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Book Review: Fragile Families, Troubled Children: The Aftermath of Infant Trauma

Children Living in Long-Stay Hospitals M Oswin pp 159 £5 London: Spastics International Medical Publications 1978 Sporadic scandals remind us of the deficiencies in services for the mentally handicapped. There are currently over 10000 children living in mental handicap hospitals. Maureen Oswin, an experienced teacher of the severely disabled, studied 223 of those aged under 20 years from 8 hospitals, to see how their needs are being met. Her findings are not surprising. Apart from noteworthy exceptions these are: overworked and unsupported staff; inadequate provision of special equipment and of treatment such as training programmes and physiotherapy; lack of communication between parents, teachers, hospital staff and local authorities; a deprived life for many of the children. The catalogue of deficiencies sounds depressing reading but this is an imaginative book that will hopefully stimulate action rather than despair. Careful observations of the children's daily lives and study of their case histories and the hospitals' functioning, enables Maureen Oswin to prescribe in detail ways in which specific lacks could be overcome. Recommendations include the need for guidelines on care of children in long-stay hospitals and the appointment of inspectors responsible for coordinating their care. Not all the recommendations, however, involve unwelcome expenses: increasing involvement of parents and improvements in ward routine for example. The book provides practical advice for those trying to improve services, and is essential reading for everyone concerned with patients such as these adults as well as children. It is remarkable for its compassion regarding the difficulties faced by parents and staff, and enthusiastically counteracts the apathy so often surrounding this whole area.