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Full text of "The child : monthly news summary"

^ 



t 



r? 933I.3A 7 







53 



Given By 



3^ 



VOLUME 17 



Vol. ^'l_ 



AUGUST-SEPTEMBER 1952 



to JUNE-JULY 1953 






\ 



U. S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE 



Social Security Administration 
Children's Bureau 



PO BL IC 



3^^- 



Superintendent of Documents 

FEB 9-1954 

INDEX 
THE CHILD 






-Xu\7^^ 



Volume 17, August-September 1952 to June-July 1953 



erson, Odin W.: 

Infant Mortality and Patterns of Liv- 
ing, 122 Apr. 
;, Bertram M.: 

Focus on Delinquency, 59 Dec. 
sing, Leo B. : 

Eyewitnesses to the Toll of Delin- 
quency — Juvenile Court, 51 Dec. 
bria, Sophie T. : 
Bool: review by, 166 June-July, 
ney, Paul R.: 
Point IV and the Children of the 

Punjab, 81 Jan. 
1 Health Day, 1953 (proclamation), 
138 May. 
lolm, Brock: 

Prescription for Peace, 140 May. 
\, Kenneth B. : 

Race Prejudice and Children, 113 Mar. 
aenen, Richard: 
Training Schools and the Future, 

3 Aug.-Sept. 
e, Marian M.: 
^ote by, 166 June-July, 
iggio, Gellestrina, and Marguerite B. 
linas : 
Parents Learn About Their Premature 

Baby, 106 Mar. 
, Martha M.: 
Furthering Individual Well-Being 

Through Social Welfare, 19 Oct. 
iVe Can Do Something About Juvenile 

Delinquency, 2, Aug.-Sept. 
What Do We Want for Our Delinquent 

Children? 50 Dec. 
3n, Lucile: 
Conference Works Toward Better 

Citizenship, 41 Nov. 
ish, O. Spurgeon: 
Book i-eview by, 118 Mar. 
hs, Elisabeth Shirley: 
For Child Welfare in Venezuela, 42 

Nov. 
re, Marion L.: 
Book reviews by, 87 Jan., 119 Mar. 

Clue to Child Health, 140 May. 
- _ e, Robert M., and Sylvia Stecher: 

Toward Better Speech and Hearing. 
154 June-July. 
Gardner, George E.: 

Children in the Contemporary Scene, 
141 May. 



Gelinas, Marguerite B., and Gellestrina Di- 
Maggio: 

Parents Learn About Their Premature 
Baby, 106 Mar. 
Gula. Martin: 

Toward Better and Safer Camping, 
7 Aug.-Sept. 
Harper, Nancy: 

Instead of "Blood-and-Thunder" Radio, 
37 Nov. 
Hobby, Oveta Gulp: 

To Understand Children Better, 139 
May. 
Huse, Betty: 

Book review by, 31 Oct. 
Illing, Hans A.: 

Book reviews by, 31 Oct., 118 Mar. 
Inslev, Virginia: 

Sick Children Benefit From a Citys 
Home-Care Program, 78 Jan. 
Kanner, Leo: 

Mental Health in Child Rearing, 116 
Mar. 
Kline, Draza B.: 

Should Children Be Separated From 
Their Parents? 74 Jan. 
Kneisel, Stephan H.: 

Eyewitnesses to the Toll of Delin- 
quency — Detention, 52 Dec. 
Leamy, Catherine M. : 

Book reviews by, 47 Nov., 166 June- 
July. 
McGrath, Earl J.: 

School Is More Than Three R's, 140 
May. 
MacNeil, Douglas H.: 

Communities Act Against Delinquency, 
66 Dec. 
Margolin, Lillian: 

For More Rewarding Summer Recrea- 
tion, 162 June-July. 
Meltzer, Esther S., and Miriam Wanne: 

Foster Parents Speak Up, 158 June- 
July. 
Morrison, L. D.: 

Eyewitnesses to the Toll of Delin- 
quency — Police, 55 Dec. 
Olson, Ruth'C: 

Book review by, 119 Mar. 
Palumbo, Adelaide Z.: 

Social Casework and the Child Camper, 
144 May. 



Phillipson, Elma: 

Follow-up of 1950 White Hou.e Con- 
ference Enters a New Stage, 1 iO P ,. . 
Prevey, Esther E.: 

Films on Family Life Stir Di.- 
148 May. 
Price, Bronson: 

Book review by, 118 Mar. 
Pruski, Beatrice: 

When a Couple Plans to Adopt 
127 Apr. 
Rubin, H. Ted and Bunny: 

A Visitor's View of Child Wf 
Vienna, 10 Aug.-Sept., 27 Oct. 
Smith, I Evelyn: 

Book review by, 46 Nov. 
Stecher, Sylvia, and Robert M. Fo 
Toward Better Speech and Hea 
June-July. 
Taylor, Alice L.: 

Social Agencies Can Imp tot 
Training, 109 Mar. 
United Nations Day, 1952 (procla 

16 Oct. 
Unsigned: 

Children and the School-Lun 

gram, 40 Nov. 
Delinquency Project Moves A - 

Nov. 
A Few Facts About Juvenil ' i" 

quency, 63 Dec. 
For Better Child Health; Pedi; 
Exchange Views on Ways 
Children's Health Problems, 
Sept. 
Recommended for Every Co; 
(services for delinquent child 
Dec. 
Veney, Lawson J. : 

Eyewitnesses to the Toll o 

quency — Training School, 57 

Wanne, Miriam, and Esther S. Me 

Foster Parents Speak Up, 11 

July. 

Winkley, Ruth: 

When a Child Must Go to the , 
34 Nov. 
Witmer, Helen Leland: 

How Can We Evaluate Socia 
24 Oct. 
Yarrow, Leon J.: 

When a Child Is Deprived of M 
84 Jan. 




AUGUST-SEPTEMBER 
1952 




i 






I 



1 



/ ' / 



/ 



WE CAN DO SOMETHING ABOUT 



JUVENILE DELINQUENCY 



JUVENILE DELINQUENCY is 
again on the increase. 
In the last 3 years the number 
of delinquency cases handled by 
juvenile courts in this country has 
risen almost 20 percent, according to 
estimates based on data now in the 
Children's Bureau. 

By 1960, even if the delinquency 
rate does not increase, law-enforce- 
ment agencies will be dealing with 50 
percent more children 10 to 17 years 
old (the age group in which most 
juvenile-delinquency cases fall) than 
in 1950. This is because the number 
of youngsters of these ages will in- 
crease that much, as a result of high 
birth rates during and after World 
War II. 

A million or so boys and girls are 
picked up by the police each year. 
And every time a child doesn't get 
the kind of help he needs at such a 
time, society is the loser. 

Far too many of our adult jails and 
prisons are filled with men and 
women who have juvenile-delinquency 
records. 

No one can calculate exactly the 
cost of maintaining all our adult 
criminals, but we know that it runs 
into millions upon millions of dollars 
a year. 

Nor can one estimate, in any 
mathematical terms, the great loss to 
the Nation in the creative, produc- 
tive, and cooperative power that 
these people might have contributed 
under other circumstances to our 
well-being, but we know the loss is 
great. 

The problem of juvenile delin- 
quency has been with us before, and 
many times. During World War II 
delinquency rose to a new peak. As 
a people, we have made some gains 
against it. But only here and there. 

We have courses of training for 
police officers who have to deal with 
youthful delinquents. But only a 



2 



handful of officers have a chance to 
benefit from such courses. 

We have to some extent stopped 
putting youngsters awaiting court 
action into jails housing adult crimi- 
nals. But 50,000 to 100,000 juvenile 
delinquents will be held in jails this 
year because there is no better place 
to put them. 

Again and again we have seen the 
help that well-selected, well-trained 
probation officers can give to juve- 
nile-court judges. Yet more than half 
our counties today have no probation 
services to help judges weigh the 
problems behind a child's delinquency. 

We have some training schools for 
juvenile delinquents which no longer 
put them in uniforms, crop their hair 
all alike, and march them this way 
and that. Some of our training 
schools have excellent diagnostic and 
treatment services, excellent school- 
ing, health, recreation, and religious 
programs, all designed to help boys 
and girls in trouble to find their way 
out of trouble and into a responsible 
and satisfying role in life. But this 
kind of training school exists only 
here and there. 

The time has come to pull together 
what we know about juvenile delin- 
quents and their needs — what we 
know has worked well in helping 
them — and to build programs of ac- 
tion that will serve, not just a few, 
but all the youngsters who come up 
against the law. 

This is a job that can best be done 
by citizens in their own communities 
and States. Many highly skilled and 
trained workers in the delinquency 
field are available to help. 

Because citizens have a right to ex- 
pect help from their Federal Gov- 
ernment too, the Children's Bureau is 
stepping up its services. We have 
established a Juvenile Delinquency 
Branch in our Division of Social Ser- 
vices. Working closely with this new 



Branch is the staff of a special Juve- 
nile Delinquency Project, created 
through the generosity of private 
contributors. 

Together, our new Branch and 
Project will help to bring out into the 
open what is known about the causes 
and treatment of juvenile delin- 
quency in this country today. They 
will help National, State, and local 
citizen groups to develop programs 
that we hope will help delinquent 
boys and girls turn to activities that 
will increase their self-respect. With- 
in the next several months, we will 
have new pamphlets and other mate- 
rials that should be useful tools for 
such groups in organizing their own 
efforts in this direction. 

Clearly, no such program can ac- 
complish its end unless it is con- 
cerned with averting delinquency as 
well as treating it. Our special j 
Branch and Project, therefore, will 
be concerned with measures to 
strengthen community services that 
make delinquency unattractive and 
unnecessary to youngsters. 

Readers of The Child, associated 
as most of you are with services for 
children, can contribute greatly to 
this Nation-wide effort. I appeal to 
you to lend it your support, through 
the work of your present organiza- 
tion and through additional efforts. 
Your State or local committee or 
council for children and youth will 
be glad to put you in touch with other 
groups working against delinquency. 
If we can be of help to you, we invite 
your correspondence. We hope you 
will share with us an account of 
your activities. 



lii^MjDcrl^ . ?^oU- 1 



Martha M. Eliot, M.D. 
Chief, Children's Bureau 

THECHILD VOL. 17N0. 1 



TRAINING 
SCHOOLS 
AND THE > 
FUTURE 



RICHARD CLENDENEN 



NINETEEN - FIFTY - TWO 
marks, as never before to my 
knowledge, a period of trial, 
change, and • flux in training-school 
programs. Developments in training 
schools do not come about through 
happenstance. They grow out of 
problem solving. And the develop- 
ments begin to add up only as they 
are related to the problems to be 
solved and the knowledge and skills 
available for their solution. It is im- 
possible for me to make a compre- 
hensive analysis of this process in a 
relatively brief paper. However, it 
seems logical to begin by listing some 
of the problems that seem somewhat 
new or pressing at this particular 
time. 

The number of boys and girls com- 
ing to the attention of law-enforce- 
ment agencies is increasing sharply 
in this country. National data indi- 
cate a rise of between 6 and 8 per- 
cent in 1951 over 1950. Individual 
communities were harder hit, some 
showing a 36 percent jump in the 
volume of juvenile delinquency court 
cases. Thus far in 1952 all signs 
point to a still further increase. 

During World War II we experi- 
enced a similar rise in the volume of 
juvenile delinquency. We were not 
surprised at this. The unsettling 
conditions of war have always re- 
sulted in increased delinquency, and 
we were able to regard the rise as a 




A training-school staff member talks over a boy's misconduct with him. When siuh every- 
day problems are handled with insight, the child is helped to reshape his entire behavior. 



temporary phenomenon. And at the 
war's end the size of the problem de- 
creased. 

But in 1949 the trend again re- 
versed, and since that time the vol- 
ume of delinquency has steadily 
mounted, each successive year. Obvi- 
ously, many of the forces that oper- 
ate during periods of tension and con- 
flict are again at work, and we can- 
not assume that the situation will 
change soon. For unlike the 1941-45 
era, the present troubled state of 
world affairs does not enable us to 



RICHARD CLENDENEN is Chief of the 
newly established Juvenile Delinquency 
Branch of the Division of Social Services, 
Children's Bureau. For several years he has 
been that Division's Consultant on Training 
Schools. 

Mr. Clendenen gave this paper at a meet- 
ing of the National Association of Training 
Schools, held in connection with the seventy- 
ninth annual meeting of the National Con- 
ference of Social Work, held at Chicago. 



look forward to so definite a termina- 
tion of the pressures which are un- 
settling our national life. 

In the Nation as a whole, training- 
school populations are mounting, too. 
Many schools are already caring for 
numbers beyond normal capacity. 
And this is not all. We know that in 
the immediate future even more chil- 
dren will need care. In the early 
forties birth rates increased sharply 
and have remained at relatively high 
levels since that time. Very soon, 
then, training schools that accept 
children as young as 10 years of age 
will feel the effects of that increase. 
By 1960 in this country we shall have 
50 percent more boys and girls age 
10 to 17 than we had in 1950. 

How are the training schools to 
care for more boys and girls? There 
are only two possible ways for them 
to do this. Either existing training 



AUGUST - SEPTEMBER 1952 



3 



schools must be enlarged or new 
facilities must be established. The 
sound answer in the majority of 
States, I believe, will not be found in 
providing additional housing in exist- 
ing plants. This may be feasible in 
very small institutions, but, more 
often than not, training schools are 
already required to care for too di- 
versified groups of children, and 
many schools are already too large. 

Additional facilities established 

There is evidence of a trend in the 
direction of establishing new facili- 
ties to permit better grouping of 
children according to their needs. 
California has taken the lead in this. 
During the last 10 years four for- 
estry camps and three additional 
training schools have been estab- 
lished there, making a total of 10 
facilities as contrasted with 3 exist- 
ing a decade ago. It is only fair to 
point out, of course, that the popula- 
tion of California has increased more 
than 50 percent during the same pe- 
riod. A number of other States have 
established additional facilities, too. 
All told, between 15 and 20 new State 
training schools have been estab- 
lished in the past 10 years; some of 
these are giving care to Negroes, a 
group for which previously no such 
care had been provided in some com- 
munities. 

Many training schools are feeling 
the eifects of receiving a larger per- 
centage of children with serious be- 
havior problems. Exact data on the 
nature and extent of this change in 
training-school populations are lack- 
ing. We do not have adequate analy- 
ses of the composition of present and 
past populations for detailed com- 
parisons, but many experienced ad- 
ministrators agree that such a shift 
has taken place. It is also logical 
to assume that a smaller proportion 
of children with less serious behavior 
problems are sent to training schools, 
as the social-insurance programs and 
the social services of schools, courts, 
and social agencies are expanded, 
thereby enabling these children, as 
well as children who are more de- 
pendent than delinquent, to remain 
in their own homes and be cared for 
in their own communities. 



4 



Training - school administrators 
have long recognized that some of the 
boys and girls committed to their care 
are too aggressive — too lacking in 
self-control — to handle themselves in 
the general program, a program 
geared to the needs of the more typi- 
cal delinquent boy or girl. Improved 
community screening before commit- 
ment has left the training school with 
a higher concentration of the very 
aggressive boys and girls who need 
more intensive treatment in a setting 
providing more physical security than 
training schools usually are able to 
offer. A number of developments de- 
signed to meet this problem are under 
way. 

Several States are planning to fol- 
low the lead of New York and estab- 
lish one or more separate facilities 
for the care and treatment of these 
so-called "unadjustable individuals." 
In Texas funds have already been 
appropriated for this purpose. A 
somewhat different approach to the 
problem is planned in California, 
where two combination receiving and 



treatment units are to be established. 
Boys and girls retained in or referred 
to these units for treatment will be 
handled apart from those in reception 
status. Still another type of facility 
has been established in New Jersey, 
where a single study and treatment 
center serves both juveniles and 
adults, referred from a variety of 
sources. 

Another movement aimed at the 
same problem, but not necessarily a 
substitute for this type of facility, 
may be seen in the establishment of 
security units within training schools. 
This is not a new idea in this field, 
but several additional units have been 
constructed within the past 2 or 3 
years. These range in type from a 
single detention room to a ward 
similar to those used for housing dis- 
turbed patients in a mental hospital. 
This is a development that needs ex- 
tremely careful and thoughtful 
scrutiny. 

There is no ready answer to "what 
to do with, how to handle" the very 
aggressive boy or girl — and a secur- 



When staff members in a training school can help a child to feel liked and wanted and impor- 
tant, they are likely to succeed in changing that child's attitudes toward society and self. 




ity unit is not an answer in itself. I 
do not question that some boys and 
girls require temporary care in 
physically secure quarters. Indeed, 
both the aims of treatment and the 
protection of other people often re- 
quire it. But boys or girls who are 
so lacking in self-control that they 
are temporarily unmanageable in the 
general training-school program are 
not helped to develop such control by 
the simple process of restricting their 
physical freedom to vent aggression 
on others and on others' rights and 
property. If such care is to be moi*e 
than cold-storage isolation, the pro- 
gram within such units must be 
geared to meeting the needs of seri- 
ously maladjusted personalities. Ade- 
quate social, psychological, and psy- 
chiatric services are a "must." And it 
may be difficult to provide these ser- 
vices in sufficient quantities on an 
institution-by-institution basis. In 
many States it would seem more 
feasible to develop such a program 
on a State-wide basis with a single 
facility serving two or more training 
schools. 

States plan to pool resources 

Adjacent small States might com- 
bine resources in order to establish 
and maintain such a facility. Again 
we have evidence of some planning 
in this direction. In 1951 a bill was 
introduced in Congress to enable the 
States of Maine, New Hampshire, 
and Vermont to enter into a compact 
relating to the joint construction of 
buildings necessary to satisfy human 
needs in the fields of education, hos- 
pitalization, welfare, and correction. 
The possibility of combining re- 
sources for the establishment of cer- 
tain institutional facilities also has 
been a topic at several interstate con- 
ferences. 

Some States meet the problem of 
handling the very aggressive boy or 
girl through administrative transfer 
to institutions established for the 
care of persons convicted of crime. 
Yet we know that finding a young 
person delinquent is not the same as 
convicting him of a crime. Not only 
is such transfer of doubtful constitu- 
tionality, but it violates the spirit of 



the cause for which we have long 
labored — namely, the development of 
specialized provisions and procedures 
for children before the law. 

It is abundantly clear that the more 
inadequate the general training- 
school program is, the larger the 
number of children who cannot ad- 
just within it. The ability of a boy 
or girl to use and benefit from the 
regular training-school program can- 
not be truly evaluated unless and un- 
til that program is reasonably ade- 
quate to do the job for which it was 
designed. I have visited training 
schools in which large security units 
had been constructed during periods 
of very inadequate program develop- 
ment, units little used after those pro- 
grams were enriched and extended. 

The need for a security unit looms 
largest during periods of stress and 
tension. And unfortunately it is at 
these very times that program ac- 
tivities become most threatened. In 
the face of mounting problems of con- 
trol, the temptation to restrict activi- 
ties is strong. Of course, some cur- 
tailment may be indicated if it seems 
impossible to supervise certain ac- 
tivities properly. But during times of 
tension in an institution, the need for 
outlets for energy and feeling is 
greater, not less. A material cut-back 
in activities will generate even more 
tension, which in turn will increase 
problems of control. 

The basic job then is not new, but 
old ; a job that training schools share 
with all other agencies serving chil- 
dren and youth. It is : How can we 
improve and extend present services? 
Obviously, as the training schools are 
called upon to care for more boys and 
girls presenting serious behavior 
problems, the task of providing pro- 
grams adequate to meet their indi- 
vidual and group needs is vastly 
complicated. To achieve and maintain 
such programs requires better train- 
ing for personnel than we have 
usually been able to provide. It re- 
quires more professional services — 
psychological, psychiatric, and social 
— than we have usually been able to 
command. It requires more effective, 
better - planned community - relations 
programs than we have generally 



had. Above all, it requires an abund- 
ance of courage to hold the line for a 
treatment program in the face of in- 
creased aggressiveness in the boys 
and girls we serve. Happily, we are 
able to report progress on some of 
these fronts too. 

Staff training is receiving wider 
and more intensive attention. Various 
new programs for on-the-job training 
of personnel have been established 
within the past 2 years. I can men- 
tion only a few here. 

The National Training School for 
Boys, in Washington, D. C, recently 
appointed a full-time staff-training 
officer, thereby becoming the first 
training school, to my knowledge, to 
employ a person to give full time to 
the orientation of new personnel and 
the on-the-job training of all staff. 
With this service, the National Train- 
ing School for Boys is experimenting 
with training methods. Recently, a 
cross-section of staff, about 12 in 
number, were released from all other 
duties to devote a full week to inten- 
sive group discussions of program. 
Interest and enthusiasm were high 
among participants, although it is 
still too early to evaluate how this 
experience has influenced the per- 
formance of these staff members. 

In New York State the Bureau of 
Child Welfare of the State Depart- 
ment of Social Welfare has until re- 
cently assigned a staff-training spe- 
cialist to work half time at the New 
York Training School for Boys. This 
specialist devoted major attention to 
working with the individuals re- 
sponsible for the direction and super- 
vision of houseparents and other cot- 
tage personnel. 

Although still in the planning 
stage, the New York Training School 
for Boys contemplates a training and 
research project geared primarily to 
on-the-job staff training. Through the 
services of specialists in the fields of 
group work, group therapy, psychi- 
atric casework, and clinical psychol- 
ogy, explorations will be made to de- 
termine what these professions have 
to offer in both methods and knowl- 
edge, which can be used in staff 
training and by staff in their respec- 
tive jobs. The project team will also 



AUGUST - SEPTEMBER 1952 



5 



include a person skilled in research 
who will be responsible for establish- 
ing the controls and methods neces- 
sary for evaluating results. 

Somewhat more than a year ago, 
the California Youth Authority em- 
barked on a carefully planned on-the- 
job training program, participated in 
by the six training schools and the 
four forestry camps administered by 
that agency. 

With the help of a committee, a 
syllabus consisting of 12 study units 
was developed. Each unit represented 
a study outline for some aspect of the 
training-school job. One staff member 
in each facility was then selected to 
serve as its training officer or in- 
structor. Prior to launching the 
training sessions, these persons were 
brought together for a week of dis- 
cussion, instruction, and indoctrina- 
tion. 

This was followed by a 3-day meet- 
ing for going over the syllabus, 
identifying and defining the func- 
tions of training officers and their 
relationship to staff and administra- 
tion, and determining the objectives 
of the training program. A specific 
amount of time was provided in each 
facility's budget for this on-the-job 
training. 

Major emphasis was given to the 
orientation and training of new staff, 
but time was allotted for the training 
of all personnel. Group sessions util- 
izing a variety of methods, such as 
discussions led by staff members or 
outside persons, lectures by selected 
speakers, and presentation of films 
followed by discussions, were then 
arranged for regularly by the train- 
ing officer in each facility. 

None of the programs outlined 
above, nor any others with which I 
am acquainted, would be described by 
the originators as ideal or as fully 
meeting on-the-job staff training 
needs. But the fact that these, among 
other programs, have been started, 
that time and money for such staff 
training have been budgeted, repre- 
sents a tremendous step forward. 
And I am convinced that we are not 
going to make material progress in 
developing staff-training programs 



until we make specific provision for 
this function in the planning of each 
year's budget and work program. 

One person responsible for program 

still another general observation 
can be made about the staff-training 
programs described here. In each 
training school, specific and continu- 
ing responsibility for carrying on the 
program was delegated to a selected 
member of the staff. Ideally, of 
course, this person should be espe- 
cially qualified for this function. In 
practice, it is gratifying to observe 
how much can be achieved through 
the leadership of a person lacking 
such ideal qualifications, if assistance 
and guidance can be provided. Ex- 
perience, which at this point is mea- 
ger, would indicate that a training 
school employing a staff of substan- 
tial size could well use the services 
of a full-time person in the develop- 
ment and provision of a staff -training 
program. A beginning might be made 
in some States by employing such a 
person and dividing his time between 
two or more training schools. 

I have said that the larger numbers 
of serious behavior problems that the 
training schools are being called upon 
to meet intensifies the need for staff 
training, professional services, and 
sound community relationships. 
Space will not permit me to discuss 
the shortage of professional person- 
nel, nor to mention some of the inter- 
esting variations in the ways profes- 
sional services are being geared into 
training-school programs. Neither 
do I have space to discuss community 
relations, a subject that is compli- 
cated by the uncertain, vacillating, 
and often punitive attitudes of the 
public toward the delinquent. I have 
also said that the job requires an 
abundance of courage to hold the line 
for a treatment program in the face 
of increased aggressiveness in the 
boys and girls we serve — aggressive- 
ness that inevitably breaks forth at 
times in a manner that results in 
public demands to "get tough." And 
that kind of courageous leadership is 
emerging more and more. 

The spread of knowledge and un- 
derstanding in the training-school 



field is impressive. We have long had 
considerable knowledge about human 
behavior, and progressive training 
schools have drawn upon this body of 
knowledge in program development. 
But we have also had large deserts 
into which the understanding that 
flows out of that knowledge has not 
penetrated. Gradually these deserts 
are diminishing. 

I am referring, for example, to a 
fuller and more widely accepted ap- 
preciation of the importance of hu- 
man relationships in the job we are 
trying to do. There is growing recog- 
nition that the end result of every 
training-school experience is deter- 
mined by the network of relationships 
existing among those sharing it. 
Whereas many training schools once 
concentrated almost exclusively upon 
outward behavior, and unfortunately 
some still do, there is greater recogni- 
tion of the importance of feelings, re- 
actions, relationships, whatever the 
outward behavior. 

How can we change a child's attitudes? 

A better understanding of the dis- 
tinction between the control of be- 
havior and its permanent modifica- 
tion is developing. I do not mean 
to imply that the control and modifi- 
cation of behavior are unrelated. 
Rather they are most intimately re- 
lated. The ways in which be- 
havior is controlled from day to day 
has a strong influence upon the 
shaping of future conduct. And rec- 
ognition that behavior grows out of 
the individual's attitude toward so- 
ciety and self has led to a wider eval- 
uation of methods utilized in main- 
taining controls. Penalties that hu- 
miliate the individual, diminish his 
self-respect, shake his self-confidence, 
or confirm his feeling that the world 
is a harsh, unfriendly place are giv- 
ing way to methods that though some- 
times less effective in altering im- 
mediate behavior will over the long 
haul build self-respect, as well as 
confidence in others. 

Recognition that a person's atti- 
tudes cannot be changed unless he 
feels liked and wanted and important 
has led to wider efforts to make boys 

(Continued on page 14) 



6 



THE CHILD VOL. 17 NO. 1 .. 



TOWARD BETTER AND SAFER CAMPING 

A State Welfare Department Surveys Children's Camps 



MARTIN GULA 

THIS SUMMER more than three 
million boys and girls have been 
away from home for weeks, or 
even months, camping in the woods, 
at a lakeside, or in some other natural 
setting. Some parents have paid sev- 
eral hundred dollars in fees for pri- 
vate camps ; others have sent their 
children to less expensive camps, op- 
erated by nonprofit organizations. 
All the parents expect the camp to 
safeguard their children's life and 
health. All hope that their children 
will have an enjoyable time that is 
also a wholesome, constructive ex- 
perience. 

Many camps fulfill these parents' 
expectations. A camp that is ad- 
mitted to membership in the Ameri- 
can Camping Association, for ex- 
ample, is recognized as a camp that 
lives up to the high standards set by 
the Association. In the same way, 
the Boy Scouts and the Girl Scouts, 
the YMCA and the YWCA, the Boys' 
Clubs of America, and some other 
national groups hold their member 
camps to high standards. 

Large numbers of camps, however, 
are not accredited by any organiza- 
tion. When a mother and father send 
Joe or Susie to a camp that they 
have heard about through an adver- 
tisement, or from a neighbor, what 
assurance have they that the camp 
will be suitable for the child? Will 
the workers in charge be mature, re- 
sponsible persons, who understand 
children and like them, who know 



MARTIN GULA is Consultant on Group 
Care in tlie Division of Social Services, Chil- 
dren's Bureau. He holds master's degrees 
in social work and in education. During 
the past 15 years his work with children 
has included a variety of positions in the 
field of social group work, including 8 years 
of directing summer camps in New York 
State. Just before joining the Children's 
Bureau staff Mr. Gula was director of a 
study and treatment residence for emotion- 
ally disturbed boys and girls. 

AUGUST - SEPTEMBER 1952 



how much activity boys and girls of 
different ages can undertake, and 
who will not subject a child to tiring 
competition? Will safety provisions 
be adequate? Will a doctor be avail- 
able if the child falls ill? How about 
emergency hospitalization? 

Many parents, and some social 
agencies too, assume that camps are 
supervised by State authorities, as 
many schools are, and as children's 
institutions are. It is true that 
most States, through their public- 
health laws and regulations, set mini- 
mum sanitary requirements, such as 
those concerning sewer facilities, 
garbage disposal, and water supply. 
But few State laws or regulations 
pay attention to the qualifications of 
the director and his staff — the per- 
sons responsible for safeguarding the 
children's lives, their health, and 
their well-being, while they are away 
from home. 

Not many States, for example, re- 
quire that a registered nurse be on 
the staff, to watch for signs of illness 
in the children and to judge when a 



doctor is needed. Few require camps 
to make sure that a doctor can be 
reached in an emergency. And al- 
though swimming and boating are a 
prominent feature of the activities in 
most camps, only a handful of States 
include a requirement that some one 
employed by the camp be able to ad- 
minister artificial respiration. 

Yet even if all the States had laws 
or regulations requiring camps to 
meet high standards, enforcing these 
requirements would take more staff 
than many State governments have 
been able to provide. Up to now, few 
States have been able even to assess 
the extent of camping within their 
borders, much less to provide enough 
staff to supervise the camps ade- 
quately. 

But in spite of the difficulties, some 
States are trying to fulfill their re- 
sponsibility for guarding the welfare 
of the youngsters that every summer 
throng to camp. Among these States 
is California. 

The California State Department 
of Social Welfare is responsible by 



"Having wonderful time." Their parents hope that it will also be a safe and healthful time. 




law for protecting children under 16 
years of age in "the absence of their 
parents," and its Division of Child 
Welfare fulfills this responsibility 
through inspecting and licensing a 
variety of facilities for child care. 

The Department has for many 
years recognized its responsibility 
for inspecting and licensing summer 
camps for children under 16, but it 
has never had enough staff for this 
purpose. However, it has been able 
to take action on any serious com- 
plaint about a camp. And it has in- 
spected and licensed a small number 
of camps that requested this service. 
Also it has worked with the help of 
the American Camping Association 
toward developing tentative stand- 
ards for protecting the health and 
safety of child campers in the State. 

A long step forward was taken to- 
ward fulfilling the Department's re- 
sponsibility for protecting children in 
camps through licensing, when the 
State legislature provided, in the De- 
partment's budget for 1951-52, the 
equivalent of two full-time positions, 
specifically for work with camps. 
With this provision the Department 
planned the following activities : 

"1. A survey of camps — locating 
and identifying camps to determine 
the number and type of camps and 
the number of children served and 
to collect information on camping 
practices. 

"2. Inspection and licensing of as 
many camps as possible on a cross- 
section sampling basis as to types 
and location. 

"3. Identification of any problem 
areas, and evaluation of the practical 
problems of licensing. 

"4. Continuation of the process of 
development of standards to protect 
the basic health and safety of camp- 
ers and to promote good camping 
practice." 

In its work toward these goals the 
Department enlisted the help of a 
committee representing the organiza- 
tions in the State with major leader- 
ship in the field of children's camp- 
ing. These included the five Cali- 
fornia sections of the American 
Camping Association ; the Pacific 
Camping Federation; the Northern 



8 



and Southern California Private 
Camp Directors' Associations; the 
national youth-serving organizations 
— Boy Scouts, Girl Scouts, Camp Fire 
Girls, YMCA, YWCA, Boys' Clubs of 
America, and Salvation Army; gov- 
ernmental agencies, such as the State 
Fire Marshal, the State Department 
of Public Health, the State Recrea- 
tion Commission, the State Depart- 
ment of Education, the State Divi- 
sion of Beaches and Parks; and the 
United States Forest Service. 

Committee's work appreciated 

This committee gave valuable ser- 
vice in locating and identifying 
camps, in interpreting the Depart- 
ment's program to individual camps, 
and in guiding the Department in 
methods of approaching the problem 
as a whole. 

The first step in the survey was 
to collect the names and addresses 
of as many camps as possible, even 
though it was clear that a large num- 
ber of these would have to be re- 
moved from the list, for some would 
be duplicates, some would no longer 
be in operation, and many would 
prove either to be not "established 
camps," by administrative definition, 
or to be outside the jurisdiction of 
the Department of Social Welfare. 
(Camps maintained by public schools 
or other public agencies, camps for 
the handicapped, week-end or day 
camps, family camps, and camps for 
boys and girls over 16 are not the 
responsibility of the Department of 
Social Welfare.) 

The members of the survey com- 
mittee provided the names of a large 
number of camps aflfiliated with their 
organizations. Other sources of in- 
formation were county health and 
welfare departments and churches 
and church organizations. Then there 
were local camp organizations, cham- 
bers of commerce, directories pub- 
lished by clothing and camp-supply 
stores, welfare councils, local park 
and recreation commissions, automo- 
bile club lists, and so forth. 

About 900 names of camps were 
obtained, and a questionnaire, accom- 
panied by an explanatory letter and 
a copy of the tentative camp stand- 



ards, was sent to each. The letter 
told the camp that the State Depart- 
ment of Social Welfare planned to 
inspect and license a cross-section of 
camps, and that for this reason the 
questionnaire had been designed to 
serve also as an application for 
license. The camps were assured that 
all information would be confidential 
and that no data on individual camps 
would be published. 

The letter went on to say: 

"In filing the completed question- 
naire, you will have fulfilled your ob- 
ligation under the law to apply for a 
license, even though the Department 
is unable to complete a licensing 
study of your camp this summer. In 
this year's work with camps the De- 
partment will select a sample of all 
types of camps in the major camping 
areas of the State. 

"If your camp is selected for li- 
censing (no fee involved), an ap- 
pointment for a visit, at your con- 
venience, will be arranged. If you 
would like to be included in the sam- 
ple, please let us know. 

"In licensing camps the Depart- 
ment will make every effort to indi- 
vidualize camps. There will be no 
attempt to fit camps to a single pre- 
conceived idea of a "good camp." The 
items on the questionnaire are not 
specifically related to licensing; "no" 
answers will not necessarily mean 
that a license could not be issued. You 
will note that the standards for li- 
censing, which are enclosed, are ten- 
tative for this year at least, and that 
suggestions for changes will be wel- 
comed." 

Among the items on the question- 
naire were : 

What is the minimum age for 
counselors? 

Has the camp been inspected by 
fire-safety officials? By health offi- 
cials? 

Is a qualified water-safety instruc- 
tor on the staff? 

Is a physician on the staff, or on 
call and accessible? 

Is a registered nurse on the staff? 

Is a precamp medical examination 
required for campers? For staflf? 

Is the camp accessible by a good 
road ? 

THECHILD VOL. UNO. 1- 



I 



Have arrangements been made for 
emergency hospitalization? 

Of the camps that were sent copies 
of the questionnaire, 368, in 43 of the 
State's 58 counties, returned com- 
pleted questionnaires in time for 
tabulating. These camps had a sea- 
sonal capacity of nearly 166,000 
campers (capacity at one time multi- 
plied by number of sessions). Non- 
profit groups operated more than 
three-fourths of the camps ; 80 camps 
were privately operated. Most of the 
camps served children in the 8-16 
group; 22 accepted children of pre- 
school age and 92 served 6- and 7- 
year-olds. The large majority of the 
campers were between 8 and 12 years 
old. 

Quality of personnel stressed 

No attempt was made to evaluate 
individual camp programs on the 
basis of the questionnaires. However, 
the Department, in its report, classi- 
fies the camps according to their ma- 
jor program emphasis. Some camps 
went in for outdoor primitive camp- 
ing; others had a major interest in 
athletics, team sports, and games ; 
others were set up for the purpose of 
religious education ; still others were 
planned to serve underprivileged chil- 
dren (a few of these camps were in- 
terested in treating children with be- 
havior disturbances). The Depart- 
ment does not intend to suggest that 
any one of these types of camp pro- 
grams is more desirable than another, 
but rather to point to the necessity 
for wider knowledge, understanding, 
and experience in persons who evalu- 
ate such programs. 

The most important factor in 
camping, as in any other child-wel- 
fare program, says the report, is the 
quality of the personnel. There is 
general recognition that camp coun- 
selors with responsibility for super- 
vision of living-groups should be ma- 
ture, responsible persons, at least 19 
years of age. It was, therefore, a 
matter for serious concern that more 
than half the camps had counselors 
under the age of 19. 

The Department selected a cross- 
section of the camps to be visited by 
its staff. With the funds allotted for 

AUGUST ■ SEPTEMBER 1952 



the 1951 work with camps a camp 
consultant was employed for 6 
months and six social-welfare agents 
for 3 months each. In the course of 
the summer the six agents visited 123 
camps of various types. These were 
in 32 counties, representing all the 
major camping areas of the State. 

Of the 123 camps visited, the De- 
partment issued licenses to 66 (53 
percent) . In practically all of the 66, 
it was necessary for the camp to 
make changes before it could be li- 
censed. 

Another 26 camps would probably 
have been licensed were it not for de- 
lay in receiving their fire-safety or 
sanitary clearances. The Department 
workers visited some of the camps 
late in the season, and frequently a 
camp would be closed before local fire 
or health officials could inspect it. A 
serious factor in lack of inspection 
was that some counties did not have 
complete fire- and health-inspection 
services. 

The remaining 28 camps could not 
be licensed, either because these 
camps did not provide basic mini- 
mum protection of the children or 
because it was not possible in a brief 
visit to obtain sufficient information 
as to whether minimum standards 
were met. 

Major problems preventing camps 
from being licensed were in the fol- 
lowing categories: 



1. Fire safety. Major changes or 
improvements were needed to bring 
the camp to minimum standards of 
fire safety. 

2. Sanitation. Correction of haz- 
ardous conditions needed before sani- 
tary conditions would be satisfactory 
— sewage disposal, water supply, and 
so forth. 

3. Personnel. Counselor staff in- 
adequate in number or questionable 
as to age, training, or experience. 

4. Medical-care program. Pre- 
camp examinations not required for 
campers, or for staff, or for both ; in- 
adequate provision for health super- 
vision or emergency medical care, or 
both. 

5. General administrative organi- 
zation. Responsibility for care and 
supervision of campers not clearly 
placed ; general organization and ad- 
ministrative lines unclear. 

In general the response to the li- 
censing program was good. Most 
camps willingly made changes or 
planned to make them in the follow- 
ing season in order to provide basic 
minimum safety. 

The Department's experience in 
visiting camps showed that a worker 
could be expected to visit two camps 
a week. Half a day in each camp is 
needed in order to gather sufficient 
information to evaluate operation 
(Continued on page 14) 



Under guidance of mature, understanding staff, children can gain rich experience in camp. 




A VISITOR'S VIEW OF 
CHILD WELFARE IN VIENNA 



H. TED and BUNNY RUBIN 

.USTRIA HAS ALWAYS looked 
to Vienna as the stimulus to 
its progress in social welfare, 
and much of the western world in 
the past has done the same. For in 
Vienna dynamic psychology had its 
genesis, and the soil out of which it 
grew was the same as that out of 
which arose Vienna's advanced so- 
cial-welfare structure. 

But World War II left Vienna with 
many bombed homes, schools, and 
welfare institutions; many health 
problems ; physically handicapped 
citizens ; parentless children ; and the 
uncountable damage resulting from 
widespread injurious experiences. 
And only now is Vienna beginning to 
shake off the deadening effects of the 
Hitler Anschluss and the devastation 
of war. 

Austria's social-welfare program, 
like that of most European nations, 
is largely a public one. In the im- 
mediate postwar period, a consider- 
able part of Vienna's social-welfare 
budget had to be allocated for recon- 
struction and rehabilitation, and 
could not be used for new develop- 
ments needed in this field. The gen- 
eral poverty of the country has seri- 
ously restricted the carrying through 
of plans for improvements. 

It has also severely limited family 
incomes. And this in turn has re- 
sulted in a high proportion of work- 
ing mothers ; in consequence, the city 
has to provide day care for a large 
number of children. 

Provision for care for preschool 
children includes day nurseries for 
children from 6 weeks of age to the 
second birthday; also day-care cen- 
ters for children 3 to 4 years of age 
and for 5- and 6-year-olds. For school- 
age children the city provides centers 
for after-school study and recreation. 
Vienna's schools, which are open 6 
days each week, close very early in 



the afternoon, and this necessitates 
many such centers. 

The American type of kindergar- 
ten, with its primary emphasis on 
education rather than on social wel- 
fare, is nonexistent in Vienna. En- 
rollment in day-care centers and kin- 
dergartens is restricted to children 
whose mothers work. Although many 
more are eligible, at present about 
one Viennese child out of seven par- 
ticipates in a preschool group experi- 
ence. 

Newer ideas slow of acceptance 

Another major factor that has 
shaped Vienna's present social-wel- 
fare program, to a degree difficult 
for the outsider to realize, has been 
the devotion to past tradition of 
many officials and of a tremendous 
part of the people as a whole. Per- 
haps it is understandable in the cur- 
rent period of impoverishment that 
the Viennese people look back to their 
once golden age of leadership. Still, 
the more progressive social-welfare 
leaders feel hindered by this glorifi- 
cation of the past and the accompany- 
ing resistance to adapting to changed 
conditions. 

Examples of this are the slow and 
difficult struggles in the municipal 
Jugendamt, or children's office, to 
shift the emphasis from the chiefly 
physical factors in the child's devel- 
opment to the social and psychologi- 



H. TED RUBIN received his master's degree 
from the School of Applied Social Sciences, 
Western Reserve University, and he is now 
a caseworker with the Illinois Children's 
Home and Aid Society, Chicago. BUNNY R. 
RUBIN received her master's degree from 
Western Reserve University in Speech and 
Hearing Therapy. She is an instructor at 
the Speech and Hearing Rehabilitation 
Clinic, University of Illinois Medical School, 
Chicago. 

In addition to studying child welfare in 
Vienna, Mr. and Mrs. Rubin have surveyed 
child-w^rlfare facilities in several other Eu- 
ropean countries and have taught at a 
training center for institutional personnel 
in Geneva. 



cal ones, and to alter accordingly the 
requirements for district directors. 
The newer movement is aiming to 
require directors to have been trained 
in working with the whole child and 
individualizing him, instead of, as at 
present, requiring them either to 
have a legal background or to have 
had training that stresses the child's 
physical development. 

In each of the various districts a 
Jugendamt forms the core of Vien- 
na's child-welfare program, and 
serves children until the end of their 
eighteenth year. It is often located 
in the same building as the district 
tuberculosis office, the health office, 
the well-baby clinic, the marriage 
bureau, the vital-statistics bureau, 
and the office of guardians for chil- 
dren born out of wedlock. 

Through the Jugendamt the city 
furnishes every baby with a complete 
layette. Behind this program is an 
effort to control congenital syphilis, 
since each expectant mother must 
undergo a Wassermann test before 
the fourth month of pregnancy in 
order to obtain the layette. The 
Jugendamt social worker arranges 
for this test and also visits the home 
after the baby is born. 

In Austria the State assumes the 
guardianship of every child born out 
of wedlock, and a so-called statutory 
guardian in the Jugendamt handles 
questions such as establishment of 
paternity and arrangement for the 
financial allotment required of the 
father. The social aspects of illegiti- 
mate birth are dealt with by the reg- 
ular Jugendamt social worker. 

In addition, this social worker reg- 
ularly serves as doctor's assistant in 
one or more well-baby clinics and 
arranges for summer holiday camps 
for school-age children. She also car- 
ries 170 or more cases, including fam- 
ily problems that involve children, 
behavior problems of children, and 
referrals to various child-care facili- 



10 



THE CHILD VOL. 17 NO. 1 ' 



ties. She makes pre-licensing studies 
of foster homes and supervises chil- 
dren in these homes. She also makes 
weekly visits to two or three schools 
or day-care centers, where she ad- 
vises teachers and works directly 
with some children. Besides all this, 
ishe writes her own short case records 
'without secretarial assistance. 

How much help can a social worker 
give individual children when she has 
such wide responsibilities? Without 
the benefit of the type of supervision 
that stimulates continuous profes- 
sional growth, without much knowl- 
edge of how to apply psychological 
principles to social work, and without 
jmuch time because of her many du- 
ties, her work must be largely limited 
to efforts to improve the children's 
environment. 



"Viennese people consider social 
service a public duty provided as a 
matter of right to all; they feel no 
diminished status in seeking such 
help, and use facilities more easily 
than do most people in the United 
States," explains Dr. Anton Tesarek, 
city director of child welfare. "Vien- 
na has a highly specialized child- 
welfare organization without highly 
trained social workers. United States 
caseworkers have done wonderfully 
in a comparatively few cases," Dr. 
Tesarek continues. "In Vienna spe- 
cialization has been neglected to han- 
dle many thousands of cases." 

A Jugendamt social worker, in her 
work with problems concerning chil- 
dren, may seek guidance from her 
senior social worker, and in cases of 
parental neglect the juvenile court 




Children of Vienna's working mothers attend day-care centers operated by the municipality. 



A step forward, however, has been 
;aken by the city-operated school of 
social work, the most advanced of 
Austrian social-work schools, which 
las initiated a long-range program 
;o develop the teaching and practice 
)f casework and to encourage the 
ntroduction of trained supervision, 
-like many other European schools 
)f social work, the Vienna school re- 
luires no previous university educa- 
ion for admission. 

iUGUST - SEPTEMBER 1952 



may actually award partial or total 
custody of the child to this senior 
worker. The latter then guides the 
regular worker in planning for and in 
supervising the child. 

For help with her most difficult 
cases, the social worker consults with 
the office's Erziehungsberater, who 
may herself advise the child and the 
family, or may recommend outside 
psychological treatment, or may sug- 
gest placing the child away from his 



home. Erziehungsberater may best 
be translated as "counselor on chil- 
dren's total development." Aichhorn 
introduced these counselors into the 
Jugendamter and trained the first of 
them in the 1920's. 

After the staff decision to place a 
child away from his home, the social 
worker takes him to Vienna's central 
212-bed KinderiibernahmsteUe, liter- 
ally the "children's-taking-over-cen- 
ter." Here the child receives physical 
and psychological examinations; and 
some social history is obtained. After 
a stay of several weeks or months, he 
is placed in a foster home or an insti- 
tution. 

Parents unable to pay for foster care 

Approximately 1,400 children are 
in foster homes supervised by the 
city of Vienna. Since by law the 
Jugendamt is responsible for super- 
vising foster homes, no private 
Viennese social agency can place chil- 
dren in such homes. Low incomes 
prevent parents from contributing a 
meaningful percentage toward reim- 
bursing the city for foster care of 
their children. 

Physical destruction resulting from 
the war has strongly contributed to 
the foster-home shortage. Twenty- 
one percent of all Viennese dwelling 
units were damaged, and only a hand- 
ful of new housing has been com- 
pleted since this took place. 

The money allotment for foster- 
home care has increased more than 
100 percent since the end of the war, 
and this has helped to increase the 
number of homes. Viennese foster 
mothers now receive the equivalent 
of $7.50 to $8 per month per child; 
this is in hne with the average 
father's monthly income of $28 to 
$30. The cost of living is far lower 
than in the United States, but in ad- 
dition to food expenditures, the fos- 
ter-home allotment must cover recre- 
ation, allowance, dry cleaning, and 
shoe repairs. Foster homes in areas 
beyond the city limits receive the 
equivalent of $4.50 to $6 per month 
per child. Nearly half the boarded- 
out children live in foster homes in 
the provinces outside Vienna. 
(To be continued in October issue) 



II 



FOR BETTER CHILD HEALTH 

Pediatricians Exchange Views on Ways to Solve Children's Health Problems! 



OW SUCCESSFULLY an ado- 
lescent solves his life problems 
depends partly on how well he 
solved the same types of problems 
when he encountered them in earlier 
childhood, said Dr. Reginald S. 
Lourie at the Eastern Area meeting 
of the American Academy of Pedi- 
atrics, held in Washington, May 22- 
23, 1952. 

Dr. Lourie, who is Director of the 
Department of Psychiatry, Chil- 
dren's Hospital, Washington, D. C, 
cited examples of the types of difR- 
culties that a child meets again and 
again in his life. Some of these. Dr. 
Lourie said, grow out of the young- 
ster's close relationships with other 
people ; some are related to the need 
for his obeying rules ; others are con- 
cerned with his learning orderliness 
and cleanliness. Then there are prob- 
lems concerning his concepts of his 
own body and of sex. 

When the adolescent gets another 
chance at solving such problems, 
went on Dr. Lourie, he may be able 
to correct distortions in his ideas that 
faulty training or environmental sit- 
uations had previously created. And 
in adolescence the child deals with 
the old problems in new ways — with 
different perspectives and more 
energy — ways that can make him and 
the people around him uncomfortable. 
Dr. Leona Baumgartner, New 
York City's Assistant Commissioner 
of Health, and formerly Associate 
Chief of the Children's Bureau, 
stressed the need for integrated and 
concentrated research on the under- 
lying causes of mortality and mor- 
bidity among infants in the danger- 
ous period before birth and just 
afterward. Dr. Baumgartner advo- 
cated development of one or more 
institutes where continuing studies 
of such mortality and morbidity can 
be made through research by workers 
in many fields — by the embryologist. 



the chemist, the physiologist, the 
pediatrician, the obstetrician, the 
physicist, the sociologist, the statis- 
tician — in fact, by every kind of re- 
search worker who has something to 
contribute toward solving this prob- 
lem. 

What one medical ward is doing 

Can we decrease the emotional im- 
pact of hospitalization on a child and 
his parents? Discussing this question. 
Dr. Dane G. Prugh of the Children's 
Medical Center, Boston, described an 
experiment in one medical ward. In 
this experiment professional workers 
in a number of fields are joining to 
lessen children's disturbing reactions 
to illness and hospitalization. 

One step in this direction is to re- 
duce the amount of separation be- 
tween child and parents. Dr. Prugh 
reminded his audience. And so the 
ward's welcome to the parents begins 
when the child is first brought to the 
hospital. At this time the mother and 
father may accompany the child to 
the ward, where they meet and talk 
with the staff members. Again, they 
are encouraged to visit their child 
every day. If they cannot come at the 
regular visiting hours, arrangements 
are made for them to come at times 
more convenient for them. They may 
also help to care for their youngster. 
They may feed him, or read him to 
sleep, or, if they wish, just sit by his 
bed and hold his hand. 

Many people concerned with hos- 
pital management have long thought 
that children cry more if their par- 
ents visit them frequently than if the 
visits are far apart, said Dr. Prugh. 
But when the parents come every 
day, he said, the children soon real- 
ize that the separation will be short. 
And they cry less frantically and less 
frequently than do children who are 
visited only once a week. 



In the experimental group, special 
attention is paid to the individual 
needs of every child. Dr. Prugh said. 
For example, a play supervisor offers 
various kinds of activities to meet the 
emotional needs of different children. 
Although more than one nurse may 
give care to a child from time to time, 
an effort is made to assign one nurse 
to be in particular charge of him. Dr. 
Prugh made it clear that this is done 
especially for a young child or one' 
having difficulty in adjusting. { 

The adjustment of different chil-; 
dren is discussed at a weekly staff 
conference. At this conference, which, 
is directed by a pediatrician with 
psychiatric training, various profes-! 
sional workers contribute ideas from 
their own points of view. Such a con- 
ference may include the ward physi-| 
cian, the head nurse, the play super-] 
visor, the occupational therapist, thej 
medical social worker, the dietitian,j 
the psychologist, and frequently aj 
public-health nurse. : 

Efforts are made to keep from 
scheduling injections or other un- 
pleasant medical procedures near the: 
child's time for play, or a meal, or a 
nap. ' 

Flexible methods v. conventional ones 

Dr. Prugh told of a research studj 
that was made to compare the adjust-^ 
ment of the children treated by these 
fiexible methods with that of the sam( 
number of children cared for by tral 
ditional methods. Children in the lat, 
ter group saw their parents only onc<i 
a week, for an hour, and in otheij 
ways the conditions were similar t(! 
those in most hospitals. i 

Dr. Prugh said that the childrei 
were studied both while they wen 
still in the hospital and after the; 
were taken home, and their reaction; 
to their hospital stay were noted. 

All the children, he said, showe( 
some adverse reactions. In botl 



12 



THE CHILD VOL. 17 NO. 



i^roups, the most severe reactions 
A^ere in the children 3 years of age 
and younger. In children 4 to 6 years 
aid severe reactions were less com- 
mon, and in children over 6 they 
were few. 

After returning home most of the 
children behaved much as they did 
before going to the hospital. A num- 
ber, however, in both groups showed 
significant behavior disturbances 
soon after being discharged that they 
had not shown before they were hos- 
pitalized. More of those in the con- 
ventionally treated group showed this 
temporary maladjustment than of 
those more flexibly treated. 

Dr. Prugh said that in every age 
group the children who had received 
the specially planned individual treat- 
ment, including daily visits from their 
parents, showed fewer and less se- 
vere reactions than did those treated 
by conventional methods. 

INarcotics users need msdical aid 

Dr. Harold Jacobziner, Director of 
New York City's Bureau of Child 
Health, urged special institutions for 
teen-age narcotics users. He based 
his recommendation on studies of 
more than 150 high-school students 
who, when given medical examina- 
tions during the 1950-51 school year, 
were discovered to be users of nar- 
cotics. 

Most of these boys and girls were 
not true addicts. Dr. Jacobziner re- 
ported. They could be weaned away 



from use of narcotics, he said, by a 
4- to 5-month course in a special 
institution. 

Dr. Jacobziner also urged that teen- 
age narcotics users not be treated 
as off'enders against the laws, but as 
diseased persons who need medical 
aid. Treatment, he continued, should 
include not only withdrawal of the 
drug but mental, emotional, and so- 
cial rehabilitation. 

Twenty-five scientific exhibits had 
been set up in connection with the 
meeting. Among these were exhibits 
on Dental services (Children's Hos- 
pital, Washington, D. C.) ; Evalua- 
tion and handling of the infant and 
preschool child with impaired hear- 
ing (Harriet Lane Home, Johns 
Hopkins University Hospital, Balti- 
more) ; Psychological evaluation of 
physically handicapped children (Bu- 
reau of Maternal and Child Welfare, 
Health Department of the District of 
Columbia) ; Unsolved problems in 
fetal and infant mortality (Children's 
Bureau, Federal Security Agency.) 

The Children's Bureau exhibit 
highlighted the hazards to babies 
during the last few weeks of gesta- 
tion and the first few weeks of life. 
It listed these facts on deaths of un- 
born and of newborn babies : 

In the United States in 1949— 

1. Unborn babies who died just 
before birth reached a total of 48,000. 
Not all of these were full term, but 
ail were at least "7-month babies." 



2. Over 37,000 babies died before 
they were a day old. These deaths 
represent a third of all deaths during 
the first year. 

3. Deaths in the first week of life 
amounted to over 65,000 — 58 percent 
of all the deaths of babies less than a 
year old. (This figure includes, of 
course, the 37,000 who died before 
they were a day old.) Of the 65,000 
babies that died during their first 
week nearly 40,000 were prematurely 
born. 

Deaths in the first weel( still high 

The exhibit compared infant deaths 
hi 1948 with those in 1915, when im- 
proved birth registration first per- 
mitted study of trends in infant mor- 
tality. During those 34 years the 
death rate for babies in their first 
year of life was reduced by more 
than two-thirds, but for those in their 
first week the decrease was only one- 
third. 

Dr. Alice D. Chenoweth, pediatric 
consultant on the staff of the Chil- 
dren's Bureau, discussed the implica- 
tions of the exhibit with some of the 
pediatricians attending the meeting. 
Now that maternal mortality has 
been so greatly reduced, she said, and 
also the deaths of infants from the 
second month of life to the end of 
the first year, both pediatricians and 
obstetricians are focusing their at- 
tention on the babies that die before 
birth or soon afterward. 



UNSOLVED PROBLEMS 



IN FETAL AMD INFANT MORTALITY 




little gain has been made in reducing 
mortslily in the first week of life 



over 60^0 of the deaths in 
the first vteek are in prematures 





TRAINING SCHOOLS 

(Continued from page 6) 

and girls in training schools feel the 
respect and dignity fundamental to 
the mental health of each of us. Care- 
fully planned reception and orienta- 
tion procedures, student participation 
in program planning— these are not 
frills but important ingredients in 
treatment. Decent clothing, palatable 
and attractive food, pleasant sur- 
roundings, courteous handling— these 
are not privileges but the rights of 
every American child, and these, too, 
are essentials in a treatment pro- 
gram. 

In my work with the Children's 
Bureau I visit training schools in 
every part of the country. And in the 
course of these visits I am impressed 
again and again by the fact that the 
training-school administrator occu- 
pies a trying and lonely position. He 
must reconcile the demands of treat- 
ment with the need to protect chil- 
dren, program, and public. Failure 
to provide adequate protection will 
quickly result in public criticism. At 
the same time, colleagues in closely 
related professions are frequently in- 
tolerant of any restrictions placed 
upon the children under care. While 
subjected to these conflicting de- 
mands, the administrator must de- 
velop a treatment program, which 
means achieving and maintaining a 
progressive but realistic focus for 
himself and staff. 

Yet in a broader sense, his is not 
a solitary endeavor. Others are en- 
gaged in this same hard task. For 
the program he seeks to develop is 
directed toward resolving human con- 
flict, improving human relationships 
—and this is the concern of all of us. 
The wellsprings of juvenile delin- 
quency—neglect, poverty, fear, hate, 
cultural conflicts, ignorance — these 
are also the wellsprings of all human 
conflict. And whether we work to 
improve training-school programs or 
the United Nations, we are applying 
ourselves to the task of helping peo- 
ple to find a constructive and satisfy- 
ing way of life in a society of free 
men. 

Reprints in about 6 weeks 



CAMPING 

{Continued from page 9) 

properly. Travel to camps requires a 
great deal of time because many of 
them are located many miles from 
the nearest major highway. 

The Department's report of the 
survey points to the serious need of 
adequate State staffing if protection 
of children in camp is to be achieved. 
The report says: 

"While the 1951 licensing experi- 
ence cannot be considered conclusive 
as to the number of camps one field 
worker can license, it did provide the 
following general conclusions, on 
which future plans for licensing 
would need to be based : 

"Staff must be available on a year- 
round basis and not during the sum- 
mer months only. The most construc- 
tive work in bringing about improve- 
ments in camps can be done only dur- 
ing the noncamping season. Changes 
in staflF, buildings, sanitary facilities, 
and so forth cannot be made while 
children are at camp. 

"Most camps begin to plan for the 
summer during January and Febru- 
ary. Counselor recruitment is begun 
in February and staffs are usually 
complete by April or May. Camp re- 
pairs and improvement are made in 
the spring and sometimes during the 
winter, if weather permits. 

"It is essential to have staff in the 
summer to visit and evaluate camps ; 
in the fall to follow-up with camps 
on the results of the summer visiting ; 
in the winter and spring to discuss 
preliminary planning for next sea- 
ion's operations. 

"Fire and sanitary inspections 
should be requested by the first of 
April at the latest, to allow time for 
any needed changes. Ideally, camps 
should be licensed before the season 
starts and visits during the season 
made as a follow-up on discussed 
plans and as the basis for next sea- 
son's license. 

"As more experience is gained and 
more camps licensed, it can be ex- 
pected that renewals of licenses will 
require less time, but it can be ex- 
pected that there will be considerable 



"Sufficient staff must be available! 
to act promptly on serious complaint| 
situations, without neglecting the to- 
tal caseload of camps. 

The foregoing information on Cali- 
fornia is given in a report of the 1951 
survey, published in February 1952 
by the State Department of Social 
Welfare, entitled "Camps for Chil- 
dren in California." 

During the present year, the De- 
partment has continued to work with 
its camp advisory committee, which 
has been expanded to include repre- 
sentatives of additional groups. 

A subcommittee, appointed to con- 
sider sound, practical requirements 
covering all aspects of fire safety in 
[•amps, has developed a booklet, 
"Guides to Fire Safety in Camps for 
Children in California," and copies 
have been sent to all camps. Another j 
subcommittee is considering sanita- 
tion and the whole area of health pro- 
tection. Plans have been worked out 
with the State Department of Public 
Health and the Conference of Local ; 
Health Ofl^cers, under which sanita- 
tion inspection services will be avail- 
able to every camp. 

Licensing activity, still on a limited 
scale, is continuing, with major em- 
phasis on private camps. Cooperative 
eff'orts toward stimulating the camps 
to meet minimum standards are con- 
tinuing with such groups as the 
American Camping Association and 
the national youth-serving agencies. 

California's State Department of 
Social Welfare is hopeful that its ef- 
forts will bring about a sound practi- 
cal program in the State, leading to 
adequate protection of children in 
camps. 

A number of other progressive 
States also are working to improve 
camping programs for their children. 
These efforts are becoming more and 
more significant in view of the rising 
number of children in the United 
States, for by the end of the present 
decade probably as many as 4,000,000 
youngsters will be going to camp each 
summer. 



THE CHILD VOL 17 NO. 1. 



THE NEWS 



Education for social work. After 
several years devoted to a study of 
methods of improving social-work 
education, the National Council on 
Social Work Education, reconstituted 
as the Council on Social Work Edu- 
cation, began operation July 1 with a 
new constitution and by-laws. 

The Council is now governed by a 
delegate body of 78 members. Thirty 
of these are representatives of educa- 
tional institutions — graduate schools 
of social work (20) and undergradu- 
ate departments (10) offering pro- 
grams with social-work content in- 
troductory to professional social 
work. Eighteen represent national 
professional social-work organiza- 
tions. Another 18 represent national 
agencies employing social workers (9 
public agencies and 9 private). The 
other 12 delegates are member s-at- 
large, representing higher education 
— especially departments of the so- 
cial sciences — disciplines related to 
social work, and the general public. 

The work is carried on by four 
commissions : A commission on ac- 
creditation ; a commission on pro- 
gram, planning and services, and 
publications ; a commission on re- 
search ; and a commission on schools 
and departments of social work. 

The Council will assume the func- 
tions that have been carried on by the 
American Association of Schools of 
Social Work and the National Asso- 
ciation of Schools of Social Work. 



OR YOUR BOOKSHELF 



A HEALTHY PERSONALITY FOR 
YOUR CHILD. Federal Security 
Agency, Social Security Adminis- 
tration, Children's Bureau. CB 
Pub. No. 337. Washington. 1952. 
23 pp. For sale at 15 cents by the 
Superintendent of Documents, 
Government Printing Office, Wash- 
ington 25, D. C. Single copies avail- 
able from the Children's Bureau 
without charge. 

Nobody is completely certain about 
the way personality gains health and 
strength. But many people — psy- 
chologists and psychiatrists, anthro- 
pologists and sociologists, physiolo- 
gists and geneticists — have been 
studying children for many years. 



They have some practical ideas about 
what brings good results in building 
healthy personalities. Some of the 
conclusions they have arrived at are 
given in this pamphlet, which was 
written by James L. Hymes, Jr., 
Ed.D., Professor of Education, 
George Peabody College for Teach- 
ers, Nashville, Tenn. 

Dr. Hymes based his manuscript 
largely on material submitted to the 
Fact Finding Committee of the Mid- 
century White House Conference by 
Dr. Erik H. Erikson and incorpo- 
rated in the report of this committee, 
entitled "For Every Child a Healthy 
Personality," which is usually re- 
ferred to as the "Fact-Finding Di- 
gest." 

For the use of parents' groups in- 
terested in exploring problems of 
emotional growth in children, a dis- 
cussion aid based on this pamphlet 
has also been published. See the 
notice below. 

DISCUSSION AID FOR "A 
HEALTHY PERSONALITY FOR 
YOUR CHILD." Federal Security 
Agency, Social Security Adminis- 
tration, Children's Bureau. CB 
Pub. No. 338. Washington. 1952. 
IG pp. For sale at 10 cents by the 
Superintendent of Documents, 
Government Printing Office, Wash- 
ington 25, D. C. Single copies 
available from the Children's Bu- 
reau without charge. 

Mrs. Marion L. Faegre, Consultant 
in Parent Education, Children's Bu- 
reau, and Dr. Hymes, the author of 
"A Healthy Personality for Your 
Child," collaborated in preparing this 
discussion aid for use by parents' 
groups. 

The bulletin includes suggestions 
on subjects for discussion and on 
methods of conducting group meet- 
ings. It lists some useful material — 
pamphlets, books, and films. 



LENDAR 



Aug. 2.5-28. American Legion. Thirty- 
fourth annual national convention. 
New York, N. Y. 

Aug. 26-28. American Political Science 
Association. Forty-eighth annual 
meeting. Buffalo, N. Y. 

Aug. 27-29. Southwest Regional Con- 
ference on Migrant Labor. (Needs 
of children and youth.) University 
of New Mexico. Albuquerque, N. 
Mex. 



Aug. 31-Sept. 2. National Council on 
Family Relations. New Brunswick, 
N. J. ' 

Sept. 1-5. National Urban League. 
Annual conference. Cleveland, 
Ohio. 

Sept. 1-6. American Psychological 
Association. Sixtieth annual meet- 
ing. Washington, D. C. 

Sept. 1-30. Sight Saving Month. In- 
formation from National Society 
for the Prevention of Blindness, 
1790 Broadway, New York 19, 
N. Y. 

Sept. 3-5. American Sociological So- 
ciety. Forty-seventh annual meet- 
ing. Atlantic City, N. J. 

Sept. 6-7. American Society of Den- 
tistry for Children. Silver anni- 
versary meeting. St. Louis, Mo. 

Sept. 8-11. American Dental Associ- 
ation. Ninety-third annual meet- 
ing. St. Louis, Mo. 

Sept. 11-13. National Legal Aid Con- 
ference. Thirtieth annual confer- 
ence. San Francisco, Calif. 

Sept. 11-16. National Conference of 
Catholic Charities. Thirty-eighth 
annual meeting. Cleveland, Ohio. 

Sept. 1.5-18. American Hospital Asso- 
ciation. Fifty-fourth annual con- 
vention. Philadelphia, Pa. 

Sept. 17. Citizenship Day. 

Sept. 17-19. National Conference on 
Citizenship. Seventh annual meet- 
ing. Washington, D. C. 

Sept. 28-Oct. 4. Christian Education 
Week. Twenty-second annual ob- 
servance. Sponsored by the Na- 
tional Council of the Churches of 
Christ, Division of Christian Edu- 
cation, 79 East Adams Street, Chi- 
cago 3, 111. 

Sept. 29-Oct. 3. National Recreation 
Association. Thirty-fourth Na- 
tional Recreation Congress. Se- 
attle, Wash. 

Regional conferences, American 
Public Welfare Association: 
Sept. 2-4. West Coast region. Vic- 
toria, B.C., Canada. 
Oct. 9-11. Northeast region. Phila- 
delphia, Pa. 
Oct. 23-25. Southeast region. Charles- 
ton, W. Va. 

Regional conference. Child Wel- 
fare League of America: 
Sept. 2.5-27. Midwest region. Des 

Moines, Iowa. 



Illustrations: 

Pages 3 and 4, Philip Bonn for the Chil- 
dren's Bureau. 
Page 11, courtesy of the authors. 



AUGUST - SEPTEMBER 1952 



15 




VOL. 17 NO. 1 

AUGUST-SEPTEMBER 

1952 



In This Issue 



Page 



We Can Do Something Abont Juvenile Delinquency 
Martha M. Eliot, M.D. 



Training Schools and the Future 3 

Richard Clendenen 

Toward Better and Safer Camping 7 

Martin Gula 

A Visitor's View of Child Welfare in Vienna 10 

H. Ted and Bunny Rubin 

For Better Child Health 12 



Published 10 times a year by the Division of Reports, Children's Bureau 
Editor, Sarah L. Doran Art Editor, Philip Bonn 

FEDERAL SECURITY AGENCY 
Oscar R. Ewing, Administrator 



SOCIAL SECURITY ADMINISTRATION 
Arthur J. Altmeyer, Commissioner 



CHILDREN'S BUREAU 
Martha M. Eliot, M.D., Chief 



Publication of THE CHILD, monthly bulletin, has been authorized by the Bureau of 
the Budget, September 19, 1950, to meet the needs of agencies working with or for 
children. The Children's Bureau does not necessarily assume responsibility for state- 
ments or opinions of contributors not connected with the Bureau. 

THE CHILD is sent free, on request, to libraries and to public employees in 
fields concerning children; address requests to the Children's Bureau, Federal Security 
Agency, Washington 25, D. C. For others the subscription price is $1.25 a year. On 
all orders of 100 or more sent to one address there is a discount of 25 percent. Send 
your remittance to the Superintendent of Documents, Government Printing Office, 
Washington 25, D. C. Single copies 15 cents each. 

Foreign postage — 25 cents additional — must be paid on all subscriptions to coun- 
tries in the Eastern Hemisphere and those sent to Argentina and Brazil. Domestic 
postage applies to all other subscriptions. 







U S. GOVERNMENT PRJNTING OFFICE: 1951—912 



HE 



CHILD 



.-X-^v^ — 



OCTOBER 1952 



mum 



'4- 




UNITED NATIONS DAY, 1952 

BY THE PRESIDENT OF THE UNITED STATES OF AMERICA 

U. 8. SUPERINTENDENT OFITOCUMEff^ 



^/7 A roclamati 



Whereas the founding of the United Nations has given the people of the world 
an organization through which nations may resolve their differences without resort to 
war and has made possible greater international cooperation in the economic, political, 
and cultural fields ; and 

Whereas the United Nations continues to be the only existing international organ 
which offers mankind a hope for ultimate world peace ; and 

Whereas the realization by citizens of other nations that the overwhelming 
majority of Americans support the United Nations and its great purposes would help 
to speed the day when there will in fact be peace on earth, good will toward men ; and 

Whereas the General Assembly of the United Nations has declared that October 
24, the anniversary of the entry into force of the United Nations Charter, shall be 
dedicated each year to the dissemination of information concerning the aims and 
accomplishments of the United Nations: 

Now, Therefore, I, Harry S. Truman, President of the United States of America, 
do hereby urge the citizens of this Nation to observe Friday, October 24, 1952, as 
United Nations Day by sending greetings to friends, relatives, and associates in other 
countries which are members of the United Nations, and by expressing their confidence 
in the United Nations, their friendship for other peoples, and their faith in the ulti- 
mate demonstration throughout the world of the brotherhood of man. 

