetoid who, despite very bad speech and a grave manual

defect, now owns a flourishing newsagent's business in the area,. What light does experience at Swansea throw on the spastic Problem as a whole ? It is a national problem, for Picture Post (November 13, 1954) has estimated the number of spastics

In Britain as 30,000, twice as many spastic children as there are blind, and nearly three times as many as deaf children.'

The National Spastic Association is doing a great deal, but

It cannot do everything. I am not competent to discuss medical or financial methods of help, though more intervention by the relevant Ministries and Local Authorities seems a fairly obvious need. Further, although I have concentrated on educational aspects, there are others which are important, notably, perhaps,

the therapeutic. Another problem which deserves attention is —if I can use the phrase without giving offence—the education of the parents of spastic children.

No one need underrate the love which most parents will lavish on their handicapped child, and many, I suppose, will temper that love with reason without having to be told how. Others, however, have been known to hide their ,spastic children away as if they were ashamed of them, and deny them all chance of treatment. Others again will take their child everywhere, treat .him as completely normal, tell him he's going to be a doctor when he grows up, ignoring, to their and his eventual pain, the purely limited improvement which is all that any training and treatment seem able to offer him. Some Parents give their child no chance to fight any battles for him- self. Some suffer from the perfectly natural, but unfounded, fear that a further pregnancy is likely to produce another spastic

bahy, thus denying the handicapped child the competitive stimulus of a, younger companion, who would also draw off

some of the mother's attention. I should dislike seeing, or being, a social worker telling the mother of a spastic child be let him fall over more, or to have another baby and not De silly, and perhaps no official approach to these particular Problems could ever be fruitful, but it might be worth trying. After all, a social worker may be wrong about whether a child Is neglected, but a doctor will rarely, these days, fail to diagnose cerebral palsy. This leads to the final point. Everybody I spoke to insisted on the importance of early diagnosis and the beginning of

treatment and training as soon as the child can benefit from it. The later he starts learning, the slower he will progress and the smaller will be his total improvement. That is a good reason for calling this whole problem an urgent one.