I also call upon the officials of the Federal, State, and local Governments, the 
National Citizens' Committee for United Nations Day, representatives of civic, educa- 
tional, and religious organizations, agencies of the press, radio, television, motion 
pictures, and other communications media, and all citizens to cooperate in appropriate 
observance of this day throughout our country. 

In Witness Whereof, I have hereunto set my hand and caused the Seal of the 
United States of America to be affixed. 

Done at the City of Washington this seventeenth day of July in the year of our 

Lord nineteen hundred and fifty-two, and of the 
Independence of the United States of America 
the one hundred and seventy-seventh. 




By the President : 




Secretary of State 



FURTHERING INDIVIDUAL WELL-BEING 
THROUGH SOCIAL WELFARE 



MARTHA M. ELIOT, M.D. 

Chief, Children's Bureau 

TO THOSE of US who spend our 
days and years in the broad field 
of social welfare, it seems un- 
necessary to labor the point that the 
welfare of our society as a whole and 
individual well-being are indivisible, 
that our culture has been built around 
the individual and his rights, his de- 
sires, his present and future hopes. 
But when we see how, in crisis situa- 
tions such as the one we are in now, 
our programs for social advance are 
questioned as expendable, as luxuries, 
we must admit that we have failed 
to make our own trust and confidence 
in these programs clear to others. It 
behooves us to restate this confidence. 
And to restate it so convincingly that 
even the most ingrown individualist 
can not only tolerate it but accept 
it as his own. 

It may be unnecessary to say it, 
but I want to make it clear that I am 
using the term welfare in the broad- 
est sense, to include, as does the 
World Health Organization's defini- 
tion of health, the total well-being of 
people in our society. Many profes- 
sions contribute to it ; it includes the 
family, the community, the Nation ; 
it means health, education, employ- 
ment, and economic security, as well 
as provision of social services ; it 
means full opportunity for the de- 
velopment of a healthy personality 
for each new member of our society 
as he or she comes into being. 

Concern for the well-being of indi- 
viduals is the essence then of our 
concept of social welfare. One of 
the wisest acts of our forefathers was 
to imbed in our Constitution — as an 



Dr. Eliot gave this paper at the California 
State Conference of Social Work, held at 
Long Beach, Calif. 



eternal reminder to us — this concept 
that individual well-being is some- 
thing that we must unite to achieve. 
It is not something that each of us 
plucks for himself. "To promote the 
general welfare," as our Constitution 
says, was one of the primary pur- 
poses for which we created this Na- 
tion. And the purpose of uniting to 
promote the general welfare was to 
achieve the greatest possible degree 
of security, happiness, freedom, and 
well-being for each individual. 

I have the privilege of serving as 
Chief of a Bureau of the Federal 
Government which was created to 
give meaning to this phrase in the 
Constitution. The act creating the 
Children's Bureau is significant be- 
cause it is a recognition that the 
struggle for the well-being of your 
child cannot be won unless it is won 
for all children. 

In a living democracy there can be 
no separation between individual and 
social well-being. 

Now individual well-being calls for 
many things . . . things of the body 



and, what is much more important, 
things of the mind and the feelings. 
As I see it, each of us is best able 
to function when we see ourselves 
and our environment in perspective; 
when we can share our purposes with 
others and trust each other and our- 
selves ; when we are not afraid to 
question, or to use our imaginations ; 
when we accept limits ; and when we 
have courage and strength to fight 
when fighting is called for. 

These are things of the mind and 
the feelings. And they are the stuff 
of life for most of us. Some of us 
do a fair job of achieving these 
qualities. But none of us achieves 
them entirely "on our own." All of 
us must have help, from our families, 
our schools, our communities and 
their institutions, our Nation . . . 
yes, and from the world. Some of us 
have need of special help in acquiring 
that quality of strength that makes 
it possible for us to function with- 
out doubts about ourselves, with 
trust and generosity toward others. 

Social welfare has many goals, but 



When day-care services are planned for children of working mothers, skills from many 
fields need to be drawn upon, such as health, social work, and nursery-school education. 



OCTOBER 1952 




one of its major goals, I am con- 
vinced, is to find the way to give that 
extra ounce of support to those indi- 
viduals who need help in finding their 
strengths so that they can build on 
them. 

Critics say that programs designed 
to underpin the economic and social 
well-being of people make people 
soft, indulge them in alleged laziness, 
shiftlessness, or vanity. They say 
the money we dole out buys sister a 
fur coat. Or when it doesn't do that, 
it encourages her to have babies out 
of wedlock. These things we resent. 

But I must say, in fairness, that 
the problem is largely one of under- 
standing on both sides. The purpose 
of social-welfare programs has not 
been sufl^ciently well interpreted to 
the general public, and social-welfare 
workers still need to understand 
more fully the forces, the traditions, 
the cultural patterns that underlie 
the criticisms. 

Democracy and the individual 

The purpose of social-welfare effort 
is simple and clear. It can also be 
persuasive. It starts from the premise 
that each individual has a uniqueness 
of power, and that each individual 
develops best and accomplishes most 
— for himself and for society — when 
he has a chance to develop along the 
line of his own strength, however 
feeble or strong it may be. 

This is, and this must be, the basic 
premise of a democratic society in 
all its activities. 

Once the idea becomes clear that 
the purpose of the social-welfare pro- 
gram is to help individuals discover 
what they are best at doing so that 
they can do their best, most of the 
cynical and hostile criticism of these 
programs will evaporate. 

I will go even a step farther and 
say this : Once the idea becomes cen- 
tral in our culture that, as Harry 
Overstreet says, "a man is at his best 
when he is doi7ig his best at what he 
can do best," then the need for at 
least some kinds of social-welfare 
programs will disappear. 

At no time in its history has our 
Nation been in greater need than 

20 



right now for competent, well-inte- 
grated, productive citizens. Instead 
of decreasing programs that make 
for social well-being and better hu- 
man relations, we should be strength- 
ening them. Instead of cutting their 
budgets, we should be zealously pro- 
tecting their priority to funds, in the 
interest both of national and indi- 
vidual well-being. The problems that 



services, medical and hospital care 
when sick, vocational counseling, and 
above all warm and congenial family 
life. But, as you and I well know, the 
picture is not as rosy as this for hun- 
dreds of thousands of our children. 

Today there are II/2 million depen- 
dent children in families receiving 
Aid to Dependent Children under the 
Social Security Act. We are proud 




Today l'/2 million children are enabled to remain at home through the Aid to Dependent 
Children program. But in some of the States the living afforded these families is meager. 



many individuals encounter in func- 
tioning as competent, well-integrated, 
productive citizens in peacetime are 
compounded when the threat of war 
hangs heavy over us. 

But it is not only external threats 
that make the support of our social- 
welfare programs essential. We have 
the obligations that a democracy has 
toward its citizens who need help. 

My first concern, naturally, is with 
the well-being of children. After see- 
ing the wretchedness that surrounds 
the lives of so many millions of chil- 
dren in other countries, I am well 
aware of the advantages that the 
great majority of our children enjoy 
— life in a free community, educa- 
tion, good housing, recreation facili- 
ties, play space, health and welfare 



that we have such a program that 
assures home life for these children. 
But we cannot take pride in the 
meager living that ADC affords many 
of them in some States, nor in the 
punitive attitude some people take to- 
ward mothers who need this help to 
hold their families together. 

Juvenile delinquency is on the up- 
grade again, if we can take as an 
index the number of youngsters who 
become known to the police or are 
brought before our courts for delin- 
quent acts. More than 350,000 de- 
linquent children, now appearing in 
juvenile courts in a year, are a stark 
reminder of the many deprivations, 
neglects, and inequities which chil- 
dren suffer, and of the lack of warm 
parent-child relations in many fami- 

THE CHILD VOL. 17 NO. 2 



lies. Between 50 and 100 thousand 
young delinquents are detained in 
city and county jails, places where no 
child should ever be housed. The 
30,000 boys and girls in training or 
correctional schools for delinquent 
children are still another prod to our 
consciences. 

In an ever-increasing number of 
homes today, the mother as well as 
the father has a job and is away from 
home for long hours. Suitable day- 
care services for children of working 
mothers — and there are well over 6 
million such children today — are all 
but nonexistent in many communities. 

Our State crippled children's agen- 
cies have on their waiting lists many 
thousands of children whose only 
hope for medical or surgical care 
rests in agencies that do not have 
adequate funds to provide such care. 

Health and welfare agencies are 
doing good jobs for children in many 
communities. But hundreds of thou- 
sands of children live in areas that 
such services rarely if ever reach. 

Of all our children, some of the 
most disadvantaged are those in 
families of migrant workers, those 
who grow up in isolated communities 
such as mining and mountain towns, 
and children who are members of 
minority groups clustered in urban 
and rural slums. The conditions under 
which many of these children live are 
a blight on our national life. 

Democracy has much unfinished 
work to do for such groups as these. 

How can the promotion of indi- 
vidual well-being best be accom- 
plished? Belief that social good is 
achieved through concern for the wel- 
fare of individuals leads away from 
generalities to some practical mea- 
sures. 

In the ifield of social service, I 
sometimes wonder whether too great 
a concentration of effort has been 
placed upon measures that will rem- 
edy or mitigate difficulties that have 
already happened. The preventive 
approach that now dominates public 
health has not yet been developed as 
effectively in the social-welfare field 
as it should and will be. Planning for 
social services too often has had to be 
restricted to children and adults in 



special need. This does not reflect on 
the planners as much as it reflects 
the limited understanding the public 
has of the positive role that social 
welfare can play. Even in public 
health, where preventive programs 
have long been accepted, it is only 
comparatively recently that workers 
have made organized efforts to pro- 
mote sound mental health and di- 
rected their efforts against the social 
conditions that undermine it. 

Health and welfare interrelated 

This growing recognition of the 
importance of emotional factors in 
individual well-being is changing the 
concept of needed measures in both 
health and welfare fields, and draw- 
ing these two fields closer together. 

As public-health workers come to 
see that few individuals can be truly 
healthy when they live in an atmos- 
phere of suspicion and doubt, or 
when their opportunity to live de- 
cently is continually threatened by 
advancing living costs, they find that 
they must reconsider what preventive 
health work calls for. 

So, too, social-welfare workers find 
that they cannot be content with mea- 
sures aimed at aiding only those who 
have fallen by the wayside. They, 
too, must do preventive work and 
reach children and families before 
damage is done. This means pro- 
grams for children in their own 
homes, in schools, in playgrounds. It 
means working ever more closely 
with health workers, who have ready 
access to the homes of nearly all 
families. 

Important as preventive measures 
are — measures that seek to assure 
that physical, social, and emotional 
growth shall proceed satisfactorily — 
we cannot, however, concentrate on 
them to the exclusion of measures for 
aiding people who are in difficulty. 
Let me touch on some of the areas 
of work to which I believe we should 
give attention right now. 

First on my list of problems of the 
welfare of individual children I have 
placed juvenile delinquency. 

Preventing delinquency is to all in- 
tents and purposes the equivalent of 
promoting individual well-being. Its 
ramifications are so varied, its area 



of operations is so broad, that it is 
indeed difficult to formulate the all- 
embracing program that might guar- 
antee success. The prevention of de- 
linquency and the study of its causes 
must, however, stand as our over-all 
purpose in any comprehensive pro- 
gram in this field. It involves all the 
best of the total welfare program. 
Those responsible for preventive wel- 
fare and health services should bear 
more constantly in mind that one of 
their goals — and a large and impor- 
tant one — is the contribution they 
can make to reducing juvenile de- 
linquency. This is too often over- 
looked, usually because the connec- 
tion has not been clear. 

There are, however, certain specific 
things we must do for children who 
are already delinquent. It is from the 
ranks of these children that many 
adult ci-iminals come. For national as 
well as individual welfare, we must 
do all we can to restore to full social 
and emotional well-being the children 
who engage in delinquent acts. 

Recently, the press of the Nation 
has been greatly agitated about one 
manifestation of delinquent behavior, 
the use of narcotics by juveniles. Al- 
though this problem seems to be 
acute among certain groups of chil- 
dren, reports indicate that it exists 
mostly in large cities, and it may not 
have the proportions that popular re- 
ports have given it. Nevertheless, 
there is still a major job to do in con- 
trolling sources of supply and in as- 
suring that the laws regarding the 
sale of narcotics are strictly enforced. 
Much more attention must also be 
given to discovering the causes of 
drug addiction on the part of young 
people and to rehabilitating those 
who have acquired this fearful habit. 

To work effectively with juvenile 
delinquents calls for many skills that, 
as a Nation, we have still to make 
generally available. It requires that 
a better job be done in equipping 
for this work police and probation 
workers, judges, and institutional 
staffs ; it means special training for 
child-welfare workers, teachers, and 
doctors, who see many of these chil- 
dren before they become known to 
police or courts. We must concern 
ourselves more with problems of the 



OCTOBER 1952 



21 



delinquent's family and with the so- 
cial conditions under which they live. 
We need skilled workers, whom we 
do not now have in sufficient num- 
bers, to carry on effective programs 
of treatment and rehabilitation. This 
includes psychiatrists and other 
workers in child-guidance clinics. We 
need special study homes or other 
provision for diagnostic and treat- 
ment facilities. We need to know 
much more about how delinquents are 
handled in detention homes and insti- 
tutions, what are the best methods of 
treatment, and what are the subse- 
quent careers of those who spend time 
in jail or correctional institutions. 

If all of us in the social-welfare, 
education, and health fields were to 
put our minds to it we could evolve 
a long-range program that would not 
only improve this situation but con- 
tribute greatly to the well-being of 
many thousands of children and 
adults. 

Second on my special list of areas 
of work for children is the care of 
children who must live away from 
home all or part of the time, either 
in foster-family homes or in institu- 
tions. 

Dr. John Bowlby, a distinguished 
child psychiatrist of the Tavistock 
Clinic in London, in a recent mono- 
graph published by the World Health 
Organization, reviews scientific evi- 
dence from many countries regarding 
the effect on children of separation 
from their mothers. He comes to the 
conclusion that this is a very hazard- 
ous undertaking. In the light of Dr. 
Bowlby's observations, it certainly 
behooves us to study various aspects 
of this problem and to examine very 
carefully our criteria and our prac- 
tices in placing childi'en away from 
their own homes. 

It is also important to determine 
how day-care services can best be 
given, what the most helpful joint 
contributions of teachers, doctors, 
nurses, and social workers can be, 
what we can learn from the experi- 
ence of nursery-school educators. 

Day care for children is a problem 
that is likely to remain with us in- 
definitely. We in the Children's Bu- 
reau are inclined to agree with Dr. 

22 



Bowlby that it is best that mothers 
of young children stay at home with 
their children whenever the strain of 
doing so does not outweigh the ad- 
vantages. Nevertheless, it is only 
realistic to recognize current develop- 
ments and to insist that, if mothers 
are to be employed, services for the 
day care of their children be pro- 
vided, and that these services be con- 
ducted in a way that conserves and 
advances the children's well-being 
and makes for their future mental 
health. 

Federal funds can, under the "De- 
fense Housing and Community Fa- 
cilities and Services Act of 1951," be 
made available for day care in critical 
defense housing areas. But whether 
they will be appropriated, and how 
soon, I do not know. Of course you 
know that grants to States for child- 
welfare services under the Social Se- 
curity Act can be used in promoting 
day-care services. The grants are not 
yet adequate to provide much in the 
line of direct services, but they can 
be effectively used for consultation 
to communities and for planning. 

The third area of work that I want 
to emphasize is research and evalua- 
tion of operational programs. This 
applies to the child-health as well as 
the child-welfare fields. It involves a 
great variety of study methods and 
without question must be multidisci- 
plinary in its approach. 

The maternal and child-welfare 
programs under the Social Security 
Act are now 17 years old. Some of 
the State and local child-health and 
child-welfare programs are much, 
much older than that. It is high time 
that we in the States and communi- 
ties and in the Federal agencies de- 
veloped better yardsticks for measur- 
ing how well we are doing our jobs. 
Progress should be made in this direc- 
tion, not only because funds must be 
well spent, but, even more, because 
the objectives of our programs have 
great meaning for the national wel- 
fare when they are well conceived 
and the ways of achieving them effec- 
tively designed and carried out. 

Along with evaluative studies 
should go research of an operational 
nature that will produce facts on 



which decisions about new programs, 
policies, and working methods can 
be based. For example, we need to 
know more about the kinds and costs 
of health service and medical care 
received by children in rural as well 
as in urban areas ; and by children in 
special groups, such as those in mi- 
gi'ant families, ADC families, and 
children in institutions. We need to 
study methods of improving the qual- 
ity of care for such children. We 
need to know what becomes of chil- 
dren who for one reason or another 
are refused care or public assistance. 
We need to know more about the end 
results of adoption practices in terms 
of the mental health of adopted chil- 
dren. The same is true for children 
in institutions. Answers to questions 
like these would give us much to go 
on in our everyday work. They might 
also prove an effective means of show- 
ing the public why health and wel- 
fare programs are so much needed. 

Basic research needed 

Evaluation and fact-finding of 
these types, however, are not enough. 
More basic research in the social and 
biological sciences should be going 
on. Our work is seriously handi- 
capped by lack of adequate under- 
standing, for example, of the values 
and customs of the various subcul- 
tures in American society and how 
they relate to the origins of delin- 
quent behavior. We recognize pre- 
mature birth as problem number one 
in reducing infant mortality, but we 
know too little about the psychologi- 
cal and physical conditions producing 
it. The choice of operational or basic 
research to be fostered could well be 
guided by questions arising in every- 
day program activities. 

Thei'e isn't a business of any size 
in the country that is operating suc- 
cessfully and keeping up with its 
market that does not earmark funds 
for research. Despite the fact that 
legislatures and social-welfare boards 
are composed largely of persons who 
are already persuaded of the value 
of market and product research, it is 
usually hard to get appropriations 
for research in the social-welfare 
field. I wonder whether much of our 
problem is not our own lack of con- 

THE CHILD VOL 17 NO 2 



viction that research in the social 
sciences must be a part of all welfare 
programs if progress in practice is 
to be continuous. Or is it that meth- 
ods of investigation in the social- 
welfare field need to be set up? Or, 
again, is it that we are satisfied for 
the time being with present practices, 
while we wait for the gaps to be nar- 
rowed between our present knowl- 
edge and the extent to which that 
knowledge is put to work? Do we 
sometimes hesitate to seek new facts 
for fear they will add more work to 
an already overburdened staif? Let 
me suggest that well-directed re- 
search, especially that of an opera- 
tional or methodological nature, may 
well simplify rather than complicate 
existing programs. Whatever the rea- 
son for the inadequacy of research, 
it seems to me to be imperative that 
new impetus be given to research that 
will provide the facts upon which 
programs in social welfare will be 
based. In such a program the central 
idea should be the search for ways of 
furthering individual well-being in 
our modern complex society. 

I can only touch on two more 
aspects of the social-welfare program 
— more and better training of more 
workers, and increased citizen par- 
ticipation in our programs — but the 



space I can give to these is no mea- 
sure of their importance. 

Again and again, experience has 
shown that effective service to people 
calls for skilled, trained workers. We 
could do a far better job of strength- 
ening individuals and of helping fam- 
ilies if more of our workers were 
given help in getting the professional 
skills they need. Too few boys and 
girls are preparing to enter the so- 
cial-welfare professions. Vigorous 
campaigns for recruitment of new 
workers must go along with expan- 
sion of training opportunities for the 
workers we now have. 

None can stand alone 

At the beginning of this paper I 
said that none of us can achieve a 
genuine feeling of well-being "on our 
own," or in isolation from the rest 
of the world. Gradually, through such 
participation, especially in local 
groups, there will spread a more 
thorough understanding and appreci- 
ation of the purposes and underlying 
principles of the total welfare pro- 
gram. 

In working with the World Health 
Organization, it was brought home 
to me again and again that typhus 
and typhoid fever, dysentery, and 
malaria have no nationalism. Mavbe 



Some of the most disadvantaged of our children are those in families of migrant workers. 




we in the health field have a special 
obligation to remind others also of 
the simple fact that the well-being 
of people everywhere is interrelated. 

I cannot urge on you too strongly 
support of the programs of the 
United Nations and of the specialized 
organizations affiliated with it, 
which are attempting to improve the 
opportunities for better living for the 
children of the world. Our own tech- 
nical-assistance program has great 
potentialities, too, for making the 
world a safer, more decent place for 
children. I share with Mr. Justice 
William Douglas the hope that wher- 
ever our Point IV program goes, 
with its technical and economic help 
to other peoples, it goes accompanied 
by a "Point V," the spirit and con- 
victions of 1776, out of which our 
ancestors framed a government dedi- 
cated to promotion of the general wel- 
fare, and, I might add, to the rights 
of peoples to self-determination and 
self-government. 

When we give assistance to so- 
called underdeveloped areas for agri- 
cultural and industrial development, 
we should give support at the same 
time to programs in the spheres of 
health and welfare which go hand in 
hand with economic development. Let 
us not be guilty of encouraging others 
to make the mistake we made in our 
own country for so long in concen- 
trating on expanding our economic 
resources and neglecting the well- 
being of the human beings for whom 
those resources are intended. The 
time to plan programs of social ad- 
vance is not after great wealth has 
been built up, but at the start of 
programs for economic development. 

In these critical times we must be 
more alert than ever to express our 
conviction that social-welfare pro- 
grams do contribute positively and 
effectively to furthering individual 
well-being and the general welfare. 
We do not have to persuade ourselves 
of this fact. But we do have to spread 
confidence that it is so, and to make 
very clear to the public our convic- 
tion that the long-time emergency we 
are in requires the utmost in preserv- 
ing and enhancing every human re- 
source we have. 



23 



HELEN LELAND WITMER 

TiHIS PAPER might well have a 
subtitle: An interpretation of 
social research to the social- 
work public and a plea for help. Year 
after year, for about 30 years, speak- 
ers before this Conference have urged 
that social workers give serious at- 
tention to the business of evaluating 
their work. Dr. Richard Cabot, in a 
presidential address in the early 
1930's, startled the Conference by 
insisting that social work should fol- 
low medicine's example and deter- 
mine the effectiveness of its services. 
Others had said much the same thing 
years before, and annually we listen 
to the same plea. Persons outside the 
profession are perhaps even more in- 
sistent that social workers should 
determine how much they accom- 
IDlish. 

In view of all this, why have we 
as a profession generally and we 
social-research people in particular 
been so slow in getting ahead with 
this task? There are various answers 
to that question: Lack of money, of 
time, of professional skill ; unwilling- 
ness to face possibly unpleasant facts ; 
and so on. All these are easily under- 
standable. But there is one answer 
to which insufficient attention has 
been paid : The inherent difficulties in 
evaluating so tenuous a thing as so- 
cial work. These difficulties are well 
known to research workers. I think, 
however, that we in research have 
hugged them to our bosom too 
fondly; they are so precious, so eso- 
teric, so useful in protecting our 
sense of self-esteem. It might be bet- 
ter if we showed them to the rest of 
you — even at the risk of having them 
disappear. 

The first problem we face in at- 
tempting to devise a scheme for judg- 
ing the effectiveness of social work is 
that of goals or objectives. In medi- 
cine — our favorite analogy — effec- 
tiveness is judged by lives saved, by 
the crippling effects of diseases and 
disorders being eliminated or re- 



24 



duced, by the progress of the disease 
be'ng halted, and so on. What are the 
comparable aims of social work? 
What do we expect the accomplish- 
ments of social work, successfully 
carried on, to be? 

Goais ssem cisar 

Offhand, it would seem as though 
that question could be easily an- 
swered. We expect social work to re- 
duce the number of delinquents, to 
result in fewer parents neglecting 
their children. If the claims of the 
drives for funds are to be believed — 
the man-on-the-street says — social 
work should mean fewer broken 
homes, fewer children separated from 
their parents, fewer old people living 
in extreme poverty. And so on. 

The trouble with this kind of test, 
however, lies in that word "fewer." 
Fewer than v/hat? Obviously we 
mean "fewer than there would have 
been if there had been no social-work 
services." But this is not the same as 
saying "fewer now than there were 
in the past." Conditions may have 
changed in such a way as to make for 
an increase in separations and di- 
vorces, a decrease in jobs for old peo- 
ple, a greater likelihood of delin- 
quency — and for these changes social 
work is neither to be credited nor 
blamed. This being so, no easy test 
of social work's effectiveness is to be 
found in comparing the present with 
the past or in noting the incidence of 
maladjustment generally. 

The criterion "fewer" may, how- 
ever, be taken to refer to change in 
particular cases. The X family ex- 
hibited such-and-such behavior be- 
fore a social worker entered the pic- 



HELEN LELAND WITMER is Director of 
the Children's Bureau Division of Research. 

Before joining the Bureau, Dr. Witmer 
was Director of Fact Finding for the Mid- 
century White House Conference for Chil- 
dren and Youth. Previously she was Direc- 
tor of Research at Smith College School for 
Social Work, and she was editor of Smith 
College Studies in Social Work. 

Dr. Witmer gave this paper at the 
seventy-ninth annual meeting of the Na- 
tional Conference of Social Work, held at 
Chicago. 



t'.u e ; Eubsequently their behavior 
changed for the better in certain 
specified respects. The imiprovement 
is ci edited to social work, and we say 
that the number of maladjusted fami- 
lies is fewer by this one case. But 
can we be more sure of cause-and- 
eiTect relationships in individual 
cases than in communities generally? 
It is again a matter of past and 
present, and the possibility of numer- 
ous ether factors having influenced 
the situation so that the part that 
i:^oc al work played is far from clear. 
But to come back to social work's 
objectives. It is probably too easy an 
answer to say, for example, that we 
expect social work to reduce the inci- 
dence of delinquency or marital dis- ; 
cord or even to make the repetition 
of such social disorders less likely in 
individual cases. Do we aim to 
achieve these outcomes regardless of 
psychological cost to the individual 
concerned? Would it be adequate to 
achieve reduction in delinquency by 
extremely punitive methods? Is mari- 
tal discord to be lessened through the 
wife — or husband — becoming utterly 
subservient and submissive? These 
may seem foolish examples but they 
highlight the fact that social work 
aims not at suppression of symptoms 
but at some other kind of change, the 
nature of which is difficult to state in 
general terms. 

The question of social-work objec- 
tives in particular programs or with 
particular types of individuals would 
be easier to answer if we could agree 
what social work in general is, what 
it is for. A conception of the basic 
function or functions of social work 
would provide a touchstone from 
which the analysis of the aims of 
particular programs could take its 
start. Lacking such an agreed-upon 
conception, we are forced to deter- 
mine for each particular program its 
raison d'etre, without reference to 
general principles. 

The lack of a unifying conception 
of social work's function also means 
that we have no way of assessing a 

THE CHILD VOL. 17 NO 2 



community's over-all need for social 
services or of determining the extent 
to which this need is being- met. I 
do not mean to imply that this need 
for service could be easily determined 
if the general purposes of social work 
were established. I only mean that 
lacking clarity on social work's func- 
tion, we cannot even consider the 
measurement of need. And, vice 
versa, it is not possible to use as a 
measure of social work's effectiveness 
the extent to which the need for social 
services, generally speaking, is met. 

When we turn to particular pro- 
grams and try to line up what their 
objectives are, we have to deal with 
the possibility that the sponsoring 
group, the professional staff, and the 
clients may have different ideas on 
this subject. It seems to be an ac- 
cepted principle of casework that if 
professional worker and client can- 
not get together on this matter of 
aims little can be accomplished. There 
are those who maintain that in the 
long run the same principle holds for 
professional staff, and boards, and 
contributing public also. At any one 
time, however, a difference of opinion 
on this matter may exist, and it then 
becomes a nice question whether the 
accomplishments of a social agency's 
program are to be judged on the 
basis of the kinds of changes the staff 
aims to produce, the kinds the con- 
tributing public wants to see brought 
about, or whether it is to the clients 
that we should look for finding out 
what they think of the agency's ser- 
vices. 

Involved in these distinctions is 
also the fact that the sponsors of a 
program are likely to have absolute 
standards and the social workers and 
clients relative ones. The sponsors 
are inclined to want to know, for ex- 
ample, how many children are no 
longer delinquent, how many families 
are no longer in need of aid of one 
kind or another. Caseworkers and 
clients are probably chiefly concerned 
with "movement" — with whether 
things got better rather than whether 
some ideal goal was reached. Closely 
related to this, too, is the casework- 
er's idea that social service is a help 
in time of trouble but no guarantee 
that trouble will not recur. 

OCTOBER 1952 



With objectives of a social-work 
program frequently so difficult to de- 
termine or at least to agree upon, 
it is easy to see why evaluative re- 
search does not flourish lustily. But 
even if goals can be set, the difficul- 
ties of evaluative research do not 
cease. The next step that must be 
taken is to decide upon criteria by 
which success, however defined, is to 
be judged. Whether this is difficult 
or not will depend in part upon the 
nature of the program's objectives. 

What constitutes success? 

If the aim of a program, for exam- 
ple, is a marked decrease in number 
of delinquents brought to court or in 
the individual child's delinquent acts, 
this step will be relatively easy. Even 
here, however, there will be differ- 
ences of opinion. Such a question as 
how large the decline must be to be 
counted as a success will have to be 
considered, as well as the knottier 
questions of whether all offenses are 
to be regarded as of equal impor- 
tance, whether first offenses count 
the same as repetitions, and so on. 

The term "success" is more appli- 
cable when results are to be judged 
in terms of degree or kind of im- 
provement in individual cases. Here 
criteria are often hard to define in 
ways that will be widely agreed upon 
and that will be similarly applied by 
various raters. And even if this is 
done, all is not clear. 

For instance, after a great deal of 
careful work McVicker Hunt was 
able to draw up criteria by which it 



could be reliably determined how 
much "movement" had occurred dur- 
ing the course of casework treatment 
of certain clients of the Community 
Service Society of New York. It was 
found, however, that these criteria 
were not applicable in a large pro- 
portion of the cases of the agency as 
a whole, either because the clients did 
not have enough interviews to yield 
information or because their difficul- 
ties were not of the sort to which the 
criteria applied. 

Others who have tried to devise 
schemes for judging success, espe- 
cially in that particularly difficult 
area, family casework, have found 
the going no easier. Whether we de- 
cide to judge results by whether the 
clients felt that they were helped, by 
what kind of solution of their prob- 
lems they arrived at, by how well- 
adjusted they became or how long 
the improvement lasted, the problem 
of criteria and their reliability and 
validity is difficult to solve. This is 
not to say that the problem is insolu- 
ble ; it is only to say that it will take 
hard thinking and painstaking work 
on the part of the profession gen- 
erally — not only the research work- 
ers — before we shall be in a position 
to state definitely : "This is what a 
given social-work program or service 
is trying to accomplish, and these are 
the signs by which you can tell that 
the goal has or has not been achieved 
in pai'ticular cases or generally." 

But even if we arrive at that happy 
stage, our troubles are not over. How 
are we going to demonstrate that 



We IVel that the social worker's efforts will brin<j good results, but how can we be sure? 




social-work efforts produced or con- 
tributed to the so-called results? This 
is perhaps the toughest part of the 
research problem. We can firmly say 
that such-and-such are to be con- 
sidered the objectives for the purpose 
of this study, that these are the goals 
with which this particular investiga- 
tion deals. And after careful consid- 
eration we can draw up a list of signs 
or describe typical cases or even con- 
struct tests that will serve as guides 
for judging the extent of change that 
occurred during or after social treat- 
ment. But how are we to demon- 
strate that it was social work that did 
the trick? 

The usual social-science answer to 
that difficulty is the control group. By 
this device the treatment in question 
is given to one series of individuals 
and withheld from another. This sec- 
ond series is chosen in such a way as 
to be as much like the first as pos- 
sible, insofar as traits or circum- 
stances likely to influence the kind of 
change under consideration are con- 
cerned. In comparable biological 
studies, the animals used in the con- 
trol group come from the same pure 
strain as those in the study group. In 
biological and psychological studies 
of human beings, identical twins are 
often regarded as the best subjects. 

So much is intangible 

In social work — according to pres- 
ent theory at least — the traits of the 
client usually regarded as most influ- 
ential in determining success or fail- 
ure in treatment are such intangibles 
as personality make-up, the dynamics 
of the problem under treatment, the 
nature of the significant environmen- 
tal circumstances (what is significant 
varying with the problem under con- 
sideration), and so on. This is not to 
say that such more or less easily de- 
terminable traits as sex, age, intelli- 
gence, nationality, and the like are of 
no importance. It is obvious, how- 
ever, that individuals can be alike in 
these latter respects and still be very 
different so far as their need for the 
services of a social worker or their 
likelihood of dealing with their prob- 
lems without such help are concerned. 
This we can probably agree on. The 

26 



tough problem, however, is how we 
are to secure for the control group a 
series of individuals whose personal- 
ity make-up and characteristic ways 
of responding to diflficulties is known 
but who have not received and are 
not to receive treatment? 

It would take more space than we 
have here to discuss this problem at 
all adequately. It should be noted, 
however, that a few attempts at solv- 
ing it have been made. In a study at 
the Jewish Board of Guardians, for 
example, children who had been ex- 
amined and found to be within the 
agency's function and yet not treated 
were used as a control group. In the 
Cambridge-Somerville Youth Study 
groups of children were equated for 
various traits on the basis of indi- 
vidual examinations and home 
studies and then arbitrarily selected 
for treatment or control purposes. 
Other investigators have used pro- 
jective tests or other such devices for 
quickly securing information about 
personality and psychological func- 
tioning. None of these methods has 
wholly solved the problem of getting 
comparable cases for control pur- 
poses, however, chiefly because some 
of the significant facts often cannot 
be learned until treatment is well 
under way. 

Recognizing the difl^culty of secur- 
ing proper controls, social-work in- 
vestigators usually pin their hope on 
intragroup comparisons. They reason 
that if the cases that turn out well 
can be shown to be different in sig- 
nificant ways from those that turned 
out poorly, a connection between out- 
come and the work of the agency is 
likely. For instance, if it is found 
that the cases labeled "success" were 
much more likely than the failures to 
have taken an active part in treat- 
ment, to have wanted treatment and 
found it useful, if many more of 
them than of the failures had traits 
that theoretically would make them 
better treatment "risks," then social- 
work investigators are inclined to say 
that the changes that took place in 
these cases were probably largely at- 
tributable to the treatment measures. 

This, however, is not wholly satis- 
factory reasoning. It may be that in- 



stead of indicating that social work 
can be helpful to certain clients in 
certain situations, these investiga- 
tions have only identified the people 
who will solve their problems satis- 
factorily with or without the help of 
a social worker. 

There is, nevertheless, an exten- 
sion of this reasoning in regard to 
determining causal relations that 
holds promise. Briefiy it is this. 
Granted that in any particular pro- 
gram the apparent success achieved 
may be explainable as above, what is 
to be said if similar studies are made 
in different kinds of programs aimed 
at, say, delinquency prevention, and 
it is found that one program appears 
to work with one kind of case and 
another program with another? 
Would this not greatly increase the 
weight of the argument that outcome 
and treatment are related? Vice 
versa, if in program after program 
the same sorts of boys turned up as 
the ones apparently aided, would this 
not suggest either that any kind of 
method works with these boys or even 
that such boys would probably get 
along all right without treatment? 

Studies of this sort, if they did in- 
dicate causal relations, would have 
the additional merit of providing in- 
formation on other important points. 
For instance, to keep to the delin- 
quency example, they would provide 
much-needed basic diagnostic cate- 
gories for distinguishing delinquents 
on the basis of treatment needs. They 
would also make possible the efficient 
use of treatment resources, for by the 
careful matching of delinquent and 
treatment measure the chance of good 
results would be greatly increased. 

We need to find answers 

It is said to be a good idea to end 
papers on a hopeful note. If so, this 
is probably the best point for ending 
what may have sounded like a dis- 
couraging account. I hope that, in 
this description of the diificulties that 
beset research when the effectiveness 
of social work is to be studied, I have 
not discouraged you but rather have 
aroused your interest in helping us 
research workers find the answers. 
Reprints in about 6 weeks 

THE CHILD VOL. 17 NO 2 



PART 2 



A VISITOR'S VIEW OF 
CHILD WELFARE IN VIENNA 



EDITOR'S NOTE: This is the second part of an article that began in our August-September 
issue. (We shall be glad to send a copy of that issue to any reader who missed part 1.) 



H. TED and BUNNY RUBIN 

In Vienna children with problems 
are usually sent to institutions rather 
than to foster homes. The basis for 
this decision is not a careful diagnosis 
and evaluation as to what setting 
would be best for the child. The de- 
termining factor for institutional 
placement, we should like to suggest, 
is that the usual Viennese family 
finds it very difficult to tolerate prob- 
lems of behavior and personality. 
Typically, the mother is strong, domi- 
neering, and overprotective, and the 
father is either a feared figure who 
commmands respect, or a genial, 
gemiitlich person who plays a role 
not always easy to define. 

Although the Viennese family is 
generally characterized as an affec- 
tionate one, this affection may often 
be used as a controlling device. Con- 
forming behavior is rewarded with 
much affection, but affection is with- 
held when a child is resistive. 

This can be a punishing environ- 
ment for an aggressive foster child, 
and the restrictive atmosphere dis- 
courages the more inhibited child 
from any expression of his feelings. 

Under these conditions, the num- 
ber of effective foster homes is natu- 
rally limited, and it w^ould also seem 
that fewer families would request 
that children be placed in their 
homes. In addition, the average 
Viennese social worker has little time 
for working toward helping foster 
parents to be more effective. It is 
generally felt that lay acceptance and 
application of established principles 
of child psychology is more advanced 
in the United States than in Austria. 

There is another long road ahead 
in improving methods for studying 
and certifying foster homes. At pres- 

OCTOBER 1952 



ent the city grants a certificate after 
approving a report submitted by a 
Jugendamt social worker who has 
visited the home only once and has 
reported mainly the physical setting 
and surface attitudes. 

The majority of Vienna's institu- 
tions for children are operated by the 
city. In 1950 the city's budget for its 
20 such institutions, approximately 
$1,000,000, covered total personnel, 
food, clothing, new furniture, and 
maintenance expenses. About one- 
eighth of the institutional budget 
over the past 6 years has been al- 
lotted to the reconstruction of dam- 
aged buildings, and completing this 
work will take another 5 years. Al- 
most 3.000 children are in these insti- 
tutions, and besides, many children 
are placed at public expense in pri- 
vate institutions. The cost to the city 
for this latter expenditure is charged 
to a budget different from the insti- 
tutional one. 

No existing institution is built on 
the cottage plan, and no new chil- 
dren's institution has been completed 
since World War I. The first cottage- 
type institution is now under con- 
struction. Family-group atmosphere, 
especially important to children who 
remain in an institution a long time, 
has been especially difficult because 
the large buildings are not divided 
into small enough units. Administra- 
tion and program of the institutions 
have not kept up with modern meth- 
ods ; and the personnel, in most of 
them, lack knowledge of psychologi- 
cal factors in human behavior. Few 
institutions have a social worker, and 
still fewer have a part-time psycholo- 
gist. It is difficult to imagine this as 
the city of Adler, Aichhorn, Freud, 
and Rank. 

An outstanding exception is a pri- 



vate institution for girls 14 to 21 
years, maintained by the Interna- 
tional Quakers. This home, with sev- 
eral associates of Aichhorn as con- 
sultants, successfully creates a free 
atmosphere, with each girl's individ- 
uality recognized and confidence 
placed in her as a person. Another 
Quaker institution, in which the city 
places some children, has been reor- 
ganized as a treatment center for dis- 
turbed children; it employs couples 
as houseparents in its approach to 
the children's problems. Only one 
other institution, a public one, does 
this. The rest have, for each group 
of children, a housemother and an 
Erzieher (counselor), or an Erzieher 
alone. The latter may live in the 
institution or may come daily to di- 
rect such group activities as arts and 
crafts, household chores, and study 
periods. 

The city operates several institu- 
tions for the care of dependent and 
neglected children up to the age of 3 
years. One is a large, central, hos- 
pital-like institution, which has 560 
beds for dependent and sick children 
under 3. The emphasis in its pro- 
gram of care is overwhelmingly medi- 
cal, and there is almost none of the 
warm, human contact needed espe- 
cially by a small child. Toddlers are 
only slowly removed to foster homes, 
and babies under 1 year are rarely 
placed in such homes. A new mother 
in need may remain in the institution 
with her baby for a nursing period 
of 3 months, and if she finds it neces- 
sary to leave the baby in the institu- 
tion longer she may visit him for 
regular feeding periods. 

In the same building is a milk bank 
that buys excess milk from nursing 
mothers for distribution to mothers 
unable to breast-feed their babies. 
(With relatively few exceptions Vien- 
nese babies are breast-fed.) The milk 
bank also dehydrates milk for ship- 
ment in powder form to smaller Aus- 
trian communities. 

One public institution specializes 
in the care of children from 3 to 6 
years of age, and another oflfers 
short-term placement for children of 
various ages. 

The city has converted an old 



27 



Hapsburg castle into a diagnostic 
center for school-age children. Chil- 
dren with more difficult behavior 
problems are sent here from the cen- 
tral reception center. After a 2- to 3- 
month observation and testing pe- 
riod, recommendations concerning 
treatment are made. This represents 
a beginning effort to use more care- 
ful methods in studying large num- 
bers of Viennese children who have 
problems. 

Vienna's vast anti-tuberculosis 
program, which has received inter- 
national attention, sprang from the 
"black menace" epidemics that 
scourged the city after World War I. 
Each district has a TB center, which 
investigates home surroundings and 
which tests and X-rays children and 
adults. Extensive preventive and con- 
trol measures also include careful 
study of school children's diet and 
health, as well as extensive use of 
health camps in the nearby mountain 
areas. Tubercular children are 
treated in three well-equipped insti- 
tutions. 

To help the handicapped 

War injuries have, of course, in- 
creased the number of handicapped 
children. Efforts to meet their needs 
are made through a combination of 
special schools and institutions. For 
the physically handicapped, including 
the cerebral-palsied and the epileptic, 
some physical therapy as well as pre- 
liminary vocational training are 
given both in the schools and the 
institutions. Although Vienna has 
long provided facilities for its handi- 
capped, its teaching techniques have 
not always kept up with modern 
methods. Lack of sufficient special 
equipment can, however, be under- 
stood in the light of present-day eco- 
nomic conditions in Austria. 

For deaf children a federally oper- 
ated institution provides both resi- 
dential care for children from bor- 
dering provinces and day-schooling 
for those nearer by. Like the chil- 
dren in most other. Viennese institu- 
tions, these children live in large 
units. The absence of any electrical 
hearing aids often thwarts the excel- 
lent efforts toward teaching these 




Vienna's child-welfare program is only now beginning to recover from the ravages of war. 



children oral language. Hearing aids, 
along with a much improved differ- 
ential diagnosis concerning the de- 
gree of the child's hearing loss and 
his potentialities for learning to talk 
would enable some of these children 
to adjust to the city's day school for 
the hard of hearing. At this latter 
school also, lack of such aids similarly 
robs some children of a future in the 
more normal environment of the reg- 
ular school. 

Children with speech handicaps 
have long received therapy within 
the normal school setting. Retraining 
is done mostly through drill mate- 
rials, with little emphasis on contrib- 
uting emotional factors. Children 
with more involved language prob- 
lems — organic or functional — may 
attend special clinics at the Univer- 
sity of Vienna Hospital for individual 
or group therapy. 

The rehabilitative work for blind 
children is done through an institu- 
tion and at the school for the par- 
tially-sighted. 

Various organizations are begin- 
ning to study how handicapped chil- 
dren can be better integrated with 
normal children. 

Austria, including Vienna, is now 
developing an important program for 
all categories of handicapped per- 
sons, including children, under the 
auspices of the newly founded Aus- 
trian Society for the Rehabilitation 
of the Physically and Sensorially 
Handicapped. It is probable that sig- 
nificant developments can be expected 
in this field in the next several years. 

Two institutions and many Hilf- 
schule, or special schools, are devoted 



to the education of mentally deficient 
children. The Viennese school system, \ 
with its high academic demands and i 
lack of pupil individualization, pre- ; 
sents great problems for the slower-] 
learning child who is, however, not' 
feeble-minded. Inaccurate diagnosis! 
incorrectly assigns to these facilities' 
certain children whose educational; 
problems are not due to feeble- j 
mindedness. 

Many school-age children with 
emotional problems are removed 
from their homes to institutions. 
Even when such removal seems to be 
the proper course, lack of profes-j 
sional staff in these institutions often! 
nullifies the purpose of the place- 
ment. 

A pavilion of the Steinhof mental 
hospital houses 60 children — psy- 
chotic, grossly feeble-minded, epilep- 
tic, encephalitic, hydrocephalic, and 
undiagnosed — all without special 
grouping. Children here receive little 
or no individual psychotherapy, and 
even the physical care is primitive. 
There is one social worker for 2,000 
cases in the entire hospital. With a 
prewar population of 4,000 patients, 
Steinhof had been one of the largest 
mental hospitals in Europe, but Nazi 
officials rewrote this figure by leading 
3,000 patients into gas chambers. 

A remarkable new experimental 
treatment center for epileptic chil- 
dren is now being set up, which offers 
great promise for the future. 

The Federal Government operates 
Steinhof, as well as training schools 
for children adjudged delinquent anc 
juvenile courts. Other personnel, whc 
may be teachers or social workers 



28 



THE CHILD VOL. 17 NO. 



assist a judge in hearing each juve- 
nile case. Through such a structure, 
the court seeks to associate itself 
more with educative and rehabilita- 
tive aims, rather than with punish- 
ment. Although some vocational 
training is given delinquents, the 
psychological and social-work ser- 
vices are quite inadequate. 

However, a newly opened home, 
organized by the police to house cer- 
tain neglected and vagrant children 
temporarily, is one of the most ad- 
vanced of Viennese institutions. 
When a child leaves this institution, 
he or she signs the guest book, the 
same guest book that government offi- 
cials and foreign visitors sign after 
inspecting the home. Here older chil- 
dren are addressed with the formal 
German "Sie," indicating respect for 
them as people. 

From school to work 

The age of 14 may be called the 
apprentice age, for at this time a 
majority of boys and girls leave 
school to begin training for their 
chosen trades. (Compulsory school 
attendance in Vienna covers an 8- 
year period between the sixth and the 
fourteenth birthdays.) 

The city, recognizing the separate 
needs of youths who have left school, 
has created a number of special in.sti- 
tutions for them. Young people from 
14 to 18 years of age eat and sleep 
in these homes, studying and work- 
ing at their trades during the day- 
time. In addition, several of these 
homes serve as temporary reception 
centers until the youngsters are able 
I to obtain other living accommoda- 
t tions. Group activities are planned 



for the evenings. As their stay length- 
ens the young people pay an increas- 
ingly larger share of the cost, since 
their small salaries increase as train- 
ing continues. 

At present a need is felt for a home 
for 18- to 21-year-olds. Such an insti- 
tution could offer a healthy group- 
living experience for these economi- 
cally self-sufficient young adults. 

It should be noted that a movement 
has been launched to raise the com- 
pulsory school-attendance age to 16. 

In addition to the services given 
by the counselor on the staff of the 
Jngendamter, psychological services 
for children are offered by several 
facilities. Two of these are in their 
early developmental stages. On the 
whole, such services are grossly in- 
sufficient. 

The best-established facility for 
psychological services is the Chil- 
dren's Clinic of the University of 
Vienna Hospital. The director of 
both the psychiatric out-patient de- 
partment and the residential diag- 
nostic center for 60 childi'en is medi- 
cally oriented, with a firm belief in 
the physical basis of deviant be- 
havior. His therapeutic approach is 
directed toward integration of the 
various centers of the brain through 
pedagogic methods. Comparatively 
little attention is given to the role 
played by the emotions or by environ- 
mental influences. No deep therapy- 
is performed in the out-patient de- 
partment. However, plans are being 
discussed for a children's treatment 
center nearby, and the first small de- 
velopment is under way in the uni- 
versity's psychiatric hospital, where 



About one Viennese child out of every seven participates in a preschool group experience. 




the approach will be from the stand- 
point of dynamic psychiatry. 

Another diagnostic center has been 
developed within the past 2 years by 
the city's school system to provide 
testing services for school-age chil- 
dren. The standards of this center 
are high, and its director has ex- 
tended the Biihler Preschool Develop- 
mental Test to school-age children 
and has adapted other tests that are 
currently used in German-speaking 
countries. In the near future this 
center will be enlarged, and its ex- 
tended services will include special 
classes, with concurrent treatment, 
for neurotic children. 

What is technically Austria's first 
child-guidance center was inaugu- 
rated in 1949 as a demonstration 
clinic. Simultaneous help to Viennese 
parents and children is offered 
through the team approach — by psy- 
chiatrist, psychologist, and social 
worker. The director, a psychiatrist, 
has an eclectic orientation, borrow- 
ing from both dynamic psychology 
and the prevalent Viennese physical 
approach. Like the psychiatrist, the 
psychologist uses play therapy, and 
in addition does testing and group 
tutoring. This clinic is one of the 
two Viennese training centers for 
social-work students who plan to be- 
come psychiatric social workers. Less 
than 2 years ago, the students in the 
first course ever offered in Austria in 
psychiatric social work completed 
their studies, which included some 
months' field placement in England. 

Although not a psychological ser- 
vice, the new special experimental 
kindergarten, the famous Sonder- 
kindergarten, should be described. 
The park-located, pavilion-type build- 
ing was especially designed for six 
groups of children under comparative 
■^tudy. These include a control group 
of normal 3- to 6-year-olds, as well 
as a group of feeble-minded children, 
a group of children with speech and 
hearing handicaps, a group of the 
physically handicapped, a group of 
emotionally disturbed children who 
have a history of mental illness in 
their families, and a similar group of 
children who do not have such a 
history. (Originally a group of blind 

29 



children was to be a part of the ex- 
periment, but there were not enough 
such children of kindergarten age to 
bring in for this purpose.) In addi- 
tion to the latest equipment and well- 
trained kindergarten teachers, the 
staff includes a social worker, a psy- 
chologist, a speech-and-hearing ther- 
apist, and a physical therapist. 

Social group work is as yet com- 
paratively unknown in practice in 
Vienna. A course in group work, 
taught by a psychologist, has been 
initiated by the city's school of social 
work. Aside from the after-school 
centers for school-age children, there 
are few recreational centers for chil- 
dren other than those provided by 
political parties. 

The future trend of Viennese child- 
welfare work will probably be chan- 
neled along the two courses of (1) 
bi'oad social planning and (2) 
further advances in social casework 
and in family services. 

Housing and day-care centers are 
the first need. At the end of 1950 
there remained 100,000 people with- 
out homes. But extensive housing 
projects, which had their first great 
growth from 1924 to 1934, are finally 
under construction again. From 1946 
to 1951 the city allocated its total 
housing budget for reconstruction of 
damaged dwellings. Vienna considers 
housing its focal problem. City wel- 
fare authorities, basing their belief 
on similar experience after World 
War I, state that the number of chil- 
dren under their care will lessen con- 
siderably when more housing units 
are available. 

Coordinated city planning will 
again include many day-care centers 
in the large housing projects, but the 
huge program will nevertheless fall 
considerably short of its goal of 
making places available in such cen- 
ters for one-third of all Viennese 
children. 

The second area, the further de- 
velopment of casework and of family 
services, depends almost completely 
upon the progress of the Vienna 
School of Social Work in conjunction 
with the Jugendamt and the Fiir- 
sorgeamt or Public Assistance Bu- 
reau. For its present students the 

30 



school is rapidly revising and ex- 
panding its program. The school has 
influenced community agencies to 
recognize the need for better-trained 
workers ; the agencies have responded 
by providing more effective field- 
work placements. Actual practice of 
casework by students is beginning to 
replace the traditional observation or 
apprentice experiences. Men stu- 
dents, first admitted to the social- 
work school in 1948, now number 
about 15 percent of each class. 

Casework courses throughout each 
of the four semesters have come to 
replace the former emphasis on pure 
theory. In the next few years the 
school plans to lengthen its curricu- 
lum from 2 to 3 years. 

The development among social 
agencies of the practice of keeping 
case records and the exchange of 
ideas and teaching materials among 
the various schools of social work in 
Europe will help to advance the de- 
velopment of the Vienna school, 
which in turn will be able to contrib- 
ute much to other schools. The school 
offers weekly classes on an extension 
basis for practicing social workers, 
conducts a special program to train 
supervisors, and plans to meet re- 
quests for similar courses for coun- 
selors and for psychiatric social 
workers. 

Creative leadership in all aspects 
of social work training in Vienna 
comes largely from the Dean of the 
Vienna School of Social Work, Dr. 
Nuna L. Sailer, and her far-seeing 
courage and soundly progressive 
ideas. She is considered one of the 
most capable leaders in European 
social work. 

In summary, Vienna's city govern- 
ment has a rich tradition of broad 
planning and legislation to serve the 
basic needs of its total population. It 
believes that the degree of its advance 
in social welfare is, like its music, a 
mark of its culture. Although dy- 
namic psychology had its birth in 
Vienna, only now is it being incor- 
porated in broad social-work prac- 
tice. The end result of this trend 
will be a heightened cultural and so- 
cial achievement for this city and in 
turn for Austria. 



ITHE NEWS 



Nursing groups. After a decade of 
progressive planning, a two-organi- 
zation plan for national nursing asso- 
ciations was adopted at the Seven- 
teenth Biennial Nursing Convention, 
held at Atlantic City, N. J., June 16- 
20, 1952. 

One of these two organizations is 
the previously existing American 
Nurses' Association, which continues 
under revised bylaws ; the other is 
the new National League for Nurs- 
ing. I 

The new League was established by i 
amendment to the existing charter of 1 
the National League of Nursing ; 
Education ; and two other organiza- i 
tions — the National Organization for I 
Public Health Nursing and the As- i 
sociation of Collegiate Schools of | 
Nursing — voted to dissolve and be- ] 
come part of the League. 

According to Pearl Mclver, R.N., 
chairman of the Joint Coordinating 
Committee on Structure, which rec- 
ommended the reorganization, the 
aim of the new League is the best 
utilization, distribution, and financial 
support of nursing services and nurs- 
ing-education facilities. All nurses, 
from every occupational field, will 
have the opportunity (and the respon- 
sibility) to plan jointly with allied 
professional workers and with the 
public in efforts to reach this goal. 

The American Nurses' Association, 
which is an organization made up of 
professional registered nurses, will 
have full responsibility for all func- 
tions which should be carried out by 
the members of a profession. These 
functions include establishing stand- 
ards for nursing practice, recom- 
mending desirable qualifications for 
nurses in the various nursing special- 
ties, and promoting the general wel- 
fai'e of nurses. 

The first national nursing organi- 
zation formed in the United States 
came into being in 1894. This was 
the National League of Nursing Edu- 
cation, the group that amended its 
charter in 1952 as a step toward 
forming the new National League for 
Nursing. In 1896 the American 
Nurses' Association was formed, 
with the help of the NLNE. In the 
more than half a century that has 
elapsed since then, various national 
nursing groups have been formed ; 
at one time there were as many as 
six. 

The two-organization plan now in 
force, with its clear differentiation 
between the functions of the groups, 

THE CHILD VOL 17 NO. 



should enable Federal agencies whose 
programs are concerned with nursing 
to work even more effectively with 
these organizations than in the past. 

Marriage and divorce. The marriage 
rate for 1951 (10.4 per thousand 
population) was 37 percent below the 
all-time high, which was reached in 
1946 (16.5 per thousand), according 
to the Bureau of the Census, Depart- 
ment of Commerce. Divorces also fell 
off. In 1951 there were 2.4 divorces 
per thousand population (44 percent 
below the 1946 peak of 5.5 per thou- 
sand) . 

Guidance services for youth were re- 
ported by only one-sixth of the public 
schools in 1948. Even those schools 
reporting such services averaged only 
one counselor to every 398 students, 
and were principally in cities. 



Deadline: October 15 

Each year, according to law, 
the Federal Security Agency 
sends each person on the official 
mailing list for The Child a pos- 
tal card asking whether he 
wishes to continue to receive it. 

You will soon receive such a 
card. Be sure to return it by 
October 15 if you want your 
name to be kept on the list. 



FOR YOUR BOOKSHELF 



MY SON'S STORY. By John P. 
Frank. Alfred A. Knopf, New 
York. 1952. 209 pp. $3. 

A father tells the story of his men- 
tally retarded child, Petey. It is a 
moving story, written with emotion 
but without sentimentality. From the 
normal and happy welcoming of the 
new baby into the family it pro- 
gresses to the first frightening ill- 
ness, the diagnosis of untreatable 
brain damage, the struggle of the 
parents between belief and despair 
on the one hand and disbelief and 
phantom hope on the other. Then 
follows for the parents a period of 
trying to find a way to meet this 
problem in the way that will be best 
for the much-loved child and for 
themselves and their other child. 

They decide to institutionalize 
Petey, but they have a most difficult 
time trying to find an institution that 

OCTOBER 1952 



will care for such a child. Eventually 
they find an excellent place, and the 
remainder of the book is concerned 
with the pain of separation and how 
the parents managed to put their 
lives together again into some sort of 
normal and satisfying pattern. 
Neither the anguish nor the courage 
of these parents is minimized. 

Mr. Frank has not written this 
story for relief of his own personal 
grief, although it may have helped 
him. Nor has he written it to help 
other parents with mentally retarded 
children, although it could not fail to 
help them. His main purpose, it 
seems, is to make people understand 
what he means when he says : "No one 
knows exactly how many retarded 
children there are, but something 
over 10,000 of Petey's general class 
are born every year. I wish that 
families less well situated than ours 
could come out as well. We and our 
fellow Americans as a people don't do 
nearly enough to provide for these 
sick children." 

Betty Huse, M.D. 

CHILD PSYCHIATRIC TECH- 
NIQUES ; diagnostic and therapeu- 
tic approach to normal and ab- 
normal development through pat- 
terned, expressive, and group be- 
havior. By Lauretta Bender, M.D. 
Charles C. Thomas, Springfield, 
111. 1952. 335 pp. $8.50. 

As Dr. Bender explains in her fore- 
word, this book consists of a collec- 
tion of papers written by Paul Schil- 
der (her late husband), herself, and 
a number of their associates at Belle- 
vue Hospital, New York City, during 
the past 15 years. She credits Dr. 
Schilder with the authorship of 4 of 
the 19 chapters; she also credits him 
with being the "originator of most 
of the concepts, attitudes, and result- 
ing philosophies expressed in all 
these papers." But the book essen- 
tially is still hers. The idea of an 
endeavor as vast as this is hers ; so 
are the concepts, with and without 
variations from Freudian concepts ; 
and so is the admirable execution of 
diagnostic and therapeutic techniques 
demonstrating the entity of the child 
as a personality. 

Most readers familiar with child 
welfare and child psychiatry will find 
little that is startlmgly new. Each of 
the various tests and psychothera- 
pies, individual and group, has been 
elaborated on in the past. It seems 
that Dr. Bender does not wish to 
present conclusions other than those 
based on the experience shown in her 
abundant case material. 

What is new is the integration of 



all techniques, regardless of origin, 
theory, or type, in one volume, to 
serve the reader as reference and as 
stimulus for further thought. 

Hans A. Uling 




Oct. 1-31. Red Feather Month. In- 
formation from the United Com- 
munitv Chests of America, 155 
East " Fortv-f ourth Street, New 
York 18, N. Y. 

Oct. 2-4. American Academy for Cer- 
ebral Palsy. Sixth annual meeting. 
Durham, N. C. 

Oct. 2-.5. Rural Youth of the U. S. A. 
Conference. Annual meeting. Jack- 
son's Mill, Weston, W. Va. 

Oct. 19-23. American School Health 
Association. Twenty-sixth annual 
meeting and twenty-fifth anniver- 
sary of the founding of the Associ- 
ation. Cleveland, Ohio. 

Oct. 20. Association of Maternal and 
Child Health and Crippled Chil- 
dren's Directors. Annual meeting. 
Cleveland, Ohio. 

Oct. 20-23. American Academy of 
Pediatrics. Twenty-first annual 
meeting. Chicago, 111. 

Oct. 20-23. National Conference of 
Juvenile Agencies. Forty-ninth an- 
nual meeting. Columbus, Ohio. 

Oct. 20-24. National Safety Council. 
Fortieth National Safety Congress 
and Exposition. Chicago, 111. 

Oct. 20-24. American Public Health 
Association. Eightieth annual 
meeting. Cleveland, Ohio. 

Oct. 21-24. American Dietetic Associ- 
ation. Thirty-fifth annual meeting. 
Minneapolis, Minn. 

Oct. 23-24. National Midcentury Com- 
mittee for Children and Youth. 
New York, N. Y. 

Oct. 24. United Nations Day. 

Oct. 26-30. National Society for Crip- 
pled Children and Adults. Twenty- 
ninth annual convention. San 
Francisco, Calif. 

Oct. 27-30. National League to Pro- 
mote School Attendance. Thirty- 
eighth annual convention. Boston. 
Mass. 



Illustrations: 

Cover, Esther Bubley for Standard Oil Co. 
P. 19, Esther Bubley for Children's Bureau. 
P. 2.3, Farm Security Administration. 
P. 25, Library of Congress photograph. 
Pp. 28 and 29, courtesy of the authors. 



31 



VOL. 17 NO. 2 
OCTOBER 1952 



In This Issue 



United Nations Dav, 1952 



Page 
. 18 



Furthering Individual Well-Being Through Social Welfare 19 
Martha M. Eliot, M.D. 



How Can We Evaluate Social Work? 
Helen Leland W itmer 



24 



A Visitor's View of Child Welfare in Vienna (Concluded) 27 
H. Ted and Bunny Rubin 



Published 10 times a year by the Division of Reports, Children's Bureau 
Editor, Sarah L. Doran Art Editor, Philip Bonn 

FEDERAL SECURITY AGENCY 
Oscar R. Ewing, Administrator 



SOCIAL SECURITY ADMINISTRATION 
Arthur J. Altmeyer, Commissioner 



CHILDREN'S BUREAU 
Martha M. Eliot, M.D., Chief 



Publication of THE CHILD, monthly bulletin, has been authorized by the Bureau of 
the Budget, September 19, 1950, to meet the needs of agencies working with or for 
children. The Children's Bureau does not necessarily assume responsibility for state- 
ments or opinions of contributors not connected with the Bureau. 

THE CHILD is sent free, on request, to libraries and to public employees in 
fields concerning children; address requests to the Children's Bureau, Federal Security 
Agency, Washington 25, D. C. For others the subscription price is $1.25 a year. On 
all orders of 100 or more sent to one address there is a discount of 25 percent. Send 
your remittance to the Superintendent of Documents, Government Printing Office, 
Washington 25, D. C. Single copies 15 cents each. 

Foreign postage — 25 cents additional — must be paid on all subscriptions to coun- 
tries in the Eastern Hemisphere and those sent to Argentina and Brazil. Domestic 
postage applies to all other subscriptions. 




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CHILD 



NOVEMBER 1952 



I. 







SUPEBIWrCHC 



NOV 25 1952 

WHEN A CHILD MUST GO TO THE HOSPITAL 

Much can be done to prevent emotional disturbances 



RUTH WINKLEY 

WE KNOW that children differ 
in the ways they meet difficult 
situations, and that a child 
who is well-adjusted, whose family 
life is a life of love, trust, and secur- 
ity, is the one who is most likely to 
go through his tonsil operation with- 
out much emotional disturbance. 

But however well-adjusted a child 
may be, his first hospitalization may 
be full of disagreeable surprises. And 
some of the hospital procedures, es- 
pecially if he misinterprets them, 
may frighten him or otherwise dis- 
turb him. 

To find out which procedures were 
bothering the child most, a team of 
five professional workers — four phy- 
sicians and a psychiatric social 
worker — have made a 3-year study 
of children undergoing tonsillectomy 
at Albany Hospital, Albany, N. Y. 
More than 100 children 3 to 8 years 
of age were studied — before they 
went to the hospital, while they were 
there, and afterward. 

Children's resentment heeded 

The study showed that what the 
children resented most was a jab 
with a hypodermic needle. And as a 
result this hospital has reduced the 
use of needles, and by the end of the 
study the only jab these children had 
to take while conscious was the finger 
prick for a hemoglobin reading. 

Some other procedures were modi- 
fied or eliminated, though many, of 
course, could not be. 

But as a step toward making the 
whole hospital experience less dis- 
turbing to the child, the social worker 
— myself — visited the child's home a 
week or two before the operation, got 
acquainted with him and his parents, 
and talked over the various things 



that would happen in the hospital. I 
especially explained the procedures 
that had been found most disturbing. 

As for reassurance, I found that 
the mother needed this more than did 
the child. What the child needed was 
information. And that is what I gave, 
along with reasons for some proce- 
dures that we had learned were mis- 
interpreted by some children in ways 
that had unhappy results. 

I also studied each child, evaluating 
his emotional characteristics and his 
relations with his parents. 

In order to bring to light the 
things that were disturbing the chil- 
dren, members of the study team con- 
sidered the situation of each child 
from the time he entered the lobby of 
the hospital until he went home the 
next day. And they noticed a source 
of disturbance for a few children at 
the very beginning of their hospitali- 
zation — in fact, in the elevator. For 
a few children are afraid of shut-in 
places. And when such a child steps 
into the hospital elevator he is likely 
to become panicky. After we learned 
about this, I included elevators in the 
discussion with the child at home. 

But even if the child knows about 
elevators, the hospital elevator may 



RUTH WINKLEY is Associate in Pedi- 
atrics at Albany Medical College, Albany, 
N. Y. She is a graduate of the University 
of Michigan and of the New York School 
of Social Work. 

The members of the team that worked on 
the study Miss Winkley describes here are 
all on the staff of Albany Medical College. 
The director of the project was Otto A. 
Faust, M.D., Professor of Pediatrics. The 
other members, besides Miss Winkley, were 
Katherine Jackson, M.D., Anesthesiologist; 
Ethel G. Cermak, M.D.. Associate Professor 
of Pediatrics; and Marjorie Murray Burtt, 
M.D., formerly Associate Professor of Pedi- 
atrics. 

The study was made with the cooperation 
and support of the New York State Depart- 
ment of Health. 



be crowded, with many grown-ups 
towering above him and obstructing 
his view, and he may become 
frightened. If he has learned to 
count, it helps if he is told beforehand 
that he and his mother are to get off, 
say, at the sixth floor. Watching the 
floors go by and confirming the truth 
of this may sufficiently engage his 
attention to keep him from being 
afraid. 

Then there are the "men in white." 
Many children have never seen doc- 
tors dressed in white, even on tele- 
vision. For an occasional child, see- 
ing men in white clothes may be a 
scary encounter unless someone has 
told him about this ahead of time. 

Another thing that may bring con- 
sternation is undressing and going to 
bed in the daytime. It may make a 
child feel that he is being punished, 
especially if that is the way he is 
punished at home. In this hospital 
a child does not need to go to bed 
when he arrives. The hospital has a 
large playroom, and there Johnny will 
find himself with other children, and 
this may take his attention away 
from his own troubles, at least to 
some extent. 

When the real bedtime comes, how- 
ever, Johnny may be distressed to 
find that his hospital bed has sides, 
like a baby's crib. If he is proud of 
his youth-bed status, the resemblance 
to a crib may bring with it a tinge 
of humiliation. But if he has been 
told at home about the kind of hos- 
pital bed he will sleep in, and if the 
reason for the crib-like sides is ex- 
plained to him, he is likely to take the 
whole thing in stride. Therefore, 
when I visited a child in his home, I 
told him why his hospital bed would 
have sides — it is because the beds are 
so high and so narrow that even a 



34 



THE CHILD VOL. 17 NO. 3 ' 




A child whose family life is a life of love, trust, and security is the one who is likely 
to go through a hospital experience, such as a tonsil operation, without much trouble. 



grown-up might roll over in his sleep 
and fall out. 

Again, if Johnny wants to be 
Hopalong Cassidy both day and night, 
and is used to wearing cowboy pa- 
jamas (and something similar may 
apply to little Mary too), the hospital 
gown will seem a rather dull affair. 
There is something about being Hopa- 
long Cassidy, even in the hospital, 
and about wearing one's own night 
clothes, that keeps many a little fel- 
low from feeling he has lost his 
identity in this very strange place. 

Mother's presence usually helps 

In Albany Hospital, a mother is en- 
couraged to stay with her child the 
2 nights he is there and is permitted 
to sleep in the same room with him. 
This, too, is a boost to most children's 
spirits. During these 2 important 
days in his life Johnny has the as- 
surance of his mother's constant pres- 
ence in case he needs her. If Johnny 
and his mother are truly close, this is 
a good arrangement; but it can be 
disturbing if his mother is more up- 
set than he is, as such feelings com- 



municate themselves to children with- 
out words. Fortunately some mothers 
know this themselves deep down in- 
side ; and sometimes one of these will 
say that Johnny will be better off 
without her, and another lets herself 
believe that she is more needed at 
home. 

Taking a blood sample is a routine 
requirement in the hospital, and, of 
course, Johnny will have to undergo 
this, often to his mother's distress. 
For most adults have disagreeable as- 
sociations with blood; and it is hard 
for a mother not to transmit to her 
child her horror, or her association of 
blood with pain. Yet children, unless 
they have picked up this idea from 
adults, need not have any such feel- 
ings. If Johnny knows ahead of time 
that his finger will receive a slight 
prick, such as he gets dozens of times 
crawling around in briars at play, fol- 
lowed by the appearance of a round 
bead of his own beautiful red blood, 
he will probably watch the whole per- 
formance with fascination. Mother 
may be standing by, trying to keep 
from shuddering or cringing, but 



Johnny watches without anxiety the 
bead of blood rise in the little glass 
tube, just as he was told it would. 

Another routine procedure is to 
take a sample of urine. Johnny may 
feel a little strange about using a 
urinal. But if he has been told about 
it beforehand and nobody hurries 
him, he may be less disturbed. And 
after he is a little more used to his 
surroundings, he is likely to produce 
the sample readily. 

For Mary this process may be a bit 
more embarrassing. Mary is proud 
of the fact that she is trained and 
never gets her bed wet. The bedpan 
with its strange feeling may make 
her think she has spilled in her bed, 
which she would never wish to do, es- 
pecially in a strange place. A little 
description ahead of time of the bed- 
pan and of how it feels, and assurance 
that it will not spill over, can make 
this procedure easier for her. 

Anesthetist briefs Johnny 

In the late afternoon a woman doc- 
tor, who is to administer the anes- 
thetic the next morning, comes to see 
Johnny to get acquainted with him. 
She is wearing her operating-room 
costume, and she tells him that when 
he goes to the operating room tomor- 
row all the other people in the room 
will be wearing clothes like hers. 

She says to him that he probably 
will not be sleepy when it is time for 
the operation because it will be day- 
time, but that she has medicine that 
will help him go to sleep so he will not 
feel anji;hing when his throat is being 
fixed. She lets him smell this medi- 
cine, and shows him the anesthesia 
mask. He turns it over and tries it on 
his nose so that he knows just what it 
will be like the next morning. She 
tells him she will put the medicine 
onto the mask a little at a time, that 
he will bcome very sleepy, maybe 
dizzy-sleepy. Then, she says, he will 
go fast asleep and will feel no pain 
during the operation. 

The anesthetist goes on to tell 
Johnny that when he awakens he will 
be back in his bed and that his mother 
will be there (if this is the case). She 
mentions to him that his throat will 



NOVEMBER 1952 



35 



be very sore, but that he will be able 
to take little sips of ice water when 
he feels thirsty. Each day after that 
his throat will be less sore, and she 
tells him that soon it will be all well. 

Johnny learns also that on the 
morning of the operation he will have 
no breakfast, as that might make his 
tummy feel sick. 

Tonight he will have his supper on 
a trav; he hkes this. 



room, there is the anesthetist he met 
the afternoon before. She hands him 
the mask, asking if he remembers 
what he does with it. He replies tliat 
of course he does, putting it on his 
nose and holding it himself. No one 
else touches it except the anesthetist, 
who tells him she is going to hold it 
steady for him. 

Then the anesthetist says quietly 
that now she is beginning to put on 




When Mary woke after her operation, there was her mother, as well as a friendly nurse. 
Pleasant awakening helps to minimize emotional disturbance caused by hospitalization. 



When it is time for him to go to 
sleep he has a snug, comfortable feel- 
ing, for there in the bed across the 
room from him is his mother. He 
also has his favorite teddy bear, 
which always sleeps with him. No- 
body in the hospital thinks that this 
is silly, but that it is a good idea to 
have whatever is familiar and com- 
forting. 

In the morning Johnny looks for 
the cart that he has been told will 
come rolling along to ride him to the 
operating room. And this time he 
rides right into the elevator on his 
cart. But this is not a surprise. He 
has been told about this too. 

When he arrives at the operating 



36 



the medicine he smelled the night be- 
fore. Johnny recognizes the smell 
and after a few moments may say, 
"I feel a little sleepy," or his hands, 
holding the mask, may slip down to 
his sides as he gets drowsier and 
drowsier. That's all there is to it! 
No battle, no holding down, and no 
feeling of a surprise attack. 

We found that among the most an- 
noying procedures for a child are 
taking his temperature by rectum 
and giving him an enema. And why 
not? Nowhere in history has anyone 
exclaimed with joy over an attack 
from the rear, so why should Johnny ? 
In tins hospital he will not be given 
an enema. His temperature is taken 



by mouth, and if he is sleeping it can 
be taken under his arm perfectly well 
without wakening him. 

Some doctors give penicillin to help 
fight any low-grade infection the 
operation might stir up. Such an in- 
jection would be painful, but there's 
nothing to it if Johnny gets it right 
after the operation while he is still 
under the anesthetic. 

Sometimes after the operation the 
child is nauseated and sometimes not. 
At any rate he is glad to have the ice 
collar on his sore throat and to sip 
cool drinks. 

Home visit repeated 

Duving our study I visited each 
child at home a week or so after the 
operation and again after 2 months. 
The child was free to say just 
what he thought of the whole thing. 
Instead of major complaints, which 
used to be the rule, these children 
had rather trivial gripes, uncon- 
nected with terror and fear. It might 
ba that being given vanilla ice cream 
instead of strawberry was the worst 
happening they could think of, or that 
the television screen in the hospital 
was not as large as theirs at home; 
some of them couldn't think of a 
single gripe about the hospital. Of 
course, we know that many children 
do not talk about feelings that are 
deep-seated. And it is true that at 
the time of this visit many of the 
children were still showing some ad- 
verse results of their experience, such 
as restlessness in their sleep. But by 
the time 2 months had passed, only 
17 of the 105 studied seemed to be 
still affected. 

Apparently these children went 
through the tonsillectomy with much 
less emotional damage than might 
have been expected. Much of this 
success was due to the understanding j 
of the hospital staff and to their en- 
thusiastic response to the changes in 
practice. But the changes have been 
made primarily through the efforts 
of the chief pediatrician (the direc- 
tor of the study), who has given | 
leadership for many years in develop- \ 
ing hospital practices in the interest ' 
of the children's emotional well-being. ! 

Reprints in about 6 weeks j 

THE CHILD VOL. 17 NO. 3' 



INSTEAD OF "BLOOD-AND-THUNDER" RADIO 

A noncommercial program encourages little children to 
learn through dramatic play 



NANCY HARPER 

SO FAR as children are con- 
cerned, everything on radio and 
television is educational. Every 
program that reaches them, regard- 
less of the quality, teaches them some- 
thing, and it seems high time for par- 
ents, and others interested in chil- 
dren, to pay more attention to what 
and how the children are learning 
from their new teachers. Of coui'se a 
child is the same person whether he 
is in school, or at home in front of a 
radio or a television set. Whatever 
he learns from radio and television, 
it should reenforce, not destroy, what 
parents and teachers are trying to 
build. 

As an experiment in radio program- 
ing, designed to give, over the air, 
some of the same kind of learning and 
fun and confidence that children 
would get in a kindergarten or nurs- 
ery school, "The Children's Circle" 
goes on the air in Boston every day at 
5:30 p.m. over a noncommercial 
radio station. In preparing the pro- 
gram, we draw on the resources and 
personnel of Boston's Museum of 
Fine Arts, Museum of Science, Chil- 
dren's Museum, and other organiza- 
tions in the Boston area that are in- 
terested in children. 



NANCY HARPER is a faculty member of 
the Nursery Training School of Boston. 
She is co-producer of '"The Children's 
Circle," a daily radio program for children 
2 to 6 years of age. which she describes 
here. She is the mother of two children. 7 
and .5 years of age. 

Mrs. Harper's radio program was begun 
in October lO.')!. It is broadcast on Boston's 
1-year-old noncommercial, educational, FM 
station, WGBH. This station is operated 
with the advice and cooperation of the 
Lowell Institute Cooperative Broadcasting 
Council, who e members are the Lowell In- 
stitute, Boston College, the Boston Sym- 
phony Orchestra, Boston University, Massa- 
chusetts Institute of Technology, the Mu- 
seum of Fine Arts, the New England Con- 
servatory of Music. Northeastern Univer- 
sity, and Tufts College. 

NOVEMBER 1952 



Patterned on everyday children's 
everyday interests, each program is 
written in a series of brief episodes, 
generously interlarded with music 
and conversational periods, to avoid 
overstretching a child's attention 
span. 

Each program lasts half an hour. 
It is given slowly; dramatic play is 
suggested; and time is allowed for 
the children to carry out the sugges- 
tions on the spot. 

On Columbus Day, for example, 
historical material is woven in. Upon 
the program's suggestion, the chil- 
dren may act out how the boy Colum- 
bus was told that the world was flat 
and how he figured out that it must 
be round. They may climb up into 
their armchair "sailing ships" and 
start on the great adventure across 
the Atlantic Ocean, which, in their 
case, of course, is the living-room rug. 

Again, a program in connection 
with science material about animal 
habits may start such a game as 
bears preparing for winter — storing 
up food and preparing their homes. 
And an hour or so later the children 
will still be "bears," eating their sup- 



pers peacefully or going to bed under 
sheets that have become, by chil- 
dren's own magic, special caves for 
baby bears! 

We keep up with the seasons 

The program moves with the 
child's life — from fall experiences to 
winter ones, and so on. 

Even before the days and nights 
begin to grow cold, coal or oil trucks 
arrive at people's houses; and chil- 
dren, for the first time, or with in- 
creased appreciation, learn where coal 
and oil come from, how they are car- 
ried to our homes, and what these 
fuels will do. 

Cooler weather brings on a ques- 
tion : "Why must I wear a jacket just 
because it's fall?" And the program 
combines science material and stories 
and music to answer just such ques- 
tions. At jacket-wearing time a child 
may find it hard to learn to zip a zip- 
per and remember to button a button. 
A game and a story and radio-sug- 
gested practice on these exasperating 
problems give such necessary things 
importance and fun. 

As fall days grow shorter, an elec- 



This time the radio story is about flowers, and a picture book helps this child to enjoy it. 




trie-light bulb becomes more impor- 
tant than it was in summer; and it 
needs explanation, along with the 
reason why a finger mustn't be poked 
into the light socket. A game about 
sunlight and shadows makes use of 
a light bulb, too, with the bulb play- 
ing the part of the sun, and the 
child's hand serving as a cloud, to 
cast shadows where it will. 

As winter approaches and sunny 
bedtimes change to dark ones, fears 
and bedtime problems may crop up. 
But they can lose their sting when a 
dramatic game accompanies an eve- 
ning program, like the one about the 
baby bears. 

Another bear story involves a 
"treasure hunt," in which a present 
for the child's mother is supposed to 
be hidden somewhere in the room. 
This leads to a search — under every 
chair, behind every cushion, even un- 
der the rug. Then, somewhat as in 
Marjorie Flack's story, "Ask Mr. 
Bear," the child meets a bear and 
asks for help. Whereupon the bear 
in this radio story whispers to the 
child and tells him where the present 
is. It is in the child's arms — a great 
big bear hug — and he promptly gives 
it to his mother. 

Violent play not always fun 

It is true that the rocket ships and 
gun-toting cowboys on many radio 
programs demand and get children's 
rapt attention, sometimes resulting in 
violent and aggressive imitative play. 
But the amount of noise a child 
makes does not necessarily indicate 
enjoyment. On the other hand, a 
child may not make much noise play- 
ing at being a trafhc policeman as 
part of a radio game, but he may en- 
joy it, and he may find it a step to- 
ward learning that his community 
really cares about him. 

And excitement is not a satisfac- 
tory substitute for the confidence 
that a child acquires when he begins 
to experiment on his own — to find out 
through play what makes a shadow 
over the sun, why a cork floats and 
stones don't, why a kite flies, and 
what makes thunder. 

The program comes into the home, 




See: We found the star in the apple, just the way The Children's Circle lady said we would! 



with the stories told as a mother or 
father would tell them, or a friend, or 
a teacher, to a child alone or with 
other children. No studio audience 
takes part, for this would probably 
only distract the home listeners. The 
program narrator permits sufficient 
time for the children to respond with 
words and action. Only simple activi- 
ties are suggested; the children de- 
velop these themselves, without a 
standard that might be too hard to 
live up to — or too easy. 

And their relaxed behavior during 
such a program is very different from 
the tense, edge-of-the-chair attention 
they give to high-powered blood-and- 
thunder programs. 

The programs are recorded, and 
some of the recordings have been 
played for children in the Boston 
Floating Hospital; some of these 
children are in bed, while others are 
up and around. Among sick children 
the program appeals to a surprisingly 
wide age range — under 2 up to 15 in 
some cases. The little children are in- 
clined to listen passively ; the older 
ones with amusement and response. 
Because the program deals with the 



everyday, comfortable things, it 
seems to offer more peace and quiet 
and comfort, not only to a child dis- 
turbed by illness, but to any young 
child who is tired at the end of a day. 

Programs can help parents 

It is not easy to help a child feel at 
home in a world that is often too com- 
plicated even for adults. In this ef- 
fort parents need any help they can 
find, and increasingly they are learn- 
ing that help can come from radio and 
television. And radio, of course, 
reaches many thousands of children 
to whom television is not yet avail- 
able (and who do not have nursery 
schools or kindergartens to go to). 

Both radio and television are be- 
coming part of the basic home edu- 
cation of children, preceding and 
sometimes overshadowing school les- 
sons. The programs can make a 
child's world more puzzling and 
frightening than it already is — even 
more full of noise and violence. Or 
they can increase his enjoyment and 
understanding and self-confidence, 
and this is the aim of the program 
called "The Children's Circle." 



38 



THECHILD VOL UNO. 3' 



DELINQUENCY PROJECT MOVES AHEAD 



GROUPS and individuals all over 
the Nation are giving their full 
support to the recently an- 
nounced Special Juvenile Delinquency 
Project sponsored by the Children's 
Bureau. This Project, on behalf of 
the Bureau, aims to focus national 
attention on the problem of delin- 
quency and to stimulate community 
action toward improvement of serv- 
ices for delinquent children. 

The Project, financed by private 
contributions to the Child Welfare 
League of America, has received 
many definite offers of assistance 
and cooperation in this campaign. 

On July 14 and 15 representatives 
of 14 national agencies whose every- 
day concern is the prevention and 
treatment of delinquent behavior met 
in Washington to advise the Bureau 
on specific needs for helping delin- 
quent children. The group empha- 
sized the need for more facts about 
delinquency, for better training of 
the personnel who work with these 
children, and for a code of desirable 
practices to govern the services of- 
fered. The agencies represented at 
the meeting have offered to aid in 
fact finding and in furnishing con- 
sultation to communities undertaking 
improvements in their services. 

Through the cooperation of the 
International Association of Chiefs of 
Police, one of the groups represented, 
a questionnaire has already been sent 
out to approximately 2,800 pohce de- 
partments in all parts of the country, 
asking whether or not they have of- 
ficers who are trained for work with 
children; how many children are 
picked up by the police each year — 
and for what reason ; and what pro- 
cedure is followed for handling these 
various children. 

The entire group of agencies will 
continue to act as an ad hoc tech- 
nical committee. 

The agencies represented at this 
meeting were: Administrative Office 
of the United States Courts; Ameri- 
can Public Welfare Association ; Bur- 
eau of Prisons, Department of Jus- 

NOVEMBER 1952 



tice; Bureau of Public Assistance, 
Federal Security Agency ; Child Wel- 
fare League of America ; Field Foun- 
dation ; International Association of 
Chiefs of Police; National Associa- 
tion of Training Schools; National 
Conference of Juvenile Agencies ; Na- 
tional Council of Juvenile Court 
Judges; National Institute of Mental 
Health, Federal Security Agency ; Na- 
tional Midcentury Committee for 
Children and Youth ; National Proba- 
tion and Parole Association ; Office 
of Education, Federal Security 
Agency; and Osborne Association. 

To promote local aciion 

One week later, on July 21, in New 
York, the National Social Welfare 
Assembly called a meeting of its 
member organizations to consider 
ways in which they could cooperate 
with the Children's Bureau in this 
Nation-wide campaign. The 33 groups 
represented at the meeting have a 
membership which reaches into 
every community in the United 
States. The national organizations 
promised their full assistance in car- 
rying information to their local chap- 
ters and in stimulating and support- 
ing local projects connected with bet- 
ter services for delinquent children. 

In addition, a number of the organ- 
izations reported that they would un- 
dertake work directly related to serv- 
ices for'delinquents. The Girl Scouts, 
for example, are organizing troops in 
training schools. The National Coun- 
cil of the Protestant Episcopal 
Church will train chaplains specifi- 
cally for work in training schools. 
Other groups indicated that they 
would explore this field of direct 
services. All the organizations rep- 
resented at the meeting promised to 
reexamine their current programs, to 
see how effective they are in pre- 
venting delinquency and whether 
they can be adapted to better advan- 
tage in this campaign. 

A summary of proceedings of an 
earlier meeting, the Conference on 



Control of Juvenile Delinquency, has 
also stimulated widespread interest. 
This conference, held in Washington 
April 17-19 under the sponsorship of 
the Children's Bureau, was attended 
mainly by experts in the field of de- 
linquency. The conference made 
recommendations affecting the opera- 
tion of services for delinquents, the 
training of personnel, and the need 
for research in the field of delin- 
quency. The summary of proceed- 
ings has been distributed recently to 
some 3,000 persons who work with 
delinquent children. 

In his foreword to the summary, 
John H. Winters, Executive Director 
of the Texas State Department of 
Public Welfare and Chairman of the 
Conference, said: "The meeting in 
Washington was, in my opinion, the 
first step in a necessary pi'ocess 
aimed at alerting leaders to the grow- 
ing problems of juvenile delinquency. 
You, the reader, are called upon to 
use the structure we have created in 
order to continue building. Specifi- 
cally, you are asked to consider the 
contents of this report and let us 
know what you think about it. We 
should be pleased to have the report 
used as a basis for meetings of per- 
sons concerned with the control of 
delinquency and to receive the min- 
utes of such meetings." 

Workers in a number of States 
have already reported plans for hold- 
ing meetings such as Mr. Winters 
calls for. Among these States are 
Connecticut, New York, Delaware, 
and the District of Columbia. Num- 
erous requests for additional copies of 
the summary continue to be received. 
A copy will be sent to any reader of 
The Child who requests it. 

Pamphlets related to the work of 
the project will shortly be available. 
A special bulletin will be issued peri- 
odically to keep all persons interested 
informed about the latest develop- 
ments. A copy of this bulletin also 
will be sent to any reader of The 
Child who would like to receive it. 



39 



CHILDREN AND THE 
SCHOOL-LUNCH PROGRAM 



THE NOON LUNCHES that a 
child eats in the course of a 
school year have an appreciable 
influence on his health, his education, 
and his general welfare. The agencies 
represented on the Interagency Com- 
mittee on Nutrition Education and 
School Lunch are concerned with one 
or more aspects of school-lunch pro- 
grams. To assist all member agencies 
in carrying out such responsibilities 
as they may have, the Interagency 
Committee has prepared a statement 
of the values inherent in school-lunch 
programs. The paragraphs that fol- 
low develop the main theme of the 
statement of goals, which is that 
school-lunch programs should be cen- 
tered on the child — his nutrition, his 
physical, mental, and emotional de- 
velopment, and his education. 

1. The school lunch should foster 
good food habits and safeguard 
the health of school children 

The noon meal served at school will 
fulfill its nutritional purpose only if 
it supplies at least one-third of the 
day's requirements for calories, pro- 
teins, vitamins, and minerals. Its 
contribution of nutrients should be 
such that, in combination with the 
breakfast and the evening meal typi- 
cal of those served in homes of the 
community, the total daily needs of 
the children will be met. Food needs 
of children differ with their size, ac- 
tivity, and physical condition. 

The school meal will serve as a 
safeguard of nutrition and health 



The agencies represented on the Inter- 
agency Committee on Nutrition Education 
and School Lunch are: In the Department 
of Agriculture, the Bureau of Human Nu- 
trition and Home Economics, the Coopera- 
tive Extension Service, the Farmers Home 
Administration, the Food Distribution 
Branch of the Production and Marketing 
Administration, the Office of Experiment 
Stations, and the Rural Electrification Ad- 
ministration; in the Federal Security 
Agency, the Children's Bureau, the Office 
of Education, and the Public Health Serv- 
ice; and the American National Red Cross. 



only if it is so acceptable that it is 
eaten by the children in the quantities 
provided for them. Therefore, the 
quality of the food and its accept- 
ability should receive due attention. 
School lunches provide a means for 
gaining acceptance of foods of high 
nutritive value, the increased con- 
sumption of which is in the interest 
of nutritional betterment. The school 
that serves only appetizing, moder- 
ately priced food under pleasant sur- 
roundings has taken an important 
step toward protecting children from 
unsuitable foods and beverages. 

Sanitary safeguards are essential 
for all food handling, especially group 
feeding. The public health agency 
often has legal responsibility for the 
sanitary conditions and practices in 
school lunchrooms. Even if legal au- 
thority is lacking, this agency can 
provide valuable advice and assist- 



When a school serves only appetizing, moderat 
has taken an important step toward protecting 



ance to school administrators in en- 
suring that school lunchrooms meet 
accepted sanitary standards both as 
to facilities and operations. 

The conditions under which the 
lunch is served affect the mental and 
emotional health of children. To this 
end effort should be directed toward 
provision of attractive surroundings, 
an unluirried quiet atmosphere, 
smoothly functioning service, servers 
who understand the children and 
their food needs, unobtrusive guid- 
ance when necessary in the choice of 
foods, and absence of any discrim- 
mination. 

2. The school lunch should contribute 
to the education of the child and 
his family 

The school lunch can provide a 
practical form of education in nutri- 
tion, sanitation, and social behavior 
for all children. It may also give 
practice to some pupils in planning 
menus ; in buying, preparing, and 
serving foods on either a home or a 
commercial scale ; and even in pro- 
ducing and processing foods. 
{Continued on page 45) 

ely priced food under pleasant surroundings, it 
children from unsuitable foods and beverages. 



40 




CONFERENCE WORKS 
TOWARD BETTER CITIZENSHIP 



I LUCILE ELLISON 

THE SPIRIT of young America, 
vigorous and unafraid, was evi- 
dent throughout the 1952 Na- 
tional Conference on Citizenship, 
held in Washington September 17-19. 
Seventh in a series, the conference 
was jointly sponsored by the National 
Education Association and the United 
States Department of Justice. In it 
were assembled 1.000 representatives 
of over 600 organizations and 
agencies, all deeply concerned with 
the rights and responsibilities con- 
nected with citizenship. They came 
from every State in the Union and 
from numerous foreign countries. 

In each of the 18 groups, a cross- 
section of America came together. 
In the words of the summarizer: ''You 
are, after all, America in miniature. 
There are some 1,000 of you, repre- 
senting millions of doctors, lawyers, 
merchant-chiefs — to say nothing of 
the butchers, bakers, and candlestick 
makers. You are not all of one mind 
and I would be less than candid if I 
were to report that you were." Each 
conference group included a number 
of young people of high-school and 
college age and they were accepted as 
equals with the adults. 

Some don't appreciate citizenship 

Some pointed questions were asked 
in the various groups : 

"How are our rights and privileges 
identified and acquired?" 

"What rights and privileges seem 
most fundamental at this midcen- 
tury?" 

"What are the most persistently 
troublesome problems arising from 



LUCILE ELLISON is a staff member of 
the National Education Association. .As- 
sistant Secretary of the NEA's National 
Commission for the Defense of Democracy 
through Education, Mrs. Ellison is assigned 
as staff liaison to the NEA's Citizenship 
Committee. In this capacity, she is a member 
of the Executive Committee for the National 
Conference on Citizenship. 

NOVEMBER 1952 



the exercise of our rights and the en- 
joyment of our privileges'?" 

"What principles can we formulate, 
and what means can we employ, to 
improve the relationship of the indi- 
vidual citizen to his rights and privi- 
leges, as well as his duties and re- 
sponsibilities, under the Constitu- 
tion?" 

First of the "troublesome" prob- 
lems to be identified was the apathy 
of many citizens toward their consti- 
tutional rights and obhgations as citi- 
zens. Such apathy, one delegate said, 
is in fact "subversive iKactivity" be- 
cause it plays into the hands of those 
seeking to destroy our democratic 
system. 

Another problem, delegates sug- 
gested, is that young adults, for many 
different reasons, either do not or 
cannot exercise their rights. For ex- 
ample, because the voting age is 
fixed at 21, many younger people lose 
interest in and concern with their re- 
sponsibilities as citizens. 

The conference gave much atten- 
tion to the practice of good citizen- 
ship. As one group reported: "It is 
not a matter of kuowing right but of 
doing right." Said the summarizer: 
"There was one point on which you 
seemed all to be in complete agree- 



ment. You couched it in different 
phrases, but the thought was this: 
Good citizenship demands action and 
participation. It is an active, not a 
passive thing." 

The youth-adult panel on the open- 
ing evening of the conference pre- 
sented the active role of schools in 
making better citizens. Dr. William 
S. Vincent, director of the Citizenship 
Education Project at Columbia Uni- 
versity and moderator of the panel, 
said: "Since their beginning in 
America, schools have devoted a large 
part of their program of courses and 
activities to citizenship education. 
But the job is not an easy one and it 
is not a cheap one. More recently we 
have come to realize that you can't 
make good citizens solely by reading 
and talking about good citizenship. 
Good citizenship is a way of behav- 
ing. It is a matter of action, and if we 
know one thing about how people 
learn it is this: Active things you 
learn through action. Imagine trying 
to teach a girl to sew without a needle 
and thread. Active things require 
some sort of laboratory approach, 
and citizenship is no exception." 

This panel also illustrated, as was 
true of the discussion groups, the in- 
tegration of young people and grown- 
ups in the conference. In it, six high- 
school students, a judge of a juvenile 
court, and a newspaper correspondent 
took part. The students represented 
public, private, and parochial schools. 
From dozens of illustrations, it be- 
{Continucd on page 44) 



What principles can we formulate, and what m 
ship of the citizen to his rights and privilege 



ean.s can we employ, to improve the relation- 
s. as well as his duties and responsibilities? 




FOR CHILD WELFARE IN VENEZUELA 



ELISABETH SHIRLEY ENOCHS 

FEW countries of the Western 
Hemisphere have made more 
i-apid progress in the field of 
child welfare than Venezuela. In 
1936, when a new Government was 
set up after the death of General 
Juan Vicente Gomez, who had ruled 
the country for more than a quarter 
of a century, one of the first oificial 
acts was issuance of a decree estab- 
lishing a child-welfare agency. Plans 
were immediately laid for the 
country's First National Child Wel- 
fare Conference, held in 1938, to 
which the Venezuelan Government 
invited the Chief of the United States 
Children's Bureau as an honored 
guest. Shortly thereafter, in line 
with recommendations made at this 
meeting, Venezuela's Federal Con- 
gress enacted a Children's Code, 
which became the organic act of the 
present Venezuelan Children's Coun- 
cil (Consejo Venezolano del Nino). 
Ten years later, in 1948, Caracas, 
the beautiful capital city of Vene- 
zuela, was host to representatives of 
all the American nations at the Ninth 
Pan American Child Congress. The 
delegation from the United States, of 
which Katharine F. Lenroot, then 
Chief of the Children's Bureau, was 
chairman, noted the great strides al- 
ready made in work for children in 
Venezuela and the eagerness with 
which all branches of government — 
Federal, State, and local — were plan- 
ning future progress. A draft of a 
new Children's Code had been devel- 
oped under the leadership of a dis- 
tinguished Venezuelan jurist who to- 
day is Minister of Justice, and that 
Pan American gathering reviewed 
the draft. Several of the United 
States delegates were members of the 
working group that reviewed the 
proposed code. A year later the Fed- 
eral Congress of Venezuela approved 
that draft, with appropriate amend- 
ments, and the Code provides the le- 
gal authority under which the Ven- 



zuelan Children's Council now oper- 
ates. 

How the Council functions 

In its structure the Council differs 
from many similarly named agencies 
in the other American Republics. In 
accordance with its basic statute it 
functions through an Assembly 
(Asamblea) ; a Board of Directors 
(Junta Directiva) ; a General Secre- 
tariat (Secretaria General) ; and 13 
Regional or State Councils (Consejos 
Seccionales). 

The Assembly is composed of rep- 
resentatives of the Federal Executive 

ELISABETH SHIRLEY ENOCHS is Chief 
of International Technical Missions (Point 
IV) in the office of the Commissioner for 
Social Security, Federal Security Agency. 
For a number of years she was on the staff 
of the Children's Bureau, during the last 10 
years as Director of the Bureau's Division 
of International Cooperation. 

Mrs. Enochs has been a delegate to vari- 
ous Pan American Child Congresses, in- 
cluding the Ninth Child Congress, which was 
held in Caracas, Venezuela. She has also 
represented the United States at several of 
the meetings of the Directing Council of the 
American International Institute for the 
Protection of Childhood. 




In Venezuela, as in our own country, children are the nation's most important resource. 



branch of the Government and of the 
Ministries of Interior, Defense, Pub- 
lic Works, Education, Health and So- 
cial Welfare, Labor, Justice, and the 
Government of the Federal District. 
In addition to issuing regulations and 
reports, as prescribed by the Chil- 
dren's Code, it serves as a consulta- 
tive body to the Council's Board of 
Directors. 

The five-member Board carries the 
full executive and administrative re- 
sponsibility of the Council; the 
Board's resolutions and orders are 
carried out through the General Sec- 
retariat. 

Designed to serve the "whole 
child," the Council is largely the 
achievement of a far-seeing group of 
experts in the fields of pediatrics, 
public health, education, law, and so- 
cial service. Its basic philosophy has 
been summed up by the President of 
the Board in the following terms: 
"... the goal of all programs of child 
care and welfare is to conserve the 
child in his own home, to strengthen 
family ties, to serve the whole child 



42 



THE CHILD VOL 17 NO. 3 



there, in his natiu-al setting. The wel- 
fare of a people can be achieved only 
through the family . . . The home is 
the first line of defense against mis- 
fortune, against crime, against im- 
morality and social crises . . ." 

Direct service to mothers and chil-" 
dren is offered through eight tech- 
nical divisions. 

The Division of Prenatal and Ma- 
ternal Care sets standards and gives 
subsidies to maternity homes and 
postnatal centers founded by volun- 
tary women's organizations. It has 
also established a nutrition center for 
pi'egnant and nursing women and has 
under study a national plan for fam- 
ily allowances. The Council works in 
close cooperation with the Ministry 
of Health and Social Assistance, 
which operates maternal and child- 
health centers. 

The Division of Infancy and Pre- 
school Children cares for children 
from birth to 7 years of age through 
day-care centers and kindergartens. 
The Council's 41 day-care centers now 
care for 1,555 children, while its 25 
kindergartens, in the capital and the 
several States, have a capacity of 
1,609. Subsidies are also given to a 
number of private agencies providing 
similar facihties. 

Dependent and delinquent children, 
as well as those with mental or physi- 
cal handicaps, are cared for through 
a division called the Division of Mi- 
nors in Irregular Situations. This 
part of the Council's program is 
largely the work of a psychiatrist, 
who was formerly Minister of Edu- 
cation and was the first Secretary 
General of the Council, Dr. Rafael 
Vegas. The program is generally re- 
ferred to as the "Vegas Plan." A 
whole article might well be written 
about this Division; its boarding 
homes ; its observation and treatment 
homes ; its educational, scholarship, 
and apprenticeship programs — as 
well as about the plans for develop- 
ing an eflfective system of financial 
aid to families to prevent many of 
the problems dealt with by these in- 
stitutions. Through a technical ad- 
visory committee many types of pro- 
fessional skill are mobilized by the 

NOVEMBER 1952 



Council to sei*ve the needs of its 
wards, and special staff-development 
programs are being planned to im- 
prove the quality of care the children 
now receive. 

The Social Service Division, with 
a staff of 58, has 27 offices through- 
out the country, including a few of- 
fices in States where as yet there is 
no regional or branch Council. The 
activities of the social workers are 
largely decentralized. In Caracas the 
social workers are assigned to work 
in the 14 maternal and child-health 
centers of the Ministry of Health and 
Social Assistance. The Division plans 
to extend this arrangement to other 
localities since it provides a basis for 
close and useful collaboration be- 
tween social workers and public- 
health nurses. The social workers do 
casework and groupwork, child plac- 
ing, and family counseling. They 
settle questions of parental authority 
and guardianship and refer certain 
problems to the Juridical Division. 

As its name implies, the Juridical 
Division handles the Council's legis- 
lative matters. In addition to main- 
taining a legislative reference center 
it provides legal-consultation service, 
and through a staff of so-called "chil- 
dren's attorneys" it appears in court 
cases where the rights of minors are 
involved. In furtherance of its vari- 
ous programs this Division is now 
planning a series of "juridical semi- 
nars" for juvenile-court judges, chil- 
dren's attorneys, and Division staff. 

The Division of Reports and Pub- 
lications and the Division of Statis- 



tics have contributed greatly to mak- 
ing known throughout the country 
the problems of child welfare and the 
services of the Council. The Admin- 
istrative Division handles all details 
of purchasing, transportation, per- 
sonnel, budget, and fiscal work for a 
program which last year totaled 
more than $12,000,000. It is esti- 
mated that the Council's services 
reach four-fifths of the approxi- 
mately 2 million children under 18 
years of age in Venezuela. 

A Cuban social worker has recently 
published in the Revista de Servicio 
Social of Havana the following ac- 
count of her work in Venezuela : 

"As a social worker J was part of 
a hard-working army on the staff of 
the Children's Council, carrying to 
the most remote and hidden hamlets 
of Venezeula the message of social 
justice and the material and spiritual 
benefits of the Council's work for 
children. 

Social workers in short supply 

"The social worker is an important 
member of the Council's staff, for it 
is she who studies at first hand each 
case referred to it and who deals di- 
rectly with the child and his family 
or, through her reports, advises di- 
rectors of agencies, doctors, attor- 
neys, and judges of juvenile courts. 
Although a large number of the so- 
cial workers graduated each year 
from the two schools of social work 
are employed by the Council, there 
are not enough to meet the needs. 
The Regional or State Councils send 



Homes of families in Venezuela are often located in tiny hamlets hidden away in the moun- 
tains; and health and social workers are likely to find much difficulty in reaching the people. 




girls on fellowships to Caracas for 
training in order to build up their 
own trained staffs in the hope of 
avoiding constant changes. 

"From the beginning of my assign- 
ment, while I was in the capital, in 
the headquarters office, I was able to 
know and evaluate the great humane 
and social task of the agency. Cara- 
cas enjoys greater resources because 
of the collaboration given by the Min- 
istry of Health and Social Assistance 
through its maternal and child-health 
centers and through the pediatric dis- 
pensaries of the Municipal Govern- 
ment. There are more agencies in 
the capital, better facilities for fos- 
ter-home placements and for adop- 
tions. There are likewise greater eco- 
nomic resources. 

"The second phase of my assign- 
ment was in the State of Bolivar. 
This State includes, in addition to 
the State capital, Ciudad Bolivar, on 
the banks of the Orinoco River, the 
whole of Venezuelan Guayana with 
its enormous reserves of iron, gold, 
and diamonds. Yet despite its min- 
eral wealth Bolivar is not one of Vene- 
zuela's richest States. It is inhabited 
by Indian tribes reached only by mis- 
sionaries and explorers. During our 
stay we found, among the hundreds 
of cases passing through our office, 
which we handled or visited pei-- 
sonally, a number related directly or 
indirectly to the Indians of those dis- 
tant jungles whom we could not visit 
but to whom the Council's work was 
not unknown. I remember the case of 
an old Indian woman who came in 
from her distant tribe with a blind 
son to ask the 'Tribunal of Children' 
to find another son, 15 years old, who 
had run away from the tribe. The 
blind son was interpreter for the old 
lady, who spoke only an Indian dia- 
lect. Having registered her request 
she went away satisfied that the 'Tri- 
bunal of Children' would find her 
boy. And a few days later, as a result 
of talegrams, press notices, and radio 
broadcasts, the young Indian lad was 
on a plans headed for Santa Elena de 
Uairen, the last outpost reached by 
the airlines in Indian territory. 

"Our last assignment was Merida, 



the university town in the West on a 
plateau in the Venezuelan Andes, 
where I established a Regional Coun- 
cil. The preliminary studies took me 
to every part of the State — to towns, 
villages, and tiny hamlets hidden in 
the mountains. I interviewed author- 
ities and neighbors, studying re- 
sources and needs. The opportunity 
thus offered me gave me a better un- 
derstanding of the scope of this work 
that the Venezuelan Children's Coun- 
cil is doing for its future citizens." 

For advanced study 

During each stage of its develop- 
ment the Children's Council has 
sought the cooperation of experts 
from the other American Republics. 

The President of the Venezuelan 
Children's Council, Dr. E. Santos 
Mendoza, has been most active in 
promoting international exchange of 
knowledge and experience with simi- 
lar agencies in other countries. A few 
years ago, at Dr. Mendoza's request, 
Katharine F. Lenroot, then Chief of 
the Children's- Bureau, made an 
agreement with him, according to 
which the Children's Bureau would 
undertake to supervise trainees — pe- 
diatricians, nurses, social workers, 
nutritionists, and so forth — who were 
sent to the United States by the 
Venezuelan Council for advanced 
work. Some assistance already has 
been given to three such trainees. 

Last year Dr. Mendoza asked the 
Bureau to recommend a specialist in 
social groupwork to be employed di- 
rectly by the Council to develop an 
in-service training program. The 
worker recommended by the Bureau 
accepted the position. And she has 
just returned from an 8-month as- 
signment in Venezuela during which 
she taught groupwork to the Coun- 
cil's social workers as part of its pro- 
gram of staff development. 

The cooperation initiated with the 
visit of the Chief of the Children's 
Bureau to Venezuela's First National 
Child Welfare Conference in 1938 has 
ripened through the years and shows 
once more that interest in the welfare 
of childi'en is a strong element in pro- 
moting international friendship. 



CITIZENSHIP 

(Continued from page 41) 

came evident that the school itself 
can be a civic laboratory that, with 
the help of community leaders, can 
broaden into the community, into the 
State, into the Nation, and into the 
world. 

But, whether for youth or adult 
citizens, "On every liberty there is a 
price tag of responsibility," delegates 
agreed. Some of the responsibilities 
of the adult citizen, they pointed out, 
were : 

To vote — regularly and intelli- 
gently, and in the primary as well as 
the general election. 

To follow-up on voting by holding 
the elected officials responsible for 
their actions and conduct. At the 
same time, it is urgent that citizens 
aid actively in the development of a 
feeling of trust and confidence in the 
vast majority of loyal, honest, and ca- 
pable public servants. 

To obey the duly enacted laws of 
the land even though some individual 
pieces of legislation may not coincide 
with our convictions. 

To pay taxes with as good a grace 
as possible and to seek information 
about the disposition of tax money in 
order to hold elected officials respon- 
sible for the wise use of it. 

To support our country in armed 
conflict. 

To oppose the activities of subver- 
sive persons and organizations, with- 
out, however, subverting the liberties 
that are guaranteed us by the Con- 
stitution. 

To put public interest ahead of 
private advancement. 

To speak out, even at considerable 
cost to the individual, in support of 
the rights of others. 

To define rights and responsibilities 
in terms meaningful to the individual 
and to develop a program of action 
for meeting the problems involved. 

To join with others in "making the 
Constitution live" by insisting upon 
a constructive approach which em- 
phasizes the contributions that all in- 
dividuals and groups are capable of 
making toward better citizenship. 



44 



THE CHILD VOL. 17 NO. 3 \ 



SCHOOL LUNCH 

' (Continued from page 40) 

The good school kinch, adequately 
pubhcized to parents by both children 
and school officials, can be a potent 
iforce in improving home food prac- 
tices and in increasing nutrition 
knowledge among other members of 
the family. 

Since the school lunch affords both 
health and education benefits, it is im- 
portant that it be available to all chil- 
dren attending school who wish to 
partake of it. If charges are made 
for the school lunch, a plan should 
be worked out so that no child is ex- 
cluded or is the object of discrimina- 
tion because of inability to pay the 
full price of the lunch. All receipts 
from school-lunch operations ought 
to be used to provide the best pos- 
sible lunches at the lowest possible 
price. In order that school lunches 
may be of maximum benefit to school 
children, community resources may 
need to be supplemented by outside 
financial aid for facilities, equipment, 
and upkeep, as well as for current 
operations. 

In order to make the school lunch a 
school-wide educational project, it has 
to be administered by school officials 
and operated with the assistance of 
qualified workers, whether paid or 
volunteer. All individuals involved in 
a school-lunch program need to be 
adequately prepared for the respon- 
sibilities they carry. This statement 
applies with equal force to adminis- 
trators, supervisors, managers, 
workers, and teachers. School-lunch 
workers should be selected because of 
their aptitudes, should be given ade- 
quate training for the job, and should 
work under competent supervision. 

3. The school lunch should be a com- 
munity-wide enterprise 

Much of the success of a school- 
lunch program rests with the local 
community. It is the concern of par- 
ents and teachers, of the agencies re- 
sponsible for or interested in com- 
munity health and welfare in general, 
and of those with specific responsi- 

NOVEMBER 1952 



bility for the health and education of 
the child of school age. 

Community planning involving par- 
ents and citizens' groups, as well as 
civic and school officials, is essential 
for full realization of the potenti- 
alities of school-lunch programs. 
These planners should direct their at- 
tention to such essentials for success- 
ful school lunches as: Adequate fin- 
ancing, facilities, and equipment; 
sound administration; competent di- 
rection by individuals aware of the 
food needs of children, as well as 
skilled in management and super- 
vision; and educational programs in 
both the school and the community. 

Copies of this statement are avail- 
able from the Nutrition Programs 
Service, Bureau of Human Nutrition 
and Home Economics, U. S. Depart- 
ment of Agriculture, Washington 25, 
D. C. 



IN THE NEWS 



Elizabeth Healy Ross, psychiatric so- 
cial worker, took office October 1, 
1952, in the newly created position 
of Deputy Chief of the Children's Bu- 
reau. As Deputy Chief, Mrs. Ross is 
working directly with Dr. Martha M. 
Eliot, Chief of the Children's Bureau, 
in directing the Bureau's programs 
of research in child life and adminis- 
tration of grants to the States for 
extending and improving maternal 
and child-health, crippled children's, 
and child-welfare services. 

Before coming to the Children's 
Bureau, Mrs. Ross was for 6 years 
consultant to various Federal and 
District of Columbia agencies on de- 
velopment of psychiatric social ser- 
vices for children, for military per- 
sonnel, and for veterans. 

Born in Fort Dodge, Iowa, Mrs. 
Ross was graduated from the Univer- 
sitv of Minnesota and from the Smith 
College School for Social Work. 

For several years she worked in 
child-guidance clinics. Then, during 
the 30's, she was a member of the 
staff of the Bank Street College of 
Education, New York City, where she 
helped develop a program of educa- 
tion for nursery-school and elemen- 
tary-school teachers. This involved 
courses in child development and 
guidance. Following her work with 
the Bank Street College, Mrs. Ross 



became admissions secretary and 
faculty member of the Pennsylvania 
School of Social Work, Philadelphia, 
Pa where she taught, among other 
things, "Approaches to Work with 
Children." 

While in Philadelphia, the major 
focus of Mrs. Ross' work was in the 
field of emotional growth of children. 
She gave courses to nursery-school 
teachers and to vocational-education 
teachers. She also served the Charles- 
town Play House, Phoenixville, Pa., 
and the Philadelphia Home for In- 
fants. 

During World War II, Mrs. Ross 
was Secretary of the War Service 
Office of the American Association ot 
Psvchiatric Social Workers, created 
with funds from the Rockefeller 
Foundation for the purpose of msur- 
ino- maximum use of psychiatric so- 
cial work personnel during the war 
period. She served as consultant in 
psychiatric social work to Dr. Wil- 
liam C. Menninger, Chief of Psychia- 
trv in the office of the Surgeon Gen- 
eral, Department of the Army, and 
has continued to advise on the mili- 
tary social-work program since the 
war. 

Since 1946 Mrs. Ross has also 
served as consultant in the develop- 
ment of program, policies, and stand- 
ards of psvchiatric social work to 
several agencies— the Veterans Ad- 
ministration; the National Institute 
of Mental Health, of the Public 
Health Service; Walter Reed Army 
Hospital ; and the Child Welfare Divi- 
sion, Board of Public Welfare, Dis- 
trict of Columbia. She assisted m the 
preparation of the Fact Finding Re- 
port of the Midcentury White House 
Conference on Children and Youth. 
Elected a member of the executive 
committee of the National Confer- 
ence of Social Work in 1951, Mrs. 
Ross is a member also of the Ameri- 
can Association of Social Workers 
and of the American Association of 
Psychiatric Social Workers. She was 
formerly on the advisory board on 
health services to the Chairman of 
the American Red Cross. Mrs. Ross' 
writings have appeared in various 
professional magazines. 

Dr Eliot and Mrs. Ross are as- 
sisted by Dr. Katherine Bain, the 
Bureau's principal consultant on 
health program, who continues to ad- 
vise particularly on matters of pro- 
gram development for the Bureau as 
a whole, and Neota Larson, whose 
special area of work is administrative 
policy and legislation. 

Melvin Glasser has been appointed 
Special Assistant for State and Na- 
tional Organization Relations on the 

45 



Special Juvenile Delinquency Project 
sponsored by the Children's Bureau. 
He will bring to this Project the full 
benefit of his experience as Executive 
Director of the Midcentury White 
House Conference. 

Community and child. How com- 
munities can improve life for children 
was one of the principal subjects dis- 
cussed by delegates from 30 nations 
at a 3-week seminar on Mental Health 
and Infant Development, which was 
held July 19 to August 10, 1952, at 
Bishop Otter College, Chichester, 
England. 

The seminar was based on clinical 
studies of child development, made in 
France, the United Kingdom, and the 
United States of America. 

The teaching faculty consisted of 
about 15 specialists from these three 
countries, and the delegates included 
doctors, psychologists, pediatricians, 
and social workers. 

The seminar was sponsored by the 
World Federation for Mental Health, 
with the cooperation of UNESCO, 
the World Health Organization, the 
International Children's Centre in 
Paris, the United States National Ad- 
visory Mental Health Council, and the 
Grant Foundation of New York. 

Young workers. According to Census 
estimates, in 1951 more than twice 
as many boys and girls under 18 were 
employed as were employed in 1940 
Two-thirds of the 2V-> million em- 
ployed in 1951 were also attending 
school. 

School enrollm. it. Data released 
July 21, 1952, by the Bureau of the 
Census show that, in October 1951, 
99 percent of the children 7 to 13 
years old in the United States were 
enrolled in school. (The age group 
7-13 is included under compulsory- 
attendance laws in practically every 
State.) Of boys and girls 14 and 15 
years of age, 94.8 percent were in 
school, but only 74.9 percent of those 
16 and 17 years. 

The high enrollment among chil- 
dren 7 to 13 years old— 18,000,000— 
is due primarily to the presence in 
the elementary grades of a large 
number of children born shortly be- 
fore World War II and during the 
war years, the report says. The num- 
ber of children in this age group en- 
rolled in October 1951 is 3,200,000 
greater than the comparable number 
for October 1945. 

Live births in the United States in 
1951 soared above 3,800,000 for the 
second time in our history, and 
topped the 1950 birth total by more 



than 200,000, according to prelimi- 
nary figures from the National Office 
of Vital Statistics, Public Health Ser- 
vice, Federal Security Agency. 

Moreover, the 1951 total may be 
an all-time high for the United States. 

The number of children born in 
1951 was estimated at 3,833,000 as 
compared with the 3,818,000 born in 
1947, the previous record year. Be- 
cause of the small difference between 
the two figures, it is necessary to wait 
for final data for 1951 before deter- 
mining whether 1951 is definitely the 
all-time high. 

The annual birth rate for 1951, 
based on registered births alone, rose 
to 24.5 per thousand population, an 
increase of 4.3 percent over 1950. 

A fall in the infant mortality rate, 
which dropped for the fifteenth 
straight year, also helped to swell the 
1951 addition to the infant popula- 
tion. Infant deaths last year oc- 
curred at the rate of 28.8 per thou- 
sand live births, contrasted with a 
rate of 47.4 in 1940 and 64.8 in 1930. 

MCH services (preliminary figures). 

Under Federal-State maternal and 
child-health programs carried on un- 
der the Social Security Act, almost 
395,000 babies under 1 year of age 
and 565,000 other children of pre- 
school age attended health clinics in 
the calendar year 1951. This repre- 
sents increases of 30 pei-cent and 35 
percent respectively over the num- 
bers attending in 1950. 

Physicians examined about 2,394,- 
000 school children in 1951 under this 
program, an increase of nearly 8 per- 
cent over the 1950 figure. 

About 189,000 women attended 
prenatal clinics in 1951, which was 
an increase of 8 percent over 1950 
(175,000). There was only a slight 
increase in the number of expectant 
mothers who received public-health- 
nursing service (268,000 in 1951 and 
258,000 in 1950) . There was a 13 per- 
cent increase in the number of women 
who received postpartum nursing 
service— nearly 279,000 in 1951. The 
number given a postpartum medical 
examination — nearly 53,000 — was 
nearly 12 percent below the number 
for the previous year. 



DEADLINE EXTENDED TO OCTOBER 31 

Owing to an unavoidable delay in 
sending out circularization cards to 
the official mailing list for The Child, 
the closing date for the return of the 
cards has been extended to Octo- 
ber 31. 



FOffliirBOOKSHELF 



SCHOOLS FOR THE VERY YOUNG. 

By Heinrich H. Waechter and 

Elizabeth Waechter. F. W. Dodge 

Corporation, 119 West Fortieth 

Street, New York 18, N. Y. 

1951. 197 pp. $6.50. 

This is the first book I have seen in 
which an architect and an educator 
join to give a comprehensive view of 
the physical and social needs of the 
preschool child in relation to physical 
equipment planned to meet these 
needs when he is in a nursery school. 

The authors review the history of 
preschool education and give a picture 
of life in the nursery school of today. 
They believe that if an architect is 
to plan and design schools for young 
children, he should visit schools "to 
observe and experience for himself 
the great difference between the 
building as an inorganic structure of 
more or less formal beauty and the 
building which has come to life by its 
use." 

Recognizing that no standardized 
methods of construction have been 
developed for these schools, the au- 
thors consider this fortunate, for the 
whole conception of preschool educa- 
tion is still in a developmental stage. 
As for their idea of how to construct 
a building for preschool education, 
they say that it is logical to draw on 
experience with construction of the 
two types of buildings most nearly 
related to it, namely, the home and 
the school. 

The book covers such subjects as 
problems of layout and design ; the 
relation of the nursery school to its 
neighborhood and community; out- 
door equipment and playground sur- 
face ; and the technological problems 
of lighting and ventilation, color, me- 
chanical equipment, and furnishings. 
There are many photographs and 
floor plans, as well as a bibliography. 

This book is "must" reading for all 
who are concerned with planning new 
buildings (or remodeling old ones) to 
give group care to young children. 

I. Evelyn Smith 

PRACTICES IN HOMEMAKER 
SERVICE; as reported by agen- 
cies providing the service on June 
30, 1949. Federal Security A- 
gency, Social Security Adminis- 
tration, Children's Bureau, Wash- 
ington, 1951. Processed. 19 
pp. Single copies free. 
This study, made by the National 

Committee on Homemaker Service, 



46 



THE CHILD VOL. 17 NO. 3 



supplies social agencies with a set 
3f facts on actual practices in home- 
naker service. It is a "working re- 
port," without comment or conclu- 
sions. 

The report tells how 63 social 
igencies were administering their 
honiemaker services in mid-1949. 
Fifty-six of the agencies were pri- 
v'ately supported, 6 were publicly 
supported, and 1 was operated un- 
der combined private and public 
auspices. Thirty-two of those pri- 
i'ately supported were family serv- 
ice societies, 19 were family and 
children's services combined into 
Dne agency, and 12 were children's 
agencies. 

The agencies reported on five 
points: (1) On how the families 
3ame to them for service and how 
the original arrangement was made ; 
(2) on their homemaker staff (num- 
ber, work week, wages, training, 
3tc.) ; and (3) on the professional 
staff (time the supervisor gives to 
the service, her education and ex- 
perience, her duties, the line of au- 
;hority, and the range of salaries) ; 
(4) on homemaker-service commit- 
;ees; and (5) on keeping the boards 
-){ directors informed about the serv- 
ce and letting the public know what 
such a service can do for families. 

PRACTICAL GUIDE FOR FOOD 
SERVICE IN NURSERY 
SCHOOLS AND OTHER GROUP 
CARE CENTERS. By Edna Mohr. 
Elizabeth McCormick Memorial 
Fund, 848 North Dearborn Street, 
Chicago 10, 111. 1951. 34 pp. 
50 cents. 

What types of foods should all 
voung children have every day? 
How many meals should be served 
n order to meet the child's daily 



food needs? What variation should 
there be in the amount and type of 
food served at different times dur- 
ing the day? How can an effec- 
tive working relationship be main- 
tained between the home and school 
in order to be certain that the child's 
food needs are met? How can the 
efforts of the home and school be 
unified in helping the child learn 
to like the foods he needs? 

This guide offers concise, practi- 
cal answers to these questions, based 
on the author's breadth of experi- 
ence as a nutritionist and nursery- 
school consultant on the staff of 
the Elizabeth McCormick Memorial 
Fund. 

The appendix contains a limited 
number of favoi-ite recipes and is 
followed bv a brief and pertinent 
bibliosrraphy. 

Although this material is designed 
narticularlv to help untrained and 
inexperienced staff, it should prove 
a helpful handbook for all con- 
renipd with plannins- snd servine 
food in group-care centers. 

Catherine M. Leamy 

YOUR NEIGHBOR'S HEALTH IS 
YOUR BUSINESS. By Albert Q. 
Maisel. Public Affairs Pamphlet 
No. 180. Public Affairs Committee, 
Inc.. 22 East Thirtv-eighth Street. 
New York 16, N. Y. 1952. 31 pp. 
25 cents. 

Graphic examples are given in this 
pamphlet of some of the things a 
health department does. 

The booklet makes specific sugges- 
tions on how a citizen can find out 
how adequate the public health serv- 
ices are in his own community and 
how to work for improvements that 
mav be needed. 



w 



;A L E N D A R 



Superintendent of Documents 
Government Printing Office 
Washington 25, D. C. 

Please send me THE CHILD for 1 year. I am enclosing $1.25 
(check or money order) . 



Name ..„ 
Address- 



On every order of 100 copies or more, sent to one address, there 
is a discount of 25 percent. 



Nov. 6. Play Schools Association. 
Annual meeting. New York, N. Y. 

Nov. 7-11. National Conference of 
Christians and Jews. Annual meet- 
ing. Washington, D. C. 

Nov. 9-15. American Education 
Week. Thirty-second annual ob- 
servance. Information from Na- 
tional Education Association, 1201 
Sixteenth Street, N. W., Washing- 
ton 6, D. C. 

Nov. 12-14. National Association of 
Intergroup Relations ffi c i a 1 s. 
Sixth annual meeting. Washing- 
ton. D. C. 

Nov. 12-14. American School Food 
Service Association. Annual meet- 
ing. Los Angeles, Calif. 

Nov. 12-15. National Association for 
Nursery Education. National con- 
ference. Minneapolis, Minn. 

Nov. 12-Dec. 10. Unite d Nations 
Educational, Scientific, and Cul- 
tural Organization (UNESCO) . 
Seventh session of the General Con- 
ference. Paris, France. 

Nov. 13-14. National Social Welfare 
Assembly. Seventh annual meet- 
ing. New York, N. Y. 

Nov. 13-15. Family Service Associa- % 
tion of America. Biennial meeting. 
Buffalo, N. Y. 

Nov. 16-22. Book Week. Thirty- 
fourth annual celebration. Infor- 
mation from Children's Book Coun- 
cil, 50 West Fifty-third Street, 
New York 19, N. Y. 

Nov. 17-19. National Association for 
Mental Health. Annual meeting. 
New York, N. Y. 

Nov. 20-22. American Speech and 
Hearing Association. Twenty- 
eighth annual meeting. Detroit, 
Mich. 



Illustrations: 

Cover and page 35, Philip Bonn for Chil- 
dren's Bureau. 

Page 36, Archie Hardy for Children's 
Bureau. 

Page 37. National Film Board, Canada. 

Page 38, R. A. Hayes for Nursery Training 
School of Boston. 

Page 40, Mathews for Production and Mar- 
keting Administration, U. S. Department of 
Agriculture. 



lOVEMBER 1952 



47 



V***"^***'**'^ *;*» ,^J ^■' V 



VOL. 17 NO. 3 
NOVEMBER 1952 



In This Issue 



Page 

When a Child Must Go to the Hospital 34 

Ruth Winkley 

Instead of "Blood-and-Thvmder" Radio 37 

Naiicy Harper 

Delinquency Project Moves Ahead 39 

Children and the School-lunch Program 40 

Conference Works Toward Better Citizenship 11 

Liicile Ellison 

For Child Welfare in Venezuela 42 

Elisabeth Shirley Enochs 



Published 10 times a year by the Division of Reports, Children's Bureau 
Editor, Sarah L. Doran Art Editor, Philip Bonn 

FEDERAL SECURITY AGENCY 
Oscar R. Ewing, Administrator 



SOCIAL SECURITY ADMINISTRATION 
Arthur J. Altmeyer, Commissioner 



CHILDREN'S BUREAU 
Martha M. Eliot, M.D., Chief 



Publication of THE CHILD, monthly bulletin, has been authorized by the Bureau of 
the Budget, September 19, 1950, to meet the needs of agencies working with or for 
children. The Children's Bureau does not necessarily assume responsibility for 
statements or opinions of contributors not connected with the Bureau. 

The subscription price of THE CHILD is S1.25 a year. On all orders of 100 or more 
sent to one address there is a discount of 25 percent. Single copies 15 cents each. 
Send your remittance to the Superintendent of Documents, Government Printing 
Office, Washington 25, D. C. 

Foreign postage — 25 cents additional — must be paid on all subscriptions to 
countries in the Eastern Hemisphere and those, sent to Argentina and Brazil. 
Domestic postage applies to all other subscriptions. 



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U. S. GOVERNMENT PRINTING OFFICE: I9S1--9I2044 



H 



CHILD 



DECEMBER 1952 




WHAT DO WE WANT FOR OUR 
DELINQUENT CHILDREN? 



WHEN A CHILD gets in trouble 
with the law, unless there are 
services available in the com- 
munity to help that child find his way 
back to normal and healthy develop- 
ment, he is apt to take just the op- 
posite road and end up in a career of 
crime. More than half of our adult 
criminals were juvenile delinquents. 

Then, you may ask, why don't we 
have the community services to pre- 
vent the development of these be- 
havior problems and to keep delin- 
quent children from going from bad 
to worse? 

One of the principal reasons why 
we don't have adequate services for 
the care and treatment of delinquent 
children is that there has not been a 
sufficient understanding on the part 
of the public of why they are neces- 
sary, what kind of services they 
should be, and what it means to a 
child to be treated as if he were a 
criminal. 

Becaus. -k of public under- 

standing, as been lack of pub- 

lic suppoi " e quality and quan- 

tity of sei lese children need. 

A good as been written in 

the efforl 1 the public about 

these ser lut sometimes this 

material 1 i complex and diffi- 

cult to vi£ Many of us have to 

see thinp-a wp can hp.lipvp. them 

or ; 

C 
sis 
agr 



spect to the total problem of how ju- 
venile delinquents are made will not 
be overcome by talk of prevention. 
Sometimes the end result of a disease 
or social ill must be studied and the 
costs to society dramatized before 
firm steps to prevention can be taken 
with public support. Then, too, chil- 
dren who are sick cannot be left to 
suffer. 

If we were to raise the quality of 
practices in our handling of juvenile 
delinquents up to the level of the best 
jobs being done here and there over 
the country, I am convinced we would 
give many delinquent boys and girls 
a much greater chance than they now 
have to find a satisfying and useful 
role in society. 

There is a practical program of 
action we can take to improve our 
treatment of juvenile delinquents. It 
calls, first, for over-all planning by 
States and communities to explore 
conditions, develop a blueprint of ob- 
jectives, and work particularly on: 

1. Aiding the police in developing 
special services for children ; 

2. Getting juveniles out of jail and 
providing proper detention facilities ; 

3. Providing the courts with ade- 
qi led probation officers ; 

g training schools to get 
qi sonnel and additional fa- 

need. 

\\ ahead in these directions 

~ single public- agency in 

ry 9^1^' with clear responsibility 



for insuring teamwork amongst the 
various services for delinquent chil- 
dren and sound relationships between 
these services and child-welfare serv- 
ices for all children. Each State will 
want to work out its own kind of 
State-wide organization. Training of 
personnel, too, must be stepped up, 
and there must be more adequate fin- 
ancing of public services for delin- 
quent children. 

Through its newly organized Juve- 
nile Delinquency Branch and the Spe- 
cial Juvenile Delinquency Project 
which is working closely with the 
Bureau, citizens and agencies will get 
increased help so they can move 
ahead on programs of improvement. 

Every reader of this issue of The 
Child can help greatly in this effort, 
even if it is no more than by spread- 
ing "the news." Will you, as a first 
step, get this issue to the attention of 
10 people in your community? Per- 
haps you can make this issue the 
focus of discussion at a coming meet- 
ing of one of the organizations in 
which you are active. 

The Children's Bureau wants to 
keep in touch with every group thai 
joins in this campaign. So when youi 
organization gets going, won't yoi 
drop us a Hne? 

Martha M. Eliot, M.D., 
Chief, Children's Bureau^ 

(JAN 6 - 1863 



THE CHILD VOL. 17 NO. 4 



EYEWITNESSES TO THE TOLL OF 
DELINQUENCY 

A juvenile-court judge, the director of a detention home, a police chief, the 
superintendent of a training school — four men whose everyday concern is 
the prevention or treatment of juvenile delinquency — tell about their exper- 
iences in this v/ork and of the problems they face 



JUVENILE COURT 



LEO B. BLESSING 

Judge of the Juvenile Court, Parish of Orleans, I\ew Orleans, La. 



IF ENOUGH SPACE were avail- 
able, I could list many problems 
and many unmet needs of our ju- 
venile court in New Orleans, and 
they would undoubtedly be those of 
every juvenile court in the Nation. I 
know of none completely satisfied 
with its situation. 

J Some of our needs are so pressing, 
the function of the court as an agency 
for good in the community is vitally 
affected. 

For example, at the present time 
we are unable to plan intelligently for 
the detention of children who are 
awaiting the court's decision as to 
what should be done with them. This 
period of detention can be a new and 
shaking experience for a child. We 
should try to profit from every mo- 
ment of it in our treatment program. 

But our present detention-care ar- 
rangement is makeshift and unsatis- 
factoiy. We are using quarters in 
other institutions, to the detriment of 
the care of their regular inmates, and 
sometimes we are forced to detain 
obstreperous juveniles in the parish 
jail. 

The absence of a treatment center 
for disturbed juveniles is sorely and 
frequently felt. Yet there is not even 
a faint stirring of recognition of this 
need by the community. 

Our case loads have grown con- 
siderably in recent times. This is 

DECEMBER 1952 



more the result of increased service 
potential than of increased delin- 
quency. We are being called on more 
than ever before by other social 
agencies to help solve their problems, 
and parents are now voluntarily com- 
ing to us with their children who 
chronically misbehave. We welcome 
this confidence, but it often taxes our 
court facilities beyond their capacity. 
Another problem is the legal segre- 
gation of races in our State. This 



makes it necessary for us to supply 
separate accommodations and facili- 
ties for Negro and white delinquents. 
There is at present only one State 
institution for white boys and girls, 
only one State institution for Negro 
boys, and no public institution of 
any kind for the care of delinquent 
Negro girls. 

Community understanding most important 

However, the greatest problem fac- 
ing the New Orleans Juvenile Court 
and, for that matter, every juvenile 
court, I believe, is failure to receive 
complete and wholehearted accept- 
ance by the community it is intended 
to serve. It may seem strange and 
perhaps even absurd that a com- 
munity should have to be urged to ac- 
cept one of its own creatures — a crea- 



The informal procedure used in this juvenile court helps to make the young delinquent feel 
relaxed and makes it easier for the judge to work effectively with him. The judge relies 
heavily on the skilled services of the trained probation officer who is attached to his court. 




ture submissive to its will and com- 
pletely at its mercy. But too often 
juvenile courts are simply poor little 
Cinderellas without the protection of 
a fairy godmother. 

As it exists in the laws of most 
States, the juvenile court is a social 
agency within the framework of the 
law. It is the hybrid result of tem- 
pering the law's sternness with mercy 
and understanding. 

In the chain of events that makes 
up the life of a dehnquent child, be- 
ing brought before the juvenile court 
is but a single link. However, it is an 
important link. 

I know parents who search about 
for the best possible schools and 
teachers for their children. They buy 
the best clothes and most wholesome 
food obtainable. When sickness oc- 
curs, they insist on only the best 
pediatrician to attend their children. 
But they pay little attention to their 
juvenile court. At every available op- 
portunity I ask these parents : "Why 
do you not insist on the maintenance 
of a good juvenile court for children 
for whom you want the best of every 
other kind of care? Why, indeed, 
this neglect of the juvenile court?" 

A great deterrent to community 
understanding and acceptance of the 
juvenile court is the fact that the 
more active and prosperous elements 
in the population have little contact 
with the court. The majority of our 
children come from a level of society 
that has no voice and no weight in 
community affairs. Many of their 
families are so entirely engaged in 
eking out an existence that they can- 
not take time to champion the cause 
of community agencies even when 
such agencies affect the futures of 
their own children. 

The vocal group in community af- 
fairs usually take little interest in 
the court because they do not expect 
to use its facilities. 

Fortunately, not all children come 
to the juvenile court, but any child 
within the juvenile-court age limit 
might get into trouble with the law 
so long as he is forced to live in the 
artificial, accelerated economic en- 
vironment of our typical urban com- 



munities. And every child remains 
a potential victim of delinquency so 
long as our social services are inade- 
quate to check the delinquency that 
exists in a community. 

Perhaps the best way to create a 
sense of community responsibility for 
these services is to help the citizens 
of our communities understand the 
importance of juvenile delinquency: 
how it springs from basic unhealthy 
conditions in the life of a community, 
and how, unless checked, it can 
spread. 

Not many people would be willing 
to gamble their whole life earnings 
on the flip of a card, but many com- 
munities are taking just as great a 
chance when they permit the whole 
future lives of many of their children 
to be decided by a poorly trained, in- 
adequately staffed, and weakly led 
juvenile court. 

If we can arouse the individual 
members of a community to an un- 
derstanding of their responsibilities 
for the proper development of their 
juvenile court, we shall then be guar- 
anteed an adequate court and all the 
necessary outside facilities for carry- 
ing out a successful treatment plan. 

Expanded New Orleans needs expanded services 

In New Orleans, where the popula- 
tion had been more or less static at 
the half-million mark for many years 
(due in part to expansion-limiting 
water boundaries and in part to a 
lack of aggressive planning), the ju- 
venile court was for a long time 
shamefully neglected by the com- 



munity and was let stagnate in hope- 
lessness and frustration. But the 
fight we have made for our court dur- 
ing the past 4 years has brought us 
recognition and is beginning to re- 
turn dividends. 

We have won an increased appro- 
priation, a trained probation staff 
(though it is still too small), and con- 
struction of physical quarters that 
have added much to effective work 
and judicial dignity and have been 
helpful in gaining additional com- ! 
munity recognition and support. 

But the fight is not finished. It is 
never-ending, for a good juvenile 
court must be progressive, flexible in 
program, and far-seeing. Already we 
are planning for our future needs — a 
program that will "sell" the com- ' 
munity on the value of the juvenile 
court and the need to protect our chil- 
dren. With reclaimed swamplands 
now available for industrial develop- 
ment and because of the courageous 
leadership of our mayor. New Orleans 
has expanded considerably within a 
few years' time, but our court has 
failed to expand in keeping with this 
increase in population, interest, and 
problems. We are already alarmingly , 
understaffed. The court's services 
are being taxed beyond their capacity, 
and we should be expanding and plan- 
ning for additional community serv- 
ice. This is our most immediate prob- 
lem, and we shall continue with cour- 
age and persistence to seek complete 
community acceptance as a major 
step toward its solution. 



DETENTION 

STEPHAN H. KNEISEL 

Executive Director of the Essex County Parental School, I\ewark, N. J. 



THE COMMENT I've been hear- 
ing for 25 years, that "Every- 
body talks about juvenile delin- 
quency, but nobody does anything 
about it," does have some truth in it. 
I believe the truth of the statement 
arises largely from the fact that this 
social ill has not been given the same 



amount of attention and focus that 
has been given such hazards to chil- 
dren as infantile paralysis, tubercu- 
losis, and various physical handicaps. 
It is therefore encouraging to have a 
special juvenile-delinquency project 
of Nation-wide scope. 

I work in a home that provides tem- 



52 



THE CHILD VOL. 17 NO. 4 



VPSI>HDRtHHI<N flbni 



■iUrL'4i4S.' 






In some 
pending 
kind of 



communities delinquents who require temporary detention, 
court hearing, are held in jail — often with criminals. This 
detention care offers nothing in the way of rehabilitation. 



Detention can be a constructive experience. In this home young de- 
linquents follow a varied program. They are offered individual coun- 
seling, and their educational and recreational needs are taken care of. 



porary detention for delinquent cliil- 
dren. This is a highly specialized 
.child-care service, little known and 
less understood by the community, 
and only recently emerging from a 
jail philosophy to that of social treat- 
ment of the emotionally ill offender. 
My primary concern in this article 
will be to comment on the problems of 
temporary detention, but I should like 
to point out that these observations 
will take into account other prob- 
lems in this field that I have met with 
during 25 years' experience working 
with children in trouble. [Mr. Kneisel 
has been a school teacher, a parole of- 
ficer, a social worker in a court psy- 
chiatric clinic, an administrator of 
day-care and nursery-school pro- 
grams, the director of a council of so- 
cial agencies, and during the past 8 
years the administrator of juvenile- 
detention facilities in three areas of 
two States. — ED.] 

Consistent with the recent reports 
on national statistics, the rate of com- 
mitments to our little detention fa- 
cihty in 1951 showed a 20-percent in- 
crease. If our experience for the first 
6 months of this year continues, 1952 
will show a substantial increase in de- 

DECEMBER 1952 



linquency over the previous year. In 
fact, during the month of May we 
were at an all-time high in the rate of 
daily admissions, exceeded only by 
the first day of June, when 18 chil- 
dren were admitted in one day. The 
impact of an additional 18 children in 
a home that is meant to accommodate 
50 can well be imagined, particularly 
when the rate of intake for the previ- 
ous week had been almost as high. 
We were sending our overflow to the 
adult house of detention. We simply 
did not have the bed space. 

Architect's plans for a more ade- 
quate juvenile-detention facility — to 
accommodate 80 children — are pres- 
ently before county officials. We hope 
for final approval before long. But if 
the rate of intake continues to in- 
crease, we may find that at peak peri- 
ods we'll have to continue to use the 
adult facilities. 

We get children who shculd not be heie 

We in children's work have long- 
been aware of the trauma involved in 
separating a child from his home for 
foster-home placement. Much time is 
therefore devoted to preparing the 
child for the separation and place- 



ment. And we recognize and accept 
that, despite our best efforts, there 
will still be deep disturbance. Yet, 
to my knowledge, throughout the 
years there has been little awareness 
of our concern for the deep trauma 
that results from forced separation 
and placement in a detention facility, 
an experience that sometimes drives 
children to emotional outbursts bord- 
ering on the psychotic, or even to at- 
tempts at suicide. The community 
and its agencies have not yet begun 
to understand fully the injustices 
ignorantly committed against chil- 
dren in this way. 

For this reason I urge that deten- 
tion be used only when it has been 
determined by competent authority 
that no other resource exists in the 
community to provide temporary care 
for the child and that it is in the best 
interest of the child and of the com- 
munity for him to be detained. The 
role of the detention facility should be 
limited to the detention and care of 
children who are too unstable and ill 
emotionally to be permitted to remain 
at large in the community. It should 
be the first step in an expeditious and 
integrated treatment process. 



53 



children in trouble with the law — where they come from and where they go 



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The detention facility should cease 
to be a juvenile jail. Too often it 
functions as the "back room" of the 
police station ; or as the temporary 
"dumping ground" for agencies too 
understaffed to follow through in 
planning for the return of a child to 
his own home or to a foster home; or 
as the agent to serve the personal vin- 
dictiveness and animosity of a par- 
ticular official toward a particular 
child. 

Detention care should be temporary 

Despite our best efforts some chil- 
dren are held in detention far too 
long. I make this observation without 
prejudice to my present facility, for it 
pertains as well to institutions I pre- 
viously served, and, in fact, it consti- 
tutes one of the gravest concerns of 
most administrators of temporary de- 
tention facilities. Along with the re- 
cent inci'eased rate of placement in 
my present facility, the number of 
days of care would have increased 
correspondingly but for the consist- 
ent effort on the part of the juvenile 
court and other local agencies to sup- 
port the intent of temporary deten- 



tion by keeping the length of stay at 
a minimum. Consequently, although 
intake went up, the average length of 
stay dropped from 11 days to 10. 

It is understood that the court 
should know something about a child 
before making a final disposition. The 
information required may vary from 
a social study to the result of psy- 
chiatric observation and diagnosis. 
However, although we have come to 
accept the need for knowing some- 
thing of the child, we have not yet 
begun to meet the need to do it ex- 
peditiously, if the child in detention 
is to be constructively served. 

Fevv communities are equipped to 
undertake such studies expeditiously, 
and weeks can run into months be- 
fore studies are completed and a 
court disposition is made. Meanwhile 
the child in detention lives in a purga- 
tory of anxiety, despite the best ef- 
forts of skilled workers and the best 
of physical facilities. 

As with my first institution, my 
present institution is in a community 
whose child-serving resources are 
probably at least equal to those of 
most communities, yet both com- 



munities lack a psychiatric hospital 
to which emotionally disturbed chil- 
dren may be referred on an immedi- 
ate and emergency basis for study 
and observation. One institution with 
which I once worked had the advan- 
tage of the services of a children's pa- 
vilion in a psychiatric hospital. I had 
forgotten how desperately such a re- 
source is needed until I came to my 
present institution and found that no 
such service existed. 

Treatment resources vitally important 

Once a diagnosis has been made 
and a treatment plan determined, the 
child should be moved to the treat- 
ment facility promptly. There can be 
no justification for continuing a child 
in temporary detention for weeks and 
months once a plan has been made. 

The result of study may indicate 
that the kind of service needed by a 
child is that provided by a foster 
home. In court the child may be told 
that he will be placed in such a home, 
rather than being sent to an institu- 
tion. The immediate reaction of the 
child is apt to be joy and new trust 
in the sincerity of the adult world. 



54 



THE CHILD VOL. 17 NO. 4' 



But as week follows dreary week and 
no foster home is forthcoming, the 
child's mood turns to bitterness and 
defiance. If a foster home is finally 
located, is it any wonder that the 
child no longer responds? Often the 
home is not found and, after weeks of 
waiting, the child is simply sent to 
the State school. 

If a foster home is not to be used, 
the study may indicate that intensive 
psychiatric treatment is needed — 
either in an institution or in the com- 
munity. Again the question is: 
Where can such service be found? 
Treatment institutions for older chil- 
dren are so rare that even where they 
exist they constitute demonstration 
projects rather than community re- 
sources. 

The present dearth of treatment 
facilities in all communities too often 
results in ultimate commitment to 
that catch-all, the State school, which 
most often is not staffed to give psy- 
chiatric treatment. If State schools 
are to continue to be the major re- 
source for the long-term detention of 
children with serious character and 
behavior disorders, steps must be 
taken to make it possible for these in- 
stitutions to offer the treatment and 
care necessary for the children com- 
mitted to their care. 

I know of no community — city. 



county. State — that is providing the 
varied and integrated services neces- 
sary for the differential treatment of 
the various types of behavior we lump 
under the head of "juvenile delin- 
quency." This is a blanket term with- 
out much meaning: — much like the 
word "sickness." We have come to 
understand that though infantile pa- 
ralysis is a sickness, it is different 
from tuberculosis both in symptoms 
and in treatment. And we accept the 
fact that although infantile paralysis, 
tuberculosis, and other diseases are 
all "sicknesses," each has to be 



treated differently, and that treat- 
ment is difficult and expensive. But 
we seem not to have accepted the 
same inevitable conclusion for juve- 
nile delinquency. 

The primary answer to the problem 
of the prevention and proper treat- 
ment of delinquent behavior is, I feel, 
the gaining of an enlightened and en- 
thusiastic public understanding and 
support of the kinds of programs and 
services that are so vitally needed by 
those children who, because of their 
behavior, are termed juvenile delin- 
quents. 



POLICE 



L. D. MORRISON 

Chief of Police, Houston, Tex. 

THE RESPONSIBILITY of the 
Police Department to help pre- 
vent juvenile dehnquency and 
crime flows naturally from its funda- 
mental obligation to protect the peo- 
ple and property of the entire com- 
munity. 

Police administrators have recog- 
nized their grave responsibility, and, 
as a result, many of them have estab- 
lished a special unit or division with- 



in their departments to meet the 
needs of those children in the com- 
munity who come to their attention 
because of misbehavior. 

Here in Houston we estabhshed 
such a division many years ago. It is 
called the Crime Prevention Division. 
Through this division we attempt to 
carry out our responsibility for delin- 
quency control in a growing metropo- 
lis. 



I In your community, when a child is picked up by a policeman for The juvenile-aid policeman who is taking this delinquent boy to a de- 
I misbehavior, is he "handled just as though he were an adult criminal? tent ion home has been trained to work constructively with children. 





A prison-like atmosphere in an institution maizes it hard for the staff 
to win the boys' cooperation. They are apt to feel like criminals. 



A pleasant and homelike air about a training school helps the boys 
to feel that they are there to be rehabilitated rather than punished. 



It is hardly necessary to say how 
valuable such a division is. Children 
are the community's most precious 
asset, and it is worth our every effort 
to help prevent future criminal ca- 
reers. 

Police officers must always be 
aware of the fact that a young per- 
son's entire future may depend upon 
his first contact with law-enforcing 
officers. If a child is treated firmly, 
but with kindness and understanding, 
much can be accomplished toward 
making a good future citizen out of a 
potential threat to society. 

Advances made with difficulty 

We are vitally conscious of our fail- 
ings and of our difficulties. Dealing 
with children has made us feel a spe- 
cial need for perfectionism, and we 
make an all-out endeavor in our work 
with them. 

We make every effort, therefore, 
to select carefully the personnel who 
staff our Crime Prevention Division. 
In the not-too-dim past, assignment 
to the juvenile division was literally 
banishment to isolation. The most 
inept officers were to be found in 
most police juvenile agencies, work- 
ing half-heartedly and without en- 
thusiasm. 



Today, because of the influx of 
young, well-trained, and energetic of- 
ficers into the police field, the picture 
is more encouraging. No longer is as- 
signment to the Crime Prevention Di- 
vision considered a casting away of 
the officers, but is a choice and favor- 
able experience. 

We have been most fortunate in 
having what we consider the most 
modern police administration build- 
ing in the South. A generous citi- 
zenry has spared no expense in build- 
ing and equipping a modern workshop 
for police activities. Consequently 
we have been able to provide more 
than adequate facilities to house a 
growing Crime Prevention Division. 
Occupying a complete wing, the Di- 
vision is able to carry out its function 
in almost total separation from the 
adult divisions. This healthful atmos- 
phere affords us a greater oppor- 
tunity to remove the damaging stig- 
ma of police procedure from the 
child's experience in the police build- 
ing. 

It is imperative that we work in 
close harmony with the many public 
and private agencies that are con- 
cerned with the welfare of children. 
We want community agencies to feel 



free to use juvenile-police services. 
The juvenile-aid officer must, to dis- 
charge his duties properly, refer 
many children to these agencies. Un- 
less they understand our function as 
a discovery and referral agency, and 
unless we know about their facilities, 
the efforts of both would be for 
nought. For that reason, we are in- 
vited to participate in the round-table 
planning of the Council of Social 
Agencies and of the Community 
Council. 

Some children, of course, cannot be 
referred by police officers to com- 
munity agencies, but must be taken 
to the juvenile court. Naturally the 
Crime Prevention Division officers 
give wholehearted support to efforts 
to improve the official public services 
for adjudged delinquents. 

In reviewing our Texas procedure 
we learned that about one-half of our 
boys and girls who are adjudged de- 
linquent are, in later life, committed 
to adult prisons. This indictment of 
our procedure led to the creation of 
the Texas Youth Development Coun- 
cil, a new and revolutionary scheme, 
which promises to be one of the Na-i 
tion's most workable plans for reha- 
bilitating delinquent children. 



56 



THE CHILD VOL. 17 NO. 4 



Narcotics and wild drivers 

Much concern has been exhibited 
in our community in recent times 
over the use of narcotics by our teen- 
agers. Certainly a southern city such 
as ours — a focal point for narcotic 
traffic northward — might be a most 
fertile ground for inducing youth to 
become addicted. But our experience 
indicates that the extent of this prob- 
lem has been greatly exaggerated. 
Records reveal that few of our chil- 
dren of school age have been dealt 
with for contact with narcotics. In 
the few cases in which this has hap- 
pened, the boy or girl was one who 
had been involved in many other de- 
linquent acts, and contact with nar- 
cotics was only one facet in the de- 
linquency pattern. We have found no 
cases where a child who was not al- 
ready delinquent has been introduced 
to the use of narcotics. 

Larger cities in Texas have found 
juvenile traffic violation to be some- 
thing of a problem. The machine age 
presents juvenile law-enforcement 
, agencies with one type of offense for 



which a satisfactory disposition re- 
mains to be found. 

At present, a statute is available — • 
though its worth is questioned by 
many — for Texas officers seeking an- 
swers to the juvenile traffic problem. 
This statute provides that juvenile 
traffic offenders found guilty of driv- 
ing intoxicated, recklessly, or above 
the maximum speed limit are subject 
to penalties similar to those that may 
be imposed on adults for the same of- 
fenses. The suspended sentence un- 
der this statute, used most widely in 
rural counties, has been found effect- 
ive. 

We still have a long way to go. But 
our experience so far has convinced 
us that the police must function as 
a working cog in the community ef- 
fort to control delinquency. Care 
must be exercised to select proper 
personnel, and great attention must 
be given to community conditions 
that might lead to delinquency. 

With a young police department, 
such as ours, much can be accom- 
plished toward effective crime pre- 
vention. 



TRAINING SCHOOL 

LAWSON J. VENEY 

Superintendent of Boys' Village of Maryland, Cheltenham, Md. 



BOYS' VILLAGE of Maryland, an 
80-year-old institution, is in many 
respects a typical training school. 
We have had our due proportion of 
failure and success. Some of the 
youths who were once here have since 
become involved in additional delin- 
quencies — and have made headlines. 
But it is difficult to fold stories about 
our successes. Although many juve- 
nile courts and other agencies fur- 
nishing aftercare service for us do re- 
port that we have been successful in 
our planning for disturbed children, 
this information does not make "good 
copy" and receives little of the atten- 
tion given our failures. 



The Village was not founded yes- 
terday; it has to live with its past. 
Local newspaper morgues are full of 
stories about its past brutality to- 
ward children. The fact that bru- 
tality was practiced cannot be denied. 
Many training schools have dungeon 
relics. Our old records show that, as 
punishment for running away or 
fighting, young boys were confined in 
these dungeons for as long as 30 days, 
with a restricted diet and after being 
lashed. But these methods of control 
have not been used at Boys' Village 
for many years. 

Our progress on other fronts has 
been somewhat slower. Not too long 



ago we had as few as 30 employees 
to control 300 or more boys. As re- 
cently as the early 1940's college 
graduates on the staff were earning 
as little as $50 a month, with other 
personnel many times receiving less, 
for long hours of work. Today we 
can talk of "treatment" and "train- 
ing," but we must remember that our 
advances have been made by a slow 
and tortuous process. It has been 
through the errors and sacrifices of 
our forerunners that we have reached 
our present "state of grace." 

In some respects the reputation 
handed down to us from the past con- 
tinues to hinder our work today. Each 
month we receive children whose 
older brothers, cousins, or fathers 
even were once institutionalized here. 
The stories that they have heard 
from these relatives have definitely 
made these children afraid of the in- 
stitution. Sometimes it takes months 
for us to succeed in overcoming their 
fears. Meanwhile, they have related 
the Village's past history to others. 

Background of deprivation 

A great deal of water has passed 
over the dam of our boys' lives before 
they come to us. Chances are they 
either were born out of wedlock or 
cannot remember a real father re- 
siding in their homes. Their mothers 
frequently were at the doll-playing 
age when they became pregnant. At 
present we have one 14-j'ear-old 
youth whose mother is but 25 years 
old. Another of our youths is the re- 
sult of a young girl's being raped at 
the age of 14. At 15 she died from 
tuberculosis, and this boy was hos- 
pitalized 5 years for the same disease 
before he came to us as physically 
cured. 

Our "average youth" is about 15 
years old, with a mother in her early 
30's. The child was reared usually 
by a grandmother or by some other 
elderly relative who neither under- 
stood nor wanted him. Often he has 
lived in a series of foster homes, 
placed there because of family neg- 
lect. In a majority of instances his 
family has lived in a well-known slum 
area, in a marginal dwelling, and has 
received public relief grants. 



DECEMBER 1952 



57 



Record after record shows that his 
schoohng did not start until after his 
seventh year. Even then he was out 
of school as often as he attended, at 
first because of lack of shoes, or too 
great distance from home, or some 
such reason ; later because remaining 
away from class became the easiest 
way to meet his failure to achieve. 

The pattern after that is often the 
same. Roaming the streets is no fun 
without money to spend, and begging 
for pennies not too successful after a 
child passes the "Uttle" stage. As one 
boy told me: "As long as I was small 
and cute, people gave me money. 
After that stopped I began shoplift- 
ing." 

Delinquents jre early truants 

On a recent visit to the Village by a 
group of public-school administrators 
from a city that sends us 65 percent 
of our students, these school officials 
expressed their amazement at the 
number of boys they could call by 
name. They told stories of how ag- 
gressive some of these children were 
toward their teachers — even to the 
extent of fighting them. Many boys 
were pointed out as gang leaders, who 
forced smaller and weaker children to 
give them money. Others were said 
to have maliciously destroyed school 
property. 

These public-school administrators 
all agreed on one point in particular, 
namely, that the children here whom 
they knew had all been persistent 
truants from school. During the past 
few years, as I have talked with in- 
stitutional officials in the United 
States and from foreign countries, 
this basic fact has been repeated 
many times: The children sent to 
training schools have been well- 
known truants who disliked and re- 
fused to attend school classes. One 
principal said: "Those of your chil- 
dren known to me were spotted years 
ago by teachers who could easily have 
predicted their commitment here." 

The typical Boys' Village youth has 
an I. Q. in the 80's. After a series of 
school failures, usually because of 
poor attendance, he may have reached 
the sixth grade at the time of his 



commitment. The results of the edu- 
cational and psychological tests given 
by the Village personnel show that he 
is 4 to 5 years behind in his school 
work. Very frequently he is a non- 
reader and is unable to do classroom 
work in a level higher than the fourth 
grade. 

After they are released, 50 percent 
of our youths 16 years or older never 
return to school. Why should they? 
As they ask, "Who wants to sit in 
classes with junior high kids and not 
understand what they are doing?" If 
they were placed at the level where 
they should be, they would be "twice 
as large" as the other children in the 
class. 

Some people call these children 
"misfits." Actually, they are children 
for whom society has failed to plan 
adequately. Thrust out into a com- 
petitive society that expects a dollar's 
work for a dollar's pay, they again 
find it difficult to achieve their bal- 
ance. Even when there are jobs avail- 
able for teen-agers, the competition 
from children who are products of in- 
tact homes is too great. 

Recently I interviewed one of our 
boys, a 16-year-old who had run 
through four jobs in 6 months' time. 
His story was typical of many I have 
heard : 

"There is no one home to get me up 
.... My mother never gives me any 
breakfast .... I didn't have lunch 
money for 8 days. When I walked 
home there was nothing to eat, and 
the boss fired me for taking too much 
time off for lunch." 

This youngster had tried to walk 
to and from home for lunch — a total 
distance of 6 miles — in one hour's 
time! 

One 16-year-old boy who was with 
us for 3 years returned to visit us 
last week in a stolen car. We learned 
that he could not find a job and his 
mother was tired of feeding him. She 
had told him to move in around the 
corner with a 17-year-old girl friend 
who worked. 

Another recently released 16-year- 
old who had made a very successful 
adjustment here, begged the courts 
to let him return. In making room 



for him at home, his mother had 
forced her boy friend to move out. 
However, she only accepted the boy 
as a "duty," and constantly irritated 
him by relating how much money her 
friend had given her. It is little 
wonder that the boy became involved 
in further trouble within 3 months of 
his release from training school. 

Careful planning needed 

Training-school employees have a 
tremendous responsibility. They re- 
ceive for treatment children who are 
usually unwanted and often unloved. 
Within a short span of time — the 
average length of stay at Boys' Vil- 
lage is 11 months — and assuming that 
there has been proper diagnosis and 
a good treatment plan, the training- 
school personnel must gain accept- 
ance of children who have learned to 
distrust adults. 

Institutions can be havens of ref- 
uge for those children who need 
planned group-living experience. The 
smaller and less complicated the 
school, the easier it is for every em- ' 
ployee to know the total child. And 
the better the State classification pro- 
cedure, the less often will feeble- 
minded children be found housed with 
aggressive delinquents, and sex de- 
viants with healthy youngsters who 
are just beginning to ask questions 
about life. 

There are answers to the many j 
problems involved in planning for in- 
stitutionalized children, though they 
may not be easy to find. Citizens 
must be alerted and officials and legis- 
lators intelligently "sold" on the need 
for services. One man or woman in 
each State can do this. But he will 
need the humility and tenacity of pur- 
pose of a Ghandi, the firmness of St. 
Peter, the wisdom of Solomon. In a 
sense, citizens who seek to give chil- 
dren the chance for a fuller and hap- 
pier life must be dedicated in their 
mission. They must believe in the 
democratic way of life. And they 
must recognize our children as 
America's richest heritage. 



58 



THE CHILD VOL. 17 NO. 4 



FOCUS ON DELINQUENCY 



BERTRA3I M. BECK 

JUST A FEW months ago repre- 
sentatives of about two dozen 
major national voluntary or- 
ganizations concerned with the wel- 
fare of children sat down to discuss 
the recent rise in delinquency. The 
group was struck by the fact that 
although practically all of them saw 
their acti\'ity as at least in part con- 
tributing to the prevention of delin- 
quency, only a few had any specific 
program for delinquent children. 
This was perhaps no more than to be 
expected. 

In the past we have quite properly 
held the view that prevention of de- 
hnquency, rather than treatment, is 
our major goal. We have been re- 
luctant to talk of a program that of- 
fers treatment to the juvenile delin- 
quent, holding that such a concept has 
little meaning and that what we do 
in the interest of children should be 
accomplished for all children, not for 
just one category. 

The recent steady rise in delin- 
quency, however, gives cause for a 
careful examination of some of our 
ideas about delinquency. We have 
come to the point where we must face 
certain questions squarely: Do de- 
linquent children have characteris- 
tics that are different from those of 
other children served by our public 
and private child-welfare program? 
If so, what are they? And if there 
are such differences, what implica- 
tions do they have for our programs 
in the prevention and treatment of 
juvenile delinquency? 

In answer to these questions, there 
is reason to believe that finally, 
though perhaps reluctantly, we are 
commencing to accept the fact that 
dehnquent children can be distin- 
guished from other children and that 
their distinguishing characteristics 
have definite implications for treat- 
ment. 

Two ways in which these children 
are distinguished will be discussed 



here. In one case the characteristic 
arises purely from their situation. 
The simple fact that a child comes 
before the court as a delinquent and 
is involved in a legal process sets him 
off from other children. The authori- 
tive setting cannot fail to have con- 
siderable significance in the way in 
which delinquent children respond to 
treatment. This fact has long been 
understood, but we have failed to ac- 
cord it sufficient recognition, par- 
ticularly in the training of person- 
nel. 

The second distinguishing charac- 
teristic is more limited but is of no 
less importance. It is the tempera- 
ment of a certain kind of delinquent 
child within the larger group of de- 
linquents, both adjudicated and non- 
adjudicated. This child is one of the 
"chronic delinquents," who make up 
the "hard core" of the delinquency 
problem. New research has shed a 
brighter light on this group of chil- 
dren. 

Let us look at the more general 
characteristic first. 

I 

Authority pervades the life of the 
delinquent child so long as he remains 
witliin the pale of legal supervision. 
And although the juvenile court acts 
in the interest of all children who 
come before it, there is a marked dif- 
ference between the reason why a de- 
linquent child is brought to court and 
the reason why a neglected or depend- 
ent child appears before the court. 

The neglected or dependent child is 
brought before the court because of 
events outside his control, the delin- 
quent child because of his own delin- 
quent act or acts. The delinquent 



BERTRAM M. BECK is Director of the 
Special Juvenile Delinquency Project spon- 
sored by the Children's Bureau. Formerly 
associated with the Community Service So- 
ciety of New- York, he has made several 
studies in the field of delinquency. Mr. 
Beck has taught at the College of the City 
of New York and at the Smith College 
School for Social Work. 



child may, and often does, view his 
court experience as punishment for 
misbehavior. The public more or less 
sees the delinquent child as a threat 
to public safety, and as an offender 
rather than as a child offended 
against. 

In other words, once a child be- 
comes the official concern of the ju- 
venile court because of an act of de- 
linquency, his court experience has 
an effect both on him and on the pub- 
lic's attitude toward him. 

Here, then, is one considerable 
difference between children coming 
to the attention of the court because 
of delinquency and children of com- 
parable age who are the concern of 
the court or of public and private 
child-welfare services for other rea- 
sons. This difference must be taken 
into account in the treatment pro- 
gram for all delinquents who come 
before the juvenile court. 

"Treatment" may seem like punishment 

Whatever the juvenile court does 
to alter the course of life of a delin- 
quent child is likely to be seen by 
that child as punishment for his mis- 
conduct. This fancied or real punish- 
ment may aggravate the hostility of 
a child and perhaps induce other re- 
bellious acts. Thus, the treatment 
may aggravate the disease. 

The delinquent's distrust and re- 
bellion against authority commence 
at an early age. The case records of 
delinquent children tell us that the 
large majority were truants from 
school. 

It is interesting in this regard to 
look at an account of the appearance 
of two ex-delinquents before a meet- 
ing of the National Conference of 
Juvenile Agencies. 

In response to the question from 
the floor, "What was the first institu- 
tion that you ever went to?" one of 
the boys named the public school he 
had attended ! 

These two boys found absolutely 
nothing good to say of the various 



DECEMBER 1952 



59 



institutions they had been in. So far 
as they were concerned, they were 
made to do things and when they 
failed to do them, they were punish- 
ed. They said they could understand 
being "knocked off" for doing some- 
thing wrong but it seemed to them 
that they were always being "knock- 
ed off" — and without any apparent 
reason. In other words, to those two 
boys, treatment was punishment. 

In summing up their opinion about 
institutions, the boys had this to say : 
"There ain't no such thing as a good 
joint — and there never will be. A 
good joint is no joint." 

Implications for treatment 

The statements of these two boys 
highlight the very difficult problems 
of those workers who are engaged 
in programs for the "officially" de- 
linquent child. 

The police officer who apprehends 
such children, the juvenile-court 
judge, the probation officer, the staff 
of the detention home, and the staff 
of the training school — all need spe- 
cial skill and knowledge to deal with 
these children. All must have an 
acute awareness of the need to pro- 
tect public safety and the civil rights 
of parents and children. All must ex- 
ercise authority vested in them by 
law. All must function in such a way, 
however, that the child is not em- 
bittered and the delinquency is not 
aggravated. 

The police have a major role in de- 
linquency control. They bring a ma- 



jority of delinquents to the court. At 
least one million children come to 
their attention each year because of 
some alleged act of delinquency. Many 
of these children are not taken to 
court. The police officer must decide 
in each instance what action he will 
take. 

Recent years have witnessed a 
rapid expansion of special branches 
of police forces for work with juve- 
niles. Many police forces have de- 
veloped services for children that 
seem more appropriately the job of 
the social agency. According to police 
authorities, however, such services 
have been developed simply because 
of the reluctance of existing social 
agencies to adapt their programs to 
meet the need of the delinquent child. 

Those social agencies that work 
with delinquent children must de- 
velop sympathetic and cooperative 
relations with the police. They must 
learn to appreciate the difficult role 
of the police, who have the dual task 
of protecting public safety and, at 
the same time, serving the broader 
interests of the child and the com- 
munity. They must aid the police by 
accepting such responsibility for 
the treatment of delinquency as is 
rightfully that of the social agency, 
and by supporting necessary mea- 
sures to promote special training for 
juvenile police officers. 

The part that the juvenile court 
plays in a program for helping de- 
linquent children is crucial. The 
juvenile-court judge must have legal 



Friendly, skilled counsel gains trust and often brings a desire to be better. Improved train- 
ing for personnel who work with children is probably the delinquency field's greatest need. 




skill and also the ability to use the 
knowledge both of the social workers 
who serve him as probation officers 
and of other such specialists. 

In some instances the judge's 
opinion as to what might be best for 
the delinquent child has to be tem- 
pered by other considerations. For 
example, a boy who sets fires may 
have to be committed to an institu-- 
tion even though he might better be 
given psychological treatment while 
remaining in his own home. In other 
words, when a delinquent constitutes 
a real and immediate danger to other 
persons, the necessity to protect pub- 
lic safety will undoubtedly influence 
treatment plans for this child. 

As another example, community 
sentiment in regard to certain sex of- 
fenses may necessitate removal of a 
child from the community in contra- 
diction to his best interest. The juve- 
nile-court judge must know how to 
strike a balance between the inter- 
est of the delinquent child and the 
protection of the public safety. Such 
considerations usually do not enter 
into his work with dependent and 
neglected children. 

Another primary consideration 
that must invariably determine the 
opinion of the judge is respect for 
the civil rights of children and their 
parents. These rights must be pro- 
tected. The fact that a child has com- 
mitted certain acts must be well 
established before a court can take 
action in the interest of the child. 
No attempt should be made to 
"stretch the law" so that a child who 
cannot properly be considered delin- 
quent under the laws of a State is 
adjudicated delinquent merely to 
make it possible for him to receive 
services. The maintenance of the 
proper legal process in protection of 
the rights of man takes precedence 
over procuring services for an indi- 
vidual child. 

The role of the probation officer 
is particularly difficult. Not only 
must he be guided by the same con- 
sideration that affects the court but 
also he must undertake treatment 
that will best help the child. The 
child on probation may, if he fails to 
make adjustment, be returned to 



60 



THE CHILD VOL. 17 NO. 4 



that court and possibly sent to an in- 
stitution — a possibility that repre- 
sents the extreme in punishment to 
most delinquent children. The proba- 
tion worker becomes for the child the 
symbol of the authority against 
which he rebels. 

The probation worker must there- 
fore attempt to convert what appears 
to be a handicap into an asset. He 
must not surrender his authority, 
but he must exercise it on behalf of 
the child and the general public. 
With skillful handling by the proba- 
tion officer, it is hoped that the child 
comes finally to accept his guidance 
and counsel. And as the child learns 
to accept reasonable authority, he 
learns also to accept the authority 
exercised in the outside adult world. 

Although probation services are 
offered by the child-welfare worker 
in many jurisdictions, the authority 
role remains the same. The worker 
needs special skill and knowledge 
over and above what is required for 
serving children in nonauthoritative 
settings. 

Discussion of the role played by 
the staff of the training school might 
best perhaps be included in our dis- 
cussion of the second major distin- 
guishing characteristic of delinquent 
children. For usually it becomes the 
responsibility of the training school 
to treat the "hard core" group of de- 
linquents, about whom we are now 
going to talk. 

n 

Within the group of adjudicated 
delinquents dealt with in the juvenile 
court, there is a smaller group of 
chronic delinquents. These children 
are different from other groups of 
delinquents, and treatment must be 
planned for them in the light of their 
special characteristics. 

Their differences have recently 
been brought out more clearly as the 
result of a study by Sheldon and 
Eleanor Glueck. In this study 500 
delinquents in a training school were 
compared with 500 nondelinquents of 
similar background and characteris- 
tics. All the children were boys, and 
all lived in underprivileged neighbor- 
hoods. In each pair, the delinquent 
and the nondelinquent were of simi- 




Will these children become delinquent? Well-planned community services can prevent this. 



lar age, intelligence, and national 
origin. 

The most important distinguishing 
characteristic between the groups of 
children was that the delinquent chil- 
dren did not have the ability to con- 
trol their rebellious, aggressive, hos- 
tile feelings, and gave vent to such 
feelings in antisocial acts. 

The nondelinquent children, on the 
other hand, either had some kind of 
safety valve, so that they could deal 
with their hostile impulses without 
conflict with the law, or they held 
their hostility inside them, where it 
contributed to a feeling of discom- 
fort but was not of immediate con- 
cern to those around them. Anyone 
who has restrained an impulse to 
"tell somebody off" and then has de- 
veloped a "nervous headache" or up- 
set stomach can understand the 
plight of such nondelinquent chil- 
dren. 

The nondelinquents, to a far 
greater extent than the institutional- 
ized delinquents, had internalized 
emotional disturbances. The delin- 
quents were free-wheelers — adven- 
turesome, restless, impulsive, and de- 
structive, but relatively free from 
worries and anxieties until the com- 
munity interfered with their be- 
havior pattern. The nondelinquent 
group contained by far the larger 
proportion of the "worried" children. 



What makes them delinquent? 

All the children the Gluecks 
studied were children of the slums. 
Sociologists, led by Clifford Shaw, 
have pointed out how most adjudged 
delinquents come from the disadvan- 
taged areas of a city. Allison Davis, 
a prominent educator, has deepened 
our understanding of why so many 
delinquents come from slums. He 
showed us how difficult it is for all the 
people in a community to have a 
single idea of right and wrong when 
people of one race or people from one 
economic level are segregated in a 
particular section of a city. The 
youngster brought up on the "wrong 
side of the tracks," where the fight 
for survival is bitter, may in turn 
enter into battle with society in gen- 
eral. The child on the "right side of 
the tracks" usually adopts the con- 
ventional or conforming behavior of 
his elders. 

All the children studied by the 
Gluecks were early in danger of be- 
coming delinquent because of condi- 
tions in the neighborhood in which 
they lived. The delinquents, however, 
had an additional handicap not suf- 
fered by the nondelinquent. To a far 
greater extent than the nondelin- 
quents, the chronic delinquents were 
reared in homes offering little affec- 
tion, guidance, stability, or protec- 
tion. Their parents, weighed down by 



DECEMBER 1952 



61 



personal misery and poverty, were 
not able to offer that extra some- 
thing that can keep a child even in 
, the worst of slums from becoming 
delinquent. 

Although most of the delinquent 
children studied did not come into 
court until early adolescence, about 
one-third were noticeably delinquent 
as early as 8 years of age. 

Implications for prevention 

Knowledge about this hard-core 
group of delinquent children now 
makes it possible for a community to 
attack the delinquency problem in a 
precise fashion — both from the pre- 
ventive and treatment aspects. 

Preventive activities can and 
should be part of a broad program 
designed to prevent all kinds of so- 
cial maladjustment. Certain activi- 
ties, however, can be aimed at a spe- 
cific objective, namely, those chil- 
dren who are prone to delinquency 
but are not officially delinquent. This 
group includes the youngster who is 
just beginning to develop a pattern 
of delinquent behavior. Also includ- 
ed are the chronic delinquents who 
have been known to law-enforcement 
agencies in the past, and those 
chronic delinquents who through wit 
or luck have escaped official notice. 

Our knowledge of the characteris- 
tics of the chronic delinquent, for 
example, demonstrates that even at 
an early age he probably cannot be 
reached by the conventional super- 
vised recreation program. He is more 
often a child of the street. He re- 
sents the authority represented by 
supervision and he craves excitement 
and adventure. To reach these chil- 
dren, therefore, a recreation pro- 
gram must reach out to the delin- 
quent child and his gang, and must 
operate in the child's own territory — 
the street. Such programs have been 
launched in several cities. 

Furthermore, we know that if we 
wish to curtail the development of a 
delinquent pattern in a child opposed 
to school, we must utilize the best in 
modern educational techniques to 
hold the attention of that child. 

The fact that the children in our 
training schools usually have an al- 



legiance to gang activity makes it 
important that a preventive program 
in the community offer services to 
the gang as a unit. 

In other words, if a community 
wants to reach the truly delinquent 
child, its program must reflect the 
definite knowledge that we have of 
the characteristics of this kind of 
child and not merely provide activity 
good for children in general. 

In addition to programs aimed at 
children already involved in delin- 
quency patterns, preventive programs 
must also be aimed at strength- 
ening family living, so that problem 
behavior will not develop among the 
very young children. New light on 
the subject of delinquency makes it 
clear that if such broad programs of 
prevention are to be successful in 
curtailing delinquency, they must be 
aimed at the preschool child. Citi- 
zens, regardless of their walk in life, 
must band together to eliminate the 
areas that are the primary breeding 
places of delinquency. Basic social 
and economic measures are usually 
necessary. Parent education and 
guidance and counseling for children 
and parents should be provided in 
the community to aid parents in the 
rearing of healthy children. All that 
we now know about the prevention 
of behavior disorders underlines the 
need to aid parents with problems of 
child rearing during the earliest 
years of the child's life. 

Implications] for treatment 

Knowledge of the special charac- 
teristics of the child whose delin- 
quency pattern is well developed pro- 
vides clues for the successful treat- 
ment of such children. 

Social and psychological under- 
standing is needed in order to com- 
prehend the relationship of family 
and community in promoting delin- 
quency. The treatment offered the 
chronic delinquent, however, prob- 
ably must be something different 
from that oflfered the emotionally 
disturbed child. 

Because of rejection by adults and 
substitution of the gang for the 
family, it may be that the chronic de- 
linquent could be treated, at least in- 



itially, in groups. Singly or in 
groups, the establishment of the re- 
lationship between the person doing 
the treating and the child being 
treated is of primary importance. 

The major problem would seem 
to be that of helping the child de- 
velop necessary inner controls of be- 
havior, rather than aiding him in the 
resolution of internal conflicts. 

Herein lies the task of the staflf of 
the training school in most instances. 

Delinquent children have special needs 

In summary we can therefore say 
that the delinquent child has, on the 
one hand, the same needs as all chil- 
dren and, on the other, special needs. 

Just like other children who re- 
quire attention from public or priv- 
ate social agencies, the delinquent 
child may need casework treatment, 
psychiatric treatment, or foster care 
— singly or in combination. Since 
such services are offered for all chil- 
dren who need them, they may be 
and often should be under the ad- 
ministrative auspices of a single 
agency. Services for certain groups 
of children, however, must be geared 
to the particular needs of those 
groups. 

Infatuation with the concept that 
children are children, and that the 
word "delinquent" is a label without 
any particular significance, has im- 
peded the development of necessary 
services for delinquent children. A 
great deal of attention has been 
given to activities for prevention. 
Such activities often march under the 
popular banner of delinquency pre- 
vention, but are, in reality, activities 
designed to make possible a healthy 
development of all children. It is 
very likely that these activities do 
prevent delinquency, as well as a host 
of other social disorders. Such pre- 
vention programs, however, will not 
cope with the chronic delinquent in 
the community, who needs preven- 
tive services specially adapted to his 
particular characteristics. 

At the present time, services for 

delinquent children who come to the 

attention of our law-enforcement | 

agencies are seriously limited. 

(Continued on page 71) 



62 



THE CHILD VOL. 17 NO. 4 



A FEW FACTS ABOUT 
JUVENILE DELINQUENCY 



OUR FACTS on juvenile delin- 
quency are taken mainly from 
two sources: police fingerprint 
records, sent in to the FBI, and juve- 
nile-court delinquency cases, reported 
to the Children's Bureau. 

All these reports are sent in on a 
voluntary basis, and they give only 
uneven coverage. As a result, the 
data may not be representative of the 
national picture. 

Limited as they are, however, these 
facts, combined with data from other 
sources, furnish the best available 
means for estimate. 

It will be one of the aims of the 
Special Juvenile Delinquency Project 
to help secure more reliable data on 
juvenile delinquents, and thereby im- 
prove our methods of helping them. 

HOW MANY DELINQUENTS? 

In 1951, (in estimaled 350,000 chil- 
dren were brought to the attention 
of the juvenile courts in this country 
for delinquent behavior. The boys 
outnumbered the girls 4 to 1. 

A much greater number, perhaps a 
million or so, came in contact with 
the police on account of misbehavior. 
This group included many who were 
referred to the court. 

Many delinquent children escape 
the attention of the lair. We do not 

know definitely the number of these 
"concealed" delinquents, but studies 
indicate that it may be considerable. 
A survey made in a large Eastern 
city of the case records of childi'en 
coming to social-work agencies for 
help and guidance revealed that of 
the large number of children who 
spoke openly of the serious acts of de- 
linquency they had committed, almost 
one-third of the children tvere itn- 



knoun to the police. It is impossible 
to estimate how many delinquent 
children escaped the attention of all 
agencies in the community. 

IS THEIR NUMBER INCREASING? 

The answer is ijcs if preliminary 
data for 19.51 from juvenile courts 
reporting to the Children's Bureau is 
a reliable indication of what is hap- 
pening. For these courts the number 
of child delinquents increased 19 per- 
cent between 1948 and 1951. Figures 
on police fingerprint records show a 
similar trend. The number of chil- 
dren in the country in the principal 
age group affected (10-17) increased 
only 5 percent during that year. 

Unless we do something now to 
prevent it, there may be further in- 
creases in the number of delinquent 
children. The total number of chil- 
dren in the age group 10-17 is ex- 
pected to increase 45 percent between 
1950 and 1960. 

The babies born during and after 
World War II are growing up. Will 
the number of delinquent children 
also increase 45 percent? Will it in- 
crease at an even greater rate, as it is 
now doing? Or will we succeed in 
preventing an increase? 

WHAT HAVE THEY DONE? 

Juvenile-court reports show that 
the majority of the boys are brought 
in for stealing or committing malici- 
ous mischief. 

Most of the girl delinquents are 
brought in for being ungovernable, 
for running auay, or for having com- 
mitted a sexual offense. 

Police fingerprint records reveal 
that in 1951 childi'en under 18 com- 



mitted 24 percent of the Nation's 
auto thefts. 

They also commit crimes of vio- 
lence : 3 percent of homicide cases 
and 7 percent of rape in 1951. 

More serious crimes were com- 
mitted by boys and girls 18 years old 
during the first 6 months of 1952 than 
by persons of any other age group. 

HOW OLD ARE THEY? 

The majority of delinquent children 
who come before juvenile courts are 
betiieen 15 and 17 years of age. 

Approximately 35 percent of the 
delinquent children who come before 
the courts have been there on one or 
more previous occasions. 

The age at which the largest num- 
ber of delinquents are first appre- 
hended by the police or referred to 
the court seems to be betueen 13 and 
15, or approximately at puberty. 
This was shown by a study of a 
thousand delinquent children. 

Nine-tenths of these same children 
were having considerable difficulty 
adjusting to normal life before they 
ivere 11 years old. More than a third 
of this total group of one thousand 
childi'en were showing noticeable 
signs of becoming delinquent at the 
age of S or younger. 

WHAT HAPPENS TO THEM? 

Of the one million children who 
came to the attention of the police for 
misbehavior last year, about 750,000 
were dealt tiith directly by the police, 
who let them go with a warning or 
perhaps referred them to a social 
agency for guidance and help. 



DECEMBER 1952 



63 



The remaining 250,000 committed 
acts of delinquency so serious that the 
police referred them to the juvenile 
court. 

An additional 100,000 were brought 
to juvenile courts by parents, teach- 
ers, social agencies, and the like. 

At least 115,000 of the 350,000 
children who were brought to the 
juvenile court were held overnight or 
longer in a detention facility, police 
station house or jail. 

It has been estimated that from 
50,000 to 100,000 children are con- 
fined in jails each year by the author- 
ity of the courts or other law-enforce- 
ment agencies. 

Of the 350,000 delinquent children 
who came before the juvenile courts 
in 1951, the cases of about half were 
dismissed, adjusted, or held open 

without further action. 

Of the remaining children, ap- 
proximately 95,000 M'cre placed on 
probation and the rest were either 
referred to other agencies, committed 
to institutions, or handled in other 
ways. 

About 35,000 children a year are 
committed by juvenile coui'ts to train- 
ing institutions designed primarily 
for delinquents. 

WHAT SERVICES ARE AVAILABLE? 

At the present time we have no ad- 
equate information as to the number 
of police officers with special training 
for work with juveniles. (This in- 
formation is currently being collected 
by the Children's Bureau and the In- 
ternational Association of Chiefs of 
Police.) The number needed has been 
estimated at 10,000, or at least 5 per- 
cent of our total number of police 
officers. A city with a population of 
20,000 should have at leas* one police- 
man trained for work with delin- 
quents. 

A recent study of 177 cities, each 
with a population of more than 
20,000, revealed that more than one- 
third of them have not yet made 



JUVENILE DELINQUENCY IS RISING SHARPLY 




Child population of U. S. (10-17 yrs. of a^e) 
World War n 



I I I I 



Korean conflic 

— \ — H 



-^ — \ — h 



special provision in their police de- 
partments for work with children. 

The Delinquency Control Institute 
of the University of Southern Cali- 
fornia, which offers the only univer- 
sity-operated training program for 
juvenile officers in the country, has 
graduated 173 persons since it was 
founded in 1946. A few other schools 
— the Police Training Institute of the 
University of Louisville, the FBI 
Academy, and local academies and 
police schools — do give some atten- 
tion to police work with juveniles, 
but, so far as we know, this instruc- 
tion represents only a small portion 
of the total curriculum. 

There are more than 2,500 juvenile 

courts distributed over the Nation. 
If the children brought before them 
are to receive even minimum help, a 
court needs sufficient probation serv- 
ice for study of each child's back- 
ground and for guiding those chil- 
dren that the court places on pro- 
bation. 

The court should also have avail- 
able to it a detention facility suitable 
for keeping children in secure cus- 
tody. One detention facility may oc- 
casionallv serve more than one court. 



The number of such detention 
homes in the United States is only 
174. 

At least one-half the counties in the 

United States are ivithout probation 

services for juvenile delinquents. 

There are at present 3,716 local 
probation officers for juveniles. Many 
of these officers serve both children 
and adults. 

In 1951 these officers had the major 
responsibility of serving not only 
350,000 delinquent children, but also 
150,000 dependent, neglected, and 
other children who are the concern 
of juvenile courts. In other words, 
there is 1 probation officer for every 
135 children coming to the court. 
Of course, this is only an average. 
Some courts have highly developed 
probation ser\aces, but many have 
none whatever. 

About 30,000 delinquent children 
are in the more than 250 training 
institutions designed primarily for 
such children. 

The average length of stay of a 
delinquent child in a training insti- 
tution is somewhat less than one year. 



;.B4 



THE CHILD VOL. 17 NO. 4 



RECOMMENDED FOR EVERY COMMUNITY 



ON THIS PAGE are set forth certain 
desirable practices, or standards of 
practice, that have been recom- 
mended to communities seeking to improve 
their services for delinquent children. 

The services considered here are those of- 
fered by the police, the juvenile court, the 
detention facility, and the training school — 
four agencies entrusted with a legal and so- 
cial responsibility for helping our delin- 
quent children become better-adjusted in- 
dividuals and better citizens. In addition, 
standards for the organization and admin- 
istration of these services are included. 

The statements given here, which are 
part of a more complete list now being 
compiled by the Children's Bureau, were 
drawn from the publications and proceed- 
ings of a large numb^r of national groups 
and organizations that are interested in 
preventing juvenile delinquency and in 
giving proper treatment to those children 
who have become delinquent. 

These organizations, and others like them, 
are continuing to add to those standards 
and to bring them up to date. During the 
coming year, the Children's Bureau will 
lend encouragement to these efforts, and 
hopes eventually to have standards formu- 
lated for every aspect of our community's 
services for delinquents. 

In the meantime, the list of existing 
standards should be useful not only in 
guiding the development of services in the 
areas covered but also to mark the areas 
not covered. 

The selection of standards on this page 
covers just a few aspects of each service. 
The goals set forth are not new. They are 
familiar to many people. But there is not 
a town in the Nation that would not bene- 
fit its children immeasurably by making 
these simple statements come true. 

State organization and administration 

In every State government a single 
department should have authority 
and responsibility for coordinating 
services for delinquent children, de- 
veloping standards for such services, 
establishing new services, relating 
these services to those of other agen- 
cies in the State, using the services of 
other agencies in the State, and stim- 
ulating leadership in local communi- 
ties. 

This State agency should have re- 
sponsibility for aiding political sub- 
divisions of the State in providing 
probation service and detention care. 

This State agency should make 
consultation service available to the 
various agencies providing care and 
treatment to delinquent children, and 
should have responsibility for pro- 
moting the development and use of 
social services in juvenile-court cases. 

This State agency should have a 



clear responsibility for giving leader- 
ship and assistance in developing in- 
service training programs in all 
State and local agencies that operate 
programs for delinquent children. 

Programs of service to children, 
including delinquent children, should 
be coordinated at the State and local 
levels by some form of planning and 
coordinating body. 

Police 

Instruction and training in the 
handling of juveniles should be a part 
of the basic training of every police 
officer. 

Police officers with a major respon- 
sibility for work with children should 
have special training that will en- 
able them to make constructive use of 
the broad discretion they have in 
handling each instance of juvenile 
delinquency that comes to their at- 
tention. 

Law-enforcement agencies should 
participate along with other com- 
munity agencies as full partners in 
the process of coordinating and plan- 
ning services for children. 

Police departments in urban cen- 
ters should have a special unit de- 
voted to protective and preventive 
work with juveniles. 

Officers assigned specific responsi- 
bihty with respect to juveniles should 
be assigned on a basis of personal fit- 
ness and capacity to work with chil- 
dren and youth. 

Juvenile court 

The juvenile-court judge should 
have legal training and should be a 
member of the bar. He should have 
sufficient knowledge of the sciences 
of human behavior to be able to use 
and to be willing to use expert advice 
on the problems of human relations. 

Provision must be made for social 
study of the child prior to final court 
action and for the services of trained 
and skilled counselors to aid children 
placed on probation. 

A probation officer should have, as a 
minimum requirement for appoint- 



ment to his position, a bachelor's de- 
gree from a college or university of 
recognized standing, with specializa- 
tion in the social sciences. 

Probation officers should be ap- 
pointed only on merit, without regard 
to political affiliation. 

Child-guidance clinics, mental- 
health clinics, and psychological, pe- 
diatric, and other needed services for 
children should be made available to 
the juvenile court. 

Detention 

A delinquent child who must be 
kept in secure custody should be held 
in a detention facility designed and 
conducted for such children, and not 
in a jail or police lockup. 

It should be possible to admit a 
child to detention at any hour of the 
day or night. All detention should be 
authorized by the court. 

Detention must in every case be as 
brief as possible. 

Every detention facility should 
have a plant, program, and staff that 
will enable it to make detention the 
first step in a constructive treatment 
process. 

Training school 

The training school should be sent 
only those children who are in need 
of and who can profit by its services. 

In the training-school treatment 
process, an attempt should be made 
soon after a child's arrival to gauge 
his emotional and social maladjust- 
ments and their underlying reasons. 
A program of individual and group 
therapy should then be prescribed to 
correct them. 

The director and staff should be 
selected on the basis of merit alone. 

Psychiatric and psychological serv- 
ices should be available. 

Children in training schools should 
have educational opportunities that 
are at least equivalent to those offer- 
ed in the community. 

An aftercare program should be 
maintained for the guidance of chil- 
dren released from the school. 



DECEMBER 1952 



65 



COMMUNITIES ACT 
AGAINST DELINQUENCY 



DOUGLAS H. MACNEIL 

COMMUNITIES find out about 
their delinquency problem in 
a number of ways, and they 
go about taking action toward solv- 
ing the problem in just as many dif- 
ferent fashions. 

Hundreds of cities and counties al- 
ready- have much information avail- 
able about their delinquency problem. 
In these communities, local commit- 
tees on children and youth collected 
facts for use in the 1950 Midcentury 
White House Conference. A number 
of these committees are continuing 
their efforts to bring these recom- 
mendations to fruition. In some 
cities, an oiUcial body — the welfare 
council for instance — may keep close 
tab on the situation and alert the 
community to any pressing need. 

Elsewhere, the discovery that there 
is a delinquency problem may come 
as a surprise, and generally that sur- 
prise is apt to be unpleasant. I know 
of a number of cases like this and will 
mention a few of them here. 

On Hallowe'en of 1950 such ex- 
treme acts of vandalism took place in 
Oneida County, Wis., that the need 
to do something about juvenile delin- 
quency was plain. The local chapter 
of the Veterans of Foreign Wars 
soon went to work and helped organ- 
ize a citizens' committee to find out 
why so many young people were get- 
ting into trouble. The State of Wis- 
consin helped Oneida County make 
a survey to see what was needed, and 
the community has gone far toward 
filling those needs. 



DOUGLAS H. MACNEIL is the Director 
of the Division of Community Services of 
the New Jersey State Department of In- 
stitutions and Agencies. This Division is 
concerned with helping communities im- 
prove and coordinate services for children 
and youth. Through the courtesy of the 
State of New Jersey, Mr. MacNeil is tem- 
porarily serving as a special consultant 
with the Juvenile Delinquency Project 
sponsored by the Children's Bureau. 



In Austin, Tex., a grand jury called 
the attention of the people to the 
problem of delinquency in that com- 
munity. During February 1948, in 
the course of investigating the ad- 
ministration of justice in the county, 
the grand jury handed down a strict 
indictment of the way delinquent 
children were being dealt with. The 
jury proposed far-reaching reforms. 
The community council was asked to 
take on the job of getting interested 
individuals and groups organized 
in an effort to bring these reforms 
into being. Today the city of Austin, 
and Travis County, together have a 
new detention home, and the proba- 
tion services of the juvenile court 
have been strengthened by the addi- 
tion of new probation officers to work 
with delinquent children. 

In Seattle, Wash., the brutal mur- 
der of a 16-year-old boy by other 



juvenile inmates in the county jail 
finally made the citizens of that com- 
munity aware of how greatly they 
had failed in their responsibility. For 
5 years the juvenile-court judge and 
other ofiicials had been warning the 
public about the terrible conditions 
under which juvenile delinquents 
were being held. But no group had 
responded to the judge's pleas, and 
he could not remedy the situation 
alone. It took a cruel and inhuman 
murder to awaken the public to the 
urgency of the need for better juve- 
nile-court facilities. Today Seattle has 
a magnificent new Youth Service 
Center dedicated to the task of re- 
habilitating its delinquent youth. 

Another case that comes to mind 
has to do with the establishment of 
the Child Guidance Clinic of the 
Oranges and Maplewood in New Jer- 
sey. For several years, the Mental 
Hygiene Committee of the Social 
Planning Council had urged the crea- 
tion of such a clinic but without much 
response from the public. Then three 
boys from families with standing in 
the community stole weapons from a 



These children in a crowded neighborhood find 
workers trying to prevent delinquency need to J 



their recreation in the street. Recreation 
eek out children wherever they congregate. 




86 



THE CHILD VOL 17 NO. 



collection of guns owned by the 
! father of one and shot a passer-by in 
the course of what amounted to an 
act of armed robbery. 

A newspaper editorial asked how 
such an episode could have been anti- 
i cipated. The Council pointed out that, 
' properly used, the proposed clinic 
might have helped. Thereupon the 
newspaper announced a substantial 
gift from its own corporate funds and 
then spearheaded an intensive drive 
for the clinic. This assured its estab- 
lishment. Now several years old, the 
clinic is one of the basic community 
services for atypical children. 

One man can do a great deal 

In each of these communities, the 
need to do something about the delin- 
quency problem had to be forced upon 
the attention of the public. And once 
the need was discovered, a group of 
people stimulated the community to 
action. But sometimes one key per- 
son, if he is determined enough, can 
open the eyes of a community to bad 
conditions affecting children. This 
person may be someone officially con- 
cerned — a juvenile-court judge, for 
example, or the chief of police. Or he 
may be just an ordinary citizen. 

A newspaperman started the ball 
rolling in Monroe, Mich., back in the 
thirties. He first began to think 
about juvenile delinquency when he 
noticed how many of the news stories 
that crossed his desk involved chil- 
I dren and young people. Soon he be- 
gan to wonder what it was in the 
community life that was causing 
these kids to become delinquent, and 
what the officials in the town were 
doing to help these children and to 
prevent further delinquency. So, in 
his own words: "I wrote to half a 
dozen people in town I knew would 
be concerned, enclosed the clippings, 
and suggested we meet Monday." 

Thus commenced a campaign that 
was to lead eventually to many im- 
provements in Monroe's services for 
children, delinquent and nondelin- 
quent. The juvenile court has been 
bettered ; two policewomen have been 
hired to work with juveniles ; recrea- 
tional facilities have been expanded 
and improved. But these gains were 



not easily won. They took 10 years of 
hard and sometimes frustrating 
work. 

In Middletown, N. Y., a boxing pro- 
moter, disturbed by the social atti- 
tudes of some of the boys who came 
to watch his fighters train, set in mo- 
tion a community program to meet 
the recreational needs of children 
who do not fit into conventional 
group-work or recreation programs. 
After much determined eft'ort, he 
succeeded in obtaining .support for 
his idea from virtually all civic and 
youth-service organizations in his 
community. 

Fixing community responsibility 

Of the many suggestions that could 
be drawn from these case histories 
of community action, I believe we 
should emphasize two in particular: 

First, no matter who starts the 
campaign, a large and representative 
group of citizens must be brought in 
to participate. It isn't a job for one 
man to carry through alone. One man 
can do much to stimulate interest 
and to prod those who lag. But if a 
campaign is to be successful, it must 
have the backing of a lot of people. 
Which brings us to the second idea: 
People must be informed about every 
aspect of the campaign — why it is 
necessary, tchat it hopes to reach, and 
hoir the goals can be accomplished. 
The public is not apt to get very ex- 
cited about raising salaries for pro- 
bation officers, or sending a local 
policeman away for training to fit 
him for work with juveniles, or build- 
ing a detention home, unless it knows 
why these things are necessary and 
what good they are expected to ac- 
complish. 

Individuals and groups undertak- 
ing such campaigns have found how 
essential it is to keep these two ideas 
in mind. In some cases they've learn- 
ed by bitter experience how unpre- 
dictable the public can be — and also 
public officials. 

Take the case of Leliigh County 
and its detention home, for example. 
Lehigh County is in Pennsylvania. 
Some professional people who work 
with delinquent children there under- 
took to bring to the community's at- 



tention the need for a detention 
home. The story of the struggle that 
ensued before the home was finally 
secured is told in the September 1951 
issue of the Quarterly of the Penn- 
sylvania Association on Probation 
and Parole. 

The campaign started back in 1932. 
School authorities conducted a sur- 
vey of detention and made a report. 
No other groups were called in, how- 
ever — and nothing happened. In 1937, 
in 1939, and again in 1943 the prob- 
lem of detention came up — but noth- 
ing was done. 

Finally, in 1946, the council of 
social agencies was asked by the pro- 
bation office and the Family Service 
Agency to undertake a study of the 
problem. Professional workers for 
children were already convinced that 
a detention home was needed. But 
this time the public was going to find 
out that a detention home was need- 
ed. Citizen participation was sought. 

A subcommittee heavily weighted 
with interested citizens was formed to 
study facilities for the care of delin- 
quent children. The first thing they 
discovered was that Lehigh County 
was keephig juvenile delinquents in 
jail. This was against the State law. 
The law clearly and specifically stated 
that no city or county could detain 
adolescents in any jail where adults 
were confined. Clearly the law was 
being violated. No one seemed very 
concerned. 

But the subcommittee was dis- 
turbed. It went to work figuring out 
plans for a detention facility. And 
fortunately at this point it called in 
the chief probation officer of the local 
juvenile court to give guidance and 
advice. Later on, the National Pro- 
bation and Parole Association was 
asked to advise on specific details of 
the construction of the home. Tech- 
nical advice of this sort is nearly al- 
ways necessary. 

After about a year's work, the sub- 
committee came out with an excellent 
report on the need for detention fa- 
cilities, and the executive committee 
of the council approved it overwhelm- 
ingly. 

A lot of publicity was given the re- 
port, but a way iiad still to be found 



DECEMBER 1952 



67 



to keep the issue alive and to press 
for action. A citizens' committee was 
formed. Composed of some 20 in- 
dividuals representing industry, la- 
bor, clubs, professions, and other in- 
terests in the community, the com- 
mittee was led by a man described as 
having the tenacity of a bulldog. He 
opened the meeting with words to 
this effect : "If any one of you thinks 
I am going to be chairman of a com- 
mittee that is going to do nothing, 
and forget this report, each and every 
one of you has another guess com- 
ing." 

The citizens' committee went about 
its task in the most direct way pos- 
sible : political action. By now, it was 
election time — September 1948. All 
the candidates for county office 
promised to take up the matter of 
the detention home the moment 
they got into office. This was very 
satisfying. But, once in office, the 
elected commissioners allowed the 
budget to get through without men- 
tion of a detention home. 

This was a blow, but the committee 
took it standing. They had been 
strengthened in their determination 
by a little demonstration staged by 
the chief probation officer that, al- 
though not generally to be recom- 
mended, left a lasting impression. 
Three or four youngsters under 13 
who had been picked up and placed 



in the county jail for some delinquent 
act were brought to a meeting of the 
committee. No one knew their names 
cr what they had done. The commit- 
tse saw simply a small group of or- 
dinary youngsters. These children 
were not criminals, to be kept in a 
jail. 

The campaign for a detention home 
went on. A mass meeting was held. 
The grand jury recommended that 
the home should be built. And finally 
a lawyer on the committee "... be- 
gan to talk of the possibility of man- 
damus proceedings against the 
county commissioners ... to compel 
these public officia's to do their duty." 

With that the battle was won. The 
county commissioners shortly there- 
after voted funds and authorized the 
drawing up of plans for a detention 
home. Today Lehigh County has a 
detention home that it feels is "sec- 
ond to none in the Commonwealth." 

Steps in a ccmmunity action program 

Perhaps these case histories have 
served to point to the steps a com- 
munity may have to take in an action 
program. Of course the situation will 
vary considerably from community to 
community, but in general there are 
several definite stages in any cam- 
paign. 

1. Someone has to start the cam- 
paign — either an individual or a 
group. 



2. Other interested individiuds 
and groups must immediately he iiv- 
vited to participate. Many com- 
munities have a Community Chest or 
Council that can sei've to coordinate 
the efforts of individuals and groups. 
In some others the committees organ- 
ized on behalf of the 1950 White 
House Conference may serve as the 
coordinating body. Still another uni- 
fying agent may be a coordinating 
council or youth-guidance council or- 
ganized for the specific purpose of im- 
proving preventive and treatment 
services relating to delinquency. 

Often it will be found that the 
problem about which a group is con- 
cerned is one that has also worried 
other groups in the community. If 
these groups join forces, the proba- 
bilities of a successful solution are 
enhanced. Or it may be found that 
someone else has thought of a dif- 
ferent solution from the one a par- 
ticular group has in mind. My advice 
in this case is, explore all the alterna- 
tives and try to reach an agreement 
as to what should be attempted. 
Nothing is more fatal to community 
progress than conflict over which 
solution or which organization should 
take precedence. 

3. The need must be ivell defined. 
Sometimes the need is self-evident. 
If a juvenile court has no probation 



Does your community give every child a fair chance starting out in 
life? Children in slum neighborhoods face some obvious handicaps. 



These children live in a reconstructed neighborhood. Healthful sur- 
roundings encourage self-respect and respect for one's community. 




service, it is obvious that such a serv- 
ice should be provided. 

In other cases, however, the situa- 
tion may be more complex. For ex- 
ample, an interested group may be- 
lieve that the community needs a de- 
tention home. Study reveals, how- 
ever, that most of the children who 
come to the juvenile court would be 
better served in their own homes or 
in foster homes, with improved proba- 
tion service. A detention home in this 
community would therefore be a 
needless expense. 

In those cases where the need is 
not clear and precise, a survey is 
generally to be recommended. Exist- 
ing services should be measured. 
Every effort should be made to find 
out what the need is and how it can 
best be filled. 

In case a full-scale survey is called 
for, to determine what the com- 
munity is doing — or 7iot doing — for 
all children, special consideration can 
be given the problem of delinquent 
children. 

4. To get accurate data on its 
needs, a community or neighborhood 
quite often requires the assistance of 
consultants. 

In Cleveland, Ohio, a citizens' group 
in a high-delinquency area used a 
■ survey made by skilled workers from 
the Welfare Federation of that city. 
The Federation also assisted in a fol- 
low-up campaign in the neighborhood, 
a campaign that led, over a 10-year 
period, to a 70-percent reduction in 
delinquency in the area. 

In the case of Oneida County, 
Wis., mentioned previously, the citi- 
zens' committee was helped by the 
Division for Children and Youth of 
the State Department of Public Wel- 
fare. A State worker went to the 
community and, with the help of local 
citizens, conducted a thorough survey 
of the services and resources avail- 
able to young people. 

In addition to Wisconsin, a num- 
ber of other States offer consultation 
service, related to juvenile delin- 
quency, to local communities. Cali- 
fornia, Minnesota, Rhode Island, Illi- 
nois, New York, Kansas, Texas, and 
Mississippi all offer assistance 
through the Department of Welfare 



or a Youth Commission, or other pub- 
lic body. 

In my own State of New Jersey, 
this service is given by the Depart- 
ment of Institutions and Agencies 
through its Division of Community 
Services, of which I am the Director. 

Sometimes it is wise to consult the 
State agency in this field even 
though you may see no immediate 
need for help. In a number of in- 
stances, our Division has been able to 
bring two groups in the same com- 
munity together, both of which per- 
ceived a need, but both unaware of 
the potential ally next door. A 
parallel service has been to bring 
groups from adjoining communities 
together so as to develop joint pro- 
grams which neither community 
could operate successfully alone. 

In New York State, in addition to 
the advisory service it offers, the 
Youth Commission has funds that 
can be granted for community youth 
service projects under certain con- 
ditions. No other State has a similar 
grant-in-aid program. But it has 
sometimes been possible for us in 
New Jersey to help local projects 
qualify for help through existing 
State or Federal grant-in-aid pro- 
grams. A community group should 
not build hopes on such support, 
however. 

In addition to these State agencies 
that offer consultation service, a 
number of voluntary organizations 
will go into a community, when in- 
vited, and help local citizens survey 
their needs and resources. In the de- 
linquency field the National Probation 
and Parole Association is an out- 
standing organization of this type. 

Perhaps it would be helpful for me 
to try to be a little more specific 
about the ways in which a group of 
citizens can obtain counsel and other 
assistance for their program of bet- 
tering the community's service for 
delinquent children. 

I suggest that the committee mem- 
bers first explore the resources right 
there in agencies, if there is one. This 
group usually bears the name wel- 
fare council, welfare federation, com- 
munity council, community chest, or 
the like. Its purpose in most cases 



is to act as a pool for all available so- 
cial knowledge and resources in the 
community. 

Failing a local resource, the group 
of citizens can go for assistance to • 
the State planning body for children 
and youth — the group that co- 
operated with the Midcentury White 
House Conference. Nearly every 
State has such an organization, 
usually appointed by the Governor. 
The Governor's office can give an in- 
terested group the address of this or- 
ganization. Generally, these planning 
bodies will be able to put a com- 
munity group in direct contact with 
the State agency or voluntary organi- 
zation that can best serve them. 

Any local group or individual that 
cannot get help or doesn't know where 
to apply for help in their own State 
can get that information from the 
Children's Bureau of the Federal Se- 
curity Agency in Washington, D. C. 

5. Publicity is the next step in 
the campaign. Once the community's 
need has been well defined — either by 
general agreement or by survey — the 
report should be made known to 
every citizen in the community. 
Newspapers, mass meetings, radio 
interviews — these are all accessible 
to any group. 

6. The final stage in the campaign 
is to press for action — wherever and 
however necessary. 

In some instances, a single official 
may be persuaded to bring about a 
much needed improvement. A police 
chief, for example, may agree to as- 
sign one or two of his men to work 
with juveniles, and to inspect public 
places that may be tending to contri- 
bute to delinquency. 

Or a group in the community can 
assume new responsibilities. A pri- 
vate social agency, for example, may 
accept for treatment cases referred 
by the juvenile court. 

But, quite often, the force of the 
entire community may be necessary 
to achieve what seems to be a very 
simple objective. For example, it 
took Lehigh County almost twenty 
years — and talk of mandamus pro- 
ceedings — to secure a detention home. 
This was no quick and easy solution. 

Indeed, there is seldom any quick 



DECEMBER 1952 



69 



and easy solution or any permanent 
one. A youth-service facility can de- 
teriorate — quickly or slowly. To as- 
sure long and fruitful life, continuing 
' citizen interest is essential. 

Perhaps the group that initiated or 
sponsored the project can transmit 
its responsibility to some successor 
organization. But, in the long run, 
the responsibility for seeing that 
community services sustain a high 
level of quahty is hkely to rest upon 
the same organizations, the same 
civic groups, the same individuals 
that fought for their establishment in 
the first instance. 

In other words, we must be real- 
istic about our community action pro- 
grams in the field of delinquency. De- 
linquency springs from social con- 
ditions that are deeply imbedded in 
community life. They cannot be 
eradicated overnight. But, with con- 
stant and patient effort, the public 
and its officials can be given a better 
understanding of the dangers of de- 
linquency- — and be persuaded to take 
measures to help children avoid seri- 
ous maladjustment in their personal 
and social life. 

The newspaperman who started 
the community effort in Monroe, 
Mich., has summed up his group's ef- 
forts in this clear and forthright 
way: 

"Kids still run wild at times . . . 
Cops still lecture miscreants and let 
them go. The new, alert judge still 
has no place to send kids not quite 
bad enough for reform school but too 
tough for foster homes. 

"On the other hand, in large part, 
both the community and officialdom 
now admit that delinquency does ex- 
ist, and both are doing something, if 
not all they could, about it. And, 
gradually, trained personnel is being 
employed by the agencies dealing 
with children and youth. Because the 
community is awake, it is easier now 
to get official action, whether for a 
new detention home or increased 
funds for foster-home care. But the 
battle must go on ... . Eternal vigil- 
ance is the price of civic virtue." 

Are not these words both honest 
and hopeful? 



REPRINTS ON JUVENILE 
DELINQUENCY 

A number of recent articles on ju- 
venile delinquency, repi'inted from 
The Child and other publications, are 
available for distribution. Smgle 
copies may be had without charge un- 
til the supply is exhausted. 

Boys and Books Get Together. By 
Leita P. Craig. Reprint from The 
Child. 

Citizens Help a Juvenile Court. By 
Charles H. Boswell. Reprint from 
The Child. 

The Institution as Therapist. Bv 
George E. Gardner, Ph.D., M.D. Re- 
print from The Child. 

Learning Casework in a Juvenile 
Probation Setting. By ElHot Studt. 
Reprinted by permission from Social 
Caseivork. 

A Look at Our Training Schools. 
By Richard Clendenen. Reprint from 
The Child. 

New Horizons for Youth. By Ber- 
tram M. Beck. Reprinted by permis- 
sion from Ohio Probation. 

Probation Work Requires Special 
Training. By Clarence M. Leeds. Re- 
printed by permission from Federal 
Prohation. 

To Synchronize the Training-school 
Program With Life in the Com- 
munity. By Richard Clendenen. Re- 
print from The Child. 

Training Schools and the Future. 
By Richard Clendenen. Reprint from 
The Child. 

We Can Do Something About Ju- 
venile Delinquency. By Martha M. 
Eliot, M.D. Reprint from The Child. 

Why Does a Young Delinquent Re- 
sist Treatment? Bv Harris B. Peck, 
M.D. Reprint from The Child. 




Dec. 1-2. National Midcentury Com- 
mittee for Children and Youth. 2- 
year anniversary conference. With 
the Advisory Council on State and 
Local Action ; the Advisory Coun- 
cil on Participation of National Or- 
ganizations and the Federal Inter- 
departmental Committee on Chil- 
dren and Youth. New York, N. Y. 



Dec. 2-4. National Conference on 
Labor Legislation. 19th annual 
meeting. Washington, D. C. 

Dec. 5-12. International Study Con- 
ference, held by the International 
Union for Child Welfare. Bombay, 
India. Information from the Inter- 
national Conference of Social Work, 
22 West Gay Street, Columbus 15, 
Ohio. 

Dec. 7-8. The Associated Women of 
the American Farm Bureau Fed- 
eration. 18th annual convention. 
Seattle, Wash. 

Dec. 8-11. Association of State and 
Territorial Health Officers. 51st an- 
nual meeting. The Association will 
meet with the Surgeon General of 
the Public Health Service and the 
Chief of the Children's Bureau as 
well as the State Mental Health Au- 
thorities and the State Hospital 
Survey and Construction Authori- 
ties. Washington, D. C. 

Dec. 9-11. American Farm Bureau 
Federation. 34th annual meeting. 
Seattle, Wash. 

Dec. 10. Human Rights Day. 4th 
anniversary of the Universal Dec- 
laration of Human Rights. 

Dec. 14-19. International Confer- 
ence of Social Work. 6th world- 
wide meeting. Madras, India. 

Dec. 27-29. American Economic As- 
sociation. 65th annual meeting.. 
Chicago, 111. 

Dec. 27-30. American Statistical As- 
sociation. 112th annual meeting. 
Chicago, 111. 

Dec. 28-30. American Anthropolo- 
gical Association. Annual meet- 
ing. Philadelphia, Pa. 

Dec. 29-31. American Association 
for the Advancement of Science. 
119th annual meeting. St. Louis, 
Mo. 

Area conference. National Child 
Welfare Division. American Legion: 

Dec. 4-6. Area E — Alaska, Ari- 
zona, California, Colorado, Hawaii, 
Idaho, Montana, Nevada, New Mex- 
ico, Oregon, Utah, Washington, Wy- 
oming. 



To Our Readers — 

AA'e welcome comments and 
siie:o;cstions about The Child. 



70 



THE CHILD VOL. 17 NO. 4 



FOCUS 

(Co)iti)iiied from page 62) 

We need more personnel, and 
better-trained personnel. This need 
continues from year to year, despite 
the fact that if we could somehow 
offer full and effective services to 
delinquent children and their famil- 
ies, we could probably prevent de- 
velopment of a major portion of 
adult criminality. 

Aiding one delinquent child to be- 
come a good citizen may prevent the 
spread of delinquency among many 
other children. Behavior of adoles- 
cents is greatly influenced by that 
of their friends and companions. Im- 
proved court services available to de- 
linquent children could reach into 
the most distressed families in our 
communities. Study upon study has 
demonstrated that delinquency most 
often occurs in a family subject to a 
variety of social ills. These are fami- 
lies, that though few in number, use 
up the lion's share of the social serv- 
ices established in any particular 
community. These are also the fami- 
lies most often shunted from agency 



to agency because the depth and 
severity of their distress makes it 
difficult for them to be assisted. 

It is because of the great gains 
that may be made by improving 
services to delinquent children that 
the Children's Bureau has establish- 
ed its Juvenile Delinquency Branch, 
which is assi-sted by a Special Juve- 
nile Delinquency Project, sponsored 
by the Children's Bureau and financ- 
ed by private contributions made to 
the Child Welfare League of 
America. 

The Branch and Project together 
are trying to stimulate State and 
local action to improve public serv- 
ices for delinquent children. Im- 
provement of such services is not 
sought as a substitute for more in- 
clusive measures to prevent malad- 
justment or to serve children who 
are not in conflict with the law but 
who need help. 

The antidelinquency program is a 
small segment of the Children's 
Bureau's total effort to aid parents 
in rearing children and to aid chil- 
dren from families that have been 
unable to give them sufficient care. 



Services to delinquent children must 
be seen as a part in the over-all pic- 
ture of child-welfare services, but in 
seeing the whole, we cannot neglect 
the special needs of groups of chil- 
dren within that whole. 



Illustrations: 

Cover. Esther Bubley for the Children's 
Bureau. 

Page .51. Courtesy of the Times Picayune 
Publishing Co., New Orleans, La. 

Page .'jS. Left, posed photograph, cour- 
tesy of the Community Service Society of 
New York. Right, courtesy of the Essex 
County (N. J.) Parental School. 

Page 54. Drawn by Philip Bonn. 

Page 55. Left, Palma for Black Star. 
Right, Philip Bonn for the Children's 
Bureau. 

Page 56. Both by Philip Bonn for the 
Children's Bureau. 

Page 60. Philip Bonn for the Children's 
Bureau. 

Page 6L Arch Hardy for the Federal Se- 
curity Agency. 

Page 66. Courtesy of the Community 
Service Society of New York. 

Page 68. Left, posed photograph, cour- 
tesy of the Community Service Society of 
New York. Right, courtesy of the New 
York City Housing Authority. 



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DECEMBER 1952 



VOL. 17 NO. 4 
DECEMBER 1952 



In This Issue 



What Do We Want for Our Delinquent Children? 
Martha M. Eliot, M.D. 



Page 
. 50 



Eyewitnesses to the Toll of Delinquency 

Juvenile Court Leo B. Blessing 51 

Detention Stephan H. Kneisel ,52 

Police L. D. Morrison 55 

Training School Laivson J. J'eney 57 

Focus on Delinquency 59 

Bertram M. Beck 

A Few Facts About Juvenile Delinquency 63 

Recommended for Every Community 65 

Communities Act Against Delinquency 66 

Douglas H. MacNeil 

This issue of THE CHILD was planned by the Special Juvenile Delinquency Project and edited 
by Stanley J. Edwards of the Project. Reprints of each article will be available in about 

6 weeks. 



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FEDERAL SECURITY AGENCY 
Oscar R. Ewing, Administrator 



SOCIAL SECURITY ADMINISTRATION 
Arthur J. Altmeyer, Commissioner 



CHILDREN'S BUREAU 
Martha M. Eliot, M.D., Chief 



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JANUARY 1953 




r 



SHOULD CHILDREN BE SEPARATED 
FROM THEIR PARENTS? 



DRAZA B. KLINE 

CHILDREN who are sent to an 
agency for placement are al- 
ways in some degree emotion- 
ally damaged. The unfortunate fam- 
ily experiences that lead to separat- 
ing a child from his parents and the 
injurious effect of that separation 
interfere with a child's normal per- 
sonality development and cause vari- 
ous psychic disabilities. Therefore 
every placement should be planned as 
treatment to improve the child's emo- 
tional health. 

The responsibility of the social 
agency, the child-guidance clinic, the 
psychiatrist, the psychologist, and 
others using placement to improve a 
child's emotional health is greater 
than is generally recognized. Part of 
this responsibility is to know, as in 
medical practice, the exact nature of 
the treatment and the secondary 
damage it may cause, so that it can 
be weighed against less radical mea- 
sures. This means that any worker 
who refers a child for foster-family 
care needs to be acquainted not only 
with the potential values of place- 
ment but also with its potential haz- 
ards — the shock to the child when 
separated from his parents, the harm- 
ful effect on the parents, the pain of 
foster-child status, and the dangers 
in changing homes. 

Placement means different things 
to different children, but for many 
a child we find that being separated 
from his parents means that he was 
either so bad or so unlovable that 
his parents had to give him up, or 
even wanted to. The stigma of being 
a foster child, different from other 
children because of his parents' fail- 
ure, is clear to himself and to some 
members of the community, who may 
bring this to his attention in many 
hurtful ways. The longing to be re- 
united with his own family, to be 
accepted by his parents, and to live. 



74 



like other children, in his own home, 
persists in some degree throughout 
his separation. 

To his parents, the separation also 
has its evils. A parent who is unable 
to care for his own child is, in his 
own eyes, a failure. When he cannot 
meet this most basic requirement of 
our culture, the damage to his ego is 
inestimable. For some this can later 
be overcome ; for others it leads to 
further damage and decreased capac- 
ity for interest in and responsibility 
for the child, despite the best efforts 
of the caseworker. 

Child may lose home afier home 

Perhaps most serious of all is the 
fact that child-welfare agencies can- 
not offer a child long-time foster care 
with assurance that he will not be 
taken out of that home and placed in 
another, thus suffering again from 
separation and loss. Foster parents, 
like other people, meet disrupting 
changes in their lives. They move to 
other parts of the country, they have 
serious illnesses, deaths, financial 
crises, emotional crises. A child is 
born to them, or a relative who needs 
their care moves in. Any such change 
may make it necessary for the family 
to give up the child. These factors, 
however, account for only a minor 
number of changes for individual 
children ; a greater number occur be- 
cause the child is so severely dis- 
turbed that there seems no way to 
treat him. The child is removed from 
home after home because the trouble 



DRAZA B. KLINE has been Director of the 
Foster Care Division of the Illinois Chil- 
dren's Home and Aid Society for the past 
6 years. Before that she was for several 
years on the staff of the Bobs Roberts Child 
Guidance Clinic at the University of Chi- 
cago Medical School, and she supervised a 
student-training unit for the School of So- 
cial Service Administration. Miss Kline's 
training was at the University of Minnesota 
and the University of Chicago. 

This paper is condensed from one given by 
Miss Kline at the seventy-ninth annual meet^ 
ing of the National Conference of Social 
Work, held at Chicago. 

.at of Documents 



\i\M O — ICCTQ 



for which he needed treatment at first 
makes his care intolerable to foster 
parents, or because his own parents 
are unable to cooperate with the 
foster parents. 

The potential dangers of place- 
ment must be weighed against the 
injurious influence of the child's 
own home. Before we decide that a 
child should be placed in a foster 
home it should be clearly established 
that the family situation is predomi- 
nantly injurious to the child. For if 
this situation can be improved suffi- 
ciently it is better to keep the family 
together. 

Sometimes there is no alternative 
to placement, but frequently the deci- 
sion must be based on factors that 
are not clear cut. In these cases a 
wise decision must be based on a com- 
prehensive diagnostic study. Such a 
study should include an accurate as- 
sessment of the character and per- 
sonality development of the child and 
his parents, of the family interrela- 
tionships, of the causes of the fam- 
ily's current failure. We need to 
evaluate the interaction of the psy- 
chological, social, and economic fac- 
tors in the family situation. From 
such a study we may determine with 
reasonable assurance how bad the 
situation is and what can be done. 

When it is decided that the family 
situation is predominantly injurious 
to the child and that the child cannot 
be treated in his own home, two addi- 
tional questions must be considered: 
(1) Is there a family available that 
can care for the child in such a way 
as to im.prove his situation? (2) Can 
the child and his parents be helped 
by placing him? If the answer is No 
to either question, the agency's ef- 
forts to give service are wasted. For 
example, a seriously disturbed child 
too often is obliged to enter on an 
endless succession of moves from one 
home to another. 

THE CHILD VOL 17 No. 5 ' 



Likewise, when a parent is incapa- 
ble of having a satisfactory parental 
relationship with the child and yet 
cannot permit him to have it with 
substitute parents, we are likely to 
provide a psychologically untenable 
situation. The parent's behavior 
makes it impossible for the child to 
feel that he belongs with either set 
af parents and makes him hostile to- 
ward both. Thus with neither love 
nor consistency, the minimum condi- 
tions necessary to healthy personality 
development are absent, and the child 
is increasingly disturbed. 

ro treat the "untreatabie" 

For us to busy ourselves with such 
unproductive and costly services vio- 
lates our responsibility to the child 
and to the community and damages 
resources that could be used advan- 
tageously for other children. Our re- 
sponsibility to the so-called "untreat- 
abie" child is to develop, in some way, 
an effective method for treating him. 

In cases in which the factors are 
not clear cut, joint examination by 
the referring agency and the place- 
ment agency would help both of them 
to understand the case and hence to 
select the appropriate service. 

Just as the decision whether a child 
should be placed in a foster home is 
based on a comprehensive analysis 
of the child and his family, so is the 
selection of the new home. The more 
fully we know the characteristics of 
the available foster homes or institu- 
tions, the better we are able to select 
the one that will most nearly meet 



the child's needs. In the following 
case story about the J family, I will 
describe some of the methods of plan- 
ning for placement which the staff of 
the Illinois Children's Home and Aid 
Society, under the psychiatric direc- 
tion of Dr. Margaret Gerard, have 
found useful. 

The case illustrates: (1) a basi- 
cally injurious and unmodifiable fam- 
ily situation; (2) diagnosis and eval- 
uation of the three children begin- 
ning at the point of intake and con- 
tinuing throughout the service; and 
(3) differential placement planning, 
based on their individual personality 
development, the characters of the 
parents, the family interrelation- 
ships, and the characteristics of the 
available resources for treatment. 

Mrs. J was referred by a child- 
guidance clinic for placement of Bill, 
her 5-year-old son. (Later, two older 
sisters, Ann, age 7, and Norma, age 
9, were also placed in foster care.) 
The first study revealed that the par- 
ents, then in their late twenties, had 
been in severe conflict throughout the 
10 years of their marriage. They had 
been known to various community 
agencies from which the mother 
sought help each time the marriage 
reached a crisis. 

The trouble had begun shortly after 
the^'^birth of the first child, with the 
crises building up from the mother's 
nagging and the father's periods of 
alcoholism and brutal attacks on the 
mother. These episodes were followed 
by separations and reconciliations. 
The mother sought help from agen- 



Each child in a family has his own individuality — his own personality and his special needs. 




cies only in financial desperation or 
in an attempt to punish her husband, 
but she did not wish to give up the 
marriage. She wished only to give up 
the children. 

The increasing tension between the 
wife and husband, which resulted in 
placement of the children in a foster 
home, seemed to arise in part from 
the mother's increasing fear of preg- 
nancy and the inability of both par- 
ents to tolerate the responsibility of 
caring for three children who were 
becoming more and more difficult to 
handle. 

This application for foster care 
for Bill came at a time when the par- 
ents were separated and the mother 
could no longer endure caring for 
Bill. She said she "yelled at him and 
beat him," and wanted to "put him 
out of the way," but she could not 
comply with the father's wish to give 
him up for adoption because she felt 
she had to be able to see him to be 
sure that he was well taken care of. 
She attributed this to her own experi- 
ence of living in an institution for 5 
years in her childhood and knowing 
how it felt to be neglected. (Later, 
however, she told of being removed 
from the institution at the age of 10 
to live with her father and new step- 
mother and wanting to return be- 
cause she had liked the routine, the 
recreation, and the other children.) 

When the mother was pregnant 
with Bill, the father had urged her 
to abort, which she refused to do. 
After Bill's birth, the father ignored 
him except when drunk ; then he was 
abusive to him. At home Bill was 
fretful and demanding, except that 
sometimes, when alone with the 
mother, he sat quietly and asked her 
to read to him. When the father was 
at home Bill frantically urged the 
mother not to go into the bedroom 
with father but to stay with him. He 
was often heard to say, "Why doesn't 
Daddy die?" 

This history shows all the condi- 
tions that point to a need for foster- 
home care. The conflict between the 
parents had been violent and per- 
sistent over a period of many years. 
Both parents openly rejected the 
child. Both parents repeatedly re- 
fused help in solving their marital 



JANUARY 1953 



75 



problems, which were destroying the 
family. 

First try unsuccessful 

Foster care for Bill was considered 
in relation to his age, his symptoms, 
and his relationships with his par- 
ents. His warm reaction to the case- 
worker indicated that his severe 
symptoms might have been the result 
of the beatings and the rejection he 
was suffering at home, rather than 
arising entirely from internal con- 
flict. If so, he could improve in a good 
foster home. Bill needed foster par- 
ents that not only offered stable fam- 
ily life and gave him consistent affec- 
tion and care, but also had the ability 
to treat his impulsiveness firmly. He 
needed a foster father who could per- 
mit Bill to test him in his role as 
father and thus to change his concept 
of a father as a cruel person. 

After first making an unsuccessful 
selection of foster parents we realized 
that for Bill foster parents would also 
have to have an unusual degree of 
personal security because he drew 
close to the foster father and ex- 
cluded the foster mother. He needed 
more than "good parenting"; he 
needed treatment within the frame- 
work of consistent parental affection 
and care. 

We accordingly placed Bill in an- 
other foster home, where he has re- 
mained for the past 4 years. Bill's 
progress in this home has been steady 
but slow. The intensity of his symp- 
toms gradually decreased, but the 
core of his neurosis has not yielded 
even to excellent environmental treat- 
ment. His need for direct psycho- 
therapy is recognized by the foster 
family and the agency, and plans are 
pending to make this available to 
him. 

Two months after Bill's placement, 
the parents were ready to request 
foster-family care for Norma and 
Ann. The mother had wanted this 
earlier, but the father, because of his 
attachment to Norma, was opposed 
to it. However, after an episode in 
which he attempted to choke the 
mother, he recognized that the chil- 
dren were terrified by the constant 
fighting, and he, too, requested the 
agency to place the girls. 



The placement of the two girls will 
illustrate the way in which the plan 
for foster care is related to the par- 
ent-child relationship, the sibling re- 
lationship, and the child's personal 
needs. 

We learned from the parents that 
Norma, the oldest child, was the favo- 
rite of both. The mother was depend- 
ent on her, confided in her, and had 
relied on her to mother the two 
younger children, because Norma 
could be more firm with them than 
she. The father looked to her for 
companionship, taught her music, and 
treated her, in general, as an adult. 

Norma, in turn, was attached to 
both parents and resisted placement. 
She had enjoyed the position of fav- 
ored child, but this was a precarious 
position since both parents were too 
immature to have a consistent rela- 
tionship even with the favorite, and 
she was often in the role of trying to 
protect one parent from the rage of 
the other or competing with one for 
the attention of the other. In addi- 
tion, her responsibility to the other 
children at too early an age made her 
hostile to them and to her parents. 
She was bossy, defiant, selfish, and 
aggressive. She had recently begun 
to steal, taking rather large sums of 
money from adults and toys from 
other children. 

The younger sister, Ann, was con- 
sistently rejected by both parents, but 
the mother was not unkind to her. 
The father had never liked her and 
he would slap her or send her to bed 
upon the slightest provocation. She 
was conforming, timid, and extremely 
fearful of men. She did well in school, 
but she was nervous and had vomit- 
ing spells with no apparent physical 
basis. Her relationships with other 
children were satisfactory. She and 
Norma were described as inseparable 
companions. 

It is clear that in psychological 
development, needs, and relationships 
to each other and to the parents the 
two girls were strikingly different. 
All these factors had to be considered 
in planning for foster care. Because 
of Norma's complex attachment to 
both parents, her resistance to place- 
ment, and the parents' attachment to 
her, it could be foreseen that she 



would be unable to accept a relation- 
ship with substitute parents and that 
her parents would be unable to free 
her to do so. Also it was apparent 
that she needed intensive casework 
help to resolve her conflict about the 
separation, correct her distorted con- 
cept of her triangular role in the rela- 
tionship between the parents, and 
realistically evaluate her relationship 
to each of them and their meaning i 
to her. : 

For Ann, from the standpoint of I 
her age and the lack of complicated ! 
involvement with the parents, one j 
would first consider foster-home care, I 
but two factors suggested a different I 
plan. First, her fear of men needed ; 
to be observed in a setting where its 
intensity could be evaluated, without 
subjecting her to too great anxiety 
from close proximity to a foster 
father. And secondly, the meaning 
of the relationship between her and 
Norma was not sufficiently clear to 
show whether the development of 
both girls would be facilitated by 
separating them or by placing them 
together. 

Sisters placed in group home 

Ordinarily, we would wish to place 
these children together. But with 
emotionally sick families, where the 
children have had to share the 
meager love of immature parents, 
the ordinary relationship between 
brothers and sisters usually is sup- 
planted by rivalry and hostility. Fail- 
ure to recognize this before placing 
children of the same family together 
often leads to the necessity to sepa- 
rate them later and place one of them 
with another foster family. When 
this occurs the child who remains in 
the home may feel responsible for his 
real or imagined part in pushing out 
the child that he hated; the one who 
leaves may feel that he is so "bad" 
that not only his own parents can't 
love him, but neither can the substi- 
tute parents, who can love his brother 
or sister. Such conflict can be modi- 
fied through skillful casework help, 
but it is safer to avoid those damag-i 
ing complications whenever possible, 
even if this means a temporary period 
in an institution. For these reasons 
it was decided to place both girls in 



76 



THE CHILD VOL. 17 No. 5' 



the agency's group home. 

In the early months it was noticed 
that during the parents' weekly visits 
they centered their attention on 
Norma and were indifferent to Ann. 
This confirmed the depth and extent 
of the neurotic involvement in the 
relationships between Norma and the 
parents, and it could be foreseen that 
this would not be quickly dissolved, if 
ever. 

In the group home Norma was ex- 
tremely jealous of Ann in her rela- 
tionships with other children and 
with houseparents. She felt displaced 
by Ann when she could not establish 
herself as the favorite. She tended 
to domineer and boss Ann in all ac- 
tivities. Ann gradually withdrew 
from Norma's domination and re- 
sponded warmly to kind, protective 
care. We soon realized that the two 
girls needed to be separated. Norma's 
relationship with the parents had to 
be continued on a regular basis and 
under adequate supervision, since 
neither she nor the parents would be 
able to tolerate separation. Ann, on 
the other hand, showed no need for 
the parents when substitute relation- 
ships were offered her. 

After a year in the institution, 
Ann's fear of men seemed to have dis- 
appeared, as a result of her experi- 
ence with kind and consistent male 
staff members and the help the case- 
worker gave her in expressing her 
fears and clarifying the difference 
between men. 

As she drew away from Norma, 
she developed her own friends and 
interests, and became an attractive, 
vivacious, lovable youngster. We real- 
ized that she needed to be cherished 
by sensitive foster parents to give her 
the long-time, sustained protection 
from hurt that would decrease her 
vulnerability to rejection. She was 
placed with foster parents who had 
some wish to adopt her. They were 
outgoing, friendly, gentle, and sensi- 
tive. The foster mother delighted in 
caring for her — sewing and selecting 
clothes for her and providing health- 
ful group activities. Ann enjoyed the 
experience of seeing herself as a loved 
and worthwhile person in the eyes of 
both foster mother and father. Like 
Bill, she has now been in her present 



home for more than 4 years. 

Norma, because of the problems 
already described, remained for 3 
years in the agency's institution, 
where it was possible to provide reg- 
ular casework treatment. When she 
showed more capacity to deal realisti- 
cally with herself and her parents 
and greater personal security in her 
performance in school and in music, 
she was moved to a girls' school. This 
school was selected because the pro- 
gram offered minimum demand for 
personal relationships; a full pro- 
gram of activities; opportunities for 
recognition for performance in the 
various areas of her talents, such as 
music and art ; and routines and rules 
that would help develop the conform- 
ing side of her nature. In such an 
environment, this child could develop 
skills without being thrown into 
further conflict by interference with 
her ties to her parents or by demand 
for closer relationships with other 
adults. 

She has made as much progress as 
possible for a child so damaged by 
neurotic parental attachments. She 
has begun to take pride in her per- 
formance as such, as contrasted to 
earlier intense and anguished rivalry 
with other children. 

The agency's work with the par- 
ents, throughout the 5 years these 
children have been under care, has 
been based on the initial evaluation 
of their characters and the meaning 
of the relationships between them 
and the children. The father eventu- 
ally withdrew from all contacts with 
the agency and the children. Our ef- 
forts to help the mother, geared to- 
ward enabling the children to main- 
tain and use their placements con- 
structively, have included keeping 
her closely informed about the chil- 
dren, thus easing her feeling of guilt 
and her sense of worthlessness as a 
parent, helping her verbalize rather 
than act in regard to the children, 
and freeing her from financial re- 
sponsibility for their care at points 
where she was unable to pay. We 
have used this method to help this 
basically dependent, distrusting 
mother to trust the agency with the 
care of her children, since it was only 
through experiencing such care her- 



self that she could permit the children 
to experience it. Through this kind 
of relationship she has been able, for 
the most part, to respond to the guid- 
ance of the caseworker and act on the 
agency's advice for the best interests 
of the children. The present immedi- 
ate casework goal is to help her re- 
linquish Ann and Bill for adoption 
and to maintain Norma's placement 
until she has completed high school. 

We see here how the study and 
treatment center served several im- 
portant purposes. The girls' relation- 
ships to their parents and each other 
became clear. The desirable degree 
of separation from each other and 
from the parents could be evaluated 
and the degree of individual person- 
ality damage determined. The plan- 
ning of institutional care for Norma 
and foster-home care in a potential 
adoptive home for Ann was based on 
evaluation of this combination of fac- 
tors. In addition, the casework treat- 
ment, in this neutral but protective 
setting, prepared them for the types 
of care in which they could develop. 

The use of a diagnostic and treat- 
ment center is not typical of the cases 
studied in a placement agency, but 
the areas of observation, diagnosis, 
and evaluation delineated here are 
applicable to all cases. Less complex 
cases can be studied while the child 
is in his own home. 

Many factors to be weighed 

A child separated from his family 
is a complicated human being, and 
the therapeutic resource consists of 
one or more human beings, less com- 
plicated but nevertheless subject to 
the usual human responses. The ob- 
jective of the principles and methods 
discussed is to bring these two to- 
gether, not in predefined, categorical 
combinations, but rather with refer- 
ence to the infinite variations in each 
personality, to meet the distinctly dif- 
ferent needs of each case. To do this, 
we must weigh all the known factors 
and arrive at a conclusion that satis- 
fies the demands of our current 
knowledge of personality develop- 
ment and individual dynamics, of the 
meaning of family relations, and of 
the unique characteristics of place- 
ment. 

Reprints in about 6 weeks 



JANUARY 1953 



77 



SICK CHILDREN BENEFIT FROM A CITY'S 
HOME-CARE PROGRAM 



VIRGINIA INSLEY 

IN RICHMOND, VA., the city 
health department's program for 
home medical care does more 
than just send a city doctor into 
the homes of people who are too sick 
to go to a clinic and who cannot af- 
ford to pay a private doctor. The pro- 
gram gives complete care to these 
patients, integrating its home medi- 
cal service with the services of clinics, 
hospitals, and other agencies in the 
fields of health and welfare. The 
home-care program provides the ser- 
vices not only of physicians, but of 
medical social workers and public- 
health nurses. 

The home-care program also works 
to improve medical education by in- 
troducing future practitioners to 
family social and economic problems 
that affect their patients — something 
their hospital training as a rule does 
not do. The opportunities given these 
young men and women to discuss 
with physicians, public-health nurses, 
and medical social workers the situ- 
ations that they observe in patients' 
homes undoubtedly will make them 
better doctors. 

More than half the patients who 
receive home care are under 20 years 
of age; large numbers are under 4. 
And besides the children actually 
treated, many more benefit through 
the home-care services provided to 
their families. 

Until the present home-care service, 
began to function, in 1949, the health 
department was giving a limited kind 
of home medical care to patients who 
could not get any other. 

For many years, in each of five dis- 
tricts of Richmond, a part-time doc- 
tor, employed by the year, was as- 
signed by the department to visit 
patients in their homes, with an addi- 
tional doctor to provide for a rotating 
assignment to answer night calls. 
One of these physicians would visit a 
patient, often after some delay, but 



unless he was specifically called again 
he did not return. 

If the patient was taken to a hos- 
pital, the physician who had called 
at his home did not see him in the 
ward, nor later in the out-patient de- 
partment. Nor was any record given 
to the physician of ward or out- 
patient treatment. After a patient 
had been discharged from the hos- 
pital the city doctor did not keep 
in touch with him. Often the patient 
did not follow the hospital recommen- 
dations, with the result that he had 
to be returned to the hospital for 
further care. 

Social workers and public-health 
nurses found it impossible to get the 
kind of medical support they needed 
in caring for a patient at home. 

The cost of the program was high 
and the medical results were poor. 

The Director of the Health Depart- 
ment realized that the system was un- 
satisfactory both from the humani- 
tarian and the economic standpoint. 
He felt that if sick people were diag- 
nosed sooner, if they were cared for 
with some continuity, and if the so- 
cial and emotional factors in their ill- 
nesses were considered by the doctor 
who visited them, the program could 
be worthwhile. Fewer of the patients 
would become severely ill, and more 
would be restored to a productive 
place in the community. Also, fewer 
people would need hospital care, and 
the cost to the city of caring for the 
sick would be reduced. 



VIRGINIA INSLEY received her master's 
degree from the Graduate School of Social 
Work, University of Washington, where she 
completed the medical social work sequence. 
She has also studied in the Boston Psycho- 
analytic Institute. 

Miss Insley has worked in the Washington 
State Health Department and in the Social 
Service Department of Beth Israel Hospital, 
Boston. 

For 2'/2 years Miss Insley was on the staff 
of the Department of Public Health, Rich- 
mond, Va., where she initiated social services 
in the health department and carried special 
responsibility in connection with the home- 
care program that she describes here. She 
has recently joined the staff of the Chil- 
dren's Bureau. 



In 1947, the Director of the Health 
Department asked the Richmond 
Area Community Council to appoint 
a committee to study the whole prob- 
lem and recommend a better plan. 

The committee worked for a year 
on the problem, consulting many per- 
sons concerned with health and wel- 
fare, such as practicing physicians, 
nurses, and social workers, and mem- 
bers of the faculty of the Medical 
College of Virginia. 

In conference with the committee, 
members of the Medical College fac- 
ulty discussed the fact that medical 
students, internes, and resident phy- 
sicians in the two hospitals affiliated 
with the College had no opportunities 
to observe, and try to solve, patients' 
personal and family problems, the 
kind that doctors have to face in prac- 
tice. The patients seen by these 
young men and women usually were 
brought to them because of some ad- 
vanced, unusual, or obscure condi- 
tion, and no patients were seen under 
the circumstances of usual medical 
practice, that is, at home. 

Joint plan adopted 

It seemed clear that the College 
would gain an important teaching 
advantage if it accepted responsibil- 
ity for cooperating with the Health 
Department in providing well-super- 
vised medical care to patients in the 
city's low-income group, and that the 
patients would benefit tremendously 
from this care. And apparently the 
cost to the city would not be higher 
than it had been, and might be lower. 
Therefore both the Health Depart- 
ment and the College favored a plan 
for joining forces in providing home 
care to the sick. 

After careful consideration all 
around, and with the approval of the 
Richmond Academy of Medicine, the 
committee recommended that the city 
adopt the cooperative plan that is 
now in operation. A grant from the 
Commonwealth Fund made it possible 



78 



THECHILD VOL. UNO. 5' 



to start the program as a demonstra- 
tion; it was continued until the 
Health Department and the Medical 
College were able to take over full re- 
sponsibility, in 1952. 

Under the plan, which is part of 
the over-all program of Richmond's 
City Department of Public Health, 
Medical College faculty members on 
the staff of the Health Department 
are responsible for supervising the 
medical care given by the department 
in the homes and for coordinating 
this care with any hospital care in a 
ward or the out-patient department. 
The medical staff of the program con- 
sists of three physicians who are 
faculty members, one of whom is 
clinical director of the program. 
These three physicians supervise the 
work of seven senior students, as well 
as of three resident physicians as- 
signed to the two hospitals affiliated 
with the college. Each student serves 
on the home-care staff for 3 weeks ; 
each resident for 10 weeks. 

When a call comes in from a sick 
person's family, or from any individ- 
ual or agency interested in the case, 
two senior medical students are sent 
to visit the patient. (The students 
are not accompanied by a physician 
on their first trip to a patient's home, 
as the program believes that this de- 
tracts from the students' interest and 
feeling of responsibility.) 

After examining the patient, gain- 
ing an impression of his personality, 
and studying his household, the stu- 
dents make a tentative diagnosis. 
They then go back to the clinic that 
is their office and write a brief re- 
port, which contains the salient facts 
about the patient's medical and social 
problems. The report should include 
notes on any physical conditions in 
the home that might affect the pa- 
tient's health. A resident physician 
reviews the case with the students, 
and then all three go to the patient's 
home. After this visit they discuss 
the case with one of the three super- 
vising physicians, who may also visit 
the patient's home if he considers this 
necessary. A pediatrician paid by the 
Health Department is available for 
consultation. 

If the supervising physician de- 
cides that the patient needs to be 




Home medical care can make a valuable contribution to a total health and welfare program. 



treated in the hospital or in a special 
clinic, this is done, and the case is 
followed throughout the treatment 
and afterward. Home visits are con- 
tinued, if necessary. If laboratory 
work is needed, or X-rays, these are 
provided ; likewise facilities for 
physical medicine. Social service and 
nursing care are available, and some- 
times homemaker service, all paid for 
by the Department of Health. 

For patients who continue to be 
treated at home, such sickroom equip- 
ment as hospital beds and wheelchairs 
can be rented at the expense of the 
Health Department. Drugs and dress- 
ings are provided by the department, 
with some help from the Cancer So- 
ciety. 

Medical students and residents are 
expected to obtain the facts of the 
family's social situation as well as 
the medical problems ; they are helped 
to understand the social factors by 
members of the social-work staff, 
who participate in daily discussions 
among students, residents, medical 
preceptors, and the clinical chief. 
Members of the medical staff and the 
social-work staff, medical students, 
social-work students, supervisors 



from public-health-nursing agencies 
and the director or assistant director 
of the Health Department attend two 
clinical conferences each week, in 
which home-care cases are presented 
by medical students and discussed by 
the entire group. Social workers 
from the Welfare Department are in- 
vited when cases known to them are 
discussed. 

Integration of services necessary 

Since the idea of the present home- 
care program was first conceived, the 
Health Department recognized that 
the program could succeed in ful- 
filling the community's needs only in- 
sofar as it could be integrated into 
the structure of health and welfare 
services. Integration of medical ser- 
vices to patients seen at some points 
by home-care physicians and at other 
times, often within a few days or 
hours, by physicians in hospitals or 
clinics, is of course essential to qual- 
ity, continuity, and economy of medi- 
cal care. 

Abbie Watson, Director of Rich- 
mond Instructive Visiting Nurse As- 
sociation, discusses the cooperation of 
nursing agencies in an article entitled 



JANUARY 1953 



79 



"The Public Health Nurse in the 
Richmond Home Care Program" 
{Public Health Nursing, May 1952). 

Social agencies in Richmond refer 
sick children to the home-care pro- 
gram for medical visits; they also 
give social services when these are 
requested, and they exchange medical 
and social data with the social-work 
staff of the program. The agency 
most concerned is the city's Welfare 
Department, which, through Aid to 
Dependent Children, contributes to 
the support of a large number of the 
children who receive medical care at 
the city's expense. This department 
i!i also responsible for the care of a 
number of children in foster homes 
who receive home medical visits. 
These children often have medical 
and social problems that require close 
cooperation between the home-care 
program and the Welfare Depart- 
ment. 

Valuable service to children has 
been given by the Welfare Depart- 
ment's protective services in dealing 
with social conditions discovered 
through home-care visits. And the 
doctors on the staff of the home-care 
program have been helpful in evalu- 
ating the physical care given children 
by parents accused of neglecting 
them. 

Program follows through 

An example of the way the pro- 
gram works to give complete care 
to a sick child, from the onset of an 
acute illness through convalescence, 
is the case of 13-year-old Edna: 

When Edna fell ill, with a very 
sore throat, her aunt, with whom she 
lived, telephoned to the city Health 
Department for a doctor. Two senior 
medical students went to the three- 
room apartment where Edna and her 
aunt lived. The apartment had run- 
ning water, but it had only an outside 
toilet. 

The students learned that since the 
death of the aunt's husband, she and 
Edna had been supported by pay- 
ments from his insurance, but that 
these had come to an end, and that 
she had applied for public assistance. 

After examining the child, the stu- 
dents returned to the Medical College 
and reported to the resident physi- 
cian on duty that in their opinion she 

80 



had acute tonsilitis and that they 
suspected that she had a kidney dis- 
ease also. The resident then went 
with them to the child's home, con- 
firmed the diagnosis of acute tonsil- 
itis, and treated her. 

The next step was to take Edna to 
the out-patient department of the 
hospital for further studies. A diag- 
nosis of kidney disease was estab- 
lished, and the child was admitted 
directly to the hospital. After 9 days 
of treatment, she was returned home 
for an indefinite period of bed rest 
under medical supervision. 

In the home-care conference that 
followed Edna's discharge from the 
hospital it was decided that a public- 
health nurse and a medical social 
worker should evaluate the adequacy 
of her home as a place for carrying 
out medical recommendations, also 
that the services of a home teacher 
should be requested so that Edna 
would not fall behind her class. 

The public-health nurse, after 
visiting the home, repoi'ted that 
Edna's aunt seemed capable of learn- 
ing how to care for the child during 
her illness, and that she was likely 
to do a good job, with supervisory 
visits from the nurse. In order to 
make Edna more comfortable, the 
nurse obtained a hospital bed, an 
over-bed table, and a bed pan from 
the Sick Room Loan Chest, a private 
agency with which the Health De- 
partment contracts for renting equip- 
ment. 



The home-care medical social worker 
learned that Edna had been living 
with her aunt for 2 years — ever since 
her mother had died. Their relation- 
ship was good, and both wanted to 
continue living together if some plan 
could be worked out for support. 
(The aunt's general public-assistance 
grant would not take care of them 
both.) Aid to Dependent Children 
was considered, but the Welfare De- 
partment found that they were not 
eligible for this, as the aunt, who had 
been reared by Edna's grandparents, 
was not really a blood relative. A 
plan under which the Welfare Depart- 
ment would make payments to the 
aunt as a foster mother was then car- 
ried out. Under this plan the home- 
care program was responsible for 
interpreting to the Welfare Depart- 
ment Edna's special needs and mak- 
ing sure of the aunt's ability to care 
for her. 

Three months after the aunt first 
called on the home-care program for 
help, the program discharged Edna 
and placed her under the supervision 
of the hospital's out-patient depart- 
ment, recommending that she in- 
crease her activities gradually and 
that she continue studying with the 
home teacher. The hospital's social- 
service department was asked to take 
the responsibility for interpreting to 
the Welfare Department medical rec- 
ommendations concerning the child. 

The way in which an integrated 
medical-care program can work to 

(Continued on joage 85) 



Hospital care may be partly wasted unless there is a plan for continued care at home. 





Jte, / 



POINT IV AND THE CHILDREN OF THE PUNJAB 

U. S. Government helps a Pakistan Province 
reestablish some social services for children 



PAUL R. CHERNEY 

IN THE PUNJAB, which used to 
be part of British India, but now 
— since 1947 — is a province of the 
new Mushm nation of Pakistan, live 
many thousands of orphans — their 
parents killed during the bloody ex- 
change of populations that took place 
at the time Pakistan separated from 
the rest of India. With millions of 
Muslims crowding into the Punjab 
and other parts of Pakistan, and mil- 
lions of Hindus and Sikhs struggling 
to get away from Pakistan into the 
Hindu provinces, trainloads of men, 
women, and children were mutilated 
or slaughtered. 

More than half the Muslims that 
fled into Pakistan settled in the Pun- 
jab, after remaining for various pe- 
riods in its capital city, Lahore. 

The resulting increase of popula- 
tion taxed the city's resources, as 
most of the incoming refugees were 
poor, and ill-equipped to earn an ade- 
quate income. And since the depart- 
ing Hindus included many of the 
teachers, social workers, and those 
supporting children's services, these 
services were seriously curtailed or in 
many instances eliminated entirely. 
With thousands of children left home- 
less, and practically nothing done for 
them, it is not strange that 3,000 beg- 
gar children were roaming the streets 
of Lahore in 1951 — three times as 
many as in 1938. 



PAUL R. CHERNEY is Executive Secretary 
of the Family and Child Welfare Section, 
United Community Services of Washington, 
D. C. 

He was formerly with the Children's Bu- 
reau; while on the staff of the Bureau he 
directed a demonstration community-organ- 
ization project in Newport News, Va., and 
later served as Regional Child Welfare Rep- 
resentative for Kentucky, Michigan, and 
Ohio. 

Mr. Cherney's previous experience in the 
Far East included a childhood spent in 
China and work in education and welfare 
as a military government officer in Japan. 



Half a dozen years before Pakistan 
became a Muslim nation, the Punjab 
Children's Aid Society was founded 
by Mrs. Rameshwari Nehru, a cousin 
of India's present Prime Minister, to 
work for the protection and well- 
being of children in the Province, 
especially those who had no one else 
to look out for them. 

The Society was established as a 
private organization, but was mainly 
supported by the Punjab Provincial 
Government. Its executive and most 
of the members of its central commit- 
tee were Hindus. 

The Society helped to raise stand- 
ards of care in orphanages and made 
efforts to improve the treatment of 
juvenile delinquents. It provided 
some direct services, maintaining a 
temporary shelter for children, oper- 
ating seven play centers, and arrang- 
ing periodic outings for children in 
congested neighborhoods. These di- 
rect services were carried on in the 
city of Lahore and did not reach the 
rural sections of the Punjab, though 
the Society's constitution provides 
for work outside the city as well as 
within it. The Society also did con- 



siderable groundwork for enactment 
of basic legislation for the care and 
protection of children. (This bill, 
called the Children's Bill, is before 
the Punjab Legislature as we go to 
press, and is expected to pass.) 

When the Hindus fled from Pakis- 
tan in 1947 the Society was left with- 
out an executive and practically with- 
out a central committee. Also, the 
building that housed its headquarters 
and the children's shelter was taken 
over by the Provincial Government as 
evacuated property and was used for 
housing refugees. 

First steps taken 

For 2 years efforts to provide any 
services for children were at a stand- 
still. Then the few remaining mem- 
bers of the Society's central commit- 
tee — Muslims and Christians — set to 
work to rebuild the committee, and 
gradually it was built up to 12 active 
members, with Muslims in the major- 
ity. The committee members, how- 
ever, were new in this type of work 
and knew little of what is necessary 
in a child-welfare program. How- 
ever, the committee succeeded in en- 



Syed Hasan, Chief Welfare Officer of the Punjab Children's Aid Society, examines a display 
of handwork at one of the play centers operated by the Society in the city of Lahore. 



JANUARY 1953 



81 




gaging- an executive, a Muslim refu- 
gee who had some social-work train- 
ing and some experience in work with 
children. I say "succeeded in engag- 
ing" because this man was, and is, 
so far as I know, the only person 
with social-work training in the Pun- 
jab. The municipal government of 
Lahore and the Punjab Department 
of Public Instruction gave the Society 
some money to operate a program, 
but little was done at that time. 

Enter Point IV 

Late in 1951 the Pakistan Govern- 
ment requested the United States 
Government to send a social worker 
to advise the Society on the reorgani- 
zation of its services, under the gen- 
eral agreement for technical coopera- 
tion between the two countries. I was 
assigned to do this work, and I ar- 
rived in Pakistan in April 1952, to 
remain there till early in August. 

The question then was how best to 
help the Children's Aid Society to 
serve the children of the Punjab. I 
was sure of one thing — that the 
social-work methods and techniques 
of one country cannot and should not 
be imposed on another; that social 
services in any place need to grow out 
of the concern that the people in that 
place feel for one another. 

But I recognized also a common 
denominator between my own coun- 
try and the one I was sent to help; 
it is a similarity in religious thinking 



that motivates the more fortunate to 
help the less fortunate. 

Besides, I realized that in both 
countries social consciousness is 
growing, and that this has found ex- 
pression in the spontaneous efforts of 
private individuals and groups and in 
Government action to promote mea- 
sures for the well-being of the people. 

But like anyone else from the West 
who goes into a country in the Far 
East, I soon noticed an approach to- 
ward social problems that is different 
from ours. 

In the Far East life is cheap; the 
individual is less important than in 
our Western culture. The social prob- 
lems are so great and so over- 
whelming that the tendency is either 
to shrug one's shoulders and say that 
nothing can be done, or else to em- 
Iiark upon a mass program. Our idea 
of starting in a small way, of dealing 
with individuals, is foreign to their 
thinking. 

Closely related to people's lack of 
interest in the individual is the idea 
that development of measures for 
welfare must be postponed, or de- 
emphasized, in favor of efforts for 
economic development. 

Again, I found little tradition for 
voluntary effort. A few voluntary 
programs have developed, but these 
are exceptions. I found little spon- 
taneous community action to meet a 
community problem. The tendency at 



At a games festival, the winner of a contest is congratulated by the author of this article. 




the moment seemed to be to look to 
the Government for everything. 

I realized that efforts to improve 
the care of children are handicapped 
by the low status of women. This 
status is changing, but in the cities 
the vast majority of women are still 
kept in seclusion (purdah) and do 
not appear in public except with their 
faces covered with a hurqa. Their 
activities are severely restricted, and 
their participation in community af- 
fairs is very much circumscribed. 
They have not been considered worth 
educating, and even now, with the 
present emphasis on extending educa- 
tion, only 15 percent of the girls of 
primary-school age (6-11) in the 
Punjab are in school, as compared 
with 55 percent of the boys. 

Subcommittee studies ths program 

As the first step toward the reor- 
ganization of the Society's services, 
the central committee designated a 
subcommittee, at my request, to (1) 
examine all aspects of the present 
program, (2) study the unmet child- 
care needs of the community, (3) de- 
termine what services might best be 
provided by the Society, and (4) 
formulate plans for a new program 
to be presented to the Society's cen- 
tral committee. 

We noted that the Society was oper- 
ating the seven play centers, as it had 
before 1947. Only one of them had a 
paid supervisor. The others depended 
on volunteers, with unsuccessful re- 
sults. 

The Society had picked up again 
on the work with orphanages, and in 
the previous year the executive had 
visited nine of them. These were 
operated under Muslim auspices and 
appealed for voluntary support on the 
basis of Zakat, a fundamental tenet 
of Islam that wealth over and beyond 
the needs of modest living is to be 
used in giving assistance to persons 
who have been unable to obtain their 
share according to their needs — espe- 
cially widows and orphans. The ex- 
ecutive found that only four of the 
orphanages were adequately operated 
with regard to feeding, medical ser- 
vices and sanitation, recreation, and 
school facilities. Several of the insti- 
tutions had very poor conditions, and 



82 



THE CHILD VOL. 17 No. 5 | 



one, referred to as a "beggars' 
school," was closed by the Governor 
of the Punjab after the Society had 
brought its conditions to public at- 
tention. 

The Society was looking forward 
to passage by the Punjab Legislature 
of the previously mentioned Chil- 
dren's Bill, which includes provisions 
for the protection of dependent and 
neglected children, and the Youthful 
Offenders Bill, which relates to de- 
linquent children. The proposed leg- 
islation provides that the Govern- 
ment shall designate "a society" to 
carry out its provisions. If the pat- 
tern that has been established in other 
major cities of the Indian subconti- 
nent is followed in the Punjab, the 
Children's Aid Society will be called 
upon by the Government to carry out 
the pi'ovisions of this act. In April 
1952, however, the Society was not 
prepared to assist in setting up a 
program under the new legislation. 
(For one thing, its executive was its 
only staff member, other than a mes- 
senger.) 

The chairman of the subcommittee, 
the widow of a former Deputy Gov- 
ernor of the Punjab, had recently 
been elected a member of Lahore's 
city council and was influential in the 
Muslim community. The other mem- 
bers of the subcommittee were two 
Muslims and two Christians. It was 
an interested and hard-working 
group, with almost perfect attend- 
ance at every one of the weekly meet- 
ings, which took place in May and 
June. This was notable in view of the 
temperatures of 110^ to 116° which 
prevail in the Punjab at that time of 
year. 

How the program stands today 

The subcommittee on reorganiza- 
tion made a number of recommenda- 
tions to the Society's central commit- 
tee, and all but one were accepted. 
The Society began at once to put the 
recommendations into effect, and the 
present status of the program may be 
described as follows : 

Recreation centers. Paid super- 
visors have been appointed in each 
of the seven recreation centers, part 
time. The pay is sufficient to interest 
I college students. As it is impossible 



to find people with training or experi- 
ence in this kind of work, selections 
were made according to an estimate 
of each applicant's potentialities 
based on his personality, school rec- 
ord, and employment history. The 
paid supervisors help to sustain the 
interest of the volunteers. 

Individual services to families and 
children. As a start in giving indi- 
vidualized social services, the Society 
has added to its staff two welfare 
officers, full time, to give "direct and 
individualized assistance to children 
and families who can be expected to 
respond constructively to such help, 
including financial assistance, family 
counseling, child guidance, and direct 
care of homeless children." 

Shelter facilities. Children who 
are left without father or mother 
often need temporary care, and help 
in being placed in the home of rela- 
tives, or in an orphanage, or else- 
where. At present unattached chil- 
dren are exploited by bogus orphan- 
ages and by beggars and criminals, 
or they work as underpaid servants 
in private homes. There has been no 
facility for temporary care of chil- 
dren since the Society's building was 
taken over as a refugee center. 

Therefore the Society plans to re- 
establish a small shelter for tempo- 
rary care of homeless children. But 
first it is trying to work out a pro- 
gram for such children in cooperation 
with one of the existing children's 



institutions with good standards. 
This would be done on a contract 
basis, and it would be considerably 
less expensive than setting up a sepa- 
rate facility. Besides, a cooperative 
relationship of this kind would bene- 
fit both agencies. 

Recreation in children's institu- 
tions. Two relatively good institu- 
tions requested the aid of the Society 
in developing recreational programs. 
One is caring for more than 300 
refugee children, the residual of some 
3,500 who have been cared for and 
resettled by this home. The other — 
for the deaf and dumb — is new. The 
two occupy different parts of what 
was once a Hindu college. 

The Society now employs a recrea- 
tion worker who divides his time be- 
tween the two institutions. Here is 
an opportunity for the Society to de- 
velop close relations with two impor- 
tant children's services. Both have 
resources that the Society will even- 
tually need to call on if it is to evolve 
a well-rounded program. 

Reorganization of the central com- 
mittee. I proposed that the terms of 
office of the Society's officers and the 
members of the central committee be 
rotated. This would provide oppor- 
tunity to different people to lead the 
work, and it is well known that when 
a person once assumes such responsi- 
bility he usually can be counted on to 
become a lifelong friend and sup- 

{Continui'd on page 86) 



A game of "Kab-bad-di" is enjoyed by both players and spectators at the Water Works 
Play Center. The water works for which the center is named can be seen in the background. 



JANUARY 1953 



83 




WHEN A CHILD IS DEPRIVED OF MOTHERING 

A Comment on Bowlby's "Maternal Care and Mental Health" 



LEON J. YARROW 

MENTAL-HEALTH workers 
agree that lack of a warm, 
continuous relationship with 
his mother or a mother substitute 
during a child's early years may lead 
to later personality disturbances. 

A number of studies of the effects 
of depriving children of such mater- 
nal care have been reported by Dr. 
John Bowlby, Director of the Child 
Guidance Department of the Tavi- 
stock Clinic, in London, at the re- 
quest of the World Health Organiza- 
tion. In a monograph, "Maternal 
Care and Mental Health," Dr. Bowlby 
analyzes research findings about chil- 
dren so deprived, and discusses the 
implications of the findings for so- 
cial-welfare programs. First he pre- 
sents evidence from research and con- 
siders its contributions to psycho- 
dynamic theories of personality de- 
velopment. Secondly he analyzes the 
social conditions that lead to depriva- 
tion of maternal care, and he makes 
suggestions for preventing such de- 
privation and alleviating its effects. 

The findings are based on three 
types of studies: The first type in- 
cludes studies of the mental health 
and development of children in insti- 
tutions, hospitals, and foster homes, 
made by direct observation of these 
children. The second group of studies 
is made up of investigations of the 
early histories of adolescents and 
adults who have developed psycho- 
logical illnesses. And the third class 
comprises follow-up studies of the 
mental health of children who have 
been deprived of their mothers in 
their early years. 

The direct studies show clearly that 
children deprived of their mothers, 

LEON J. YARROW is Assistant Chief of the 
Child Development Research Branch in the 
Research Division of the Children's Bureau. 
He was formerly Research Psychologist on 
the staff of the Child Research Council, 
University of Colorado School of Medicine, 
where he took part in a longitudinal study 
of the growth of normal children. 



with no warm and loving substitute, 
are retarded in their language devel- 
opment and in their social and adap- 
tive behavior. Dr. Rene Spitz's 
studies of infants in emotionally 
sterile institutions demonstrate dra- 
matically the psychological — as well 
as the physical — impact of extreme 
deprivation of this kind. Other studies 
found the same patterns of intellec- 
tual retardation and emotional blunt- 
ing in older children who had lived in 
institutions over a period of years. 

Life histories studied 

The retrospective studies review a 
great deal of evidence based on the 
histories of adolescents and adults 
who were treated in psychiatric 
clinics or brought before juvenile 
courts. A common background factor 
in one group of persons, who were 
called by Bowlby "affectionless char- 
acters," is a history of being placed 
in an institution very early in life, or 
otherwise being separated from their 
mothers or mother-substitutes. The 
outstanding characteristic of these 
persons is an inability to establish 
genuine, warm human relationships. 

The follow-up studies tend to sup- 
port the general findings of the direct 
and the retrospective investigations. 

W. Goldfarb, who has contributed 



the major share of the studies, sum- 
marizes concisely the chief effects of 
deprivation in early life on the per- 
sonality. The children brought up in 
institutions, he finds, "present a his- 
tory of aggressive, distractible, un- 
controlled behavior. Normal patterns 
of anxiety and self-inhibition are not 
developed. Human identifications are 
limited, and relationships are weak 
and easily broken. . . . Finally, the 
fact that personality distortions 
caused by early deprivation are not 
overcome by later community and 
family experience must be stressed. 
There is a continuity of essential 
traits as late as adolescence. If any- 
thing, there is growing inaccessibility 
to change." 

From a research point of view, it 
would have been desirable to analyze 
critically the methodological limita- 
tions of these studies. Such an analy- 
sis would point up the need for better 
designed and more carefully con- 
trolled studies to clarify or elaborate 
on the significant nuances of these 
early relationships that lead to emo- 
tional or personality disturbances. 

The sheer mass of evidence in sup- 
port of the basic thesis that extreme 
emotional deprivation in infancy re- 
sults in personality disturbances is 
overwhelming. It should be empha- 



What is believed to be essential for mental health, says Dr. John Bowlby, is that the in- 
fant and young child should experience a warm, intimate, and continuous relationship with 
the mother (or permanent mother-substitute), in which both find satisfaction and enjoyment. 



84 



THE CHILD VOL. 17 No. 5 




:* 



sized that the majority of the studies 
are based on circumstances of ex- 
treme deprivation resulting from 
prolonged stay in an institution. For 
practice as well as for basic theory, 
we need research on the effects of 
less extreme deprivation, as well as 
critical studies of the extent to which 
subsequent favorable experiences can 
overcome or mitigate the effects of 
very early traumatic experiences. 

Bowlby does not distinguish 
sharply between the effects of separa- 
tion, of deprivation, and of institu- 
tionalization. The experience of sepa- 
ration — a break in the continuity of 
the mother-child relationship — can be 
differentiated from that of depriva- 
tion. Deprivation essentially involves 
a lack of warm mothering either by 
the mother herself or by a substitute. 
Institutionalization may involve both 
separation and deprivation, but may 
be different from either in that there 
is prolonged absence of a consistent 
mother-figure. 

None of the studies gives any clear 
evidence on the highly significant 
question for adoption practices — that 
of the age at which separation from 
the mother is most damaging. Most 
of the studies suggest that the second 
half of the first year is the critical 
period; some indicate that separa- 
tion during the first 6 months is 
equally traumatic. The basic hy- 
pothesis that needs further testing is 
whether the crucial age is that at 
which the child has begun to identify 
himself with a mother-figure. We 
need to consider also how individual 
differences among infants may in- 
fluence the degree or nature of per- 
sonality damage. 

Another significant question is: 
What is the effect on the child of the 
kind of mothering he has had before 
being separated from his mother or 
mother-substitute? If a child receives 
"warm mothering" before the sepa- 
ration, this, of course, may increase 
the severity of his immediate reac- 
tions. Still, one might hypothesize 
that the loving relations that existed 
between mother and child in his early 
life might provide the child with a 
foundation for forming new close 
relationships, and thus lessen the 
probability of later damage being 



done to the child's personality. 

Bowlby, of course, recognizes the 
need for further research, and is cur- 
rently engaged in such research. In 
the November 1951 issue of the 
Courrier of the International Chil- 
dren's Center (Paris), Rosenbluth, 
Bowlby, and Roudinesco offer sug- 
gestions on some of the factors to 
be considered in further studies on 
separation. ("Separation from the 
Mother as a Traumatic Experience 
for the Child: Some Notes on Ob- 
taining a Relevant History.") Some 
of these factors are the age of the 
child at separation, the length of the 
separation, the quality of the mother- 
child relationship before separation, 
and the quality of the substitute 
mothering. In evaluating the effects 
on the child of the separation experi- 
ence they suggest as significant ob- 
servations : The child's initial re- 
sponses to separation (screaming, 
regressing, fretting, withdrawal, de- 
pression), his later adjustment as the 
separation is prolonged (quality and 
degree of discrimination of new re- 
lationship in environment), and his 
reactions when reunited with his 
mother. 

In the light of the evidence, Bowlby 
develops in some detail recommenda- 
tions for foster care, adoption prac- 
tices, and hospital care of children. 
He advocates that sick children, 
whenever possible, should be cared 
for at home. If a child is hospitalized, 
he recommends that the mother be 
allowed to remain with him in the 
hospital. If a child is to be adopted, 
Bowlby recommends the adoption as 
soon after birth as possible. While 
maintaining firmly that the "right 
place for a child is in his own home," 
Bowlby recognizes that in certain 
situations care outside of the home 
is necessary. He feels this should be 
undertaken only as a last resort, 
when it is impossible to make the 
home fit for the child. 

This work will certainly have an 
impact on social-work practice. Be- 
yond its application to the immediate 
problems with which it is concerned, 
it represents a significant contribu- 
tion by demonstrating the close inter- 
dependence of psychological theory 
and social-work practice. 



HOME-CARE PROGRAM 

{Continued from page 80) 

guard the physical health of a child 
whose mother is sick, and to protect 
both from too much emotional shock 
caused by separation is shown in the 
story of Bobby S, 9 years old. 

Bobby's mother had felt increas- 
ingly ill ever since her husband was 
admitted to a mental hospital, 6 
weeks before. At last she telephoned 
the home-care ofliice. The medical stu- 
dents who visited her diagnosed 
pneumonia, and reported this diag- 
nosis to a resident physician, who 
went to the home and confirmed the 
diagnosis ; he also raised the question 
that Mrs. S. might have tuberculosis, 
and recommended X-ray studies. 

Next, arrangements were made for 
Mrs. S to talk with a medical social 
worker about making plans for Bobby 
in case the X-ray studies established 
the fact that she had tuberculosis and 
needed hospitalization. 

Mrs. S was taken to the hospital in 
an ambulance for the X-rays. But 
before being admitted to the hospital 
for treatment, she was taken home in 
an ambulance so that she could ex- 
plain to Bobby what was happening, 
and could tell him that she would 
have to stay away from him for some 
time, and why. This kept him from 
being frightened by her absence. 

The medical social worker ar- 
ranged with a children's agency to 
find a foster home where Bobby could 
stay until his mother could return. 

Mrs. S was treated in the hospital 
for pneumonia and later was trans- 
ferred to a tuberculosis sanitarium. 

Since Bobby had been exposed to 
the danger of catching tuberculosis 
from his mother, the doctor arranged 
with a public-health nurse to see that 
he received adequate and continuous 
health supervision, including regular 
check-ups at the hospital chest clinic. 

Thus, through the home-care pro- 
gram, not only were the mother's 
medical needs fulfilled, but her mind 
was set at rest by the knowledge that 
her boy was well cared for. Bobby 
was benefited through the thoughtful 
and sensitive action of the doctor who 
saw to it that the mother had the 
opportunity to prepare the little boy 
for the necessary separation. 



JANUARY 1953 



85 



It is not remarkable that a pro- 
gram set up to give good home medi- 
cal care, with consideration of social 
factors, can evaluate the total needs 
of chronically ill patients treated 
over long periods of time. It is more 
difficult, and probably more impor- 
tant from a preventive standpoint, to 
find and deal with the problems of 
patients and their families seen only 
once or twice for minor illnesses. 

The majority of children seen by 
home-care physicians have diseases 
such as measles and upper-respii'a- 
tory infections. Despite the fact that 
these diseases usually require only 
two or three medical visits, it is fre- 
quently possible for students and 
residents to learn to recognize symp- 
toms of serious medical and social 
pathology in these visits. The home- 
care program is often the means of 
introducing patients and their fami- 
lies to other community services 
which may be helpful in the future. 
A child whose heart murmur was dis- 
covered by a medical student, a fam- 
ily whose landlord refused to repair 
the plumbing, and a mother who ob- 
viously preferred one child to another 
were all referred to appropriate agen- 
cies in the course of visits requested 
for treatment of measles. 

Although the agencies that helped 
to solve these problems were avail- 
able in the community where the 
problems were found, it is unlikely 
that these families would have known 
of these agencies or would have seen 
the need for their services without 
the help of the home-care program. 
It is certain that many medical and 
social problems are thus discovered 
and dealt with before they reach 
serious proportions. 

In conclusion it may be said that 
many medical and social problems of 
children in economically underprivi- 
leged families can be found and 
treated in a program operated by a 
health department and a medical 
school. Many other children may 
benefit, as the future patients of 
medical students and resident phy- 
sicians trained in the program. And 
all the children in the city should 
benefit from growing up in a 
healthier community. 

Reprints in about 6 weeks 



PUNJAB 

(Continued from page 83) 

porter. This, however, was a new 
idea to the committee, and it was not 
possible for all of them to accept it, 
and so action on the proposal was 
postponed. 

Finances. For several years the 
Society had been spending less than 
the amounts granted it by the Pro- 
vincial Government, and a surplus 
had accumulated — enough to finance 
the new program for almost a year. 
Soon, however, more money will be 
needed. And I recommended that it 
would be better if the Society sought 
funds not only from the Government 
but also from voluntary contributors. 
This would bring more people into 
direct contact with the work of the 
Society — a result that might benefit 
the program even more than the ac- 
tual funds contributed. At present, 
though some persons are contributing 
to help care for orphans and for other 
worthwhile causes, many give only to 
beggars. 

I suggested that a committee of in- 
fluential men and women be organ- 
ized to make an annual appeal to the 
community on the basis of Zakat and 
charity to support the part of the So- 
ciety's program that helps widows 
and homeless children. 

What of the program's future? It 
seems to me that this depends largely 
on what can be done to obtain profes- 
sional training for social-work per- 
sonnel. Some steps have been taken 
toward making such training avail- 
able. In the fall of 1951 the trustees 
of Punjab University authorized es- 
tablishment of a committee to con- 
sider ways and means of establishing 
a diploma course in social work. Co- 
operative relationships have been es- 
tablished between the United Nations 
technical-assistance program and the 
Pakistan Government to assist Pun- 
jab University and Pakistan in estab- 
lishing facilities for this course. 

If the Society can carry out its pro- 
gram successfully, this will be a most 
important step toward integrating 
children's services. The recreation 
centers are strategically placed to 
reach the locations where child-care 
needs are greatest. They should in- 



fluence the adults of the neighbor- 
hood to take more responsibility for 
improving neighborhood conditions 
that affect the well-being of the chil- 
dren and also to bring to the atten- 
tion of organized services the prob- 
lems that cannot be met by the people 
unaided. 

The individual counseling service 
just getting under way will focus on 
the child as an individual and will 
concentrate on strengthening his 
family. This approach will empha- 
size that almost every threat to the 
well-being of child and family is 
many-sided and that help should be 
drawn from several different facili- 
ties — from health service, from 
school program, from economic and 
employment aid, and so forth. It is 
the responsibility of the welfare offi- 
cer to seek out and use these different 
resources in dealing with problems of 
families and children. 

Whether the program can be car- 
ried out will depend on the skill and 
understanding of the personnel. Or- 
dinarily professional training is re- 
quired to develop the skills essential 
for such work. Up to now such train- 
ing has not been available in Pakis- 
tan but, as I have indicated, is now 
being started under the sponsorship 
of the central Government. The mem- 
bers of the new staff have been care- 
fully selected and show great prom- 
ise, and we expect that they will soon 
obtain the professional training that 
they need. 

The significance of the Punjab 
Children's Aid Society reaches far 
beyond the size, scope, and variety 
of services that it will be able to 
undertake in the immediate future. If 
its new program is successful the 
Society's efforts will mean much more 
for child welfare than they do now. 
But we shall note the significance of 
its work in the extent to which it can 
demonstrate the effectiveness of the 
scientific approach in alleviating so- 
cial problems, in arousing community 
interest, and in obtaining widespread 
participation in and support of social 
work for children. Its success will 
depend on how much it contributes to 
the development of a coordinated 
community program of services for 
the care of children. 



86 



THE CHILD VOL. 17 No. 5 



FOR YOUR BOOKSHELF 



YOUR CHILD CAN HE HAPPY IN 
BED ; over 100 ways in which chil- 
dren can entertain themselves. By 
Cornelia Stratton Parker. Thomas 
Y. Crowell Co., New York. 1952. 
275 pp. $2.95. 

Not only parents, but professional 
workers caring for sick or convales- 
cent children, will bless Mrs. Parker 
for the practical suggestions given in 
this book. 

"What can be done to bring happi- 
ness to a small patient feeling none 
too physically fit, and time lying so 
heavy on his hands?" The author an- 
swers this question with hundreds of 
tested ideas. She gives detailed — and 
lively — instructions for such things 
as modeling, papier-mache work, 
doll-making, and weaving. She out- 
lines amusements according to age 
periods, beginning with "around 1 
year"; going on to "by 15 months"; 
then "by 18 months" ; and so on, up 
to "9 and 10." She itemizes toys ac- 
cording to the child's age, with ap- 
proximate prices ; story books, again 
by age periods ; book catalogs ; infor- 
mation on children's magazines; and 
recipes, such as for modeling mate- 
rials and for finger-paint. 

But this is much more than another 
"what-to-do" book. It is a guide, 
based on knowing how children de- 
velop and on using this knowledge 
for keeping a sick child happy. 

Marion L. Faegre 



IN THE NEWS 



Juvenile delinquency. Many addi- 
tional national organizations with 
widespread membership have ex- 
pressed to the Children's Bureau and 
the Special Juvenile Delinquency 
Project their interest in the campaign 
against juvenile delinquency. "Three 
recent meetings brought large groups 
together in New York and Washing- 
ington to discuss the problem of de- 
linquency and to work out ways in 
which they might cooperate in the 
current campaign to improve com- 
munity services that treat children 
for delinquent behavior. The meet- 
ings were of health agencies, educa- 
tional organizations, and civic groups. 
The first of these meetings was 
held on October 15 in New York 
under the sponsorship of the National 
Health Council. The member agen- 
cies of this Council met to study some 
of the specific implications of chil- 
dren's delinquent behavior so far as 

JANUARY 1953 



the health services are concerned. Dr. 
Martha M. Eliot, Chief of the Chil- 
dren's Bureau, and Bertram M. Beck, 
Director of the Special Juvenile De- 
linquency Project, explored the prob- 
lem with the organizations repre- 
sented and asked them to seek out 
ways in which, through their existing 
programs, the health agencies could 
contribute to the over-all objective of 
improving services for delinquent 
children. 

In Washington, on November 12, a 
meeting jointly sponsored by the 
Office of Education and the Children's 
Bureau brought together a number of 
prominent individuals, educators, and 
representatives of about 15 national 
educational organizations that are 
concerned about the problem of juve- 
nile delinquency. The American Red 
Cross and the National Institute of 
Mental Health also sent delegates to 
this meeting. In their discussion of 
the problem of juvenile delinquency 
as it affects schools, the representa- 
tives pointed out a number of specific 
needs : 

(1) School programs should be 
evaluated to see if each child is get- 
ting the sort of teaching from which 
he can profit. (2) Teachers require 
better training to be able to recognize 
signs of approaching delinquency — 
it was believed in-service training 
might be stressed. (3) Many commu- 
nities lack the social and clinical ser- 
vices to which schools might profit- 
ably refer children having difficulty 
in personal adjustment. (4) Good 
consultative services within the 
school or the community could aid 
schools in helping children and might 
also be used for teacher training. 

The group felt that all State mem- 
bers of the national organizations, 
including the various member groups 
of the National Education Associa- 
tion, should receive full information 
about the delinquency problem, and 
that meetings should be held to dis- 
cuss the campaign against increasing 
delinquency. It was recommended 
that the NEA issue a special pam- 
phlet explaining the problem and 
suggesting what could be done about 
it. 

The third and largest of these three 
meetings was that of representatives 
of about 30 major civic organizations 
— fraternal, religious, veteran, educa- 
tional, and professional. They met 
in Washington on November 17-18. 
The group heard the delinquency sit- 
uation described — as it is today and 
as it may be tomorrow — by people 
who work in the field: A police- 
woman, Captain Mary Ganey of 
Washington, D. C. ; a detention-home 
director. Dr. Preston Sharp of Phila- 
delphia; a juvenile-court judge, the 



Hon. Alfred D. Noyes of Montgomery 
County, Md. ; a training-school super- 
intendent, Charles W. Leonard of 
Illinois; and the director of a State 
community-service program, Douglas 
H. MacNeil of New Jersey. 

Representatives at the meeting 
stressed the necessity for developing 
public understanding of the problem, 
of juvenile delinquency, and of creat- 
ing public awareness that something 
can be done to help delinquent chil- 
dren become well-adjusted and law- 
abiding citizens. A number of people 
at the meeting thought that their na- 
tional organizations would undertake 
to inform all their local groups about 
the size and importance of the prob- 
lem, ask them to look into their local 
situation, and then encourage them to 
take appropriate action, along with 
other interested groups, toward im- 
proving their local situation. The 
groups will also work at the State 
level in cooperation with the various 
State planning bodies for children and 
youth. Some of the national organi- 
zations, it was reported, have already 
worked out plans for working toward 
the Delinquency Project goals during 
the coming year. 



CALENDAR 



Jan. 9-10. American Group Psycho- 
therapy Association. 10th annual 
conference. New York, N. Y. 

Jan. 17-18. United Service for New 
Americans. Annual meeting. New 
York, N. Y. 

Jan. 19-30. Population Commission, 
United Nations Economic and So- 
cial Council. 7th session. New York, 
N. Y. 

Jan. 21-24. Council on Social Work 
Education. 1st annual program 
meeting. St. Louis, Mo. 

Jan. 24-29. American Academy of 
Orthopaedic Surgeons. 20th annual 
meeting. Chicago, 111. 

Area conferences. National Child 
Welfare Division, American Legion: 

Jan. 9-10. Area D — Illinois, Indi- 
ana, Iowa, Kansas, Michigan, Minne- 
sota, Missouri, Nebraska, North Da- 
kota, Ohio, South Dakota, Wisconsin. 

Feb. 6-7. Area B — Delaware, Dis- 
trict of Columbia, Maryland, New 
Jersey, New York, Pennsylvania, 
Puerto Rico, Virginia, West Virginia. 



Illustrations: 
Cover, Philip Bonn. 

I'. 7.'.. Larry Elliott. 

Pp. 79, 80, Virginia State Department of 

Health. 
Pp. 81, 82, 83, courtesy of the author. 

87 



r 










^ 



VOL. 17 NO. 5 
JANUARY 1953 



in This Issue 



Should Children Be Separated from Their Parents? 
Draza B. Kline 



Page 

. 74 



Sick Children Benefit from^a City's Home-Care Program . 78 
Virginia Insley 



Point IV and the Children of the Punjab 
Paul R. Cherney 



When a Child Is Deprived of Mothering 
Leon J. Yarrow 



81 



84 



Published 10 times a year by the Division of Reports, Children's Bureau 
Editor, Sarah L. Doran Art Editor, Philip Bonn 



FEDERAL SECURITY AGENCY 
Oscar R. Evving, Administrator 



SOCIAL SECURITY ADMINISTRATION 
Arthur J. Altmeyer, Commissioner 



CHILDREN'S BUREAU 
Martha M. Eliot, M.D., Chief 



Publication of THE CHILD, monthly bulletin, has been authorized by the Bureau of 
the Budget, September 19, 1950, to meet the needs of agencies working with or for 
children. The Children's Bureau does not necessarily assume responsibility for 
statements or opinions of contributors not connected with the Bureau. 

THE CHILD is sent free, on request, to libraries and to public employees in fields 
concerning children; address requests to the Children's Bureau, Federal Security 
Agency, Washington 25, D. C. For others the subscription price is $1.25 a year. On 
all orders of 100 or more sent to one address there is a discount of 25 percent. Single 
copies 15 cents each. Send your remittance to the Superintendent of Documents, 
Government Printing OfiSce, Washington 25, D. C. 

Foreign postage — 25 cents additional — must be paid on all subscriptions to 
countries in the Eastern Hemisphere and those sent to Argentina and Brazil. 
Domestic postage applies to all other subscriptions. 



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MAR 10 1953 



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nearly 4 MILLION 



NEW CHANCES 



to fashion a Nation of healthy, wholesome, and wise citizens 



VITAL statisticians have not 
yet been able to count every 
last one, but they think the 
number of babies born in 1952 topped 
all previous records. Nearly 4 million 
were born. 

With each new year, the chances 



grow better that babies will survive 
the threat of illness and death from 
diseases. They grow better, too, for 
older children. But they are still far 
from even for all children. 

Just keeping alive of course is not 
good enough. Our goal for every child 
is buoyant good health and the chance 



for him to grow equally well in social 
and emotional health. Here, too, the 
chances are unequal. 

These pages picture a few of the 
yardsticks we have with which to 
measure differences in opportunity 
for children, and to point up our un- 
finished business for them. 



BIGGEST FAMILIES HAVE 
LOWEST INCOMES 

The Nation's children are concen- 
trated in a small proportion of its 
families. Over half its 47 million 
under 18 belong to 16 percent of its 
families. These are the families with 
three or more children. Families with 
one or two children under 18 make 
up 40 percent of the total. The rest 
are families with no children under 
18. Families with the most children 
usually have the lowest incomes. The 
median income for all families in 
1950 was $3,319. 

One out of every 10 families is 
headed by a woman. In 1950, families 
headed by a woman had an average 
income of $1,922. 



© 

I ©I 
'.(7) 

I© 

i© 



or more 
































Median family Incomes, 1950 



THE CHILD VOL. 17 NO. 6 



A ROUND-UP OF FACTS 



ABOUT CHILDREN 



AND CHILDREN'S SERVICES 



as seen by the Children's Bureau 




Number of children under 18 for every 100 adults of working age, 



REGIONS RICHEST IN CHILDREN 
HAVE LOWER INCOMES 

Regions rich in children have pro- 
portionately fewer adults to support 
both children and the schools, the 
health, Avelfare, and other community 
activities that serve children. These 
regions have lower per capita in- 
comes, too. In the South, for instance, 
South Carolina, with 74 children 
under 18 years for every 100 adults 
of working age (18 to 64 years), had 
a per capita income of $838 in 1950. 
At the other extreme, in the North- 
east, New York, with 40 children per 
100 adults of working age, had a per 
capita income of $1,875. 




MANY CHILDREN LIVE IN BROKEN HOMES 

Nine out of every 100 children 
under 18 years of age live with one 
parent only; 6 live with neither par- 
ent. Among the more than 4 million 
children with one parent, some 
1,700,000 have a widowed parent; 
900,000 have a divorced parent; 
1,500,000 have a parent living away. 

Divorces, down from their peak 
figure of 610,000 in 1946, are esti- 
mated at 371,000 for 1951. Family 
breakups put great strains on chil- 
dren, as well as parents, that some- 
times can be reduced when skilled 
workers are at hand to help. 



The home of I out of 7 children lacked one or both parents in 1950 



FEBRUARY 1953 



MANY INFANTS ARE BORN 
OUTSIDE [CARRIAGE 

Children born to unmarried 
mothers are in special need of help. 
First, the mothers should have as- 
sistance before, during, and after 
childbirth. In 1940, 89,500 babies 
were born out of wedlock. By 1949 
the number had swelled to 133,200. 
In 1940, the rate of illegitimate births 
was 7.1 for every 1,000 unmarried 
women 15 to 44 years of age. By 
1949, the rate was 13.4. In that year 
30,000 of these unmarried mothers 
were 17 years of age or younger. 



1940 



1949 



n 



13.4 



numb&r per 1,000 unmarried women 15-44 years of age 



Number of illegitimate births 



INFANT MORTALITY IS TOO HIGH 
IN MANY PLACES 

A larger proportion of babies now 
reach their first birthday than ever 
before. In 1950, the U. S. infant mor- 
tality rate was 29 for every 1,000 
live births. Ten years earlier the 
figure was 47. Still, many babies die 
who need not die. If the record of 
infant lifesaving in the years 1946- 
49 had been as good in the shaded 
counties, mostly rural areas, as it was 
in metropolitan counties (where the 
death rate was 29.7), 50,000 babies 
would have been saved. Over 180,000 
babies born in 1949 had no medical 
attendance at birth. 




Greatest gains can be made In these counties 



MORE HEALTH CARE OF CHILDREN 
IS NEEDED 

Only the very old are sick more 
often than children. While deaths 
from many serious communicable 
diseases are all but wiped out, these 
diseases still occur often among chil- 
dren. Other types of sickness also 
occur often. However, doctors, nurses, 
hospitals, and clinics tend to center in 
cities and towns; specialists, in big 
cities. Children in isolated counties, 
in low-income families, and those 
with dark skins stand the poorest 
chances for health care in this coun- 
try. In the whole country, there are 
232 children under 18 years for each 
physician. 




Number of children under 18 for each physician 



THE CHILD VOL. 17 NO. 




Out of any 10,000 under 18 years, these numbers of cliildren attend psyctiiatric clinics 



MENTAL-HEALTH SERVICES ARE 
HARD TO FIND 

Emotional difficulties are now high 
up on the list of health problems 
of childhood. As a Nation we are 
beginning to develop mental-health 
services through community clinics, 
and some children's specialists are 
giving increased attention to emo- 
tional problems. Little psychiatric 
treatment is given to children 
through private practitioners. Many 
well-child clinics make no provision 
for psychiatric advice. Many juvenile 
courts and institutions for delinquent 
children are unable to provide ade- 
quate psychiatric diagnosis and treat- 
ment. Psychiatric clinics, usually 
with long waiting lists, are able to 
provide for only 33 out of every 10,- 
000 children. 




1,695 counties liave no full-time public child-welfare workers 



FULL-Tlli/IE PUBLIC CHILD-WELFARE 
WORKERS ARE TOO FEW 

In June 1951, in this country, 4,465 
full-time public child-welfare work- 
ers were employed through local, 
State, or Federal funds. The great 
majority of these were caseworkers 
working directly on the problems of 
children. These caseworkers were 
available to children in less than half 
our 3,187 counties. Some counties 
without full-time public child-welfare 
workers used the services of general 
public-welfare workers (mostly pub- 
lic-assistance workers) who gave part 
time to children. Most caseworkers 
in voluntary agencies are in urban 
areas ; few in rural areas. Rural areas, 
if served at all, are usually served by 
public child-welfare workers. 



PARENTS have primary respon- 
sibility for providing the daily 
care and opportunity for growth 
that every child should have. 

To plan wisely, they must know 
what children require for physical, 
emotional, and social health. They 
need facts from skilled and objective 
investigators and reporters, and guid- 
ance from persons especially trained 
in child development, education, 
health, and welfare. 



Parents must have at hand, ready 
to use when needed, a broad range 
of facilities and services that no 
family, rich or poor, can of itself sup- 
ply. Good schools, libraries, and 
churches; good playgrounds and rec- 
reation facilities; good hospitals, 
clinics, and health services ; these are 
only a few of the community aids 
to a healthy, happy childhood. 

Children who have lost their par- 
ents, or whose parents are unable to 



fulfill their responsibilities, have al- 
ways had a special claim for help. 

Children in the United States are, 
in many ways, much more fortunate 
than the children of many lands. Our 
ideal, however, of a secure, whole- 
some, and invigorating personal, 
family, and community life for every 
child, from birth throughout his 
growing years, is still far from 
achievement. 



FEBRUARY 1953 



93 



TO BETTER CHILDREN'S CHANCES 

the Children's Bureau works with public and private agencies, 
professional workers, civic groups, and parents 



THE Children's Bureau, as au- 
thorized by the Congress and 
the Federal Security Adminis- 
trator, operates under two directives. 
The first, to investigate and report 
"upon all matters pertaining to the 
welfare of children and child life 
among all classes of our people," 
comes from the 1912 act creating the 
Bureau. Under this act the Bureau 
studies many types of conditions af- 
fecting the lives of children ; provides 
data and makes recommendations to 
improve practice in child-health and 
child-welfare service programs under 
the Social Security Act; helps to es- 
tablish standards for the care of 
children. 

The second of its directives charges 
it with the responsibility of making 
grants to States to "extend and im- 
prove" services for promoting the 
health and welfare of children, espe- 
cially in rural areas and in areas of 
special need. This is contained in the 
Social Security Act, first passed in 
1935, and amended in 1939, 1946, 
and 1950. 

1. Helping parents and citi- 
zens generally with facts about 
children's needs which the Chil- 
dren's Bureau gathers from its 
investigations. 



2. advising with workers and 
agencies serving children on 
methods and standards of care, 

3. administering- grants to 
States to strengthen State and 
local child-health and child- 
welfare services — 

these are the three broad fronts on 
which the Bureau serves the children 
of the Nation. 

The progress it can make, year 
after year, must be measured against 
its resources of persons and money. 
In 1952 the Children's Bureau had a 
staff of 244 workers and an operating 
budget of $1,585,000. 

For children's health and welfare 

Title V of the Social Security Act 
established the principle that all the 
people of the United States, through 
their Federal Government, share with 
State governments responsibility for 
helping to provide community health 
and welfare services that children 
need. 

When this act was passed, the first 
full year's authorized grants totaled 
$8,150,000. Under the 1950 amend- 
ments, the total that may be appro- 
priated in any one year is fixed at 
$41,500,000. Actual appropriations 



for the fiscal year were $31,500,000. 
Of this total, $12,524,100 was for ma- 
ternal and child-health services ; 
$11,385,500 for services for crippled 
children; and $7,590,400 for child- 
welfare services. The great bulk of 
it pays salaries of doctors, nurses, 
medical social workers, nutritionists, 
dentists, physical therapists, child- 
welfare workers, and other profes- 
sional workers for children. Some is 
used to help increase the number of 
trained workers by granting stipends 
to promising candidates for training 
in various professional fields. Most 
of the money for crippled children 
pays for medical, hospital, clinic, and 
convalescent care. Some of the child- 
welfare money helps to pay the cost 
of foster care for children who can- 
not be cared for at home. 

All States, with one exception, and 
the District of Columbia, Alaska, 
Hawaii, Puerto Rico, and the Virgin 
Islands receive grants-in-aid for all 
three of these programs. (The one 
exception is Arizona, which, at pres- 
ent, does not receive Federal grants 
for crippled children's services.) 

Each State receives a flat amount, 
specified in the Social Security Act, 
for each of the three programs. The 
balance of the Federal funds is 



Helping young couples learn more about their expected baby is part 
of the maternity care given by public-health nurses in many States. 



Members of the staffs of State and local health departmenti 
helping large numbers of mothers to keep their well babies 




apportioned to the States on the basis 
of various factors that reflect the size 
of the child population and the State's 
resources for meeting the needs of 
its children. 

To receive funds, State agencies 
present plans for spending Federal 
grants that meet the requirements of 
the Social Security Act and that as- 
sure good quality of services. These 
plans are approved by the Children's 
Bureau. 

To take full advantage of the 
grants for maternal and child-health 
services and for crippled children's 
services, each State must match part 
of its Federal grant. 

To take advantage of the child- 
welfare funds, each State must as- 
sume some of the cost of services in 
rural areas, although no fixed amount 
of Federal funds must be matched. 

Of course, no State is limited in the 
amount of its own money that it 
spends for children's services. In- 
deed, many States spend a great deal 
more of their money than the amount 
needed to match Federal funds. 

So long as States meet the require- 
ments of the Social Security Act, they 
are free to use Federal funds in the 
way they think best. As a result, no 
two State plans are alike. This is one 
of the great strengths of these grant- 
in-aid programs. They respect and 
preserve State and local initiative. 

In planning their programs, State 
agencies consult with voluntary 
agencies and groups on what services 
are needed, so as to avoid duplication 
and to encourage good teamwork be- 
tween public and voluntary agencies. 



States themselves decide which chil- 
dren may get the benefits of Federally 
supported services, under certain gen- 
eral policies laid down by the Federal 
Government. The staff of the Chil- 
dren's Bureau is available to State 
agencies to help them in planning and 
strengthening their services. 

Types of services 

Most of the services provided by 
State and local health departments 
for mothers and children are health- 
promotion services; that is, they are 
designed to help well mothers and 
children keep well. Typical health- 
promotion services are : prenatal 
clinics ; child-health conferences ; im- 
munization services ; health services 
for children of school age. Some 
States also provide medical care for 
pregnant women and for premature 
infants, but this is done in a limited 
way for relatively few. All States 
use some of their funds for the train- 
ing of professional personnel needed 
to provide these services. 

In their programs for crippled chil- 
dren, all States provide diagnostic 
services. Within the limits of their 
funds, all States pay for skilled treat- 
ment for some children. This may 
include medical care, hospitalization, 
and convalescent care. Children most 
generally helped are those needing 
orthopedic or plastic treatment. But 
most States do something also for 
children with other handicapping 
conditions, such as rheumatic fever, 
cerebral palsy, epilepsy, and hearing 
defects. 

Child-welfare services are social 



services for children. They are usu- 
ally provided by social workers who 
have some special training or experi- 
ence in child welfare. These workers 
help parents with social and emo- 
tional problems that affect the well- 
being of their children. The first 
effort of a child-welfare worker is 
to keep the family together. But if 
the problems are such that its chil- 
dren are neglected, or emotionally dis- 
turbed, or show other adverse effects, 
it may be necessary, for the protec- 
tion of the children, to remove them 
from their homes. When this hap- 
pens, child-welfare workers help to 
make other plans for the care of such 
children, either in foster-family 
homes or in institutions. They place 
children for adoption when it has 
been determined that a child must be 
permanently removed from his own 
home. They find family homes or day 
nurseries for children whose mothers 
work outside the home. They help 
children who get into trouble with 
the law, and work with agencies deal- 
ing with such children. They help 
unmarried mothers, and babies born 
out of wedlock. They work with citi- 
zens and agencies in improving State 
laws on adoption, guardianship, and 
support, and in building better com- 
munity conditions for children. In a 
limited way, they give help to mothers 
receiving assistance for dependent 
children under the Public Assistance 
program. 

Pages that follow report on recent 
developments in children's services 
aided by Federal funds. 



; crippled children's agencies hospitalize 4,3,000 children a year. To find welcoming families like this for children without homes is 
;hey provide care at clinics for more than four times as many. one of the many big jobs that State child-welfare workers are doing. 




• i III I 

• I lilll I? 

H .11, i 






School health 



Speech therapy 



Homemaker services 



SOME CHILDREN ARE WINNERS 



IN THE past decade and a half, 
during which the Social Security 
Act has been in effect, many hun- 
dreds of thousands of children have 
benefited through the provisions for 
maternal and child health, for crip- 
pled children, and for child welfare. 

The numbers served under these 
State-Federal programs in 1951, as 
made available through reports from 
the States, are shown in the table on 
the next page. 

In that year, the number of expec- 
tant mothers attending prenatal 
clinics approached 200,000. Almost 
400,000 babies were brought to well- 
baby clinics. Well over half a million 
children of preschool age attended 
well-child conferences. 

In the same year about 230,000 
children received care under the 
crippled children's program. 

Under the child-welfare program 
in 1951 more than a quarter of a 
million children received child-wel- 
fare casework service, the largest 
proportion of them in foster homes. 

Every State, of course, has its own 
individual approach to problems con- 
cerning children's well-being, accord- 
ing to its resources and the condi- 
tions in the State. Here are a very 
few examples of the work done in the 
various States for maternal and child 
health, crippled children, and child 
welfare : 

MATERNAL AND CHILD HEALTH 

More and more State health de- 
partments are joining with hospitals 
and medical schools in developing 



community services for the care of 
premature babies. And they are un- 
derstanding better what a financial 
burden premature birth places on a 
family. 

In order to reduce complications 
of pregnancy, which cause many pre- 
mature births, several States that 
have been active in caring for pre- 
mature babies are giving greater 
emphasis to prenatal care, and to 
planning for medical and hospital 
care for women with complications 
of pregnancy. 

Sixteen State health departments 
are helping families to pay the costs 
of medical and hospital care for a 
limited number of such infants. 



In several States — California, for 
example, the health department joins 
with a medical school's department 
of pediatrics to bring a well-trained 
pediatrician into rural areas regu- 
larly, so that he can provide consul- 
tation services to the doctors in these 
areas. More arrangements like this 
would greatly improve the care of 
children. 

A number of State health depart- 
ments, especially in the Southwest, 
have been joining with their State 
departments of education to develop 
better health services for children of 
school age. Arkansas, for instance, 
has a "pilot-school health program." 
This means that several schools, in 
different parts of the State, have 
been developing a complete health- 
education program in their own 



localities. These serve as examples 
to the other schools in the State, sug- 
gesting what can be accomplished 
when all a community's services for 
children are focused on the schools 
in the interest of the children's 
health. Each summer key personnel 
from the pilot schools meet to review 
the programs. 

CRIPPLED CHILDREN 

State crippled children's agencies 
are continuing to broaden their pro- 
grams to include more kinds of handi- 
capping conditions, and are experi- 
menting with new types of services. 

Perhaps the most notable example 
of these is the rapid development of 
clinic and hospital care for children 
with congenital heart disease. Many 
States that have the specialists 
needed to care for children with con- 
genital heart disease are including 
such children under the regular crip- 
pled children's program. 

In order to diagnose and treat chil- 
dren who live in States that do not 
have this type of medical and surgical 
experts, regional centers have been 
established in three States — Con- 
necticut, to serve some of the New 
England States; Illinois, to serve 12 
States in the Midwest; and Cali- 
fornia, to serve Far Western States, 
as well as Alaska and Hawaii. Two 
more centers — in Marjiand and 
Texas — are beginning work. 



The importance of a child's hear- 
ing and speech, in school and in later 
life, is recognized by many States, 



96 



THE CHILD VOL. 17 NO. 6 



and their concern has been gaining 
momentum. 

Tennessee's State Health Depart- 
ment has joined with the Tennessee 
Speech and Hearing Foundation and 
Vanderbilt University to develop in 
Nashville a speech and hearing facil- 
ity for diagnosis and treatment. Ten- 
nessee's legislature has appropriated 
$120,000 for each of 2 years— fiscal 
years 1951-52 and 1952-53 — in order 
to develop a State-wide speech and 
hearing program that includes hear- 
ing tests and speech evaluation 
throughout the schools. When further 
diagnosis and treatment are needed 
the children are referred to the 
speech-and-hearing center. 

A center for the hard-of-hearing 
has been established in Houston, Tex. 
The District of Columbia now offers 
crippled children's services to chil- 
dren who are hard of hearing. Cali- 
fornia has virtually completed plans 
for a speech-and-hearing center in 
Los Angeles, to which children may 
be sent by the MCH and CC programs 
for complete study and treatment. In 
Arizona a hearing program is being 
developed in cooperation with the 
schools and other agencies, aimed at 
early discovery of children with hear- 
ing impairments and provision of 
medical treatment and corrective 
therapy, as well as adjustment of 
their educational programs. 



Although programs for children 
with epilepsy have not developed 
widely as yet, the States have shown 
increasing interest in them. Utah, 
Maryland, Iowa, and Illinois have set 
up special programs for such chil- 
dren ; and a number of other States 
are working out plans for epilepsy 
programs. 

CHILD WELFARE 

Reaching children before their 
troubles become so serious that they 
must be removed from their homes 
is a major objective of the child- 
welfare programs. Both public and 
voluntary agencies are trying to do 
this through providing social services 
to children in their own homes. 

Some States (notably Alabama, 
California, Florida, and New York) 
are studying the relation between the 



child-welfare program and the Public 
Assistance program for Aid to De- 
pendent Children, and methods of 
providing social services to children 
in families receiving Aid to Depen- 
dent Children. 

Interest in homemaker services as 
part of a program for the social, emo- 
tional, and physical well-being of 
children is growing. Under this plan, 
a social agency selects women chosen 
for their skills in homemaking and 
their ability to work with children 
and to adjust to various situations, 
and places them in homes where chil- 
dren lack their mother's care because 
of her death or illness. Councils of 
social agencies are trying to extend 
or develop this type of service in 
Worcester, Mass. ; Dallas, Tex. ; San 
Francisco and Los Angeles, Calif. ; 
Toledo and Dayton, Ohio; South 
Bend and Richmond, Ind. ; and others. 
Several States have initiated home- 
maker service as part of their public 
child-welfare programs. 

Development of protective services 
for children who are neglected or 
abused by their parents continues, 
especially in Denver, St. Paul, St. 
Louis, and Chicago. 

A number of States have strength- 
ened standards for licensing foster- 
family homes, child-placing agencies, 
and children's institutions. Public 
and voluntary agencies are helping 
foster parents, and cottage parents 
and other staff members in children's 
institutions, to provide better care 
for children. The number of children 
in foster-family care has increased 
in many communities, but the need 
for additional foster-family homes is 
still urgent. 

Widespread public interest in adop- 
tion continues. The Arizona Bar As- 
sociation is sponsoring legislation for 
improving the adoption law; a civic 
group in Portland, Oreg., has studied 
the State adoption law and has rec- 
ommended further legislation to im- 
prove it; California has developed 
State and local citizens' groups to 
study and foster improved adoption 
programs. 

Many agencies are giving more at- 
tention to the need of older children 
for adoption as well as to placement 
of infants at an earlier age. 



CHILDREN AND MOTHERS SERVED 

BY STATE AGENCIES 

UNDER TITLE V, SOCIAL SECURITY ACT 

Maternal and Child-Health Services in 1951 

Medical services 

Mothers admitted to antepartum 

medical service 189,000 

Mothers given postpartum medical 

examination 53,000 

Infants admitted to medical ser- 
vice 395,000 

Preschool children admitted to 

medical service 565,000 

Examinations by physicians of 

school-age children 2,394,000 

Public-health nursing services 

Mothers admitted to antepartum 

nursing service 268,000 

Mothers given nursing service at 

delivery 4,000 

Mothers admitted to postpartum 

nursing service 279,000 

Infants admitted to nursing ser- 
vice 677,000 

Preschool children admitted to 

nursing service 697,000 

Field and office nursing visits for 

school-age children 2,160,000 

Immunizations 

Smallpox 1,821,000 

Diphtheria 1,831,000 

Dental inspections 

Preschool children 80,000 

School children 2,466,000 

Crippled Children's Services in 1951 

Total, children receiving physi- 
cians' services from State crip- 
pled children's agencies (un- 
duplicated count) 229,000 

Physicians' services 

Clinic service 186,000 

Hospital in-patient care 43,000 

Convalescent-home care 6,000 

Physicians' services other than 
clinic services, hospital in- 
patient care, or convalescent- 
home care 24,000 

Child-Welfare Services, December 31, 1951 

Total, children receiving child- 
welfare casework service from 

State public welfare agencies . . 258,000 

In homes of parents or relatives 102,000 

In foster-family homes 112,000 

In institutions or elsewhere 44,000 



FEBRUARY 1953 



97 



CHILDREN IN SPECIAL JEOPARDY 



CHILDREN in this country are 
on the whole making gains, 
but some groups seem to have 
two strikes against them. 

Among these are: 

1. Babies prematurely born, and 
babies born in places where health 
and medical services are poor or lack- 
ing. 

2. Children of migratory agricul- 
tural laborei's. 

3. Boys and girls who are delin- 
quent or in danger of becoming de- 
linquent. 

There are others, but special attention 
was given in 1951-52 to studying the 
situation affecting these groups. 

INFANT MORTALITY 

Special medical and nursing ser- 
vices are already saving many pre- 
mature babies' lives ; even very small 
babies have been saved. Even so, 
large numbers die. More than one- 
third of all the babies who die in the 
first year of life and 60 percent of 
those who die in the first month are 
prematures. 

With some 200,000 babies a year 
born prematurely — at least 6 percent 
of all the babies born alive in this 
country — the main problem is not 
only to save these babies after they 
are born, but also to prolong preg- 
nancy to normal duration. 

It is now well established that 
women who have poor prenatal care, 
or none, are more likely to have a 
premature baby than are those who 
have good prenatal care. 

Good prenatal care, with special 
care for women with complications of 
pregnancy, offers the greatest possi- 
bility of reducing the incidence of 
prematurity and thereby of lowering 
infant mortality. 

In saving babies' lives, a question 
that is equal in importance to that 



of prematurity is the problem of the 
baby — premature or full term — who 
is born in one of the many localities — 
mainly rural — where progress in pro- 
viding medical services for mothers 
and babies lags far behind that of 
the Nation as a whole. 

Problems connected with saving 
premature and other babies' lives in 
such localities are more than medical 
ones. They involve low incomes, poor 
sanitation, and habits of people. 
Needlessly high are the infant death 
rates among Negroes, among the 
Spanish-speaking, among Indians, 
and among migratory agricultural 
laborers. 

These people need comprehensive 
help with their problems by volun- 
tary agencies and local. State, and 
Federal Governments. 

Such concerted action should bring 
to these people more doctors, nurses, 
nutritionists, and medical social 
workers who know the special prob- 
lems of the group they are dealing 
with and can work with them effec- 
tively. 

Community programs focused on 
saving the lives of babies in such 
places must, of course, be a part of 
the State and community health 
programs. They must be kept closely 
related to the skills of the public- 
health officer, the public-health nurse, 
and the sanitary engineer, and to 
treatment in doctors' offices, clinics, 
and hospitals. Social services may 
often be needed to help individual 
families with economic or social prob- 
lems that in themselves affect the 
health care that can be given. Where 
this type of help is needed a medical- 
social worker or a child-welfare 
worker in the community may be 
called for. 

If a local health unit is already 
established, maternal and child-health 
services should be operated in and 
from that unit. In areas with few or 



no health facilities, additional local 
health centers designed to make a 
frontal attack on infant mortality 
may need to be organized. 

CHILDREN IN MIGRANT FAMILIES 

Children of migratory agricultural 
laborers are, economically and so- 
cially, the most depressed group of 




Modern ways of caring for prematures save 
many lives; but the main problem is to re- 
duce the incidence of prematurity through 
adequate care of mothers during pregnancy. 

children in the United States. There 
are between 250,000 and 1,500,000 
of these children. Too many of them 
are growing up without having 
enough of anything: enough food, 
adequate shelter and clothing, ade- 
quate medical care, and basic educa- 
tion. Sickness and mortality rates 
are high among them. As they follow 
the crops, many of these families 
move from one set of makeshift quar- 
ters to another, badly overcrowded, 
dirty, unsanitary, dilapidated. 

Their problem is fundamentally an 



THECHILD VOL. 17N0. 6" 



economic one, and its solution lies in 
long-range social and industrial mea- 
sures. But in the meantime much 
could be done for them. 

Though in some localities these 
families are receiving particular at- 
tention, in others their needs are 
ignored. If efforts to improve their 
situation are to be effective, not only- 
must the several agencies involved 
within a State work together, but 
States must work together coopera- 
tively. Among the measures these 
families need are : Adequate housing ; 
environmental sanitation ; health and 
medical care for infants and expec- 
tant mothers ; health education that 





■ 


n 




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Sl^Ih 






^^^^^^^^^^H 


'^r^M 


mL'- ^Bly 





A boy in trouble with the law wonders what 
will happen to him. If his community has 
good treatment services, he will be helped 
to find his way to normal social adjustment. 



will reach the different cultural 
groups. 

One of the basic handicaps in pro- 
viding help for migrants is the lack 
of coverage by local health units. 
Strengthening local health units 
should have a high priority among 
public-health advances. When these 
exist, especially in rural areas, the 
mechanism will be available for solv- 
ing other urgent health needs. 

Mobile health units may also be a 
-useful device for putting health care 
within reach of these families. Prob- 



ably additional staff — physicians, 
nurses, medical social workers, nutri- 
tionists, health educators — will be 
needed to provide individual care and 
to make arrangements with social 
agencies for welfare services. In view 
of the poor resources these families 
have, provision must be made for 
medical and hospital care. Exchange 
of information between States on a 
planned basis would help to maintain 
the services. 

Another constructive measure for 
health as well as welfare would be 
provision of day-care centers. Since 
in these families both the parents and 
the older children usually work. 




Many children of migrant agricultural labor- 
ers grow up without enough of anything — 
enough food, adequate shelter and clothing, 
adequate medical care, and basic education. 

young children are often left pretty, 
much on their own. In a few States, 
day care is provided, but this type of 
care is sparse indeed. 

State and local health and welfare 
departments, which have the basic 
organization to do the job, should 
take responsibility for administering 
health and welfare services to meet 
the needs of migrants. Migrants 
should not be set off from the rest 
of the population, brt should be en- 
abled to participate in all community 
services as much as possible. 



JUVENILE DELINQUENCY 

One of the most serious by-prod- 
ucts of the general insecurity brought 
about by periods of international un- 
rest — a period such as we are now 
again experiencing — is the marked 
increase in juvenile delinquency. 

Adolescence is a period when youth 
is naturally in revolt against the 
adult world. In seeking their own 
place in the world and establishing 
their identity, adolescents tend to 
band together. They may easily fall 
into antisocial patterns of behavior, 
with which we are familiar in this 
country. They may also be exploited, 
as in totalitarian countries. Adults 
dare not shirk their responsibility to 
understand the behavior of ado- 
lescents and to help direct it into con- 
structive channels. 

Because this problem is becoming 
increasingly serious, the Children's 
Bureau during the past year gave a 
major part of its attention to it. It 
established in the Division of Social 
Services a newly organized Juvenile 
Delinquency Branch. Working closely 
with this Branch is a Special Juve- 
nile Delinquency Project, financed 
through private contributions to the 
Child Welfare League of America. In 
cooperation with the Special Project 
the Children's Bureau has sponsored 
a series of conferences with many 
leaders in this field and with public 
and private agencies. 

The Project and the Bureau have 
been developing material that will be 
of immediate practical value. Many 
States and communities are not clear 
about what kind of services they 
should have. The Project and the 
Bureau have therefore undertaken to 
develop standards, or statements of 
desirable practices, governing juve- 
nile-police services, the juvenile 
court, and the training school. Spe- 
cialists from over the country are, or 
will soon be, working on these stand- 
ards. When completed, they should 
be useful guides in bettering services. 

The Children's Bureau is also pre- 
paring material for the use of State 
agencies when working with their 
State legislatures in the organization 
and administration of services for 
children, including delinquents. 



FEBRUARY 1953 



99 



WORKERS BEHIND THE CHILDREN 



IF PROGRAMS to aid children are 
to be of value, they have to be 
manned by competent people. 
Even though colleges, universities, 
and professional schools are trying 
to increase the number and the skills 
of people competent to vs^ork with 
children, the demand for these work- 
ers far exceeds the supply. 

For this reason one of the major 
uses to which State agencies put their 
Federal grants for maternal and 
child-health, crippled children's, and 
child-welfare services is in special 
training of workers. One way they 
do this is to help finance the cost of 
courses, institutes, or work groups, 
where doctors, nurses, social workers, 
and others can go for specialized 
training in the care of children. An- 
other way is to use some of their 
Federal-State funds for stipends and 
tuition for people to take advanced 
training in some specialized area of 
child care. 

Recently, training opportunities in 
such specialized areas as audiology 
(the science of hearing) , rheumatic 
fever, epilepsy, and care of prema- 
ture infants have been utilized more 
fully by the States. Persons complet- 
ing the special training project in 
audiology at the State University of 
Iowa have taken positions in widely 
scattered States. 



The epilepsy training program in 
Massachusetts trained six physicians 
and five electroencephalographic tech- 
nicians in its first 6 months. 



The 1952 rheumatic-fever work 
group in Connecticut was attended 
by medical, nursing, medical social, 
and administrative personnel from 
rheumatic-fever programs in Cali- 
fornia, Kentucky, Nebraska, New 
Hampshire, Oklahoma, and Washing- 
ton. 



The institutes sponsored by the 
New York Hospital Premature Train- 
ing Project have been attended by 
teams of physicians and nurses from 
New York City, New York State, 
Connecticut, Florida, Maine, New 
Hampshire, New Jersey, North Caro- 
lina, Massachusetts, and Pennsyl- 
vania. 



Additional training facilities in 
public-health nutrition have been set 
up by two schools of public health 
(at the University of Minnesota and 
the University of Pittsburgh) . A 
number of other educational institu- 
tions are attempting to bridge the 
gap between the demand and the sup- 
ply of nutritionists by offering for the 
first time a major in public-health 
nutrition. 

A few States are providing work- 
ers with stipends for the second year 
of medical social work training or for 
an interneship program in medical 
social work in a hospital. Special 
training projects in medical social 
work have been established by three 
States (Illinois, Louisiana, and Mas- 
sachusetts), with schools of social 
work cooperating in preparing medi- 
cal social workers more adequately 
for the maternal and child-health and 
crippled children's programs. 

The shortage of maternity and 
pediatric nurses is particularly seri- 



ous. Advanced programs of study in 
maternity and pediatric nursing have 
been developed in six university cen- 
ters. Scholarship funds are not yet 
suflScient to meet the requests of 
many young nurses who wish to spe- 
cialize in maternal and child care. 



Health personnel working with 
mothers and children need under- 
standing about the emotional grov^rth 
and development of children. Many 
State agencies have been active in 
this field, holding work groups in 
child development for physicians, 
nurses, and other personnel, and help- 
ing medical schools provide training 
in maternal and child-health work. 
An institute for medical social work- 
ers, on growth and development of 
children, organized by the Harvard 
School of Public Health was enthusi- 
astically received. 

State public-welfare agencies are 
making steady progress in training 
and staff-development programs for 
child-welfare staff. This is reflected 
in increases in the positions estab- 
lished for special consultants on staff 
development; in the number of field- 
work training units developed in co- 
operation with schools of social work ; 
in the amounts set aside for profes- 
sional education; and in the number 
of States providing Federal funds for 
salaries of new workers during orien- 
tation before they enroll in a school 
of social work. Work groups and 
institutes, including representatives 
from other public agencies serving 
children and from voluntary agen- 
cies, are being used to a greater ex- 
tent as a medium for staff develop- 
ment. 



100 



THE CHILD VOL. 17 NO. 8 



QUEST FOR KNOWLEDGE 



FORTY-THREE years ago, the 
President of the United States, 
in urging the creation of a Chil- 
dren's Bureau, said this in a Message 
to Congress : 

"It is not only discreditable to us 
as a people that there is now no rec- 
ognized and authoritative source of 
information upon these subjects re- 
lating to child life, but in the absence 
of such information as should be 
supplied by the Federal Government 
many abuses have gone unchecked ; 
for public sentiment, with its great 
corrective power, can only be 
aroused by full knowledge of the 
facts." 

Two years later a Children's Bu- 
reau came into existence by Act of 
Congress. The act creating it charged 
it to investigate and report on child 
life. 

For close to 41 years this Bureau 
has been gathering facts about chil- 
dren and ways of caring for them. 
Because it has always been a small 
bureau and the child population has, 
happily, been large, it has had to be 
selective about the aspects of child 
life which it studied. 

Main target of its investigations 
through the years has been the plight 
of disadvantaged children: babies 
who die in infancy ; children who are 
beyond the reach of good health ser- 
vices; infants born to unmarried 
mothers ; children who have lost their 
parents or whose parents are unable 
to carry their responsibilities for 
their children; juvenile delinquents; 
children who go to work at too early 
an age and in hazardous occupations ; 
crippled and handicapped children. 

"Public sentiment, with its great 
corrective power," informed by these 
studies, has corrected many of the 
"abuses" that were common four 
decades ago. Many State laws today 
deal more wisely with the child who 
is in trouble with the law; the child 
who is to be adopted; the child who 
I has been neglected or abused ; the 
child for whom a legal guardian must 



be approved by the court; the child 
who is crippled. 

Federal laws, too, have reflected 
the findings of these studies. Out of 
the Bureau's investigations, at least 
in part, flowed the Sheppard-Towner 
Maternity and Infancy Act of the 
20's — the first Federal law to put 
Federal funds in the hands of State 
departments of health for extending 
and improving their maternal and 
child-health services. In the 30's came 
the Social Security Act, again to 
strengthen State and local maternal 



HOW . . . WHEN . . . FROM 
WHERE WILL ANSWERS 
COME TO SUCH QUES- 
TIONS AS THESE . . . 

How many feeble-minded children 
are there who should be cared for 
at home rather than in institu- 
tions? 

Is the health of school children 
improving through existing school 
health services? 

W'hy are some physically handi- 
capped children able to function 
well socially when others, with the 
same handicap, cannot? 

Could well-child clinics do a more 
effective job of preventing illness? 

Which adoptions turn out well? 

What becomes of children of un- 
married mothers who are refused 
Aid to Dependent Children? 



and child-health services, and to do 
the same for the social services chil- 
dren need. Behind the program of Aid 
to Dependent Children, provided for 
in the same act, were many studies 
made by the Bureau into the problems 
of mothers who had to carry entire 
responsibility for their children. The 
child-labor provisions of the Fair 
Labor Standards Act of the late 30's 
had as a forerunner years of Bureau 



investigation into conditions of child 
employment. 

At the turn of the midcentury, a 
year ago, the Bureau took a long look 
at its record of investigations. It had 
earlier called in experts from a wide 
variety of research fields to advise 
the Bureau on future plans. With 
them, the Bureau pondered at length 
its responsibility as the Federal Gov- 
ernment's chief investigator of "all 
matters pertaining to the welfare of 
children and child life among all 
classes of our people." 

Clearly the job of fact finding had 
not come to an end. Indeed, the pres- 
sure on the Bureau for more and 
more facts had grown with the years. 
With the establishment of the ma- 
ternal- and child-welfare programs 
under the Social Security Act, a mul- 
titude of questions and problems 
arising out of the service programs 
had turned up for study and answer. 
The questions, too, had become more 
difficult to answer as the people con- 
cerned about the well-being of chil- 
dren had grown more sensitive to the 
emotional needs of growing human 
beings. 

For four years the Bureau has 
maintained a Clearinghouse of infor- 
mation on research on child life con- 
ducted in universities and other cen- 
ters around the country. From this, 
it has gathered a general view of 
where the answers to questions about 
children might be forthcoming from 
others. 

Out of this review, the Bureau has 
now drawn its plan of investigations 
for the immediate years ahead. For 
the present, at least, the Bureau pro- 
poses to hold rather closely to the line 
suggested by its past studies, focus- 
ing its investigations on children 
whose health or welfare is in jeop- 
ardy. Studies of such children can 
add greatly to knowledge of child 
life in general, for they will raise and 
deal with questions of fundamental 
importance for the health and wel- 
fare of all childi'en. 

(Continued on page 103) 



FEBRUARY 1953 



101 



TEAMWORK HELPS 



Cooperation with otiier countries 

Although this Nation has large 
concerns in improving the chances of 
its own children, it realizes more and 
more that their well-being is affected 
by the well-being of children in other 
countries. The Children's Bureau has 
for years exchanged experience and 
ideas with children's agencies in 
other countries. In recent years the 
scope of its international program 
has broadened. 

Under Point IV, for example, the 
Bureau is responsible for sending 
specialists to assist in establishing 
or improving programs of social ser- 
vices for children and of maternal 
and child health, when countries re- 
quest our Government for such help. 
At the present time the Bureau has 
12 such specialists working abroad. 

■ Many specialists in maternal and 
child health and child welfare come 
to the United States, under various 
auspices or independently, to study 
and observe activities of public and 
private social or health agencies. The 
Children's Bureau is responsible for 
planning programs of study and ob- 
servation for these specialists. 

Many of these visitors are spon- 
sored by the United Nations Secre- 
tariat, some by the World Health Or- 
ganization, others by the Mutual Se- 
curity Agency. The Department of 
State sponsors certain leaders from 
many countries, including former 
enemy nations, as well as visitors 
under the sponsorship of their own 
governments. 

During the fiscal year 1952 pro- 
grams of observation and study were 
planned and arranged for 66 visitors 
from 29 countries (in this country 
for periods varying from a month to 
2 years) ; and interviews, group dis- 
cussions, and brief observation for 
257 visitors from 48 countries (for 
periods varying from a day to sev- 
eral weeks) . 

Cooperation witli otiier Federal agencies 

By May 1953 the Interdepartmen- 
tal Committee on Children and Youth 



102 



will have completed 5 years of shar- 
ing information about their programs 
affecting the well-being of children 
and youth. Through this exchange, 
cooperative effort between the mem- 
ber agencies has been greatly 
strengthened. 

The committee, which includes 35 
representatives of Federal agencies 
and their subdivisions, has met 
monthly since May 1948, when it was 
created at the request of the Presi- 
dent of the United States. 

Much of the committee's work goes 
forward through subcommittees. One 
subcommittee, on "Research in the 
Federal Government on Problems of 
Child Life," is chaired by a repre- 
sentative of the National Institute of 
Health. Another is working on "Care 
of American and American-Related 
Children Outside the United States," 
under the chairmanship of a member 
of the Defense Department. A third, 
whose chairman is on the staff of the 
Department of Labor, is studying 
"Children in Families of Migratory 
Agricultural Workers." 

Several of the committee's impor- 
tant problems have been discussed at 
seminars, at which consultants from 
different parts of the country con- 
tribute experience and ideas. 

The first of these, held with the 
help of the Josiah Macy, Jr., Founda- 
tion, was developed to help the com- 



mittee consider how the philosophy 
and findings of the Midcentury White 
House Conference on Children and 
Youth could be woven into Federal 
programs affecting children and 
young people. 

Understanding and Working To- 
gether on Juvenile Delinquency was 
the subject of the second seminar. 

The committee's most recent semi- 
nar aimed to arrive at a plan whereby 
all interested Federal agencies can 
work together in behalf of children 
of agricultural migratory laborers. 

The commmittee has issued three 
reports : "The Needs of Children of 
Puerto Rico" (1950), "Programs of 
the Federal Government Affecting 
Children and Youth" (1951), and 
"Youth — the Nation's Richest Re- 
source" (1953). 

Among the agencies represented are: De- 
partment of Agriculture (Extension Ser- 
vice; Production and Marketing Adminis- 
tration). Department of Defense (Depart- 
ments of the Army, Navy, and Air Force). 
Department of the Interior (Bureau of 
Indian Affairs; Office of Territories). De- 
partment of Justice (Bureau of Prisons). 
Department of Labor (Bureau of Labor 
Standards ; Bureau of Employment Secur- 
ity; Wage and Hour and Public Contracts 
Divisions). Department of State (five sub- 
divisions). Administrative Office of the 
U. S. Courts (Division of Probation). Fed- 
eral Security Agency (Children's Bureau; 
Bureau of Public Assistance; Office of Edu- 
cation; Public Health Service; Bureau of 
Old Age and Survivors Insurance; Office 
of Vocational Rehabilitation). Housing and 
Home Finance Agency (Public Housing 
Administration). Selective Service System. 
The committee also includes a consultant 
from the Bureau of the Budget. 



Children benefit through cooperation between nations. This mother is learning how to care 
for her baby through a program carried on by Pakistan's Government with the help of the 
United Nations International Children's Emergency Fund and the World Health Organization. 




QUEST FOR KNOWLEDGE 

{Co>ttinued from page 101) 

Many thousands of children, for 
one reason or another — such as their 
own illness, or the death of or neglect 
by their parents, or their own illegiti- 
mate birth — are separated from their 
parents. Sometimes this separation 
is short; sometimes it is for life. 
Health and social workers are often 
involved in such separations and so 
must know how to deal with them 
wisely. 

Because such situations may cause 
deep-seated difficulties for many chil- 
dren and because they have been 
studied so little, the Bureau is making 
them the focus of its investigations 
in the immediate future. At first a 
small study to test out research 
method will be made. Depending on 
its outcome, a broader piece of re- 
search will be undertaken in this field 
later. 

Such questions as these will be ex- 
plored : How harmful is the separa- 
tion of a child from his parents? At 
what ages, under what circumstances, 
in what ways, and to what extent is 
it damaging? By what means can 
the detrimental effects of separation 
from parents be overcome? 

To learn|about delinquency 

Another line of inquiry which the 
Bureau will pursue in the near future 
concerns juvenile delinquency. Out 
of this study the Bureau hopes to find 
answers to such questions as these: 
What different methods have been at- 
tempted to reduce the incidence of 
juvenile delinquency? How successful 
did they prove to be? Do some meth- 
ods prove to be more effective with 
some boys and girls? Does experience 
point to new and better ways of 
treating these youngsters? 

Again, this would be a pilot investi- 
gation, a gathering together of cur- 
rent knowledge, intended to pave the 
way to more comprehensive research 
later. This might be undertaken by 
some other research organization, by 
itself or in cooperation with the 
Bureau. 

The whole area of parental atti- 
tudes toward child rearing presents 
many difficult questions crying for 
answers. To what extent are parents 



unduly worried about how to bring 
up their children? Are over-worried 
parents found in all economic and 
cultural groups? How can such undue 
anxiety be alleviated? How success- 
ful have the various means of educat- 
ing parents been in reducing over- 
concern in parents? Exploration of 
such questions is something which 
the Bureau cannot undertake in the 
near future, but it is on the Bureau's 
long-time calendar. 

How effective is the worit for cliildren? 

Like all sound business enterprises, 
many health and welfare agencies 
serving children, eager to make their 
time, their skills, and their dollars 
produce the greatest possible good 
for their clients, are asking for help 
in appraising the effectiveness of 
their operations. Because of their 
close working relations with the Chil- 
dren's Bureau under the grant-in-aid 
child health or welfare programs, 
some of them turn to this Bureau for 
advice on how such studies can be 
made. A part of the time of the Bu- 
reau's research staff is, therefore, 
earmarked for this kind of assistance. 
The staff is still small, however, so 
the amount of consultation that can 
be given is limited. To spread its 
knowledge more widely, the staff is 
preparing a report on methodology 
of this kind of research which will 
be shared with all interested child- 
health and welfare agencies. 

As the Children's Bureau moves 
into its fifth decade of investigating 
and reporting, it rededicates itself 
to finding new or better guides to help 
parents and workers give all children 
the fair chance they should have for 
a useful and satisfying life. 



CALENDAR 



Feb. 2. Natioiiul Children's Dental 
Health Day. 5th annual observ- 
ance. Information from Bureau of 
Public Information, American Den- 
tal Association, 222 East Superior 
Street, Chicago 11. 111. 

Feb. 7-13. Boy Scout Week. 43rd an- 
niversary. Information from Boy 
Scouts of America, 2 Park Avenue, 
New York 16, N. Y. 

Feb. S-15. Negro History Week. 28th 



annual observance. Information 
from the Association for the Study 
of Negro Life and History, 1538 
Ninth Street, N.W., Washington 1, 
D. C. 
Feb. 15-22. Brotherhood Week. 19th 
annual observance. Sponsored by 
the National Conference of Chris- 
tians and Jews. Information from 
the National Conference of Chris- 
tians and Jews, 381 Fourth Ave- 
nue, New York 16, N. Y. 
Feb. 18-20. National Conference 
of Superintendents of Training 
Schools and Reformatories. 30th 
annual meeting. New York, N. Y. 
Feb. 23-25. American Orthopsychia- 
tric Association. 30th annual meet- 
ing. Cleveland, Ohio. 
Feb. 27-28. Eighth National Confer- 
ence on Rural Health. Council on 
Rural Health, American Medical 
Association. Roanoke, Va. 
Regional conferences. Child Wel- 
fare League of America: 

Feb. 4-6. Eastern Region. Asbury 
Park, N. J. 

Mar. 16-18. Central Region. Co- 
lumbus, Ohio. 

Apr. 16-18. Southern Region. Nash- 
ville, Tenn. 

Apr. 26-28. South Pacific Region. 
Berkeley, Calif. 

Apr. 30-May 2. North Pacific Re- 
gion. Seattle, Wash. 

Area conferences. National Child 
Welfare Division, American Legion: 
Feb. 6-7. Area B — Delaware, Dis- 
trict of Columbia, Maryland, New 
Jersey, New York, Pennsylvania, 
Puerto Rico, Virginia, West Virginia. 
Feb. 12-14. Area C— Alabama, Ar- 
kansas, Florida, Georgia, Kentucky, 
Louisiana, Mississippi, North Caro- 
lina, Oklahoma, Panama Canal Zone, 
South Carolina, Tennessee, Texas. 

Mar. 13-14 (tentative). Area A — 
Connecticut, Maine, Massachusetts, 
New Hampshire, Rhode Island, Ver- 
mont. 

• 

The National Midcentury Committee on 
Children and Youth has closed its office in 
New York. Inquiries may be addressed to 
the chairman. Leonard W. Mavo, Room 700, 
580 Fifth Avenue, New York 36. N. Y. 

Illustrations: 

Cover and page 9.5, left. Esther Bublev. 

Page 90, Philip Bonn. 

Page 91, left and right, Rie Gaddis Photog- 
raphy, Chicago. 

Page 95, right. New York State College of 
Home Economics at Cornell Universitv. 

Page B(i, left. Public Health Service," Fed- 
eral Security Agency. 

Page 96, center, Kentucky Society for 
Crippled Children. 

Page 96. right, Lilo Kaskell, New York. 

Page 98, Virginia State Department of 
Health. 

Page 99, left. Look Magazine photograph. 

Page 99, right. Library of Congress photo- 
graph. 

Page 102, Unations. 



FEBRUARY 1953 



103 




VOL. 17 NO. 6 
FEBRUARY 1953 



In This Issue 

Page 

Nearly 4 Million New Chances 90 

To Better Children's Chances 94 

Some Children Are Winners 96 

Children in Special Jeopardy 98 

Workers Behind the Children 100 

Quest for Knowledge 101 

Teamwork Helps, 102 



Published 10 times a year by the Division of Reports, Children's Bureau 
Editor, Sarah L. Doran Art Editor, Philip Bonn 

FEDERAL SECURITY AGENCY 
Oveta Culp Hobby, Administrator 

SOCIAL SECURITY ADMINISTRATION CHILDREN'S BUREAU 

Arthur J. Altmeyer, Commissioner Martha M. Eliot, M.D., Chief 

Publication of THE CHILD, monthly bulletin, has been authorized by the Bureau of 
the Budget, September 19, 1950, to meet the needs of agencies working with or for 
children. The Children's Bureau does not necessarily assume responsibility for 
statements or opinions of contributors not connected with the Bureau. 

THE CHILD is sent free, on request, to libraries and to public employees in fields 
concerning children; address requests to the Children's Bureau, Federal Security 
Agency, Washington 25, D. C. For others the subscription price is $1.25 a year. On 
all orders of 100 or more sent to one address there is a discount of 25 percent. Single 
copies 15 cents each. Send your remittance to the Superintendent of Documents, 
Government Printing Office, Washington 25, D. C. 

Foreign postage — 25 cents additional — must be paid on all subscriptions to 
countries in the Eastern Hemisphere and those sent to Argentina and Brazil. 
Domestic postage applies to all other subscriptions. 



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MARCH 1953 




PARENTS LEARN 
ABOUT THEIR 



PREMATURE BABY 

Boston Public i^. ,-^^, 
Superintendent of Documents 

MAYl 1953 



Hospital holds 
discussion groups to help 
fathers and mothers 
whose baby 
is born ahead of time 



GELLESTRINA DIMAGGIO, R.N. 

and 

MARGUERITE B. GELINAS 

HEN A BABY is born pre- 
maturely in our hospital, we 
of the staff try to reassure the 
parents and help them to solve their 
problems concerning the baby. Some 
parents are afraid that they are 
responsible for the baby's prema- 
turity, and sometimes one parent 
thinks the other is at fault. Most 
do not understand why a prem.ature 
baby needs such special care. A large 
number fear that the baby will be 
mentally retarded, or in some way 
marked. Many other doubts and fears 
plague the parents of a premature 
baby. 

Meeting supplements hospita! teacfiing 

In the comparatvely short time the 
mother remains in the hospital it is 
impossible for the staff to give the 
parents all the information and reas- 
surance they need, even though the 
doctor, the nurses, and the medical 
social worker do what they can in 
the time available. 

Since we staff members cannot 
help the parents as much as we should 
like to during the mother's hospitali- 
zation, we take a step toward help- 
ing them later. For this purpose we 
invite the parents of each premature 
baby to meet with some of us, along 
with a group of other such parents 
soon after the mother is discharged, 
while the baby is still in the hospital. 

Before the mother goes home the 



medical social worker tells her and 
the father about the meeting. She 
says that it will be held some evening 
within a month, at the hospital, and 
that three hospital staff members that 
the parents already know will be 
there to answer questions. These staff 
members are: a doctor (who is an 
assistant resident assigned to the 
pediatric ward) ; a nurse; and the 
medical social worker. The medical 
social worker points out to the father 
and mother that other parents may 
have problems like theirs, and that 
the various couples will have a chance 
to exchange ideas. She encourages 
them to go to the meeting and to ex- 
press their views, and she helps them 
to formulate some of the questions 
they have in the back of their minds 
so that they can be more ready to 
ask them at the meeting. Lastly she 
tells them that they will soon receive 
a postal card telling them when the 
meeting will be held. 

We find that if the postal card is 
followed by a personal invitation 
from the nurse, the doctor, or the 



GELLESTRINA DIMAGGIO, R.N.. is Admin- 
istrative Supervisor on the Children's Ser- 
vice at the Grace-New Haven Community 
Hospital, New Haven, Conn. She received 
her degree as master of nursing from Yale 
University School of Nursing. 

MARGUERITE GELINAS is the in-patient 
Pediatric Social Worker at the Grace-New 
Haven Community Hospital. She received 
her master's degree in social work from 
Simmons College and has worked at the 
Gushing Veterans Administration Hospital in 
Framington, Mass. 

This article is an outgrowth of material 
prepared for the eightieth National Confer- 
ence of the American Public Health Asso- 
ciation. 



medical social worker, the couples in- 
vited are more likely to come. We 
welcome also grandmothers, aunts, 
and others who will be helping to 
care for the baby. 

On the evening of the meeting the 
parents gather in a conference room 
adjoining the children's ward in the 
hospital, and they sit in easy chairs, 
in an informal circle. The doctor in- 
troduces the couples to one another 
and says a few words about the pur- 
pose of the meeting. He then goes on 
to tell the parents some of the facts 
about prematurity. Now and then 
during the doctor's talk the nurse and 
the medical social worker (the pres- 
ent writers) raise questions that we 
know some of the parents wish to 
have answered. 

Prematurity explained 

The doctor explains what happens 
when a baby is born prematurely and 
tells what is known about the causes 
of premature birth. Then he makes 
clear why the baby must be kept un- 
der special care in the hospital until 
he has developed sufficiently to be 
taken home like other babies, and he 
points out the great importance of 
gain in the premature baby's weight, 
which shows that he is becoming 
more mature — more like a full-term 
baby. 

Explaining the purpose of incuba- 
tors, he tells about the special pre- 
cautions that must be taken when a 
baby is in an incubator. 

The special hospital care, the doc- 
tor goes on, brings the baby through 



106 



THE CHILD VOL. 17 NO. 7 




A nurse shows how she holds a premature baby in her arms while giving him feedings. 



the ci'ucial period after premature 
birth by providing, so far as possible, 
the protection he would have had if 
he had remained in his mother's body 
for the full term. The doctor helps 
the parents to see that when they take 
their baby home they can treat him 
just like a full-term newborn baby. 

The doctor explains why the baby 
needs to be followed up by an oph- 
thalmologist. The explanation is pre- 
sented to the parents as a precaution- 
ary measure even though only a very 
small percentage of babies develop 
retrolentral fibroplasia, an eye condi- 
tion associated with prematurity. 

When the doctor is through speak- 
ing, he asks the nurse to tell a little 
about the care that the nurses give 
to a premature baby and to offer the 
parenls some suggestions on caring 
for the baby after he is taken home. 

The nurse tells the parents that a 
premature baby needs much more at- 
tention when he is little than does a 
full-term newborn baby, and that the 
smaller the baby the more nursing 
care he needs. She says that the very 
small baby, who needs incubator care, 
remains in the incubator as long as 
his body temperature is unstable and 
as long as he needs to be given 



oxygen ; later he will be placed in a 
little crib. When he is very small, she 
goes on, he is too weak to suck, and is 
fed through a tube or with a medicine 
dropper while he lies in the incubator. 
Later, when he is strong enough to 
suck, a nurse holds him in her arms 
and gives him his feedings from a 
nursing bottle. 

Shs encourages the parents to come 
in during the baby's last few weeks 
in the hospital to visit, hold, feed, 
bathe, and get acquainted with him, 
explaining that when the baby is 
ready to be discharged, he has been 
receiving for a week or two the reg- 
ular baby care that the mother her- 
self will give. 

The nurse tells the gi'oup that a 
day's supply of formula will be given 
the family on discharge. A discus- 
sion usually follows as to the type of 
formula that will be needed and how 
to prepare it at home. 

Many questions asked 

Questions that parents frequently 
ask the nurse are : When can we take 
the baby outdoors? What should be 
the temperature of the baby's room? 
Can we open the window? May the 
baby have sun baths? Do we have 



to give any particular care to the 
baby's clothes? Can we use commer- 
cial diaper service? What kind of 
skin care should the baby have? Is a 
flexible schedule suitable for prema- 
ture babies? 

She explains also that some one on 
the hospital staff will ask the visit- 
ing nurse to look in on the mother 
and baby in the home a few times to 
be sure that everything is going well. 
This is not because we expect any 
difficulties, but because we feel it 
gives a sense of security to the mother 
and helps bridge the gap from hos- 
pital to home for the baby. The par- 
ents are glad to have this help; as a 
rule they have already been visited 
by the nurse before they attend this 
meeting. They know who she is, 
remember what she has discussed 
with them, and realize that she will 
help them to prepare the home for the 
coming of the baby and that she will 
visit the baby after he is discharged 
from the hospital. 

During the nurse's talk the medical 
social worker and the doctor ask 
questions as a step toward amplify- 
ing some of the points she brings up. 

After the nurse finishes, the medi- 
cal social worker talks with the 
group of parents about various ques- 
tions, most of which the parents have 
already mentioned to her. Most of 
these questions revolve around six 
topics : 

1. Why was this child premature? 
One young mother attributed the 

premature birth to the fact that she 
washed a floor once during preg- 
nancy. After the baby was born her 
anxious husband told her that he 
would be boss during the next pre- 
natal period. 

2. What can be expected of the 
growth and development of a pre- 
mature baby? 

One father was sure that the child 
would be an idiot. He could see the 
child was v\'ell formed, but he felt 
that some major mark of prematurity 
must remain. 

3. Is there danger of overprotect- 
ing the baby because he is prema- 
ture? 

The word "premature" is discussed, 
and emphasis given to what may hap- 



MARCH 1S53 



107 



pen if the parents continue to think 
of the child as being premature after 
he has reached the stage where his 
development is going along at a nor- 
mal pace. 

4. How should the other children 
at home be prepared for the home- 
coming of the premature baby? 

What the parents have already told 
the other children is discussed, as well 
as what the other youngsters expect 
this baby to look like when he is 
brought home, since he may be 
smaller than they expect. 

5. What are the feelings of the 
parents themselves about not having 
had the baby at home with them dur- 
ing his long hospital stay, and how 



Some parents feel that this baby 
may be more fragile than their other 
children were or that they may ex- 
pect too much of him during his per- 
iod of growth. 

In the discussion, individual mem- 
bers support and stimulate one an- 
other. Sometimes a shy mother will 
speak up when the parent next to her 
asks a question bordering on one she 
herself has in mind. 

We have learned the value of recog- 
nizing the parent who might be a 
good discussion leader. If this par- 
ent's interest is stimulated he or she 
may be able to initiate discussion 
around particular points. 

Often intelligent, articulate par- 




This premature baby is just as well-developed as a full-term newborn baby, after comple- 
tion of his special hospital care. His parents were not worried, for hospital staff members 
had helped them realize that the baby would soon catch up with normal development. 



might their feelings affect their care 
of the baby during the post-hospitali- 
zation period? 

This question is closely related to 
the feelings of guilt that some par- 
ents have when they imagine that 
they have done something during the 
mother's pregnancy that might have 
brought on the premature birth — or 
that they have neglected to take some 
necessary precautions. 

6. Might the parents feel insecure 
in caring for such a small baby? 



ents who have had a previous pre- 
mature baby are present. Such par- 
ents can speak from experience and 
can supply concrete examples of some 
of the problems involved in the care 
of these babies. They can also de- 
scribe their methods of solving those 
problems. 

The staff assisting with the meet- 
ings has learned a great deal. We 
have seen that a simple explanation 
to the parents about prematurity does 
not necessarily tell them all they 



want to know. They must be given 
an opportunity to express their 
doubts and fears. The discussions at 
the meetings show us where each 
couple needs help most. 

Most of the parents come to only 
one meeting, though a few come to 
the next one if their child is in the 
hospital for more than a month. Par- 
ents seem to get enough help from 
one group session to enable them to 
work more effectively with the medi- 
cal social worker, the doctor, and the 
nurse on the ward if the premature 
baby is still in the hospital, or with 
the visiting nurse if he is already at 
home. 

Attendance at the meetings varies 
greatly. Usually only three or four 
sets of parents attend. The number 
seems to vary according to how many 
premature babies are in the hospital 
and the time of the babies' stay there. 
We feel that the attendance is also 
related to the spacing of the meet- 
ings. In the future we hope to reach 
more parents by having the meetings 
every 3 weeks instead of once a 
month. 

It may also be true that the parents 
of a premature baby who is already 
at home may not feel they need to 
attend the meeting if things are go- 
ing well with them and with the 
baby. 

Most of the parents feel that these 
meetings are helpful to them; they 
feel that we are interested in them 
as well as in the baby; and in talk- 
ing with other parents face to face 
they realize that they are not the only 
ones who have questions about their 
baby. 

The help given at the meeting, ac- 
cording to many parents, makes their 
adjustment to their baby easier. 

We have found the program ex- 
tremely valuable in helping parents 
give better care to their premature 
babies. We are examining the pro- 
cedure and seeking methods of im- 
provement. This has been an inter- 
esting experience for all of us and 
one that we hope has contributed to 
the care of premature babies in 
general. 

Reprints in about 6 weeks 

THE CHILD VOL 17 NO. 7 



I 



SOCIAL AGENCIES CAN IMPROVE 
STAFF TRAINING 



ALICE L. TAYLOR 

FOR HALF A CENTURY, par- 
ticularly in the last 15 years, 
the social-work profession has 
been talking about the preparation of 
social workers and who should be re- 
sponsible for it. We are still saying 
many of the things that we have said 
in the past, but two important steps 
have been taken toward clarifying 
the problem and solving it. 

One of these is the completion of 
the Bureau of Labor Statistics sur- 
vey, "Social Workers in 1950" (pub- 
lished by the American Association 
of Social Workers, 1952). This re- 
port gives, among other facts, the 
number of workers in various posi- 
tions in social-work agencies and 
their education and experience. The 
facts are sobering, because they point 
out serious lacks in the educational 
status of the profession. 

The other step was taken when a 
new national body, the Council on 
Social Work Education, was formed 
in 1952. The Council represents not 
only graduate schools of social work 
and agencies employing social work- 
ers, but also undergraduate colleges, 
professional social-work organiza- 
tions, and the general public. Under 
the Council's constitution, the agen- 
cies assume a share of the responsi- 
bility for developing policies, prin- 
ciples, and programs for education in 
social work. The other groups repre- 




Expcriencf. based on professional education, 
in helping people. These skills can be de 

sented on the Council also share in 

this responsibility. 

As a result of these two important 
happenings we now have not only 
some facts on which planning for 
social-work education can be based, 
but also a broadly representative 
body to lead and coordinate this 
planning. 

As a base from which to plan, both 
for preparing new social workers and 
for giving additional training to those 



ALICE L. TAYLOR, Special Lecturer, How- 
ard LTniversity School of Social Work, is a 
graduate of the George Warren Brown 
School of Social Work, W'ashington L'niver- 
sity, St. Louis, Mo. She was a specialist 
on training and education in the Division of 
Technical Training in the Federal Security 
Agency's Bureau of Public Assistance, 1945- 
1952. 

Miss Taylor has been associated with the 
St. Louis Provident Association, the Missouri 
Social Security Commission, and the Nebras- 
ka Division of Child Welfare and Public 
Assistance. She has been on the faculties 
of the schools of social work of the Univer- 



sity of Nebraska, the University of British 
Columbia, and McGill LTniversity, and has 
supervised field-work students from the L'ni- 
versity of Chicago, the LTniversity of Mis- 
souri, St. Louis University, and Washington 
L'niversity. 

With Dr. Ernest V. Hollis, Miss Taylor is 
co-author of "Social Work Education in the 
L^nited States" (Columbia University Press, 

1951). 

This article is condensed from a paper 
.Miss Taylor gave at the seventy-ninth annual 
meeting of the National Conference of Social 
Work, held at Chicago. 



enables a social worker to develop her skills 
veloped further through in-service training. 

already employed, let us look at the 
total number of positions in social- 
work agencies in the United States. 
In June 1950 this number was 75,000, 
the Bureau of Labor Statistics study 
shows; and only one-sixth of the 
people in these positions had had the 
two years of graduate study in social 
work that is now generally accepted 
as professional preparation for a 
social worker. 

These figures give us a rough idea 
of what social workers lack in the 
way of professional education. But we 
cannot be sure that the figure 75,000 
represents the upper limit of the num- 
ber of social-work positions for which 
educational planning needs to be con- 
sidered. 

Why is it not necessarily the upper 
limit? 

1. Because no comprehensive study 
has been made to determine what each 



MARCH 1953 



109 



of these 75,000 positions requires 
with regard to knowledge and skill. 

2. Because we do not know how 
many additional social workers will 
be employed in established social-wel- 
fare programs, or in new social serv- 
ices, or in the social-work programs 
of organizations that are not primar- 
ily social agencies. Additional social 
workers may be employed by the 
public-health services and by large 
private medical-care programs. They 
may take positions with labor unions 
and industry; they may join the staffs 
of public schools ; and they may enter 
the international field of social work. 

3. Because more than 40 percent of 
these 75,000 positions are in public- 
assistance work, the need for which 
should decrease as more people are 
covered by social insurance and as in- 
surance payments to individuals be- 
come more adequate. Thus, we do not 
know how many staff members will 
be necessary in order to serve the 
people still needing public assistance. 
Again, we do not know what qualifi- 
cations will be required of these work- 
ers nor of those carrying social-work 
functions in insurance programs. 

Since we cannot know how various 
factors will affect the number of 
social workers needed, we must, for 
the time being, consider 75,000 social- 
work positions as a basis for planning 
improvements in professional prep- 
aration. 

At the same time we recognize that 
the distribution of workers among 
programs and the qualifications re- 
quired in the various positions may 
shift with continued movement of 
workers, with more knowledge about 
the specifics of practice, and with re- 
finement of our professional knowl- 
edge and skills through research. 

The Bureau of Labor Statistics fig- 
ures, of course, can give us little on 
quality of service and individual com- 
petence. Social work differs from pro- 
fessions like law and medicine, whose 
practitioners are licensed as compe- 
tent to practice. To identify a social 
woi'ker who is professionally quali- 
fied, a social agency depends upon the 
amount and kind of education he has 
and on his membership in profes- 
sional organizations, based on educa- 



110 



tional requirements. In a public 
agency the merit system may deline- 
ate further qualifications required of 
the social worker. 

The social worker practices, not on 
his own, but within the structure of 
agency administration, policy, philos- 
ophy, and supervision, all of which 
are subject to review by the commu- 
nity; for example, by a board or a 
council of social agencies, or through 
legislative study, or through a licens- 
ing procedure, as in a child-welfare 
agency. Although social workers 
hold themselves individually respon- 
sible as professional people, they 
should recognize the importance to 
the public interest of the supervisory 
structure within which they operate. 

The community depends for protec- 
tion upon the agency's upholding the 
quality of its service through selec- 
tion of qualified staff, through ad- 
ministrative standards, and through 
supervision and continuing develop- 
ment of staff on the job. 

In view of the lack of full profes- 
sional preparation of five-sixths of 
the workers already employed by 
social agencies, as shown by the Bu- 
reau of Labor Statistics report, and 
the many changes occurring in the 
field, it is clear that some practical 
steps need to be taken by the agencies 
toward improving the training of 
their workers. 

We are generally agreed that agen- 
cies have two goals in staff develop- 
ment : The first is to get the agency's 

A child welfare worker helps a child and his foster parents better when her natural ability 
and her training are backed up by good agency supervision and continued in-service training. 



work done effectively. The second is 
to help each employee, trained or un- 
trained, to keep abreast of the field 
and to develop as he carries out his 
part of the work. These two purposes 
are not to be looked at as primary and 
secondary purposes, but rather as as- 
sociated goals. 

Survey figures point to need 

There is no doubt that all agencies, 
particularly the public social services, 
have urgent responsibilities for staff 
training. The needs of the public 
services are especially clear from fig- 
ures in the survey showing that gov- 
ernmental workers at the State and 
local level have had the least educa- 
tion and experience. 

Also, the fact must be faced square- 
ly that for years to come the agencies 
will have to operate with a number 
of untrained workers. This points to 
the need for a study of agency prac- 
tice to determine which jobs require 
professional training as a "must." 

An agency in the long view should 
aim at engaging persons with a col- 
lege degree as a minimum educational 
requirement. This is important, par- 
ticularly as the degree is one require- 
ment for admission to a school of 
social work, and the worker may later 
be given educational leave to enter 
such a school. 

For older, untrained workers who 
have demonstrated ability and ca- 
pacity for growth, on-the-job training 
will continue to be the chief measure 




by which their competence can be 
improved. Refresher opportunities 
should be provided by the agency to 
keep workers up to date. With social 
workers at an average age of around 
40 years, we would indeed be a dis- 
couraged profession if we believed 
that only young persons can continue 
to learn. 

Since good supervision is the key- 
stone of an agency's constant efforts 
to improve the work of its staff, let us 
look at the qualifications of the more 
than 6,000 supervisors of casework- 
ers and group workers reported in 
the Bureau of Labor Statistics study. 

In State and local tax-supported 
agencies as a whole — including public 
welfare agencies, courts, hospitals, 
and others — just over half the super- 
visors had had some graduate social- 
work study; another fourth reported 
some other type of graduate study, or 
a bachelor's degree but no graduate 
study. Only about one-sixth had had 
two years or more of graduate social- 
work study. 

In the private agencies almost four- 
fifths of the supervisors reported 
some graduate social-work study, and 
54 per cent had had two years or 
more of graduate social-work study. 

We see that the supervisors in the 
private agencies had more profes- 
sional education than those in the 
public agencies. But even in the pri- 
vate agencies only a little more than 
half the supervisors had had the two 
or more years of graduate social-work 
study now accepted as the profes- 
sional education needed by a social 
worker. Yet the supervisors are re- 
sponsible for teaching other workers 
on the job through the supervisory 
process. 

The supervisors were an experi- 
enced group. About three-fifths of 
them reported 10 or more years of 
social-work experience of various 
types; only 10 percent had had less 
than five years. Experience is exceed- 
ingly important in developing compe- 
tence and expertness, but experience 
needs to be based on professional 
education. 

Whatever the content of the job, if 
persons in supervisory positions are 
to teach staff and otherwise give 



leadership in social work, they should 
be well equipped with social-work 
knowledge and skills. I shall refer to 
this later in discussing the steps that 
agencies should take in staff develop- 
ment. If individuals and communities 
are to receive the social services they 
need, social agencies need to pay spe- 
cial attention to the number and 
qualifications of supervisors, their 
salaries, and the distribution of quali- 
fied supervisors among the various 
services. 

Share responsibility for training 

Let us turn for a moment from the 
number and qualifications of social 
workers to the significance of agency 
membership in the Council on Social 
Work Education. 

The Council recognizes that — 

1. Social-work education is the re- 
sponsibility of the whole profession — 
educators, practitioners, membership 
organizations, social agencies, and 
regulatory bodies. 

2. The public has a stake in the kind 
of social-work education that is pro- 
vided, as this determines largely the 
nature and caliber of services in the 
community. 

How do these principles affect 
agencies that employ social workers? 

Over the years, selected social 
agencies have been contributing to 
social-work education by providing 
field work for students from schools 
of social work. Most agencies have 
followed some plan for training their 
own staffs. 

But do agencies realize what it will 
mean to share fully, through the 
Council, the responsibility for social- 
work education? It will mean that if 
the agencies are dissatisfied with the 
products of social-work education, 
they can no longer complain without 
doing something about it. The agen- 
cies must share fully in a long-range 
plan to improve the preparation of 
social workers. 

Since under the principles agreed 
upon, the agencies have a voice in 
formulating educational policy and 
plans, they will be expected also to 
contribute to carrjing out these poli- 
cies and plans. How can the agencies 
best do this during the next few 



years? I present several suggestions, 
which concern study of agency prac- 
tices, financial support, exchange of 
personnel between schools and agen- 
cies, and staff development within the 
agency, particularly the training of 
supervisors. 

Social agencies should find ways to 
take part in establishing and carrying 
out a profession-wide study of agency 
practice, to include analysis both of 
social-work concepts and of social- 
work jobs. Such a study would help 
point out more clearly the role of 
social work in the community and the 
nature of the qualifications required 
in each of the 75,000 social-work 
positions. 

This tremendous undertaking is 
essential if we are to be clearer about 
what should be taught in agencies and 
in schools. The agencies should carry 
a full share of responsibility in this 
kind of project as the next important 
study among the many areas of social- 
work research that await doing. 

To contribute to such a project, 
agencies will need to give their staffs 
time to work, in groups or individu- 
ally, toward clarifying concepts and 
methods and to designate or prepare 
materials identifying these. This kind 
of activity will contribute directly to 
improving curriculum content. 

The need for a study of practice is 
already under consideration by na- 
tional organizations closely related to 
practice, such as the American Public 
Welfare Association, the American 
Association of Social Workers, and 
the National Social Welfare As- 
sembly. 

Agencies can contribute to the 
study of practice in many ways. 

An agency might study, for ex- 
ample, the relation between the social 
workers' job and jobs of other pro- 
fessional persons, a relation about 
which there is still a good deal of 
confusion. This relation has been 
highlighted in the international field 
through increasing emphasis on team- 
work between social workers and, for 
instance, public-health nurses, and on 
the domestic scene, between social 
workers and clinical psychologists. 

Efforts need to be made, also, to 
answer questions that have arisen as 
to the social-work content in public- 



MARCH 1953 



111 



assistance work and the specific 
knowledge and skills needed by ad- 
ministrators and consultants in large 
public welfare and health programs. 

Delineation of social-work function 
may come more easily if tackled first 
in the better-defined and long-estab- 
lished fields such as child welfare or 
medical social work. 

In placing a child, for example, the 
responsibilities of the social worker, 
the judge, the doctor, and the psy- 
chologist are fairly specific. 

Medical social work, which has 
clarified its functions in relation to 
doctors, nurses, dietitians, and other 
hospital personnel, could well carry 
this on by further delineation of the 
broader medical social work functions 
in large public welfare and health 
programs. In fact, the Federal Secur- 
ity Agency's Children's Bureau has 
begun preliminary exploration of this 
subject with medical social consult- 
ants from State maternal and child 
health and crippled children's pro- 
grams. The Bureau of Public Assist- 
ance is also engaged in this type of 
study, focusing it on the social-service 
components of Aid to Dependent Chil- 
dren. 

Again, agency studies to clarify 
concepts, principles, and processes of 
administration in the public social 
services would help in curriculum re- 
vision to strengthen courses in ad- 
ministration and public welfare. 
Curriculum study by the American 
Association of Schools of Social Work 
has indicated need for such improve- 
ment. Local, State, and Federal agen- 
cies, which have developed and im- 
proved administrative practice in the 
last 15 years, have much to offer 
curriculum. 

Discussion of agency responsibility 
for the study of content of social- 
work practice leads to a second area 
in which agencies should contribute 
to staff development directly and in- 
directly. 

Faculties of schools of social work, 
as well as agency personnel, need re- 
fresher opportunities. Faculty mem- 
bers need more time for research and 
greater opportunity to keep in direct 
touch with agency programs in order 
to distill from practice the principles 
of professional education. This will 



112 



keep social-work education abreast of 
the needs of the field and thus will 
contribute to the competence of 
agency staffs. 

Agencies should consider ways to 
provide opportunities for faculties to 
participate more directly and continu- 
ously in practice. This could be done 
by inviting faculty members to attend 
conferences on policy formulation, to 
join in special agency training ses- 
sions, to help develop — or to carry on 
— research projects, and to partici- 
pate as temporary employees in the 
day-to-day work of the agency during 
the nonteaching semester or while on 
sabbatical leave. Participation in 
these activities would contribute both 
to agencies' administration and to 
faculty development and would help 
to clarify the areas of content that 
should become a part of the cur- 
riculum. 

Another example of a desirable 
two-way flow between the agency and 
the school is the opportunity for 
qualified agency staff to teach, on 
request, in schools of social work. 

To plan in-service training 

This kind of exchange between the 
agency and the school, and on-the-job 
training of staff as outlined below, 
will require that agencies designate 
a portion of the budget for educa- 
tional purposes. Agencies should con- 
sider, also, ways to stabilize this part 
of the budget, so that educational 
planning can be done on a long-range 
basis, say 5 to 10 years. 

Extended use of such educational 
funds to strengthen the qualifications 
of staff on the job should be consid- 
ered. This may well be done : 

1. By establishing a well-balanced 
staff-development plan and a clearly 
written policy to carry it out, includ- 
ing orientation, adequate supervision, 
educational leave, and use of supple- 
mentary resources. 

2. By assigning the staff -training 
function in large agencies to a special 
position, and in small agencies speci- 
fying clearly its place among related 
functions. 

3. By making staff training an in- 
tegral part of the program. 

This requires conviction about staff 



4. By considering plans for educa- 
tional leave. If the agency pays 
salaries, tuition, and travel costs to 
permit staff to obtain basic or special- 
ized training, or refresher courses, 
depending upon the agency's needs, 
this will make formal professional 
education possible for workers. 

To improve its supervisory group, 
for example, agencies should develop 
objective criteria for potential super- 
visors, spot such people within the 
agency, and give them opportunity to 
learn to supervise. This will involve 
practice in supervising others while 
receiving supervision. Developing 
skill on the job on a planned basis 
is essential. Such a program may 
well require special educational-leave 
planning for this group. This kind of 
staff training cannot and need not 
wait on analysis of practice. 

Schools also should consider their 
part in supplementing agency re- 
sources for development of super- 
visors. Supervisors need to be well 
equipped as professional persons, re- 
gardless of the breadth or intensive 
nature of services or program content 
supervised. 

I have not attempted to provide the 
answers to even one of the many com- 
plex problems in development of staff. 
My suggestions will be validated or 
discarded and the answers found only 
as the four groups represented in the 
Council for Social Work Education — 
the agencies, the schools, professional 
organizations, and the general public 
— work together nationally and in 
local and State communities. Develop- 
ment of staff is not the responsibility 
of agencies or schools alone. It must 
be a shared responsibility. 

Reprints in about 6 weeks 

THE CHILD VOL. 17 NO. 7 



RACE PREJUDICEIAND CHILDREN 



KENNETH B. CLARK 

RACE PREJUDICE damages the 
children of the dominant group 
as well as children of the minor- 
ity group against which the prejudice 
is directed. As minority-group chil- 
dren learn about the inferior status 
to which they are assigned — as they 
observe the fact that they are almost 
always kept apart from the dominant 
group, who are treated with more re- 
spect by society as a whole — these 
children may react with deep feelings 
of inferiority and a sense of humilia- 
tion. They lose some of their self- 
esteem; they become doubtful about 
their personal worth. Like all other 
human beings, they need a sense of 
personal dignity ; but almost nowhere 
do they find their dignity as human 
beings respected. 

Under these conditions it is inevit- 
able that the minority-group child is 
thrown into a conflict that affects not 
only his attitudes toward himself but 
also his attitudes toward his group. 
"Am I and my group worthy of no 
more respect that we get?" he asks. 
And thus the seeds of self -hatred and 
of rejection of his own group are 
sown. 

These children need to find some 
way in which to deal with their con- 
fusion. The way in which a given 
child resolves this basic conflict de- 
pends upon many interrelated factors. 
Among these are : the cultural and 
historical background of his particu- 
lar minority group; the social and 
economic class of his family ; the sta- 
bility and quality of his family re- 
lations; the cultural and educational 
background of his parents ; his own 
personal characteristics, intelligence, 
special talents, and personality pat- 
tern. 

Not all minority-group children re- 
act to racial rejection with the same 
patterns of behavior. Some children, 




^•H^ 



Not all children are learning to build up prejudice against persons of minority groups. 



usually of the lower socio-economic 
classes, may react by overt aggression 
and hostility, directed toward their 
own group or toward members of the 
dominant group. Then the larger 
society may not only punish the chil- 
dren concerned, but may interpret 
their aggressive behavior as justifica- 
tion for prejudice and segregation. 
Thus the cycle is perpetuated. 

Middle- and upper-class minority- 



KENNETH B. CLARK is Associate Profes- 
sor of Psychology, College of the City of 
New York, and Associate Director of the 
Northside Center for Child Development, 
New York City. He is Social Science Con- 
sultant to the Legal Division of the National 
Association for the Advancement of Colored 
People. 

During the preparatory period for the Mid- 
century White House Conference on Chil- 
dren and Youth, Dr. Clark was on the staff 
of the Fact Finding Committee. 

This article is excerpted from a paper pre- 
sented by Dr. Clark at a meeting of the 
National Urban League, in connection with 
the seventy-ninth meeting of the National 
Conference of Social Work, held in Chicago. 



group children are more likely to re- 
act to their racial frustrations and 
conflicts by withdrawn and submis- 
sive behavior. On the other hand, they 
may compensate by rigidly conform- 
ing to the prevailing middle-class 
values and aggressively determining 
to succeed in meeting these values in 
spite of the handicap of their minor- 
ity status. 

Many children, however, of various 
social and economic classes, react 
with a generally defeatist attitude 
and a lowering of personal ambitions. 
These children tend to be hypersensi- 
tive and to be anxious about their 
relations with the larger society. They 
see hostility and rejection even where 
they do not exist. 

Undoubtedly a pattern of person- 
ality difficulties results when any 
human beings are placed in an unjust 
and unreasonable social situation. Al- 
though the specific aspects of this 



MARCH 1953 



113 



pattern do not hold for every child 
in a rejected minority group, and 
although the range of individual dif- 
ferences among members of such a 
group is as wide as among other peo- 
ples, the evidence suggests that all 
these children are in some vi^ays un- 
necessarily harmed by discrimination 
against them. 

The effect of race prejudice on the 
personalities of children of the domi- 
nant group is more subtle and some- 
vi^hat more obscure. These children 
are supposed to benefit from the 
system of differentiated status. It is 
their position that allegedly is being 
safeguarded against the encroach- 
ments of the "inferior" peoples. They 
stand to gain in economic and social 
status. How then can we say that 
such a child's personality is damaged 
by the very system that seeks to offer 
him such advantages ? How is it that 
the advantages gained through race 
prejudice interfere with the develop- 
ment of healthy personality in the 
children of the dominant group? 

The children of the dominant group 
who are required to adopt the preju- 
dices of their society are taught to 
gain status at the expense of the 
status of others. They are not ex- 
pected, when comparing themselves 
with members of a minority group, 
to evaluate themselves in terms of the 
basic standards of personal ability 
and achievement. 

Our culture permits them, and at 
times encourages them, to direct their 
feelings of hostility against whole 
groups of people. These children learn 
to fear and hate the rejected minority 
peoples. They develop mechanisms to 
use in an attempt to protect them- 
selves from recognizing the injustice 
of their behavior toward the minority 
group. 

Teaching may be contradictory 

Children who are being taught race 
prejudice at the same time and by the 
same persons and institutions that 
teach them the moral, religious, and 
democratic principles of the brother- 
hood of man and the importance of 
justice and fair play are likely to 
become confused. It is clear to chil- 
dren of average intelligence and 
higher that there is a contradiction 




To be effective in an interracial agency a worker must understand basic human values. 



between adults' race prejudice and 
their moral teachings. When this con- 
tradiction is imposed upon children, 
it may become a personal problem 
that demands personal attempts at 
solution. Some may try to solve the 
problem by intensifying their hostil- 
ity toward the minority group. Others 
may react with feelings of guilt, 
which are not necessarily reflected in 
more humane attitudes toward the 
minority group. 

A serious reaction to this moral and 
ethical conflict brought about by race 
prejudice in an ostensibly democratic 
society is the development of a pat- 
tern of moral cynicism, through 
which some of the children of the 
dominant group attempt to relieve 
themselves of disturbing moral pres- 
sures. Such children react by repudi- 
ating the right of their parents and 
other authority figures to offer any 
moral guidance. They excuse their 
own egocentric behavior by develop- 
ing a pseudo-sophisticated philosophy 
of life, expressed as "The strong 
should dominate the weak" — "Every 
man for himself" — "Get what you can 
while you can." 



Other children may attempt to re- 
solve this conflict by assuming a rigid 
and uncritical acceptance of the right- 
ness of their parents and other au- 
thority figures. These children tend 
to idealize all authority figures, such 
as their parents and strong political 
and economic leaders. They despise 
the weak, while they obsequiously and 
unquestionably conform to the de- 
mands of the strong. 

Understanding of the effect of race 
prejudice on the lives of children of 
different groups has encouraged the 
idea of combating such prejudice 
through the medium of the interracial 
social agency. 

More and more social agencies are 
being recognized as an effective force 
in bringing about social change. But 
it would be too much to expect that 
all the workers in this or any other 
field have escaped the many personal 
and social manifestations of race 
prejudice. The corroding effect of 
such prejudice is seen in the fact that 
many social agencies exclude from 
their benefits the members of minor- 



114 



THE CHILD VOL. 17 NO. 7 



ity groups who are most in need of 
help. Others accept a token number 
of such people in order to appease 
their feeling of guilt and to satisfy 
the vestige of their social conscience. 
Some have strict quotas as to the 
number of minority-group persons 
they will help. 

Should develop out of needs 

This fosters development of agen- 
cies dealing exclusively with a partic- 
ular minority group. Many agencies 
dealing exclusively with Negroes 
reflect the community pattern of 
segregation ; and, what is even more 
serious, they tend to perpetuate it. 

An agency that seeks to help the 
members of a minority group to break 
down the barriers of segregation 
needs to develop a pattern of con- 
structive interracial activity and per- 
sonnel. A truly interracial agency 
that works effectively in reducing the 
economic and psychological racial 
pressures upon the Negro is difficult 
to find. 

An interracial agency cannot be 
imposed upon the Negro community 
by detached, impersonal whites, no 



matter how good their intellectual 
motives, and be effective. To be effec- 
tive the agency must develop out of 
the real needs of the people whom it 
intends to serve. It must be a result 
of the cooperative efforts of truly ma- 
ture people who recognize these needs 
and are able to work together as 
human beings in an attempt to meet 
them realistically. 

A genuinely successful interracial 
agency will not indulge in the trans- 
parent maneuver of having a token 
number of individuals of one or the 
other group in a professional capac- 
ity, or a token number of clients of 
either group. 

One should not fall into the trap of 
thinking that a strong and effective 
interracial agency can be built by 
choosing personnel of different races 
primarily in terms of race and with 
little regard for the qualifications of 
the individual and the degree to 
which these are appropriate to the job 
that he will be required to do. A 
strong agency must have qualified 
people. To have an unqualified Negro 
in a position in order to demonstrate 
that an agency is "democratic" does 



Race prejudice injures not only the children of rejected minority groups, but all children. 




MARCH 1953 



not help society, the agency, or the 
Negro. There are an increasing num- 
ber of Negroes who are qualified and 
who can be evaluated by the standards 
used to evaluate whites. Either posi- 
tive or negative use of a double 
standard of judgment represents race 
prejudice. 

The personality demands upon the 
individuals who attempt to work to- 
gether in an interracial agency are 
great. These demands cannot be mini- 
mized for either the whites or the 
Negroes. The work will require the 
highest level of maturity of personal- 
ity that is attainable in our culture 
today. Only truly developed human 
beings can work with individuals of 
a different race with mutual respect. 

Mature personalities needed 

It is to be expected that some 
whites, who eventually might be quite 
effective in a joint social-action pro- 
gram, will at first bring to their 
attempts to work with Negroes the 
residue of past stereotyped ideas, con- 
descending and patronizing attitudes, 
and at times naive and oversentimen- 
tal ideas. On the other hand, many 
Negroes show their discomfort in an 
interracial situation by self-righteous 
posings, by aggressiveness, and by 
hostile hypersensitivity concerning 
the intentions of whites. If an inter- 
racial agency is to make an effective 
contribution to our society, the indi- 
viduals of both groups must rise from 
these infantile levels of reaction to a 
more mature one. 

An individual, white or Negro, who 
seeks to function successfully in an 
interracial agency cannot be status- 
conscious, since such agencies gener- 
ally do not have high status. If an 
individual can find personal security 
only in rigid conformity to conven- 
tional, middle-class values, he is not 
likely to be an asset to such an agency. 

Furthermore, a white worker who 
is still struggling with the elementary 
problem of unresolved racial guilt 
feelings, and who expresses this 
struggle by "loving" all Negroes or 
constantly proclaiming his freedom 
from prejudice, is likely to arouse the 
suspicion and resentment of Negroes 
and thereby reduce his effectiveness. 
(Continued on page 117) 



115 



MENTAL HEALTH IN CHILD REARING 



LEO KANNER, M.D. 

IN THE past few decades consider- 
able stirring has taken place 
among psychologists, educators, 
and psychiatrists concerning the fac- 
tors responsible for adequate person- 
ality development in children. 

We have seen a stage in which 
rigid rules and regulations were 
handed to parents in order to assure 
what seemed to be optimal nutrition 
and "habit conditioning" for the 
child. This pediatric perfectionism 
and behaviorist mechanization of 
child rearing tended, perhaps un- 
intentionally, to lay down the law and 
to treat such auxiliaries as the clock 
and the scales as major factors in 
bringing up children. 

Parents sometimes confused 

Now that we recognize the signifi- 
cance of parent-child relationships in 
the child's development, we no longer 
set up commandments requiring cer- 
tain procedures in child-rearing, but 
rather emphasize the effects of par- 
ental attitudes. However, I believe 
that the literature — both professional 
and popular — has put too much stress 
on injurious parental attitudes and 
not enough on affection, acceptance, 
and approval. 

As a result, many parents have 
been made uneasily self-conscious 
about their influence on their chil- 
dren. The whole modern development 
has somewhat too abruptly taken 
away from parents the age-old sanc- 
tions that they had received from 
centuries of "Mother knows best," 
"Children should be seen and not 
heard," "Spare the rod and spoil the 
child." Those were the days when 
discipline was interpreted as "break- 
ing a child's will." There was no 
room for doubt. It was clearly 
parents' obligation to teach children 
to submit unquestioningly. For the 
children's future safety, any tendency 
toward nonconformance had to be 
nipped in the bud. Surrender by the 




child was "good" behavior, and any- 
thing less than surrender was "bad" 
behavior. 

Now, however, instead of feeling 
under obligation to fit their children 
into a prescribed mold, parents have 
grown to feel — with considerable jus- 
tification — that these are secondary 
in importance to something that we 
call, more or less vaguely, the child's 
happiness, security, or emotional 
comfort. A generation or two of par- 
ents has had to relearn, to shift from 
coerciveness to guidance. 

Hence we have a mixture, puzzling 
to parents, of age-old tradition and 
relatively new ideas — a mixture that 
impinges differently on different par- 
ental personalities. The mature, se- 
cure, genuinely accepting parent has 
little difficulty in adjusting to the 
newer ideas because they blend easily 
with his or her own needs. 

The newer ideas lift from the 
parents the pressures which earlier. 



against their nature, had pushed 
them toward a repressive kind of 
child rearing. 

Rejecting, perfectionist parents 
can find great comfort in pooh-pooh- 
ing the "newfangled" ideas and can 
find sanctuary in the pronouncements 
of pediatricians and psychologists 
who still believe the old ways of child- 
rearing are best. Overprotective par- 
ents can seek solace for their agita- 
tions in the scary type of pseudo-pre- 
ventive ideas which are poured upon 
them, lava-like, from frightening 
books — now fortunately decreasing — 
from advertisements, from the lips of 
neighbors, and even from some medi- 
cal peddlers of gloom. 

We are now in the middle of the 
twentieth century, which Ellen Key, 
the Swedish sociologist, called "the 
century of the child." In the first half 
of these hundred years, with the help 
of various branches of science, we 
have come to an understanding of the 
needs of children, both physical and 
emotional. There is still much to be 
learned, but a certain number of basic 
principles have emerged, which, even 
after the disappearance of ephemeral 
fashions, should stand the test of 
time. 

We have learned the simple truth 
that any child has a good chance for 
satisfactory mental health, regardless 
of physical condition and I.Q. and 
other circumstances, if he can from 



LEO KANNER, M.D., has been director of 
the Children's Psychiatric Service of the 
Johns Hopkins Hospital since 1930. He is 
Associate Professor of Psychiatry and Asso- 
ciate Professor of Pediatrics at the Johns 
Hopkins University School of Medicine. He 
is the author of a number of books, includ- 
ing "Child Psychiatry" and "In Defense of 
Mothers." 

This article is based by Dr. Kanner on a 
paper that he prepared for the Midcentury 
White House Conference on Children and 
Youth. The paper is one of a number that 
served as resource material for the Fact 
Finding Report of the Midcentury White 
House Conference on Children and Youth. 
The procedures of the conference did not 
provide for official approval of these papers. 
Address inquiries to the chairman, Leonard 
W. Mavo, Room 700, 580 Fifth Avenue, New 
York 36, N. Y. 



116 



THE CHILD VOL. 17 NO. 7 



the beginning of life feel that those 
closest to him like him, want him, and 
accept him as he is. We have also 
learned that it is not only severe cere- 
bral and endocrinologic disorders 
that can work havoc with the mental 
health and adjustment of human 
beings ; personality and behavior dis- 
orders can also result from the atti- 
tudes of parents who are max'kedly 
rejecting, disapproving, exploiting, 
perfectionistic, overprotective, or 
overpossessive. 

We have not quite learned how to 
translate this knowledge into terms 
that would lead it to become as thor- 
oughly accepted by parents as is, for 
instance, the knowledge that children 
should be vaccinated against small- 
pox or that cleanliness will prevent 
many forms of physical illness. Such 
acceptance is difficult because many 
individuals are too emotionally in- 
volved in the older ideas of child rear- 
ing to accept the newer ones. 

To restore parents' self-confidence 

There will always be parents who 
will need individual guidance, and 
this, we hope, will be offered them 
through an expanding number of 
child - guidance and mental - health 
units all over the country. Neverthe- 
less much will be gained if we can 
present to the public simply stated 
truths, which can eventually become 
an integral part of our culture and 
that of future generations. 

Because of progress in the sciences 
dealing with human beings, we have 
taken away from parents the cer- 
tainty, the complacency, the assumed 
omniscience, the power that was theirs 
in generations past. We have thus 
made parents self-conscious in their 
role as parents, have made them grop- 
ing and jittery. We have produced a 
generation of parents who wail : "It 
is all our fault, but what can we do?" 
It is therefore our solemn obligation, 
which we shall not and dare not 
evade, to restore to parents a com- 
fortable modicum of self-reliance, 
poise, and composure and to provide 
a basis for self-confidence that is dif- 
ferent from the authoritarian rigidity 
that underlay it in the not too distant 
past. 

Reprints in about 6 weeks 



RACE PREJUDICE 

{Continued from page 115) 
Equally ineffective is the Negro who 
is constantly demanding of whites 
absolute freedom from all forms of 
prejudice or the one who seeks to 
curry favor with whites by obsequi- 
ous and fawning behavior. 

The individuals of each group must 
be people of integrity. They must 
have an understanding of basic hu- 
man values. And they must be clear 
about their common human and social 
goals. In short, they must be so clear 
about the relation between their joint 
struggle for racial justice and the 
larger goals of strengthening the 
foundations of American democracy 
for all people, that they are not likely 
to become ensnared in racialism even 
as they are allegedly fighting for 
racial justice. It should be clear that 
they are in a joint fight for human 
equality, decency, and justice. This, I 
believe should be the basic philosophy 
of the staff, the board of directors, 
and the contributors to an effective 
interracial social agency. 

Fortunately, the days of the Lady 
Bountiful approach to social services 
have gone. The modern world de- 
mands that the field of social work 
become a dynamic instrument in the 
process of social action. Intelligent 
planning of the curriculum in schools 
of social work will have to take 
into account the fundamental social 
changes that are taking place in our 
society. These schools must play a 
positive role in preparing their stu- 
dents to take an active part in social 
action beyond the more restricted 
community programs. 

Social workers must be prepared to 
help individuals live more effectively 
in a changed world — a more demo- 
cratic world. Social workers must be 
prepared to help people mobilize their 
strength to help in the attainment of 
a more democratic world by demo- 
cratic means. 

In order to do this a social worker 
must be clear in his own values. He 
must understand the need of all 
human beings for that dignity and 
integrity which is the essence of 
humanity. 

Reprints in about 6 weeks 



IN THE NEWS 



A child adopted in a foreign country 
by American citizens can now be nat- 
uralized on the petition of his adoptive 
parents without being readopted in 
this country. This is provided by an 
act of Congress that became effective 
December 24, 1952 (Public Law 414) . 

Previously such a child could not 
be naturalized before he became 18 
years of age unless a decree of adop- 
tion had been issued for him in this 
country. 

Under the present law, before a 
child adopted in a foreign country can 
be naturalized he must have been 
admitted to the United States for 
permanent residence ; must have been 
adopted before he reached the age of 
16; and must have resided continu- 
ously in the United States in legal 
custody of the adoptive parent or 
parents for 2 years before the peti- 
tion for naturalization is filed, though 
only 1 year of the child's physical 
presence is required. 

The present law applies not only to 
children adopted after the law became 
effective but to children adopted 
previously. 

Under the former law children of 
some racial origins were not eligible 
for citizenship, but under the present 
law any child is eligible who is admit- 
ted to this country for permanent 
residence. Thus a Japanese or a Ko- 
rean child adopted abroad by Ameri- 
can citizens can now be naturalized. 
Population. The number of children 
in the United States under 18 years 
old increased more than twice as fast 
as the total population between April 
1, 1950, the date of the last census, 
and July 1, 1951, according to esti- 
mates released February 11, 1953, by 
the Bureau of the Census, Depart- 
ment of Commerce. On July 1, 1951, 
there were 48,585,000 children under 
18, compared with 46,724,000 on 
April 1, 1950 — an increase of about 
4.0 percent. During that 15-month 
period, the total population in the 
United States increased from 150,- 
697,361 to 153,383,000 — an increase 
of only about 1.8 percent. The figures 
for both dates relate to the civilian 
population and exclude persons serv- 
ing in the armed forces. 

The relatively large increase in the 
population under 18 years old reflects 
the high birth rates of the 1950's. 
Moreover, the children born in the 
early 1930's, when birth rates were 
low, are attaining age 18 and leaving 



MARCH 1953 



117 



this group. The number of persons 
under 18 is expected to increase at a 
rapid rate for several years as per- 
sons born during the 1950's replace 
those born during the depression 
years. 

Adoptions have increased sharply in 
the last few years. In 1951 the num- 
ber of adoption petitions filed in the 
United States probably reached 80,000 
— 60 percent more than in 1944. 

These estimates are based on re- 
ports from State public welfare agen- 
cies that transmitted adoption data to 
the Children's Bureau. In 1951, 33 
States reported; and their reports 
provide the base for the estimate for 
that year. 

There seems to be an increase both 
in the number of children adopted by 
stepparents or other relatives and the 
number adopted by nonrelated per- 
sons. In the small and perhaps un- 
representative group of 11 States for 
which such data are available a 65 
percent increase took place between 
1944 and 1951 in adoptions by rela- 
tives, and an 85 percent increase in 
adoptions by persons not related to 
the child. 

Among the factors accounting for 
the increase in adoptions is the large 
number of homes broken during and 
following World War II by death, 
divorce, or desertion. In many cases 
the mothers remarried and the chil- 
dren were subsequently adopted by 
their stepfathers. 

Columbia University Press publishes 
"Maternal Care and Mental Health," 
by John Bowlby, M.D. This informa- 
tion was accidentally omitted from 
the discussion of this subject that was 
published in the January issue of The 
Child. 






UNDERSTANDING HEEEDITY; 
an introduction to genetics. By 
Richard B. Goldschmidt. John 
Wiley & Sons, New York. 1952. 
228 pp. $3.75. 

For those who have no knowledge 
of genetics to begin with, this book 
is probably not as good an introduc- 
tion to the subject as several of the 
books that the author recommends 
to his readers. Nevertheless, those 
seeking highly authoritative infor- 
mation will find it in this book. For 
Goldschmidt is among those few 
great experimental researchers who, 
after generations before them had 
failed, have at last wrested from na- 



ture the secrets of how heredity 
works. 

The author is famous for his con- 
tributions to the genetics of sex, 
physiological genetics, and chromo- 
some theory. Yet the reader who did 
not know that fact in advance would 
hardly guess it from this book, which 
covers all the main principles of gen- 
etical science in a balanced fashion. 
Goldschmidt assures the reader that 
those main principles will not be 
changed by further developments in 
genetical theory. This assurance is 
noteworthy because it is given by a 
geneticist who has upset his col- 
leagues' thinking as often — and as 
constructively — as anyone in the field. 

Difficult terms are well defined as 
they come up in the text, and a con- 
venient glossary is included. What the 
book lacks (from the layman's view- 
point) in the style of writing is 
largely compensated for by the lib- 
eral use of diagrams. Most of them 
are unusually well done, and they 
would be worth studying even if the 
reader did not attempt to assimilate 
all of the accompanying discussion. 

The author uses few examples 
from human genetics, yet he stresses 
throughout the book that the princi- 
ples derived from work with other 
animals apply equally to humans. 
Goldschmidt maintains that man can- 
not claim "any special position" or 
exemption so far as the laws of 
heredity are concerned. He points 
out that genetic differences are modi- 
fied by environmental factors, but he 
does not say that behavior traits are 
more susceptible to environmental 
conditions than are physical traits. 
Indeed, he repeatedly mentions hu- 
man psychological traits as being in- 
fluenced by genetic factors in essen- 
tially the same ways as are other 
kinds of traits. Moreover, though 
man is unique in being able to hand 
down an immense treasure of knowl- 
edge, "no one receives any of it via 
hereditary transmission in the bio- 
logical sense." The Soviet Politburo's 
denial of that fact is, he declares, a 
"pai'tiy ridiculous, partly mystical as- 
semblage of nonsensical claims." 

Bronson Price 



CHILD PSYCHOTHERAPY. By 
S. R. Slavson. Columbia Univer- 
sity Press, New York. 1952. 332 
pp. $4.50. 

Although the author implicitly ad- 
mits that he has already presented 
many of the ideas ofi'ered in this book, 
he nevertheless hopes that "new vigor 
and meaning is given them by a fresh 
restatement in a different context, in 
new relations, and in the integrative 



approach to the biopsychosocial en- 
tity that is MAN." 

The book indeed restates with 
"new vigor and meaning" the Freud- 
ian psychology, both orthodox and 
modified, for social workers and other 
nonmedical therapists. It has the "in- 
tegrative approach" that, in a book 
by Slavson, makes the third and larg- 
est portion a novelty. Here the entire 
basis of psychotherapy is examined — 
its various aims, settings, and dy- 
namics; the relationships between 
the child patient and his parents and 
between each of these persons and 
the therapist. Only one-fourth of the 
entire discussion is devoted to group 
psychotherapy as one of the many 
techniciues within the broad scope of 
psychotherapy. 

In the last chapter, a case history 
entitled, "Treatment of a Neurotic 
Nine-Year-Old Boy with Organic De- 
ficiency," not only illustrates the ap- 
plication of the various techniques at 
the right time and place, but also 
demonstrates the operation of real 
team action among five workers — two 
psychiatric caseworkers, a group psy- 
chotherapist, a psychologist, and a 
psychiatrist. 

Few social workers can afford to 
ignore this "restatement" of Slav- 
son's, if they are concerned with the 
child and the "orderly and sound de- 
velopment of his dynamic drives for 
action, achievement, and reality con- 
trol." 

Hans A. Illing 

GUIDANCE IN A RURAL COM- 
MUNITY; Green Sea — a South 
Carolina school district plans with 
and for boys and girls. By Amber 
Arthun Warburton. Alliance for 
Guidance of Rural Youth and the 
Department of Rural Education, 
of the National Education Associa- i 
tion, 1201 Sixteenth Street, N.W. 
Washington 6, D. C. 1952. 156 pp. 
$2. 

More than 3 years ago the Green 
Sea High School District in Horry 
County, S. C, launched a guidance 
program, with the aid of the South 
Carolina State Department of Edu- 
cation and of the Alliance for Guid- 
ance of Rural Youth, to stimulate 
concerted community action to bene- 
fit rural children ancl young people. 

Community problems concerning 
children, such as irregular school at- 
tendance and premature school leav- 
ing, were studied. These conditions, . 
it was found, resulted from many • 
causes, such as sickness, dissatisfac- 
tion with school, and use of child 
labor by parents at peak farming 
seasons. 

In turn, recognition of each of 
these causes uncovered other condi- 



118 



THE CHILD VOL. 17 NO. 7 



tions needing correction. For in- 
stance, sickness was traced to unsani- 
tary conditions at school and at home, 
inadequate food, and uncorrected 
physical defects. Removing these 
causes involved a broad community- 
betterment program. The program 
involved skillful counseling, improved 
methods of instruction, curriculum 
changes, and adjustment in school 
programs. Besides, guidance and 
counseling programs for parents 
were instituted to help them recog- 
nize conditions hindering the chil- 
dren and to develop and utilize re- 
sources available for helping the 
children mature. 

The author conveys very well the 
wide scope of activities involved as 
well as the method of developing en- 
thusiasm and carrying an excellent 
program forward in a strictly agri- 
cultural community. This book should 
serve as a guide for many rural areas 
that are in need of instituting a 
similar program. Such guidance ac- 
tivity, carried out on a large scale, 
would improve immeasurably the 
health, both physical and mental, of 
the people in our country. 

O. Spurgeon English, M.D. 



PARENT GROUPS AND SOCIAL 
AGENCIES; the activities of 
health and welfare agencies with 
groups of parents of handicapped 
children in Chicago. By Joseph 
H. Levy. University of Chicago 
Press, Chicago. 1951. 103 pp. 
$2. 

Two different types of groups are 
discussed in this report. These 
are: (1) associations of parents of 
handicapped children, which are 
composed entirely or predominantly 
of such parents — associations that 
are either affiliated with or opera,t- 
ing independently of health or wel- 
fare agencies, and (2) projects 
sponsored by the agencies, in which 
groups of parents are brought to- 
gether for education or counseling. 

The author describes the compo- 
sition and organization of various 
such groups in Chicago, their activi- 
ties, and the relationships between 
the groups and the agencies. A 
chapter is devoted to the values and 
limitations of parents' groups. An- 
other one raises some questions con- 
cerning the formation of such 
groups and the role of the social- 
work profession in relation to them ; 
this chapter points out clearly the 
need for further study of these 
questions. 

Ruth C. Okon 



UNDERSTANDING YOUR CHILD. 
Bv James L. Hymes, Jr. Prentice- 
Hall, New York. 1952. 188 pp. 
$2.95. 

James L. Hymes' name has come 
to be a synonym for guides for par- 
ents — pointed but reassuring, light- 
hearted but solidly meaningful. 
He knows child development, but 
what's more, he knows children. He 
knows how to communicate ideas, 
too. 

Take for example his suggestions 
on bothersome behavior that arises 
out of the stage of growth a child is 
in: 

"Ygu tolerate it. You practice the 
fine art of looking the other way, of 
not hearing every word that is 
spoken, of letting a lot that goes on 
just slide off your back. 

"You cJkddh'I it, when you have 
taken as much as you comfortably 
can. 'You can't do this in here, but 
you can out there. . . . You can't do 
it now, but you can later. . . .' 

"YoK stop it, when you have racked 



your brain and no bright ideas come ; 
when despite all your thinking, you 
cannot stand it any more. You stop 
it firmly if you must, but you stop it 
gently, without anger and without 
upset. You stop it definitely if you 
must, but with no illusions that it is 
stopped forever." 

Even when "you cannot stand it 
any more," and thoughtlessly use the 
last-resort method without meaning 
to, he says, there's always a chance 
to start over, always a chance to get 
a better grasp of reasons back of 
the behavior. Effective discipline, 
whether of the 2- or the 10-year-old, 
is "What frees. What opens up. What 
makes possible." 

The helpful, deeply understanding 
advice offered in this .small book will 
be sought over and over again. The 
amusing illustrations do a lot to point 
up the author's sensible and sensitive 
analysis of how parents — and teach- 
ers, too — can help to bring out in 
children the best that is in them. 

Marion L. Faegre 



Mar. 1-7. S.i\-.' "ri>r.r A'ision Week. 
Twenty-seventh annual observance. 
Information from American Opto- 
metric Association, Jenkins Build- 
ing, Pittsburgh 22, Pa. 

Mar. 2. Child Study Association of 
America. Annual conference. New 
York, N. Y. 

Mar. 15-20. National Council of Jew- 
ish Women. Twentieth triennial 
convention. Cleveland, Ohio. 

Mar. 1.5-21. Camp Fire Girls Birthday 
Week. Forty-third anniversary. In- 
formation from Camp Fire Girls, 
Inc.. 16 East Fortv-eighth Street, 
New York 17, N. Y. 

Mar. 18-20. National Society for the 
Prevention of Blindness. Forty- 
fifth annual conference. New York, 
N. Y. 

Mar. 18-20. National Health Council. 
Thirty-third annual meeting. New- 
York, N. Y. 

Mar. 20-27. Jewish Youth Week. Fifth 
annual observance. Information 
from National Jewish Youth Con- 
ference, 145 East Thirty-second 
Street, New York 16, N. Y. 

Mar. 29-Apr. 2. American Personnel 
and Guidance Association (former- 
ly the Council of Guidance and 
Personnel Associations). (Four 
organizations — the American Col- 
lege Personnel Association, the 
National Association of Guidance 



Supervisors and Counselor Train- 
ers, the National Vocational Guid- 
ance Association, and the Student 
Personnel Association for Teacher 
Education — have become Divisions 
of the new American Personnel and 
Guidance Association.) Annual 
convention. Chicago, 111. 
Regional conferences, Child Wel- 
fare League of America : 
Mar. 16-18. Central Region. Colum- 
bus, Ohio. 

Apr. 16-18. Southern Region. Nash- 
ville, Tenn. 

Apr. 26-28. South Pacific Region. 
Berkeley, Calif. 

Apr. .30-Mav 2. North Pacific Region. 
Seattle, Wash. 

May 18-19. New England Region. 
Swampscott. Mass. 

June 10-12. Southwest Region. Den- 
ver, Colo. 
Regional conferences, American 

Public Welfare Asseciation: 

Mar. 23-24. Southwest Region. Little 
Rock, Ark. 

Apr. 26-28. Central Region. St. Paul, 
Minn. 

Mav 6-8. Mountain Region. Bismarck, 
N. Dak. 

Illuslrations: 

Cover and pages 113, 114, 115, Esther 
Bubley. 

Page 107, George Washington University. 

Page 108, Philip Bonn. 

Page 109, American National Red Cross. 

Page 110, Boston University School of So- 
cial Work. 

Page 116, Richard Perlman. 



MARCH 1953 



119 




VOL. 17 NO. 7 
MARCH 1953 



n 



This Is 



sue 



Page 



Parents Learn About Their Premature Baby 106 

Gellestrina DiMaggio, R. N., and Marguerite B. Gelinas 

Social Agencies Can Improve Staff" Training 109 

Alice L. Taylor 

Race Prejudice and Children 113 

Kenneth B. Clark 

Mental Health in Child Rearing 116 

Leo Kanner, M.D. 



Published 10 times a year by the Division of Reports, Children's Bureau 
Editor, Sarah L. Doran Art Editor, Philip Bonn 

FEDERAL SECURITY AGENCY 
Oveta Culp Hobby, Administrator 

SOCIAL SECURITY ADMINISTRATION CHILDREN'S BUREAU 

Arthur J. Altmeyer, Commissioner Martha M. El^ii, M.D., Chief 

Publication of THE CHILD, monthly bulletin, has been authorized by the Bureau of 
the Budget, September 19, 1950, to meet the needs of agencies working with or for 
children. The Children's Bureau does not necessarily assume responsibility for 
statements or opinions of contributors not connected with the Bureau. 

THE CHILD is sent free, on request, to libraries and to public employees in fields 
concerning children; address requests to the Children's Bureau, Federal Security 
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copies 15 cents each. Send your remittance to the Superintendent of Documents, 
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Foreign postage — 25 cents additional — must be paid on all subscriptions to 
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Domestic postage applies to all other subscriptions. 



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APRIL 1953 




Boston Public Libriry 
Superintendent of Doquments 



MAYl 195;) 



INFANT MORTALITY AND 
PAHERNS OF LIVING 



What directions should new research take? 



ODIN^W. ANDERSON 

MORE AND MORE BABIES' 
lives have been saved in 
Western countries since the 
turn of the century. Before that 100 
to 150 deaths under 1 year per thous- 
and live births were common in coun- 
tries like Sweden, England and 
Wales, Germany, and New Zealand; 
now an infant mortality rate over 50 
is uncommon in such countries. 

It is well known that infant mor- 
tality rates vary widely between coun- 
tries, between areas within countries, 
and even between residential areas 
within cities. In 1949 Chile's rate was 
169; Sweden's only 23. In 1947 
Scotland reported an infant mortality 
rate of 27 in its most favored social 
class, but 89 in its most disadvan- 
taged one. The difference suggests 
strongly the effect of environment on 
infant mortality. Again and again, 
in the extensive literature on infant 
mortality that has appeared in the 
last 50 years, we find that infant mor- 
tality differs in various groups of 
people, according to income, occupa- 
tion, socio-economic group, country, 
color, and so on. 

We know that a high infant mor- 
tality rate is associated with poverty ; 
we know that the rate began to drop 
perceptibly in many countries at a 
certain stage of their technological 
development; we know that in the 
United States infant mortality before 
the turn of the century was higher in 
cities than in rural areas and that 
this continued until 1920 or so, after 
which the rates in cities were lower. 

Infant mortality is often referred 
to as a sensitive index of health level. 
For example, Berlin in 1943 had an 
infant mortality rate of 66; 2 years 



later, as a result of extreme disrup- 
tion caused by bombing, the rate shot 
up to 359. A year later, in 1946, the 
rate dropped to 123, and in 1949 it 
was 75. Similarly, but to a lesser 
degree, France's rate increased — 
from 73 in 1941 to 109 in 1945. Addi- 
tional evidence of the effects of war 
on infant mortality rates has been 
presented graphically by Collins. [1] 
Of course, high infant mortality rates 
in wartime are not caused only by 
bombing or other violence; many in- 
fant deaths are undobutedly due to 
health hazards caused by wartime 
disruption of living patterns. Where 
the health level is low, whether in 
wartime or peacetime, the infant 
mortality is high accordingly. 

Obviously, it is difficult if not im- 
possible to isolate the specific factors 
influencing an infant mortality rate. 
A reasonable plan, however, is to look 
at fairly general factors and show 
how they are likely to operate at any 
given time and place. 

Some biological factors, such as 
age and sex, are stable and are inde- 



ODIN W. ANDERSON received his B.A. and 
M.A. from the University of Wisconsin and 
his Ph.D. from the University of Michigan — 
all in sociology. 

Under a fellowship granted by the World 
Health Organization, Dr. Anderson studied 
and observed in the field of preventive medi- 
cine in Great Britain, Norway, Denmark, and 
Sweden, in 19.51. He is a member of the 
American Sociological Society and of the 
Society for Applied Anthropology, and a fel- 
low of the American Public Health Associa- 
tion. 

This article is condensed from a paper that 
Dr. Anderson gave before the Maternal and 
Child Health Section of the American Public 
Health Association at its eightieth annual 
meeting, held at Cleveland. 

When Dr. Anderson gave the paper he was 
Associate Professor in Charge of the Social 
Aspects of Medicine, Faculty of Medicine, 
University of Western Ontario, London, On- 
tario, Canada. He is now Research Director 
of the Health Information Foundation, New 
York City. 



pendent of period and place; and an- 
other stable factor may be a con- 
stitutional predisposition to certain 
diseases. Individuals who may be 
predisposed to certain diseases be- 
cause of constitutional factors can 
usually be found in a representative 
sample of the population. Such con- 
ditions can be regarded as biological 
facts that cannot be changed in the 
short run. 

Other factors, basically biological, 
respond somewhat to environment; 
that is, their effects vary from time 
to time and from place to place. 
Death itself is a biological fact, but 
in some contemporary populations 
most deaths occur after age 65 ; in 
others most occur under 50. Similar 
differences are found even within the 
first year of life. 

Another biological factor respon- 
sive to environment is birth, since 
the number of births in a population 
and the size of families vary consid- 
erably with circumstances. These in 
turn have real though undetermined 
influences on infant mortality. For 
example, a high birth rate is associ- 
ated with a high infant mortality 
rate. A low birth rate could conceiv- 
ably be associated with a high rate of 
deaths during the first month of life, 
because a low birth rate suggests a 
high proportion of first births, which 
in turn is associated with a relatively 
high mortality rate during the first 
month of life. 

Among the socio-economic factors 
that influence the magnitude and dis- 
tribution of biological factors are: 
Occupation ; income ; level of educa- 
tion ; marital status ; and place of 
residence, such as rural, urban, 
slum, high-income. These factors, 
which overlap considerably, indicate 
roughly socio-economic differences 



122 



THE CHILD VOL. 17 NO. 8 




New research may succeed in showing how mothering affects babies' health and survival. 



among groups of people. They tell us 
little, however, of the quality of the 
human beings themselves unless we 
assume that the higher the socio- 
economic group the more biologically 
able to survive are the people. Ex- 
cept for so-called "problem families" 
and apparent social misfits, this as- 
sumption is scientifically untenable, 
because so many factors other than 
"ability," however defined, are re- 
sponsible for the socio-economic 
niche a person or a family may 
occupy. 

Socio-economic factors, of course, 
reflect patterns of living in the gen- 
eral population and in subgroups 
such as ethnic and occupational 
groups. Patterns of living, as we 
know, vary with religious beliefs and 
practices, attitudes toward human 
life, concepts of standards of living, 
hygienic habits — in short, what social 
anthropologists call culture. 

Long-term trends show gains 

Until the latter part of the nine- 
teenth century, infant mortality rates 
in England and Wales, Scotland, and 
Iceland underwent great annual oscil- 
lations. At the beginning of the 
twentieth century, when the periodic 
epidemics of childhood communicable 
diseases were becoming less common 
and less virulent, these oscillations 
diminished. Many other factors have 

APRIL 1953 



operated indirectly to reduce infant 
mortality, but they are extremely 
difficult to isolate. 

Sweden's records of infant mor- 
tality rates go back further than 
those of any other country. In the 
decade 1751-1800 the rates for differ- 
ent years ranged from 164 to 286 
deaths in the first year of life per 
thousand live births. In the decade 
after that the range was from 141 
to 2.32. Since 1812 the infant mor- 
tality rate has never exceeded 200, 
and in each of the following decades 
it has decreased consistently. In 
1941-49 the rates ranged from 23 
to 37. 

In Scotland, for which we have 
reports as far back as 1855, the 
rates during the period 1855-1900 
ranged from 108 to 138. In the 
decade 1901-20 the range was 92 to 
129, and the rates decreased in each 
of the next two decades. For the 
period 1941-47 the range was 54-83. 

Making allowance for the small 
population of Iceland (only 140,000 
even today), we note that that coun- 
try experienced extremely violent os- 
cillations in infant mortality during 
the nineteenth century, but that dur- 
ing the twentieth century it has com- 
pared very favorably with any other 
area in the world. 



The rates in other countries, such 
as Denmark and Norway, have had 
a similar pattern. 

A similar change in trends of in- 
fant mortality rates has taken place 
in areas like India, Cyprus, Jamaica, 
and Spain; this suggests that the 
annual oscillations are narrowing and 
that the rates are becoming more 
stable, although declining. 

At periods during which the in- 
fant mortality rates fell perceptibly 
in various countries the trends sug- 
gest that similar forces influencing 
the decline of infant mortality were 
operating simultaneously over wide 
areas. In the decade 1890-99 the rate 
fell noticeably in Denmark, England 
and Wales, Iceland, Scotland, New 
Zealand, Sweden, Switzerland, Nor- 
way, and France. In 1900-09, a simi- 
lar fall took place in Luxemburg; in 
1910-19, in Quebec and in India; in 
1920-29, in Jamaica and in Spain; 
and in 1930-39, in Cyprus. 

The decade 1890-1900 is an ex- 
tremely important one in the history 
of infant mortality in Europe because 
so many countries experienced an im- 
provement in such mortality. A 
similar improvement occurred in cer- 
tain large cities in the United States, 
as reported by Winslow and Holland. 
[2] In other areas infant mortality 
rates improved distinctly in later dec- 
ades, and it should be easy to demon- 
strate that the periods during which 
the rates began to decline are asso- 
ciated with sanitary and hygienic 
developments. This was true, for 
example, in Quebec, India, Spain, and 
Cyprus. 

Some causes of death are being controlled 

In saving the lives of babies less 
than a year old, the greatest gain 
has taken place during the period 
after the first month of life. Improve- 
ments in mortality during the first 
month of life have also been made, 
but hardly to the same degree as dur- 
ing the ensuing 11-month period. The 
reason for this lies in how well cer- 
tain causes of death are being con- 
trolled. Prematurity and congenital 
malformations account for the largest 
proportion of deaths during the first 



123 



year of life, and usually the majority 
of these deaths occur before the end 
of the first month. The greatest pro- 
portion of deaths from respiratory 
and gastro-intestinal conditions usu- 
ally occurs after the first month. 
These causes are responsive to en- 
vironmental sanitation. Respiratory 
and gastro-intestinal causes have de- 
clined markedly in importance, and 
prematurity to a lesser degree; con- 
genital malformations have not de- 
clined. 

In a study of infant mortality in 
Cleveland, Green showed that from 
1919 to 1937 the mortality among 
vv^hite infants 1 to 12 months of age 
improved 73 percent while mortality 
in the first month improved only 24 
percent. [3] 

Continuing studies of infant mor- 
tality in the United States made by 
the Children's Bureau reveal a simi- 
lar pattern. From 1915 to 1949 the 
mortality among infants in the age 
group from 1 to 12 months improved 
82 percent ; and among those 1 month 
of age and under, it improved 52 per- 
cent. [4] 

In Ontario, Canada, the rate of 
deaths during the first year of life 
improved 55 percent between the pe- 
riod 1921-25 and the period 1941-45, 
while the rate for the first month 
improved only 39 percent. 

Association of low mortality rate 
in the first year of life with high per- 
centage of deaths in the first month 
can be seen clearly when we compare 
deaths in some countries that have 
very high infant mortality rates with 
deaths in other countries that have 
very low rates. I have selected New 
Zealand, Sweden, and the United 
States as low-rate countries, and 
Guatemala, Mexico, and Egypt as 
high-rate ones. The period is 1945-47. 

In New Zealand the death rate for 
the first year of life was only 26, and 
the percentage of babies that died 
during the first month was high — 73. 
In Guatemala, whose rate for the 
first year was as high as 153, only 
14 percent of the babies died in their 
first month. For all six countries a 
similar relation appears between the 
figures for the ages concerned, as 
will be seen in the following list: 



Percentage of 

Deaths under infants under 1 

1 year, per 1,000 year that died 

live births, in first month. 

Country 191,0-1,7 19l,5-l,7 

New Zealand 26 73 



Sweden 30 

United States 34 

Guatemala 110 

Mexico 111 

Egypt 153 



64 
71 
36 
33 
14 



Studies of the causes of infant mor- 
tality by age over a long period of 
time are few, but an excellent and 
authoritative one has recently been 
made by W. P. D. Logan, using data 
from England and Wales for the past 
100 years. 

The greatest relative improvements 
occurred in mortality from diseases 
that are more likely to occur after the 
first month of life — • communicable 
diseases, and diarrhea and enteritis, 
rather than in mortality from pre- 
maturity, congenital conditions, and 
other prenatal and natal causes. Also, 
prenatal and natal causes accounted 
for about a third of the deaths in 
1901-1910, and for nearly half in 
1947. [5] 

Obviously, socio-economic group, 
occupation, and income are closely re- 
lated to one another, and in turn are 
associated with infant mortality 
rates. The higher the socio-economic 
group and income, the lower is the 
infant mortality rate for the group, 
although there are exceptions, which 
will be discussed later. 

A study of infant mortality among 
the families of the rulers of European 
countries since the year 1500 by Fel- 
ler reveals a noteworthy long-term 
trend among a wealthy segment of 
the population. [6] Over 8,460 chil- 
dren in these families were born to 
parents who married between 1500 
and 1930. This relatively small num- 
ber, statistically speaking, is subject 
to some error, but there is no doubt 
of the trend, as shown in the follow- 
ing list. 



Time of 
parents' 
marriage 

1500-99 


DeatJis under 
1 year, per 

1,000 
live births 

193 


Deaths under 

1 month, per 

1,000 

live births 

98 


1600-99 


246 


96 


1700-99 


153 


60 


1800-49 


96 


50 


1850-99 


41 


17 


1900-30 


8 


5 



The improvements in mortality 
rates among ruling families — both 
for the first year of life and the first 
month — preceded the improvements 
among the general populations of the 
countries ruled by these families by 50 
years or more. Infant mortality rates 
as low as 96 and 41 did not begin to 
appear in statistics for these coun- 
tries until the end of the nineteenth 
century. An infant mortality rate of 
8 has never been recorded for a gen- 
eral population, nor a neonatal mor- 
tality rate of 5. With present medi- 
cal knowledge these low rates seem 
almost impossible to attain in a gen- 
eral population. But as reported for 
the ruling families they may be so low 
merely because they were calculated 
on such a small number of infants. 
The lowest recorded neonatal rate to- 
day for any country is Norway's 18 ; 
yet a rate of 17 was recorded for the 
ruling families as far back as 1850-99. 

About a quarter of a century ago a 
crude but significant study of infant 
mortality in 1865 by age and eco- 
nomic group was made by Chapin. He 
separated the population of Provi- 
dence, R. I., into persons who paid 
certain taxes and those who did not. 
He found that the infant mortality 
rate in the nontaxpaying group was 
twice that in the other group — 190 
and 93 respectively. [7] 

In York, England, at the turn of 
the century, Rowntree made his 
famous study of poverty, a study that 
was repeated nearly four decades 
later. In this study the population 
was divided into four classes. One 
included only people who kept serv- 
ants. The other three were groups of 
working people, and the groups were 
described, according to economic 
status, as "highest," "middle," and 
"poorest." As would be expected, he 
found the best infant mortality rate 
among the group that could afford to 
keep servants — 94. In the three 
groups of working people the rates 
were : 247 for the "poorest," 184 for 
the middle group, and 173 for the 
highest-income group of workers. In 
1936 the corresponding rates for the 
three groups were 78, 75, and 41. 
(The rate for the servant-keeping 
group in 1939 was not given.) [8] 



124 



THE CHILD VOL. 17 NO. 8 



At irregular intervals for the past 
40 years the Registrar-General's Of- 
fice for England and Wales has pub- 
lished infant mortality rates for each 
of five socio-economic groups. In 1939 
the infant mortality rate for the low- 
est group was better than the 1911 
rate for the highest. During the 
period from 1911 to 1930-32 the 
higher the group the greater was the 
relative improvement, but from 1930- 
32 to 1939 the four lower groups ex- 
perienced gains greater than that of 
the highest, and their own improve- 
ments were almost equal. This may 
indicate that the upper group is 
reaching a "diminishing return," as 
its 1939 rate was relatively low — 27. 
In both 1911 and 1939 the difi'erences 
between the highest and the lowest 
groups in infant mortality rates are 
far greater than their differences in 
neonatal mortality rates, indicating 
that the neonatal mortality rates are 
relatively less variable among differ- 
ent groups and at different periods. 
Among- all groups the infant mortal- 
ity rate declined much more than did 
the neonatal rate. 

As is to be expected, mortality rates 
by income alone follow the same pat- 
tern as do rates by socio-economic 
group. 

What a pioneer study sJiowed 

In an early study of infant and neo- 
natal mortality, made by Woodbury 
for the Children's Bureau from 1911 
to 1916, in eight cities in the United 
States, the earnings of the father 
were studied in relation to infant 
mortality in seven of the eight cities. 
In the highest-income group the mor- 
tality rate was 59.1 ; in the lowest the 
rate was 166.9. The neonatal mortal- 
ity rate for the highest-income group 
was 38.2; for the lowest it was 55.8. 
As did other studies of income groups, 
this one showed much less variation 
in the mortality rates for the first 
month than for the first year. [9] 

Green's aforementioned study of 
economic status and infant mortal- 
ity in Cleveland, made in the peri- 
ods 1919-23 and 1934-37, repeats 
the findings even when the differ- 
ences between the income groups are 
slight. [10] 



INFANT MORTALITY, 1915-49 

(U.S. BIRTH REGISTRATION AREA) 



1900 



1910 



1930 



1940 



1950 



UNDER I YEAR 




100 



50 






10 



Deaths between the ages of 1 month and 1 year have dropped rapidlv, for these deaths 
are chiefly due to causes that can be controlled through improved community health con- 
ditions and better baby care. Deaths under 1 month of age, however, have decreased slow- 
ly; these babies die mainly from prenatal and natal causes, about which we know too little. 



Our discussion of the relationships 
between income and infant mortality 
may well be closed by reference to a 
recently published study of 973 cities 
in the United States, 1939-1940, by 
Altenderfer and Crowther. In this 
study, again, the group of cities with 
the highest per capita income had the 
lowe-st infant mortality rate (28) ; 
the group with the lowest per capita 
income, the highest rate (73). [11] 

Studies show us that infant mortal- 
ity rates vary widely by residential 
areas within cities [12] ; rural rates 
are higher than urban rates [13] ; 
rates for nonwhites are higher than 
for whites [13] ; certain ethnic 
groups have higher rates than others 
[14] ; rates for foreign-born families 
are higher than those for native-born 
[14] and so on. 

In summary, when we examine the 
gross relationships between infant 



mortality and various socio-economic 
factors, we see that a low infant mor- 
tality rate goes with high income, 
with high socio-economic status, with 
well-paying occupations, and with 
other favorable socio-economic fac- 
tors. An apparently obvious inference 
from this fact is that if all families 
could enjoy the general standard of 
living as to food, clothing, shelter, 
medical care, and public-health serv- 
ices that is attained by the level of 
society experiencing the lowest infant 
mortality rate, all families would then 
approximate this rate. In short, there 
is assumed to be a direct and un- 
diminished correlation between a 
high standard of living and low in- 
fant mortality. 

It might reasonably be suggested 
that where infant mortality rates go 
higher than about 30, an improve- 
ment in the standard of living will 



APRIL 1953 



125 



have a long-run effect, as it has had 
since 1890 in various countries. It 
seems, however, that, for a given 
population, once the rate drops to 
about 30, the broad economic and 
social factors operate with lessening 
effect. Then an increasing influence 
on the rate begins to be exercised by 
personal factors in the care of the 
baby. Among these factors are 
(1) adequacy of mothering and (2) 
readiness — and ability — to use proved 
methods of infant care. 

Perhaps the dividing line of 30 is 
too high or too low, but I submit that 
a theoretical line exists at one point 
or another. Perhaps that point is 
where the socio-economic level for the 
population as a whole is favorable, 
and family differences in this respect 
are small. 

Tradition may be a factor 

I suggest, then, that some fairly 
specific practices in infant care are 
relatively independent of economics, 
once basic essentials of living are 
accessible. (Given the essentials of 
living, use of a bottle sterilizer, for 
example, can have a greater effect in 
some families on saving babies' lives 
than an increase in income of $500 a 
year.) 

Attainment of an infant mortality 
rate of 15 to 20 would require excel- 
lent care of each baby. If this were 
given, a low rate could be achieved 
by families in Canada and the United 
States earning considerably less than 
families whose incomes are in the 
upper range of the income scale. 

Among the 45 or more studies on 
infant mortality and social and cul- 
tural factors are two studies that 
suggest the plausible idea that, once 
the basic minimum standard of liv- 
ing has been attained in a given popu- 
lation, there is a point of diminishing 
return in the effect on infant mortal- 
ity, of income, occupation, and socio- 
economic group. 

When the Children's Bureau made 
its studies of infant mortality in 
eight cities, which I referred to pre- 
viously, the infant mortality rate for 
the eight cities studied was 111, indi- 
cating a tremendous area of potential 



126 



improvement by means of broadside 
attacks on poverty, bad housing, and 
ignorance, with demonstrable effects 
in a short time. 

One of the analyses was by color 
and nationality of mother, as follows : 
Colored ; native-born white ; foreign- 
born white (Italian, Jewish, French- 
Canadian, German, Polish, Portu- 
guese). [15] 

Even though the Jewish mothers 
were foreign-born, lived under as 
crowded conditions as the other 
foreign-born, had families as large as 
any other groups, and had an income 
that was much lower than that of the 
native-born white mothers, the Jew- 
ish group experienced the lowest 
infant mortality rate of all groups — 
54 — and the lowest neonatal mortal- 
ity rate — 28. (The native-born white 
group had much poorer rates — an 
infant mortality rate of 94 and a neo- 
natal rate of 42.) 

Obviously factors other than gen- 
eral economic ones account for the 
low infant mortality rates among the 
foreign-born Jewish group. Closer 
examination would probably reveal a 
pattern of infant care of a high order 
embedded in the Jewish culture, since 
even bottle-fed Jewish infants experi- 
enced a lower mortality rate than 
infants of native-born whites. This 
is implicit in a Canadian study 
atso. [16] 

A second study that points to the 
influence of a factor in infant mor- 
tality other than economic ones was 
made in British Columbia, 1945-46. 
This gives infant mortality rates by 
occupation of father. The total infant 
mortality rate for the population 
studied was 31. The best rate among 
the occupation groups, 16, was at- 
tained, not by the professional and 
owner-manager groups, which had 
rates of 27 and 28, respectively, but 
by the clerical group, which hardly 
had a high income. To me this sug- 
gests especially good care of the 
babies in the families in the clerical 
group. [17] 

I suggest that any further research 
to establish general relationships be- 
tween infant mortality and such 
factors as income level and occupa- 
tion is probably needless, because the 



gross relationships have been estab- 
lished conclusively enough. 

Toward the future 

What research, then, other than 
purely medical, is needed concerning 
factors in infant survival? 

One such field in which few studies 
have been made recently is illness of 
babies in relation to socio-economic 
factors. A study of this relation, 
made since World War II in a town 
in England, found the usual class 
difference in infant mortality, but 
suggested, at least tentatively, that no 
such difference was evident in infant 
sickness. [18] Evidence from a later 
study, based on a larger number of 
babies, who were dravm from all 
parts of Great Britain, disagrees with 
this. [19] This, of course, suggests 
need for further research. 

Another subject, relatively un- 
touched, concerns the effect of ad- 
verse socio-economic conditions on 
the unborn baby and on the ability of 
the mother to bear a full-term, 
healthy child. Such study is especially 
needed to help us understand the 
causes of deaths of infants just before 
birth, during birth, and in their first 
days of life. As a step toward pre- 
venting the numerous deaths — many 
associated with prematurity — during 
this critical period, we need a fuller 
understanding of the relation be- 
tween these deaths and the adequacy 
of the care the mother receives dur- 
ing pregnancy. Such care, undoubt- 
edly, depends to some extent on the 
socio-economic status of the family 
and the community. 

Many other questions are still un- 
answered concerning socio-economic 
and ethnic factors in relation to ba- 
bies' deaths: What are the environ- 
mental conditions in localities where 
infant mortality is still extra high by 
m.odern standards? How do tradi- 
tional ways of caring for infants in 
various ethnic groups affect the sur- 
vival of infants in these groups? 
These are only a few of the many 
questions that research workers 
might attack as steps toward mak- 
ing available to doctors and other 
health workers facts that will help 
them to save babies' lives. 

(References are on page 134) 

THE CHILD VOL. 17 NO. 8 




L^ - 'IB^I^^iMiipl^ 



WHEN A COUPLE PLANS TO ADOPT A BABY 

Group technique helps to clarify agency procedures 



BEATRICE PRUSKI 

COUPLES that apply to an adop- 
tion agency for a child often 
have very little idea of how the 
agency goes about getting children 
for adoption or of how it decides 
which applicants are to receive chil- 
dren. They are likely to feel that the 
process is mysterious and that the 
agency makes its decisions arbitrar- 
ily. When a couple does not receive a 
child for adoption they often resent 
this and feel that the agency must 
consider them in some way inferior. 

Agencies use different methods of 
meeting this problem. One agency 
that uses a group technique in work- 
ing with the applicants is the Los 
Angeles Adoption Institute, a non- 
profit, fee-supported agency. This 
agency serves not only couples who 
apply for a child, but the child's 
natural parents. And its first interest 
is the welfare of the child himself. 

In the interest of the child, the 



agency wishes to make clear to all 
applicants just what its purposes are, 
how it proceeds, and what it requires 
of couples wishing to adopt a child. 
It has found that an effective way to 
do this is by means of a group meet- 
ing, not as a substitute for separate, 
individual interviews, but as a prep- 
aration for them. 

Couples face same problems 

The group meeting gives the 
couples their first opportunity to talk 
with professional staff members of 
the agency. Before that, they have 
had only a brief conversation with a 
receptionist, who has checked their 
eligibility with regard to age, resi- 
dence, citizenship, and length of mar- 
riage. The receptionist has noted also 
some additional information on race, 
religion, and number of children, has 
assured them of the agency's desire 
to be of service, and has explained 
that all general que-stions would be 
discussed at a meeting to be attended 



by a number of other couples who also 
were applying for a child. 

The meeting is held in the evening ; 
usually about 10 couples attend. Join- 
ing with other applicants brings home 
to each couple that they are not alone 
with their problem. Also, group dis- 
cussion can modify the extremely per- 
sonal point of view of an individual 
family's situation. Each couple is part 
of a group in which all have faced the 
question of sterility and are now tak- 
ing the same chances of disappoint- 
ment in trying to adopt a child. They 
feel that all will be treated alike. 

The group meeting helps to set the 
tone for all later individual relations 
with the agency workers. At the time 
of this first contact there are 20 
clients to 1 professional worker. The 

BEATRICE PRUSKI has the degree of 
master of arts in psychology from the Uni- 
versity of Chicago. For about 20 years she 
has worked in various phases of vocational 
and clinical psychology. 

At the time Mrs. Pruski wrote this article 
she was Director of the Los Angeles Adop- 
tion Institute. 



APRIL 1953 



127 



couples have the support of a group 
of other couples who hope to become 
adoptive parents. Their problems are 
immediately identified to some extent 
with the problems of the agency, and 
they are asked to join in trying to 
solve them. Through questions that 
other couples ask, which might not 
have occurred to them, they see the 
whole situation in broader terms. 
Also, people who do not easily formu- 
late in words the things that concern 
them, or who are shy about asking, 
benefit through the verbal facility of 
others. The dominance of the pro- 
fessional worker is reduced to a mini- 
mum ; and a more mature, a more co- 
operative, and a more nearly equal 
relationship is established at the out- 
set. 

When the meeting begins 

The method of handling the meet- 
ing varies somewhat with the worker 
who acts as leader. Since people begin 
arriving at least 20 minutes early, 
this time needs to be used in some 
way other than having them sit 
around self-consciously. At first, 
couples were asked to write down 
their ideas about their adoption plans, 
but later a more flexible plan was 
followed. The leader gives out paper 
and suggests that the people jot down 
questions they wish to ask, but she 
also carries on conversation with 
those who prefer to talk. The discus- 
sion starts not later than 10 minutes 
after the designated time. 

Discussion may start directly with 
the questions uppermost in the minds 
of the couples, and gradually may be 
shaped into a general outline; or the 
leader may follow an outline, allow- 
ing time for discussion of each point. 
Whichever method is followed, a 
number of fundamental questions al- 
ways emerge, although the content 
differs somewhat at different meet- 
ings. 

All groups ask about the origin of 
the agency, who is behind it, and how 
it is financed. Since the Institute is 
fee-supported, the leader explains this 
type of financing, as well as the 
method of paying the fees. This leads 
up to the agency's procedure for ap- 
plicants ; this is discussed and then a 




When a couple receives a baby from an authorized adoption agency, they can be sure 
that the child's interests have been given first importance in all the planning by the agency. 



written statement of it is distributed 
for the group members to take home. 
Under this procedure, which aims to 
solve the problem of long lists of 
applicants and an indefinite waiting 
period, each couple's application 
moves according to definite time in- 
tervals, and the applicants always 
know where they stand. 

Each group is asked whether they 
can think of a better plan. Although 
it is a long time since anyone has 
made a new suggestion, the discussion 
helps the applicants to realize that the 
agency is doing everything in its 
power to show them consideration. 

Agency's procedure explained 

Every group is interested in where 
we get our children, what we know 
about the child himself at the time of 
placement, and what we know about 
his background. The leader explains 
that the agency tells the adoptive 
parents all it knows about the child's 
background and makes clear that it 
would never place a child with a fam- 
ily that would be uneasy about any 
specific fact in his history. The role 
of heredity is discussed from the 
point of view of helping the appli- 
cants to clarify their own beliefs be- 
fore the individual interview that 



each couple will have with a staff 
member. Only two definite points are 
made : { 1 ) That we have no conclusive 
evidence on what is hereditary; (2) 
that many characteristics run in 
families, but that this does not neces- 
sarily mean that any particular char- 
acteristic, other than physical ones, is 
transmitted by heredity rather than 
by environment. 

The applicants always ask, and are 
frankly told, what the agency is look- 
ing for in homes for the children. It 
is most gratifying to see how simply 
and spontaneously this discussion 
focuses on the needs of the child, 
rather than on the needs of the appli- 
cants. 

The leader begins with the ques- 
tion, "Suppose that you had to sur- 
render a child of your own to be 
reared by sti'angers, what things 
would you want to be sure were pres- 
ent in that home and what things 
would you want to be sure were not 
there?" 

All groups spontaneously place 
personality and emotional traits first. 
Experience has shown that it is best 
to keep this discussion in general 
terms. Too much detail in this field, 
particularly if illustrated by ex- 
amples, tends to make some people 



128 



THE CHILD VOL. 17 NO. 8 



uneasy and self-conscious in the in- 
dividual interviews that are to come. 
Properly handled, however, this dis- 
cussion makes for greater ease and 
frankness later. The mere fact that 
the applicants gain some idea of 
what the agency is looking for, in- 
stead of depending on rumor about 
agency standards, gives them much 
more assurance. 

The agency is able to make the 
point that it does not bar people be- 
cause of any specific experience of 
their own, such as a broken home in 
their childhood, or a divorce. It is 
interested only in what these experi- 
ences have done to them ; and the final 
result may be favorable, since people 
who have met and solved problems 
are stronger than those who have not. 

The group knows the agency does 
not consider itself infallible in evalu- 
ating their situation and that it needs 
their help. The worker explains fully 
the agency's attitudes on finances, 
living space, health, and life expec- 
tancy, and it has never met with any- 
thing but complete approval of these. 
Each couple sees, as a result of dis- 
cussion, that the agency's standards 
are not artificial values of its own. 

Every adoption involves rislts 

It is well known that personal 
anxiety is often relieved through 
group discussion. People are able to 
ask questions that might be difficult 
for them in an individual interview. 

For example, "If the child develops 
a handicap, will the agency take him 
back before the final adoption?" 
Couples usually ask this because they 
fear they might lose a child after they 
have become attached to him, but 
sometimes the question is whether 
they can return a child who is un- 
satisfactory to them, and what will be 
done about the fee in that case. They 
want to know what risks they take in 
regard to the child himself. The 
agency does not minimize these risks, 
especially since it believes in placing 
babies early in life. 

Every group contains some people 
who are concerned about these risks, 
and some who dismiss the whole ques- 
tion on the ground that you take even 
greater risks with a child of your 



own. In the discussion, the group per- 
forms its own therapy for extreme 
attitudes of either type. Many 
couples have told the worker later 
that they felt she was overstressing 
these risks, and so the agency now 
tells the groups how very few real 
problems it has encountered regard- 
ing the children placed. 

Major anxieties seem to concern 
the question of the applicants' own 
qualifications and the reputed strict- 
ness and artificiality of agency prac- 
tices in general. Here too the group 
sets its own standards and performs 
its own therapy. Sometimes, although 
rarely, this discussion arouses such 
anxiety that a couple decides not to 
proceed with the application. Most 
people, however, feel enough security 
in their marriage, and at this point 
have enough faith in the agency's 
fairness, to go ahead in a much more 
relaxed frame of mind after the 
group discussion. 

Interesting emotional reactions are 
often noticed during the meeting. 
Couples often move physically closer 
together and frequently hold each 
other's hands. Naturally they feel an 
implied challenge in the discussion of 
qualifications; and in the face of it, 
surrounded by other people experi- 
encing the same challenge, a couple 
will become more conscious of their 
unity and of how much they mean to 
each other. One can sense their de- 
cision to stand by each other. The ex- 
pression of their faith in each other 
seems to help them go through the 
rest of the procedure with greater 
frankness and courage. 

Couples have frequently told the 
workers, and also have mentioned to 
outsiders, how much more informa- 
tion they have given than they had 
originally intended to give. When 
they are asked why, they usually 
answer, "Because we felt from the 
beginning that you cared what hap- 
pened to us and would do the best 
you could for us." The agency feels 
that the close emotional unity of the 
group meeting has a great deal to do 
with setting this tone. 

One of the chief ways in which the 
group meeting saves time later is that 
it stimulates the applicants to visual- 



ize themselves as possible parents be- 
fore the individual interviews. Con- 
scious effort is made to have them do 
this to prepare themselves to co- 
operate later in their interviews. 

The agency is now trying to formu- 
late the best content for group meet- 
ings in relation to the interviews. At 
the time of the individual interviews 
applicants are asked for comments on 
the group meeting. On specific points 
the comments are often constructively 
critical, and on the subject in general 
they are usually enthusiastic. People 
often tell the agency they have 
thought considerably about certain 
points afterward or have discussed 
them with friends. 

Group meeting has several values 

One value of the group meeting is 
the contribution it makes to the 
agency's own thinking and to clarifi- 
cation of policy. On a question that 
hinges on how people in general feel, 
an agency will gain more by bringing 
it up in a group meeting than by hav- 
ing the staff debate it among them- 
selves. One such question is that of 
placement of a child with handi- 
capped parents — whether or not such 
a child would be injured by com- 
munity attitudes. This is a sensitive 
area today and one which no one can 
dismiss lightly in view of the number 
of men who returned handicapped 
from the war. 

By the time the Institute set its pol- 
icy on this, it had behind it the think- 
ing and feeling of a number of the 
applicants, who certainly represent 
a broader sample of the community 
than does any agency staff. The 
couples talked very frankly on this 
point, with some differences of opin- 
ion but much fundamental agreement. 
It was evident that most of them felt 
that to preclude placement of a child 
in a home there must be some reason 
beyond the physical fact of a parent's 
handicap itself. They gave example 
after example of people they knew 
who were in this situation and of 
the neighborhood attitude and appar- 
ent effect on the children. 

In group meetings, discussions of 
problems are kept general, but many 
(Continued on page 134) 



APRIL 1953 



129 




FOLLOW-UP OF 1950 WHITE HOUSE 
CONFERENCE ENTERS A NEW STAGE 

National Committee hands torch to other groups 



ELMA PHILLIPSON 

AFTER 2 years of leading the 
work of advancing the findings 
of the 1950 White House Con- 
ference, the National Midcentury 
Committee for Children and Youth 
has placed the Conference follow-up 
in the hands of permanent groups and 
has voted to dissolve in the near 
future. 

The Committee's two Advisory 
Councils, however, will continue to 
lead their constituent agencies in 
their follow-up work. (The Advisory 
Council on State and Local Action 
represents 51 State and Territorial 
committees and more than 1,100 local 
units. The Advisory Council on Par- 
ticipation of National Organizations 
represents 452 national organizations, 
whose membership extends into all 
the States and Territories.) 

These decisions were announced at 
a Two- Year Anniversary Conference, 
held by the Committee and the two 
Councils, November 30 and December 
1-2, 1952, at New York. 

The meeting was held to inven- 
tory progress made throughout the 
country in translating into action the 
findings of the Midcentury Confer- 
ence and to note what still must be 
done to reach the goal of the Confer- 
ence — the goal of assuring for every 



child a fair chance for healthy person- 
ality development. 

Although five White House Confer- 
ences on children were held during 
the first half of this century, the 1950 
Conference was the first to hold a 
follow-up meeting such as this one. 

The Committee's chairman, Leonard 
W. Mayo, said frankly that the Mid- 
century Committee would have wel- 
comed another year's active work — if 
money had been available. But, he 
said, the Committee was never in- 
tended to function more than 2 or 3 
years. 

"Two years of intensive follow-up 
under the National Midcentury Com- 
mittee have already been provided," 
he said. "There are a good number of 
highly competent and experienced 
national organizations in the country 
that are not only capable of but inter- 
ested in advancing the findings of the 

ELMA PHILLIPSON, whose A.M. degree is 
from the University of Chicago's School of 
Social Service Administration, has been Ex- 
ecutive Secretary of the National Midcentury 
Committee for Children and Youth ever 
since it was created, December 19.50. For 
more than a year before that she had been 
on the staff of the White House Conference, 
working with the 464 national voluntary or- 
ganizations that took part in preparing for 
the Conference. Previously she had had wide 
experience with such organizations. 

Miss Phillipson is now planning and di- 
recting a recruitment project for the Ameri- 
can Association of Medical Social Workers — 
a G-month project made possible by means 
of a grant from the National Foundation 
for Infantile Paralysis. 



White House Conference through 
their programs. This is an appropri- 
ate time to bring to a successful con- 
clusion the work of the National Mid- 
century Committee." 

What are the next steps? 

Among the reasons why the com- 
mittee should plan an early exit, Mr. 
Mayo said, are the solid job being 
done by most of the State and local 
committees and the necessity for leav- 
ing a clear field for the planners of 
the 1960 White House Conference. 

Taking up the big question in the 
mind of every delegate, Mr. Mayo 
asked, "Where do we go from here?" 
As for future action, he asked the 
Conference to consider three ques- 
tions : 

1. How can we accelerate inte- 
gration of the formal follow-up 
program of the White House 
Conference with the main stream 
of regular agency and commun- 
ity programs and services? Al- 
ready, he said, the "main 
stream" has been modified in 
many parts of the country by the 
infiltration of the follow-up pro- 
gram and by many other con- 
structive influences. 

2. How can the impetus that has 
been given to the work of State 
and ' local committees be con- 



130 



THE CHILD VOL 17 NO. 8 



tinued and stren^hened? And 
in this strengthening how can 
encouragement be given to the 
process by which committees or- 
ganized for White House Con- 
ference follow-up are moving 
into broader community plan- 
ning for children and youth? 
3. What provisions should be made 
with respect to the main phases 
of the follow-up program? 
Foremost among the achievements 
of the 1950 Conference and its follow- 
up program are the impetus given to 
local, State and Territorial commit- 
tees and the impetus generated by 
them, Mr. Mayo continued. These 
committees, he said, should strength- 
en and expand their activities. "Some 
committees have been broad planning 
bodies throughout their existence," 
he pointed out. "Others have already 
moved from programs devoted solely 
to preparation for and follow-up of 
the White House Conference to even 
broader planning and action func- 
tions, in cooperation with existing 
organizations." 

Harking back to the National Mid- 
century Committee's original aims, 
Mr. Mayo specifically recommended: 

1. Continued interpretation and pub- 

licizing of White House Confer- 
ence findings by local and State 
committees. National organiza- 
tions, and Government agencies. 

2. Continued life for the Advisory 
Council on State and Local Ac- 
tion and the Advisory Council on 
Participation of National Or- 
ganizations. 

3. More emphasis on youth partici- 
pation, which should become "a 
main interest of all youth-serv- 
ing agencies." 

4. Drafting of a research program 
in personality development and 
the broad field of child care, on 
the basis of the Fact-Finding 
Report of the White House Con- 
ference, by a qualified profes- 
sional group. 

Two additional questions, some- 
what broader in scope, Mr. Mayo 
said, need to be asked because they 
bear such a close relation to the other 
problems. 

The first question arises in view of 



the fact that there is no general 
agreement on what constitutes a 
sound and comprehensive program 
for children and youth in a commu- 
nity. Shouldn't there be a definition, 
he asked, to serve as a goal for pro- 
fessional and lay workers in com- 
munities that are doing less than they 
might? It is likely that an answer 
will be found through a study being 
made jointly by the Children's Bureau 
and the Child Welfare League of 
America, he said. 

Secondly, Mr. Mayo asked, should 
provision be made for the organiza- 
tion of a national group of outstand- 
ing citizens whose sole function would 
be to represent, and to act as a spear- 
head for, the broad interests of the 
children and youth of the Nation? 
This, he said, would be a group of 
distinguished citizens who would be 
responsible to the Nation and not 
primarily or exclusively to any or- 
ganization. 

Gains made in many States over 
the past 2 years in putting into prac- 
tice the findings and recommenda- 
tions of the Midcentury Conference 
were reviewed by Lyman Bryson, 
professor of education. Teachers 
College, Columbia University. Mr. 
Bryson drew his facts from the Com- 
mittee's "Report on Children and 
Youth, 1950-52." 

Mr. Bryson discussed some gains 
that the Committee had reported in 
different States. Among the gains: 
State aid was voted for more educa- 
tion for mentally retarded, hospital- 
ized, and home-bound children; com- 
munity health councils were organ- 
ized ; small towns were included in 
public recreation programs. And 
some disappointments were reported 
too, such as rejection by some adults 
of youth participation; no public- 
health nurse in many counties; juve- 
nile offenders jailed with adults; de- 
feat of legislation for a children's 
psychiatric-treatment center. 

Speaking of the defeat concerning 
psychiatric treatment, Mr. Bryson 
said, "You can get help for a child 
whose difficulty is obvious and visible, 
but it is hard to persuade people to 
pay attention to children's emotional 
and psychological problems. 



"It's extraordinarily difficult to 
equip, and to get the proper personnel 
for, good juvenile courts and for psy- 
chiatric treatment for juvenile of- 
fenders," he pointed out. "The public 
won't quite get over the combination 
of sentimentality and brutality which 
means that if a child is obviously 
handicapped something can be done 
about it, but if the handicap is secret, 
elusive, and difficult to get at, nothing 
can be done about it." 

Going back to the bright side, Mr. 
Bryson pointed to the importance of 
small gains. "Don't think that because 
the great program is not immediately 
accepted, the little victory doesn't 
count," he said. "The little victories 
give the campaigners something to 
talk about; they encourage the staff 
and the committee members, and they 
give the local citizens something to 
be proud of." 

Young people's opinions valued 

A great need today, Mr. Bryson 
said, is to get people to look at hurt 
souls. "But it's going to be hard to 
minister to the souls of the young un- 
less we know what youth is thinking 
and doing. 

"We had young people in the meet- 
ings at Washington in 1950. They 
were disruptive, they were sometimes 
extravagant, they were often wise; 
they were always interesting; and 
they were eminently worth while. 

"I've tried a number of quite ex- 
tensive experiments, trying to get 
at the contributions which young 
people make to public opinion. I've 
found that they nearly always have 
good opinions. Just on a straight Yes 
or No vote I would be as willing to 
put any nontechnical public question 
to the vote of the young people — say 
between 16 and 20 — as to any other 
group in the United States. 

"The reason why they don't con- 
tribute much to the deliberations and 
operation of public agencies is that 
they very often don't know why they 
have those good opinions. 

"There are two fallacies in this 
field. One is the fallacy of young 
people who think that intelligence is 
a substitute for experience. The other 
is that of older people who think that 



APRIL 1953 



131 



experience is a substitute for intelli- 
gence. 

"The real reason why we want 
youth in our deliberations is not for 
their contribution, but for what it 
does for them. Young people are 
living now. Citizenship is not only 
something you learn for the future, 
but it's something you practice for 
what it does to you while you're 
practicing it. Young people have a 
right to that, for its own sake and for 
now." 

Concluding, Mr. Bryson cautioned 
against resting on the progress made 
so far. "Each of us," he said, "must 
help constantly to make a different 
social atmosphere in America, help 
constantly to make more people sensi- 
tive to the things that are wrong, to 
straighten out conditions which are 
evil and damaging." 

Melvin A. Glasser, who was execu- 
tive director of the Midcentury White 
House Conference, pointed out that 
young people have been getting more 
plentiful than ever. There were 
35,000,000 children under the age of 
18 when President Theodore Roose- 
velt called the first White House Con- 
ference in 1909. In the next 40 years 
that figure was increased by only 
12,000,000, but in the current decade 
alone an increase of 10,000,000 is 
expected. 

Midcentury marks improvements 

Significant gains cited by Mr. 
Glasser were : New emphasis on chil- 
dren's emotional needs, increased 
activity of citizens, greater attention 
to the teen-age group, more coopera- 
tion among the professions, and 
heightened interest in fact finding 
and research. He cautioned against 
being content with the status quo and 
urged the delegates to keep pushing 
forward. 

Martha M. Eliot, M.D., Chief of the 
Children's Bureau, spoke as vice 
chairman of the Federal Interdepart- 
mental Committee on Children and 
Youth. 

"The meetings of this anniversary 
conference," she said, "have made me 
realize more keenly than ever before 
the effective leadership which the 
National Midcentury Committee has 



given to the White House Conference 
follow-up program." 

Dr. Eliot explained the work of the 
Federal Interdepartmental Commit- 
tee on Children and Youth, which 
represents 35 Government agencies, 
and showed how both public and pri- 
vate agencies gain from a friendly 
interrelationship. 

"Each older generation piously 
hopes that its successors will be able 
to avoid the mistakes of its forerun- 
ners and triumph over the legacy of 
difficulty bequeathed to it," said Dr. 
Buell Gallagher, President of the 
College of the City of New York. "Yet 
each oncoming generation is forced to 



PUBLICATIONS of the Mid- 
century White House Conference, 
including the "Report on Children 
and Youth, 1950-1952" (46 pp. $1) 
and the "Directory of State and Ter- 
ritorial Committees Cooperating 
with the National Midcentury Com- 
mittee for Children and Youth" (60 
pp. 75 cents), should be ordered 
from Health Publications Institute, 
216 North Dawson Street, Raleigh, 
N. C. Ask for quantity and packet 
rates. 

Health Publications Institute, a 
nonprofit organization, has on sale 
all the Midcentury Conference pub- 
lications except "Personality in the 
Making," which is published by Har- 
per & Bros. (454 pp.). 



grow up in a world where adults set 
the patterns of control and determine 
the possibilities for growth. Each 
generation's teeth are set on edge by 
the sour grapes eaten by its fathers. 

"No matter how much progress can 
be shown over the last half -century, 
we know that the next half-century 
still poses for the present generation 
of adults the same old problem — how 
to release the leadership of today's 
children in constructive directions 
without corrupting it with the preju- 
dices, foibles, and chicanery of to- 
day's adults." 

Dr. Gallagher pointed out that it 
won't be easy to give children a better 
chance. Citizens can be rallied to 
battle against "entrenched evil when 
it is clearly unmasked," but they are 
slow to meet the need for patient, 
plodding work on constructive pro- 
jects. Too many are willing to stop 
at the talking, or listening, stage. 



And even when they move ahead, 
much of their energy is wasted in the 
cumbersome process of building the 
kind of machinery that will ulti- 
mately get results. 

"Since today's children will be to- 
morrow's leaders, the only way to 
make sure they will lead well is to give 
them good leadership today," Dr. 
Gallagher said. 

"We must work very hard on to- 
day's adults," he continued. "There is 
no other way to make sure that those 
who today lead tomorrow's leaders 
will not corrupt and ruin the bright 
hope on which mankind must rely." 

As a goal in reforming the current 
crop of adults. Dr. Gallagher sug- 
gested that adulthood should "seek 
earnestly to recapture the virtues 
(without the vices) of youth, to be- 
come childlike without being childish." 

Margaret Price, chairman of the 
Advisory Council on State and Local 
Action, said : "In some cases I believe 
the citizens are ahead of us in their 
desire for action." She cautioned the 
State committees to make sure in 
future planning "that this citizen 
interest shall neither die nor be 
siphoned off into unproductive chan- 
nels." Mrs. Price announced that the 
Advisory Council on State and Local 
Action is planning to expand its ac- 
tivities, and that another meeting of 
the Council is to be held toward the 
end of 1953. 

George Corwin, vice chairman of 
the Advisory Council on Participation 
of National Organizations, said that 
the 92 national organizations repre- 
sented at the meeting had agreed to 
urge all national groups to step up 
their efforts to eliminate prejudice 
and discrimination; to strengthen 
local welfare councils, to develop more 
lay leadership, to work for vital legis- 
lation, and to encourage youth par- 
ticipation. 

A strong plea for more attention 
to young people who will not go to 
college or may not even finish high 
school was made by Charlotte Peter- 
son of Detroit, a Wayne University 
student who is vice chairman of the 
Michigan Youth Advisory Council. 

"The schools' educational and coun- 
seling programs are not as effective 



132 



THE CHILD VOL 17 NO. 8 



as they could be," she said. "Too often 
they pay attention to the top group 
who will go to college, or to the 
troublemakers at the bottom." 

Better vocational-counseling serv- 
ice, coupled with full recognition of 
the dignity of all forms of labor, are 
two main goals of the Michigan Youth 
Advisory Council, Miss Peterson re- 
ported. Another aim is to give boys 
and girls "the opportunity to acquire 
an actual, constructive work experi- 
ence on a job they are best qualified 
to perform." Employers and labor 
unions should help work out a feasible 
apprenticeship program, she said. 

Strengthening of State and Terri- 
torial youth committees to make them 
better watchdogs was recommended 
by the Advisory Council on State and 
Local Action. 

The delegates urged that every 
State committee have a formally de- 
fined purpose and a clearly outlined 
structure. 

Committee members, rather than 
the executive secretary, should be 
primarily responsible for raising 
money, the group agreed. Because 
the planning functions of the com- 
mittees involve both public and pri- 
vate services, it was recommended 
that funds be sought from public 
and/or private sources. 

The importance of regularly sched- 
uled conferences and regularly pub- 
lished newsletters was emphasized. It 
was suggested that State and Terri- 
torial committees give special atten- 
tion to one or more projects with 
youth participation and to enactment 
of needed legislation. 

How to eliminate prejudice and 
discrimination that still persist in the 
programs and staff and membership 
policies of many national organiza- 
tions was discussed by the Advisory 
Council on Participation of National 
Organizations at a work session. 

Many national organizations, the 
delegates reported, have changed 
their bylaws or adopted policies to 
prevent discrimination in their own 
ranks, and to avoid holding con- 
ventions in cities that practice seg- 
regation. 

"We recommend," the discussion 
group announced, "that national or- 



ganizations gather the facts about the 
makeup of their personnel and their 
constituency and their existing prac- 
tices and then face the implications of 
these findings in terms of policy 
changes. 

"We recommend that national or- 
ganizations help set a pattern by 
operating with completely integrated 
national clerical and professional 
.staffs." 

Fairness called for 

The delegates pointed out that dis- 
crimination is not limited to racial 
and religious groups but extends also 
to physically handicapped persons 
and low-income families. Action to 
stop discrimination in these areas is 
also needed, it was agreed. 

The Committee's new pamphlet, 
"Report on Children and Youth, 1950- 
1952," was distributed at the Two- 
Year Anniversary Conference. 

Based on material supplied by 
State and Territorial youth commit- 
tees, by national organizations, and by 
Federal agencies, the report is packed 
with examples of voluntary and offi- 
cial action in carrying out the find- 
ings of the White House Conference. 

The Committee has issued another 
new publication, the "Directory of 
State and Territorial Committees Co- 
operating with the National Mid- 
century Committee for Children and 



Youth." This is far more than just 
a directory. It includes highlights of 
the present activities of many of the 
State and Territorial Committees' 
programs, as well as some of their 
plans for the future. As the Mid- 
century Committee chairman says in 
the foreword, "It reveals amazing and 
admirable ingenuity, skill, and leader- 
ship on the part of State and Terri- 
torial Committees in providing in- 
creasingly better opportunities for 
the healthy personality development 
of all our children and youth." 

As was reported in the February 
issue of The Child, the National Mid- 
century Committee has closed its 
office in New York. The Committee 
will not disband, however, until July 
or possibly later in 1953. General 
correspondence should be addressed 
henceforth to the chairman, Leonard 
W. Mayo, director of the Association 
for the Aid of Crippled Children, 580 
Fifth Avenue, New York 36. 

The Advisory Council on State and 
Local Action should be addressed in 
care of the secretary, Douglas H. 
MacNeil, 222 West State Street, 
Trenton 8, N. J. 

The Advisory Council on Participa- 
tion of National Organizations should 
be addressed in care of the chairman, 
Robert E. Bondy, National Social 
Welfare Assembly, 1790 Broadway, 
New York 19. 




At the Midcenturj ( imrcrfnce, in 1950, at which \()iiP!; doloyates t(»()k part in discussions, 
adults found that the younj; people had good opinions, though they didn't always know why. 



APRIL 1953 



133 



INFANT MORTALITY 

(Continned fro»i page 126) 

REFERENCES 

1. Selwyn D. Collins: Trends in Illness and Mor- 
tality. Public Health Reports, May 1952, 67, pp. 
502-503. 

2. C.-E. A. Winslow and Dorothy F. Holland: The 
Influence of Certain Public Health Procedures upon 
Infant Mortality. Hinrian Biology, May 1937, 9, pp. 
133-174. 

3. Howard W. Green : Infant Mortality and Eco- 
nomic Status. Cleveland Five-City Area, Cleveland, 
Cleveland Health Council, 1939, p. 10. 

4. U. S. Children's Bureau: Statistical Series No. 
9. Charts on Infant, Childhood, and Maternal Mor- 
tality, 1949. Washington. 

5. W. P. D. Logan : Mortality in England and 
Wales from 1848 to 1947 ; a Survey of the Changing 
Causes of Death During the Past Hundred Years. 
Population Studies, September 1950, 4, pp. 132-178. 

6. Sigismund Feller: Studies on Mortality since the 
Renaissance. Bulletin of the History of Medicine, 
1943, 13, pp. 427-461. 

7. Charles V. Chapin : Deaths among Taxpayers 
and Nontaxpayers Income Tax, Providence, 1865. 
American Journal of Public Health, August 1924, 14, 
p. 648. 

8. B. Seebohm Rowntree : Poverty and Progress : 
a Second Social Survey of York. London, Longmans, 
Green, 1941, p. 297, 298. 

9. Robert M. Woodbury: Causal Factors in Infant 
Mortality ; a Statistical Study Based on Investiga- 
tions in Eight Cities. 1925. 246 pp. (U. S. Children's 
Bureau Publication No. 142), p. 148. 

10. Howard W. Green, op. cit., p. 33. 

11. Marion E Altenderfer and Beatrice Crowther: 
Relationship between Infant Mortality and Socio- 
Economic Factors in Urban Areas. Public Health 
Reports, March 18, 1949, 64, p. 333. 

12. A. D. H. Kaplan : Significance of Infant Mor- 
tality Data in Appraisal of an Urban Community. 
American Journal of Public Health, October 1932, 
22, pp. 1037-49. C. A. McMahan : The People of 
Atlanta ; a Demographic Study of Georgia's Capital 
City. Athens, Ga., University of Georgia Press, 1950, 
pp. 172-173. 

13. Mary Cover: Negro Mortality. II. The Birth 
Rate and Infant and Maternal Mortality. Public 
Health Reports, October 25, 1946, 61, pp. 1529-1538. 
Amanda L. Stoughton : A Study of Negro Infant 
Mortality. Public Health Reports. November 8, 1929, 
44, pp. 2705-2731. 

Howard W. Green : Op. cit. 

Alfred Yankauer: The Relationship of Fetal and In- 
fant Mortality to Residential Segregation ; an Inquiry 
into Social Epidemiology. American Sociological Re- 
view, October 1950, 15, pp. 664-648. 
Harry Bakwin : The Negro Infant. Human Biology, 
February, 1932, 4, pp. 1-33. 

Herbert J. Sommers : Infant Mortality in Rural and 
Urban Areas. Public Health Reports, October 2, 
1942, 57, pp. 1494-1501. 

14. Robert W. Woodbury: Op. cit. 

15. Ibid., pp. 104-106. 

16. Louis Rosenberg : Canada's Jews : A Social and 
Economic Study of the Jews in Canada. Montreal, 
Canadian Jewish Congress, 1939. 418 pp. 

17. J. Doughty: Some Observations from a Prelim- 
inary Study of Infant Mortality in British Columbia, 
Based on Birth-Death Linkage. Canadian Journal of 
Public Health, July 1949, 40, p. 303. 

18. E. M. Dykes: Illness in Infancy; a Compara- 
tive Study of Infant Sickness and Infant Mortality in 
Luton. Luton, England, Leagrave Press, 1950. 46 pp. 

19. J. W. B. Douglas: Social Class Differences in 
Health and Survival during the First Two Years of 
Life; the Results of a National Survey. Population 
Studies, July 1951, 5, p. 37. 



References to official vital-statistics reports, 
here, are in complete paper. 



litted 



Copies of the complete paper now available 
from the Children's Bureau. 



ADOPTION 

{Continued from page 129) 

couples remain to ask questions later 
about their personal situation. This 
also saves much time for everyone 
concerned, since special problems can 
be clarified before the couple makes 
another special trip for an intervie-w. 
Through the discussion they become 
aware of problems that might other- 
wise not emerge until later in a per- 
sonal interview. 

As already noted, preparation for 
rejection of applications is achieved 
in the group meeting as it never could 
be through any number of individual 
interviews. The applicants know that 
only a few of the couples who are 
sitting there with them can possibly 
be given a child, because there are not 
enough children to go around. They 
know that all these people are sensi- 
tive about sterility, and that this con- 
dition is one of the main reasons why 
they are at the meeting. 

The agency explains that the appli- 
cants will be notified of rejection 
simply by a form letter and tells why 
no reasons will be given at the time. 
The couples know that they will be 
told during the interview about tangi- 
ble reasons such as finances or health 
or about anything they could change 
without getting involved in problems 
of psychotherapy. 

When the couples are first asked if 
they would like to have reasons given, 
the answer is almost universally yes. 
However, the leader points out what 
it might do to a marriage if the rea- 
sons for rejection were focused solely 
on one person and not the other. 
Again, she shows that attempting 
such explanations would add to the 
size of the fee. She makes clear that 
if the explanations were given briefly 
and not followed up by help in solving 
the problems, the result would be at 
least nonconstructive and might be 
injurious. When the applicants stop 
to think of all these factors most of 
them come to agree with the agency 
practice. People with any degree of 
imagination or insight realize that in 
applying for a child they are not ask- 
ing for discussion of deep emotional 
problems to which they may have al- 



ready worked out some sort of adjust- 
ment, or which may not even exist. 

The agency stresses that when it 
has nothing constructive to offer it 
has no desire to convince the couples 
that its decision is right, and there is 
always the possibility that its workers 
are mistaken. Although the agency 
must abide by its own best judgment 
in doing its job, no one is infallible in 
evaluating emotional traits and esti- 
mating their effect upon a child who 
is not yet there. It would be unfortu- 
nate if anxieties were aroused that 
might not even be based upon reality 
and that the agency is not prepared 
to work out with the applicants. 

Not enough babies for all 

There is no doubt that not giving 
reasons for a rejection can arouse 
great anxiety. However, it is made 
clear that because of the surplus of 
applicants, standards for acceptance 
are high, and therefore reasons for 
rejection are not necessarily serious. 

It is true that, in spite of this prep- 
aration, some applicants do request 
reasons at the time of rejection, but 
the number is very small and the 
request is usually prefixed by the 
statement, "We know that this is con- 
trary to your policy, but we hoped 
in this case . . ." Usually a restate- 
ment of the agency's position is suffi- 
cient to close the matter without great 
resentment, although the agency sees 
its share of people whose only desire 
is to strike out irrationally at some- 
thing. However, for most reasonably 
well-adjusted people, and these make 
up the vast majority of couples who 
apply for babies to adopt, a good 
preparation for the rejection is found 
in the group meeting. 

The group technique has proved so 
successful that the agency's director 
is now considering extending it in two 
other possible ways. One would be to 
have small groups of accepted appli- 
cants come together prior to receiving 
their child for a discussion of child 
care. The other would be for small 
groups of couples ready for final 
adoption to discuss the court pro- 
cedure and questions of later child 
development. 

Reprints in about 6 weeks 



134 



THE CHILD VOL 17 NO. 8 



IN THE NEWS 



Jobs in social work. A public em- 
ployment service office, manned by 
employment specialists and serving 
as a Nation-wide clearinghouse for 
jobs in the social-work field, will be 
a feature of the 1953 National Con- 
ference of Social Work in Cleveland. 
The job clearinghouse will be in- 
stalled on an experimental basis by 
the United States Employment Serv- 
ice in cooperation with aifiliated State 
Employment Services. The specific 
purpose of the plan is to provide ar- 
rangements for bringing job orders 
and job applicants in the social-work 
field together. A centrally placed 
booth, staffed by experienced employ- 
ment service interviewers, will be 
available to bring together interested 
applicants and agency representatives 
who have listed vacancies. 

Advanced training courses for child- 
care specialists of many countries will 
be conducted in 1953 by the Interna- 
tional Children's Center in Paris, an 
institution aided by the United Na- 
tions International Children's Emer- 
gency Fund. 

The four courses offered deal with : 
(1) The prevention of tuberculosis in 
children, including methods of BCG 
vaccination; (2) the rehabilitation of 
motor-handicapped children; (3) so- 
cial pediatrics ; and (4) problems en- 
countered in prenatal care and at the 
time of childbirth. 

Fellowships for doctors, health offi- 
cers, and social workers are offered to 
help personnel in some 50 countries 
and territories to participate in the 
training, which will include field trips 
to a number of French institutions. 

In addition to offering the training 
courses, the Center will continue a 
number of research projects on child- 
development problems, will serve as 
a documentation center in the field, 
will issue publications on child-care 
questions, and will organize a popular 
educational exhibition. 

Young people of working age. 

Because fewer babies were born dur- 
ing the depression of the 1930's, the 
number of boys and girls now reach- 
ing working age — 15 years — is com- 
paratively small. There was a drop 
of 13 percent in the 15- to 19-year 
age group in 1950 as compared with 
1940 (from 12,333,523 to some 10,- 
732,000), according to decennial- 
census figures. This is the age group 
now leaving school and college and 
starting work. Military demands on 
the boys and early marriage and 



childbearing among the girls further 
reduce the number of new workers. 
By 1960, however, because of the 
large number of births during and 
since World War II, the Bureau of 
the Census estimates that the number 
of young people in the 15- to 19-year 
age group will be 30 percent greater 
than it was in 1950. 

Millions of mothers employed. Just 
over 514. million women workers were 
mothers of children under 18 in April 
1951, according to the Bureau of the 
Census ; about 2 million had children 
under 6. 

Absence of the husband tends to 
force mothers into seeking employ- 
ment. Of all mothers with children 
under 18, one-fifth of those with the 
husband present and one-half of all 
other women that were ever married 
were employed. 

Even among mothers whose chil- 
dren were all under 6, the proportion 
of working mothers was considerable 
— 14 percent for those with husband 
present, and 37 percent for all others 
ever married. 



To Our Readers — 

We welcome comments and 
suggestions about The Child. 



CAL 



Apr. 6-10. AssuciHtion for Childhood 
Education International. Annual 
study conference. Denver, Colo. 

Apr. 7. World Health Day. 

Apr. 8-10. United States-Mexico Bor- 
der Public Health Association. 
Eleventh annual meeting. El Paso, 
Tex., and Ciudad Juarez, Chihua- 
hua, Mexico. 

Apr. 8-11. International Council for 
Exceptional Children. Thirty-first 
annual convention. Boston, Mass. 

Apr. 8-12. American Heart Associa- 
tion. Twenty-ninth annual meeting 
and twentv-sixth scientific sessions. 
Atlantic City, N. J. 

Apr. 10-11. American Academy of 
Political and Social Science. Fifty- 
seventh annual meeting. Philadel- 
phia, Pa. 

Apr. 13-15. Girls Clubs of America. 
Eighth annual conference. New 
York, N. Y. 

Apr. 13-19. National Boys' Club Week. 
Information from Boys' Clubs of 
America, 381 Fourth Avenue, New 
York 16, N. Y. 



Apr. 18-19. American Psychosomatic 
Society. Tenth annual meeting. At- 
lantic City, N. J. 

Apr. 19-25. National YWCA Week. 
Sixth annual observance. Informa- 
tion from National Board, Young 
Women's Christian Association, 
600 Lexington Avenue, New York 
22, N. Y. 

Apr. 20-22. Sixteenth Annual Groves 
Conference on Marriage and the 
Family. Sponsored by the Univer- 
sity of North Carolina. Held at 
Ohio State University, Columbus. 

Apr. 20-23. National Council of Juve- 
nile Court Judges. Sixteenth an- 
nual conference. The National 
Juvenile Court Foundation will 
meet concurrently with the Na- 
tional Council. New Orleans, La. 

Apr. 21 - 26. International Union 
Against the Venereal Diseases. 
Nineteenth general assembly. Rot- 
terdam, Netherlands. 

Apr. 22. National Social Hygiene 
Day. Information from the Ameri- 
can Social Hygiene Association, 
1790 Broadway, New York 19, 
N. Y. 

Apr. 25-May 2. Boys and Girls Week. 
Thirty-third annual observance. In- 
formation may be obtained from 
the nearest Rotary Club. 

Apr. 27-28. American Association 
for Cleft Palate Rehabilitation. 
Eleventh annual convention. At- 
lanta, Ga. 

Apr. 30-May 3. American Psycho- 
analytic Association. Annual meet- 
ing. Los Angeles, Calif. 

Regional conferences, American 
Public Health Association: 

Apr. 23-25. Southern Branch. At- 
lanta, Ga. 

June 10-13. Western Branch. Los 
Angeles, Calif. 

Regional conferences. Child Wel- 
fare League of America: 

Apr. 16-18. Southern Region. Nash- 
ville, Tenn. 

Apr. 26-28. South Pacific Region. 
Berkeley, Calif. 

Apr. 30-May 2. North Pacific Re- 
gion. Seattle, Wash. 

May 18-19. New England Region. 
Swampscott, Mass. 

June 10-12. Southwest Region. Den- 
ver, Colo. 

Illustrations: 

Cover. Esther Bubley. 

P. 127, Jane Schroeter. 

P. 128, courtesy of Parade and the Spence- 
Chapin Adoption Service. 

P. 130: Left, seal of the Midcentury Con- 
ference, drawn by William N. Thompson; 
right, Esther Bubley for UAW-CIO. 

P. 133, Singer for Children's Bureau. 



APRIL 1953 



135 




VOL. 17 NO. 8 
APRIL 1953 



In This Issue 



Infant Mortality and Patterns of Living 
Odin W. Anderson 

When a Couple Plans to Adopt a Baby 
Beatrice Pruski 



Follow-up of 1950 White House Conference Enters 

a New Stage 

Elma Phillipson 



Page 

122 

127 
130 



Published 10 times a year by tiie Division of Reports, Children's Bureau 
Editor, Sarah L. Doran Art Editor, Philip Bonn 

FEDERAL SECURITY AGENCY 
Oveta Culp Hobby, Administrator 

CHILDREN'S BUREAU 
Martha M. Eliot, M.D., Chief 



SOCIAL SECURITY ADMINISTRATION 
Arthur J. Altmeyer, Commissioner 



Publication of THE CHILD, monthly bulletin, has been authorized by the Bureau of 
the Budget, September 19, 1950, to meet the needs of agencies working with or for 
children. The Children's Bureau does not necessarily assume responsibility for 
statements or opinions of contributors not connected with the Bureau. 

THE CHILD is sent free, on request, to libraries and to public employees in fields 
concerning children; address requests to the Children's Bureau, Federal Security 
Agency, Washington 25, D. C. For others the subscription price is $1.25 a year. On 
all orders of 100 or more sent to one address there is a discount of 25 percent. Single 
copies 15 cents each. Send your remittance to the Superintendent of Documents, 
Government Printing Office, Washington 25, D. C. 

Foreign postage — 25 cents additional — must be paid on all subscriptions to 
countries in the Eastern Hemisphere and those sent to Argentina and Brazil. 
Domestic postage applies to all other subscriptions. 




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U. S. GOVERNMENT PRfNTING OFFICE; I95I--912044 



MAY 1953 




CHILD HEALTH DAY, 1953 

by the President of the United States of America 

Boston Public Library 
Superintendent of Documents 

JUN16 1953 a Proclamation 



Whereas the Congress, by a joint resolution of May 18, 1928 (45 Stat. 617), 
authorized and requested the President of the United States to issue annually a proc- 
lamation setting apart May 1 as Child Health Day; and 

Whereas the health and wholesome development of our children are matters of 
the deepest concern to all Americans ; and 

Whereas the stresses and strains of our times create many problems bearing on 
the spiritual and emotional health of our children and are reflected notably in juvenile 
delinquency; and 

Whereas we have made tremendous advances in overcoming the most severe physi- 
cal hazards of childhood, and are now striving to make equally significant progress in- 
understanding the nature of emotional health, in order that our children may grow into 
mature, responsible citizens of a democracy : 

Now, Therefore, I, Dwight D. Eisenhower, President of the United States of 
America, do hereby designate the first day of May, 1953, as Child Health Day; and I 
urge all parents and young people, and all other individuals, as well as agencies and 
organizations interested in the well-being of children, to increase their understanding of 
the emotional, social, and spiritual growth of children, so as to apply this understanding 
in their day-to-day relations with the rising generation. 

In Witness Whereof, I have hereunto set my hand and caused the Seal of the 
United States of America to be affixed. 

Done at the City of Washington this twentieth day of February in the year of our 

Lord nineteen hundred and fifty-three, and 
of the Independence of the United States 
of America the one hundred and seventy- 
seventh. 




By the President : 



/ 



Ljis-^ C-i^^ Ca-iCc^ X^i-o.^ 




Secretary of State 



138 



THE CHILD VOL. 17 NO. 9 



TO UNDERSTAND 
CHILDREN BETTER 




OVETA GULP HOBBY 

A MERICANS could do a tremen- 
r^ dous job of preventing crime, 
unhappiness, and mental ill- 
ness if they would carry out the ob- 
jective of Child Health Day for 1953. 

Child Health Day, proclaimed by 
President Eisenhower for May 1, 
1953, is the day on which all Ameri- 
cans are urged "to increase their 
understanding of the emotional, so- 
cial, and spiritual gro^^'th of children, 
so as to apply this understanding in 
their day-to-day relations with the 
rising generation." 

We know that children who do not 
get the chance to develop their fullest 
capacities in each stage of their 
growth run larger risks of growing 
into maladjusted, unhappy, and not 
fully productive adults. 

All along the way we see evidence 
that the knowledge we have about 
child growth is not being fully ap- 
plied. We see it in rising juvenile- 
delinquency rates, in a fantastically 
large national crime bill, in mounting 
numbers of emotionally disturbed, 
mentally ill people. 

There is nothing that leads us to 
believe that people are born delin- 
quents or criminals. It is in their 
childhood that tendencies in these di- 
rections first appear. 

If, as parents, we can understand 
more about the growth processes of 
childhood, we increase the chances 
that our children can develop the 
emotional and mental strength re- 
quired to live happy, useful, and sat- 
isfying lives. 



Those who are interested in learn- 
ing more about the stages of growth 
might start with "A Healthy Person- 
ality for Your Child," a booklet pub- 
lished by the Children's Bureau. It 
sums up in popular form what we 
know today of how children grow 
emotionally and has a companion 
"Discussion Aid" for groups that 
want to talk over the problems they 
encounter in rearing and working 
with children. 

The Children's Bureau is proud to 
join with the State and local health 
departments, traditional sponsors of 
Child Health Day activities, in their 
observance of May Day. 

The 1953 observance marks the 
twenty-fifth year that Child Health 
Day has been observed by Presiden- 
tial proclamation. It was authorized 



by a joint congressional resolution, 
passed in 1928, which called atten- 
tion to "the fundamental necessity of 
a year-round program for the protec- 
tion and development of the Nation's 
children." 

In the quarter century since Presi- 
dent Coolidge issued the first Child 
Health Day Proclamation, through 
new medical and scientific discoveries 
and extensive public-health work, our 
country has made tremendous ad- 
vances in overcoming many of the 
great physical hazards that used to 
threaten children. 

In the words of President Eisen- 
hower, "We are now striving to make 
equally significant progress in under- 
standing the nature of emotional 
health in order that our children may 
grow into mature, responsible citi- 
zens of a democracy." 



OVETA GULP HOBBY became the first 
Secretary of Health, Education, and Welfare 
April 11." 195.3. 

On that day, the President's Reorganiza- 
tion Plan Xo. 1. 1!).53, went into effect, chang- 
ing the former Federal Security Agency, 
of which Mrs. Hobby was Administrator, 
into the U. S. Department of Health, Educa- 
tion, and Welfare. 

Mrs. Hobby was born in Killeen, Tex. She 
received her education in the public schools 
of Killeen, under private tutors, and at Mary 
Hardin-Baylor College. 

In 1942 when the Women's Army Auxili- 
ary Corps was created Mrs. Hobby was ap- 
pointed as Director. In 1943 the Corps be- 
came the Women's Army Corps, and Mrs. 
Hobbv served as its Director, with the rank 
of Colonel, till 194.5. She was awarded the 
Distinguished Service Medal by the United 
States Government and the Jlilitary Merit 
.Medal by the Philippine Government. 

At the time of her appointment as Federal 
Security Administrator, Mrs. Hobby was edi- 
tor and publisher of the Houston Post and 



executive director of Station KPRC-AM- 
FM-TV. 

Mrs. Hobby served as consultant on the 
Bipartisan Commission on Organization of 
the Executive Branch of the Government, 
and later on the Board of Directors of the 
Citizens Committee for the Hoover Report. 
She was on the National Advisory Council 
of the American Cancer Society. 

She is a former member of the Board of 
Governors of the American National Red 
Cross and has been a member of the De- 
fense Advisory Committee on Women in the 
Services. For several years she served on 
the Board of Directors of the National Con- 
ference of Christians and Jews. 

Mrs. Hobby holds honorary degrees from 
Baylor University, Mary Hardin-Baylor Col- 
lege, the University of Chattanooga, Sam 
Houston State Teachers College, Colorado 
Woman's College, and Bard College. In 1950 
she was awarded honor medals for distin- 
guished service to journalism by the Uni- 
versity of Missouri and by the Texas Press 
Association. In 1951 her name was added to 
the roster of the South's Hall of Fame for 
the Living. 



MAY 1953 



139 



FOR BETTER AND HAPPIER CHILDREN 



School Is More 
Than Three R's 

EARL J. McGRATH 

Commissioner of Education. 
Department of Health, Edncation, and Welfare 

Most children like to go to school. 
They like to go for a variety of rea- 
sons. Usually, when boys and girls 
are enthusiastic about school it is 
because they feel the teacher likes 
and understands them. In return, 
they like her. 

All over the country, there are 
classrooms that reflect good pupil re- 
lationships. In such classrooms, 
every child comes to know that : 

— he has friends in the class, his 
being "there" makes a difference, 
and he is missed when he is away. 

— the teacher and principal believe 
in him. He and his schoolmates have 
a part in planning what goes on in 
school. Their ideas count. 

— his work is important to the 
group. Once he accepts responsibility 
for something which he is able to do 
and which is needed by the group, he 
must carry through; he approaches 
his responsibility with confidence 
that he can carry it. He knows that 
he does not have to work exactly as 
others do; instead, he can work at a 
pace and in a way that is comfortable 
for him. He learns, however, that he 
must often work hard to do the work 
he really wants to do. 

— he can get help in carrying out 
his responsibilities from his teacher 
and classmates, from books and other 
source materials as he works alone, 
in a group, or as a committee mem- 
ber. 

— he is becoming more skillful day 
by day as he learns to read, write, 
figure, listen, and talk ; to make deci- 
sions on the basis of what he reads, 
hears, sees, and discusses ; to express 
himself creatively through difi'erent 
mediums; and to work with mate- 
rials and tools. He knows that as he 
becomes more skillful both he and 
the group profit. 

— other children respect his rights 



and belongings and he is learning to 
respect their rights and belongings. 

— he can trust the teacher and his 
classmates and they can have faith 
in him. 

— the teacher is a friend who will 
listen to him when he is troubled and 
will hold in confidence the things he 
tells her in confidence. 

— he and his teacher and his par- 
ents are all friends, working together 
to help him "grow up" and since he 
is doing his best they, as well as he, 
are satisfied with his progress. Con- 
sequently, he is free from anxiety, 
tension, and fear. 

Prescription 



for Peace 



BROCK CHISHOLM 

Director General, World Health Organization 

The observance of Child Health 
Day in the United States is a remind- 
er to all of us of the very intimate 
relationship which exists between the 
health of the child — when defined as 
total health — and the solution of the 
great crisis which confronts human- 
ity today. 

If in our ignorance, our short- 
sightedness, our lack of courage and 
vision, we continue to deny our chil- 
dren the blessings of physical well- 
being; if, moreover, we continue to 
inculcate in them prejudices, uncriti- 
cal and emotional beliefs in unreason- 
able things, excessive fears of others 
and, as a result, aggressive desire for 
power and domination, then we can 
be sure that the world of tomorrow 
will be a world of fear, of chaos, of 
cruelty — and of death. 

If, on the other hand, we succeed 
not only in making our children 
physically healthy, but also in freeing 
them of our taboos, our anxieties, our 
destructive impulses; if we teach 
them to feel, and to act in accord 
with, a sense of responsibility for the 
welfare of their fellow human beings 
— not just locally, not just nationally, 
but for the whole human race, then 
we need not worry about our future 



and theirs; it cannot but be secure, 
peaceful, and truly rich in the values 
that make life worthwhile. 

To resolve on May 1 to dedicate 
our energies to the healthy emotional 
development of our children will be 
to provide ourselves and them with 
one of the strongest possible guar- 
antees that man's age-old dream of a 
better and happier world shall after 
all become a living reality. 

Clue to Child Health 

R. H. FELIX, M.D. 

Director, National Institnte of Mental Health, 

Fnl'lic Health Service, 

Department of Health, Education, and Welfare 

On Child Health Day in 1953, we 
can see the gradual evolution during 
the past few years of a new concept 
in child health. 

We recognize that the child with 
persistent behavior problems is 
neither happy nor healthy, and that 
a crippled personality may be just 
as serious a handicap as a crippled 
body. We also recognize that it is 
impossible to deal with the child 
alone, and that we must also deal 
with the adults upon whom he is de- 
pendent. 

It is gratifying that communities 
are making efforts to help both chil- 
dren and parents by establishing 
more child-guidance clinics. All child- 
guidance workers recognize how im- 
portant it is for parents to see that a 
child feels wanted and loved through- 
out childhood. 

Parents should help the child de- 
velop his own personality, and not 
try to make him a carbon copy of 
someone else. He should not be over- 
protected or overindulged, but should 
rather be able to feel that he can rely 
on his parents for consistent atti- 
tudes, sympathetic understanding, 
and a gradual "loosening of the apron 
strings." 

Child Health Day should remind 
us all of our obligation to help every 
child grow up to be a well-adjusted 
individual, able to face his duties 
with resourcefulness and to choose 
his opportunities with wisdom. 



140 



THE CHILD VOL. 17 NO. 9 



CHILDREN IN THE CONTEMPORARY SCENE 



GEORGE E. GARDNER, Ph.D., M.D. 

ONE of the hardest things in the 
world for man to evaluate is 
his present world — his con- 
temporary scene — whether he views 
it solely in relation to his own posi- 
tion, enmeshed in his own series of 
relationships, or whether he tries to 
estimate the worth of his entire soci- 
ety in respect to some particular so- 
cial issue or social program. It is 
much easier for him to appraise a his- 
torical segment of the past or to spec- 
ulate upon the f ruitf ulness of a future 
plan than to state categorically and 
emphatically just where he now 
stands. His own involvement or in- 
vestment in his numberless roles in 
the present precludes accuracy and 
minimizes objectivity. 

But he is forever trying such mea- 
surements, and I too shall try as a 
physician and psychiatrist to outline 
for you what the American child and 
parent face as they seek what seems 
to me to be that ultimate goal for 
both — namely, a comprehensive child- 
care program in a democratic society. 
I have no doubts whatsoever as to 
the correctness of the goal, and I 
would be particularly emphatic in my 
inclusion of the word "comprehen- 
sive" and the word "democratic." For 
you will note as I proceed that any 
shortcomings that we have in the 
care of children in our country today 
can be ascribed either to a lack of 
"comprehensiveness" or to a lack of 
"democraticity" or to both. 

This then is the larger measure- 
ment that I would apply — or better, 
it is the microscopic low-power view 
that one can take of our present 
scene. But the high-power view, and 
the most revealing measure applica- 
ble, is that which involves not the 
whole field, but the selection merely 
of the individual child within an 
area — any specifically designated 
child in any area of our field. Only 




The child-guidance clinic, with its emphasis on psychiatric care, is less than 50 years old. 



through such samplings can one get 
an estimate of how far we have actu- 
ally approached our goal of demo- 
cratic comprehensive child care, and 
only in such samplings do we dis- 
cover the moderate — or the painful — 
lacks that must be eradicated. My 
basic thesis, therefore, is that our 
present scene — or any society — can 
be judged in respect to the adequacy 
of its child care only by estimating 
what programs have been devised in 
that society to care for the individual 
needs of the individual child, and to 
what extent this program of indi- 
viduation has become universally 
applied. The battles that have been 
waged and won to secure the more 



GEORGE E. GARDNER is Director of the 
Judge Baker Guidance Center, at Boston. 
He is also Editor of the American Journal 
of Orthopsychiatry. 

Dr. Gardner gave this paper at the Play 
Schools Association Conference, New York 
City, January 24, 1953. 



adequate care of children, whether 
in the area of sheer protection of life, 
the prevention of disease, universal 
education (or specialized education 
within this framework) , the treat- 
ment of the delinquent child or the 
emotionally disturbed child — all these 
battles have been waged for the ex- 
pansion of the concept of individual 
treatment in accordance with indi- 
vidual needs. 

Advantages not universal 

Then how does our contemporary 
scene measure up? I am intrinsically 
an optimist. In other writings I 
have declared my position as an 
optimist as regards both Ameri- 
can children and American parents, 
and I am happy to do so again and 
with it add my optimism regarding 
the present-day scene in general. I 
do this in the hope that it may have 
a tempering effect on whatever pessi- 



MAY 1953 



141 



mism I have toward the present 
scene, which we are now considering. 
I am an optimist, but not a satisfied 
one — and least of all a blind one. 

However, I am thoroughly con- 
vinced that nowhere in the world at 
any time in history has the level of 
child care been as high as it is in 
America today. Widespread pro- 
grams of disease prevention — super- 
vision of milk and food supplies, rules 
and regulations in regard to sanita- 
tion, well-timed immunization pro- 
cedures, and recreational programs 
— are all designed to meet the basic 
physical needs of children. 

I know, of course, that these do not 
reach every individual child, and 
hence fall short of our goal of uni- 
versality, but withal these disease- 
prevention programs of ours are the 
marvel of the world when viewed 
from the distance of numberless 
countries that one might mention. 

To move to the area of cii.re of 
disease in childhood, I might men- 
tion that just a short 16 years ago 
when I was a house pupil and resi- 
dent in pediatrics, before the dis- 
covery of the modern antibiotics, we 
were (at least by present-day stand- 
ards) practically powerless in the 
face of certain infectious agents. (I 
should say in passing that the major 

Programs for prevention of disease in children are at a high level in this country today. 



emphasis in pediatric practice will 
probably change under the impact of 
these curative measures.) Finally, 
merely to emphasize the uniqueness 
and comprehensiveness of the child- 
care scene, I will recall to your mind 
that the child-guidance clinic, with 
its emphasis on the psychiatric care 
of children, is a contribution to the 
total program that is less than 50 
years old. 

Parents are conscientious 

And now to reemphasize my opti- 
mism, I should state also that in spite 
of the fact that I am a child psychia- 
trist who sees at times the most 
flagrant evidences of the physical, 
emotional, social, and moral neglect 
of children by their parents, I am 
convinced that no society of parents, 
taken by and large, have ever been 
so desirous as are parents in present- 
day America of extending to their 
children — and so eager to prepare 
themselves to extend to their chil- 
dren — over-all thoughtful and scien- 
tific care. 

As one views the sincere efforts of 
the great majority of American par- 
ents to familiarize themselves with 
all the tenets of good child care in- 
volved in the medical and psychiatric 
programs that I have outlined above, 




and when one notes the eagerness 
and conscientiousness displayed in 
insuring that their children receive 
the benefits to be derived from such 
programs, one very soon gives up the 
easy and seemingly popular role of 
"parent-baiter." (Possibly I shall be 
read out of the American Academy 
of Child Psychiatry for such heresy, 
but if so, I shall feel that I have been 
demoted for leading a much-needed 
crusade!) 

In the light of all this, why should 
I not be completely contented with 
the contemporary scene? For I am 
really not content. I am not content 
for two reasons : First, because — as 
I stated above — these programs are 
not yet universally applied and 
within the reach of all parents and 
children ; and secondly, because we in 
America are continually forced to use 
up a lot of • our energy in fighting 
rear-guard actions against those who 
would either (a) modify our present 
programs of individuation of treat- 
ment of children; (b) prevent an ex- 
pansion of them; or (c) worst of all, 
eliminate them entirely on the 
grounds that society as a whole is not 
responsible for carrying them out. 

Before specifying the area of my 
discontent, I would like to bring to 
your attention what seems to me to 
be a growing tendency of the moment 
in regard to the general philosophy 
of child care. This tendency is a 
temporary (I hope it is temporary) 
swing away from programs entailing 
inherent democracy and individua- 
tion in child care toward those in- 
herently totalitarian and disciplinary 
in nature. There is a growing dis- 
trust of that which might be termed 
progressive and individuated in na- 
ture. 

As indicators of this undesirable 
reaction I would cite for you three 
items printed recently in one of our 
large metropolitan dailies: 
1 The first was a reported inter- 
^* view with a judge of one of our 
leading juvenile courts, outlining the 
causes of the recent increase in juve- 
nile delinquency throughout the coun- 
try. The report said that the judge 
"attributed this intolerable situation 
to four factors : (1) misinformed but 
well-intentioned social workers; (2) 



142 



THE CHILD VOL. 17 NO. 9 



police laxity on full enforcement of 
the law; (3) courts handicapped by 
pressure of modern thinking; and 
(4) parents." The judge also "said 
the situation has been developing for 
the past 20 years, 'or since about the 
time of the introduction of the phi- 
losophy that there is magic in the 
medical approach to cure young de- 
linquents. This is known as the pro- 
gressive attitude.' " As the treat- 



It is obvious to us that these pro- 
nouncements indicate a growing dis- 
trust of our programs of individu- 
ated child care; and though a single 
statement does not reflect the feeling 
of all the representatives of any one 
of these three fields, there may well 
be a generalization of such feelings 
at the present time ; and the struggle 
for ideas and ideals essentially demo- 
cratic in nature against the yearning 




We now know much more than we used to about how to cure the diseases of childhood. 



ments of choice the judge urged that 
"we mu^ get as tough as they are 
and put them where they won't be 
menaces to the public," and added, 
"We have to return to the system of 
reward and punishment." 
iy A second item, from the field of 
^* the clergy, suggested that the 
maladjustments and misbehavior of 
children were the result solely of god- 
lessness and urged the induction of 
rigid moral codes as the one best pre- 
ventative or treatment. 

3 The third voice was raised by a 
• group of nationally prominent 
educators, who were firm in their be- 
lief that the present-day emphasis on 
social studies was ineffectual and a 
waste of time, and urged that a re- 
turn to an efficient grounding in "the 
three R's" and academically oriented 
history be instituted in our schools. 



for the more disciplinary totalitarian 
notions of child rearing is always 
with us. 

Problems worth solving 

I submit that one essential differ- 
ence between totalitarian programs 
and democratic programs in this area 
is that the totalitarian programs are 
easier to carry out. There would be 
fewer problems in such a system, and 
problems as they arose would be han- 
dled in a swift, summary, and re- 
pressive manner. On the other hand, 
the very essence of our democratic, 
progressive program of child care is 
that it places a higher value upon 
sensible and constructive freedom of 
expression by the child than it does 
upon coercion and restraint. And to 
maintain this value, we must content 
ourselves with being faced forever 



with more problems to be solved, 
and we must be ready with en- 
lightened methods to solve them. It 
will be well worth the price. 

The repeated emergence of this 
opposing philosophy of child care is 
the source of my general discontent 
with the contemporary scene. I will 
list some specific areas of child life 
that need our attention if all children 
are to be accorded the comprehensive 
and individuated care that is my 
chosen measure of minimal excel- 
lence : 

"I In the field of physical health 
-*- • more and more research and 
treatment programs are needed rela- 
tive to (a) prenatal care of mothers; 
(b) care of premature infants; (c) 
early and adequate treatment of con- 
genital defects; and (d) care of chil- 
dren who are physically handicapped 
as a result of infections, such as 
polio, that attack the central nervous 
system, or of handicaps resulting 
from the accidents sustained by chil- 
dren in this exceedingly dangerous 
(to children) world of ours. In re- 
spect to all our services, I would espe- 
cially emphasize the woeful lacks in 
application in our rural areas. Chil- 
dren and mothers in these areas are 
definitely in the position of second- 
class citizens when their opportuni- 
ties to secure medical care to insure 
life and health are compared with 
those within easy reach of people in 
urban places. 

iy I would cite secondly the mini- 
^* mal or nonexistent facilities for 
mental-health care (and particularly 
preventive care) of children in all 
areas of the country. This applies to 
both the mentally handicapped child 
and the emotionally upset or malad- 
justed child. 

O In the field of education we are 
*-*• not yet even approaching the 
needed emphasis on the individual 
educational needs of our children. I do 
not refer here only to the lack of 
physical facilities or the lack of 
teachers. These shortcomings are 
known to you. But of equal concern 
is the lack of individual care of large 
numbers of normal children with 
generalized or specialized learning 
blocks or disabilities. Not to apply 

(Continued on page 149) 



MAY 1953 



143 



SOCIAL CASEWORK AND THE CHILD CAMPER 



ADELAIDE Z. PALUMBO 

CAMP has been reputed to do a 
child so much "good" that 
ideas about it have outranked 
those about spinach as a "must" for 
sturdy growth. The concentrated 
period of group living outdoors has 
been believed to supply any quantity 
or quality of nutrients for a child's 
body, mind, and soul. With the best of 
intentions, we caseworkers have fed 
camp to a child without first assess- 
ing his need to have it or his capacity 
to take it. 

A camp vacation, of course, can be 
a truly enriching summer interlude 
in a child's life. In camping 24 hours 
a day he meets all kinds of spontane- 
ous and planned opportunities for so- 
cial relationships not only with other 
children but with adults, and for 
creative and educational experiences. 

One major factor to remember, 
however, is that a child's primary 
group experience comes from his 
family, and we must not, therefore, 
lose sight of the fact that the child's 
camp stay is a temporary group 
placement. If we caseworkers have 
a part in planning a camp placement, 
we should accept our responsibility 
for knowing enough about the pro- 
spective camper, his family, and 
their interrelationships so that we 
are clear that a camp vacation is 
what the child needs and wants. Also 
we should have enough knowledge 
about the camp. There are camps and 
camps, and the fact that a camp is 
approved does not mean that it is 



ADELAIDE Z. PALUMBO has her master's 
degree from the School of Applied Social 
Sciences of Western Reserve University, 
from which school she also received a Com- 
monwealth Fund Fellowship in Advanced 
Psychiatric Social Work. She has had a wide 
experience in family, children's, group, and 
health agencies. 

Mrs. Palumbo's article is drawn from 
personal experiences in agencies in the Mid- 
west and the East. Since 1947 she has been 
with the Community Service Society of New 
York both as a caseworker and as group 
therapist in its Division of Family Services 
and for the past 2 years in its Department 
of Public Interest, where she is also a con- 
tributing editor to the Community Service 
Society Weekly Bulletin. 



necessarily a good camp for a par- 
ticular child. 

Because family agencies, children's 
agencies, and health agencies have 
been sending children to camp for 
years, it is rare to find a caseworker 
who has not had some direct or in- 
direct experience in placing children 
in camp. 

In order to improve their practice 
in camp placements, some agencies 
have a caseworker as "camp chair- 
man," who handles all arrangements 
and relations with camps, consults 
with their staffs, and, through visits 
and reports, evaluates the camps the 
agency will use. Others set up tem- 
porary staff committees to study the 
casework practice of the agency in 
relation to camping. 

One such committee concluded that 
"camp placement is a casework ser- 
vice, which requires as good diagnos- 
tic thinking and casework planning 
as any service which the agency has 
to offer." This is a sound first princi- 
ple in camp placement. 



Camp life is an environmental 
treatment experience that we offer 
children with various individual or 
family difficulties. How can we make 
the most of this temporary placement 
for the best interests of the parents 
and of their children? 

There is a growing trend toward 
working out ways and means of 
answering this question. Casework- 
ers and groupworkers who have 
worked in camps, and the camping 
organizations that have employed 
them, are becoming convinced that 
closer cooperation between camping 
organizations and social-work agen- 
cies is a sound and effective way to 
team up toward their common goal 
of helping children. 

Social workers are now taking 
varied roles as camp counselor, as 
supervisor of counselors, and as 
camp-intake and follow-up worker. 
Insofar as we in social work take a 
more active part in camping pro- 
grams, our understanding of chil- 
dren's behavior will be enriched by 



In 24-hour-a-day camping a child gains spontaneous and planned opportunities for social rela- 
tionships with other children and with adults, and for creative and educational experiences. 




144 



THE CHILD VOL. 17 NO. 9 



more first-hand experience with both 
normal and maladjusted children, 
and we shall learn more ways by 
which we can improve and quicken 
our help to them. 

The day may come when it will be 
more common for workers in health, 
education, social work, and camping 
to team up in camp. Some privately 
owned and operated camps, as well 
as organizational ones, have done 
this by engaging groupworkers and 
caseworkers, psychiatrists, psycholo- 
gists, and education and recreation 
specialists. These workers' experi- 
ence indicates that camping is as yet 
an untapped natural resource for 
dealing with the whole child. Some 
camps are authorized to offer ac- 
credited field experience to social- 
work students. Social workers who 
are planning to work with families 
and children in casework, group- 
work, or psychiatric agencies would 
do well to investigate such opportuni- 
ties. 

The caseworker acts as consultant on camping 

The caseworker from an outside 
agency who is to serve as consultant 
to the camp of a groupwork agency 
should first become well acquainted 
with the function of the latter. This 
is especially important if he has 
never had any groupwork experi- 
ence. His role may be defined by 
assignment: for example, he may 
help in the training of camp person- 
nel, or he may be available for con- 
sultation on individual situations. 

If the caseworker is on the staff 
of the groupwork agency he should 
know when to suggest closer case- 
work and groupwork cooperation in 
the over-all program. In the YWCA, 
for example, a caseworker, known as 
the "personal counselor," is available 
for help to any individual who comes 
to the "Y," or to any of the depart- 
ments of the Association. She thus 
functions in connection with the vari- 
ous agency services as well as in her 
own line of giving individual help. 
This has particular value in relation 
to camping. 

For instance, it was a chance inter- 
view between such a worker and a 
little girl that brought about an im- 



portant improvement in the camp- 
application policy of a YWCA. 

In the camp director's absence, I 
was asked to interview a 12-year-old 
youngster, Kathe, who came to our 
office during her vacation from an 
out-of-town boarding school. Kathe 
feared her camp application might be 
rejected, as a balance was due on her 
last year's bill. 

She matter-of-f actly explained that 
her aunt, who had sent her to camp, 
was not her legal guardian, although 
she was the only relative on whom 
she could depend. Her parents, sepa- 
rated by mutual consent, had never 
got along well enough to make a home 
for her. 

Her father, out of town on a war 
job, was accustomed to sending her 
tuition fees directly to her school be- 
cause her mother was not responsible 
in handling money. Unfortunately, 
instead of paying the camp fees in 
the same way, he had given the camp 
pajTnent to her mother, and the camp 
bill was not paid. 

Kathe could not bear to think she 
might not go to camp. She "lived" 
for it all year. When I said that she 
was with a lot of girls during the 
year and suggested that she might 
want a vacation from dormitory life, 
Kathe took me to task and said there 
was "no comparison." She described 
her life in a large sectarian boarding 
school, where she got along fairly 
well. Though the dormitories were 
large, she felt it was the best solu- 
tion for her in view of her broken 
home. 

At camp, however, there were only 
six beds in a cabin and she and her 
bunkmates had a counselor "all to 
themselves." The girl found living in 
a small group under able, relaxed 
leadership a happy experience to 
which she wanted to return. It was 
evident that to Kathe her bunk unit 
was a substitute family group. 

When I asked Kathe to tell me 
about how she happened to go to 
camp in the first place, she sighed and 
said it was "quite a story." At the end 
of her school year she had returned 
to her aunt's home to begin her sum- 
mer vacation. But her aunt told her 
that the hours of her war job were 
changeable from time to time, and 



therefore she could not have Kathe 
with her. The next morning Kathe 
found her clothes packed for a "sur- 
prise" trip. She was apprehensive, 
yet she realized that her aunt could 
not possibly care for her. Although 
she knew her aunt would not send 
her "just any place," Kathe was 
"plenty scared," even after she had 
arrived at camp. 

When I said it was too bad she had 
not known about camp and that it 
was a lucky break that she liked it, 
Kathe agreed. She "loved" camp and 
if she could go again she would ex- 
plain about the bill to her father. I 
told her that the bill would need to 
be paid first but that I would talk 
to her aunt. Everjlhing was settled 
later, and Kathe went to camp. 

This girl's application, like most 
applications at that time, had been 
handled by mail. Not until she was 
interviewed in person was her prob- 
lem brought to the fore. When the 
interviews with Kathe and with her 
aunt were described to an advisory 
committee composed of lay and pro- 
fessional people, they unanimously 
recommended that in future all camp 
applicants and parents have a per- 
sonal interview, and they offered the 
services of the "personal counselor" 
to the camping department. 

When the agency executive, the 
camp director, and the counselor met 
together to set down criteria for 
camp intake, they drew up two out- 
line forms for interviews with each 
camper and her parent. Caseworkers 
on committees and groupworkers on 
the staff voluntered to help in the 
interviews, which were to be sched- 
uled for both day and evening ap- 
pointments. 

Records of sample interviews held 
by the counselor and the camp direc- 
tor were examined so that they could 
use practical experience with the out- 
lines in orienting interviewers. In 
this way the interviewers became 
somewhat acquainted with all phases 
of camp life, such as regulations, 
policy in handling bedwetting, food 
fads, and illness, and so on, so as to 
be prepared for parents' and camp- 
ers' questions. The arrangement of 
the waiting room, with camp pic- 
tures, set the feeling tone of the camp 
project. 



MAY 1953 



145 



Through the intake interview it 
was possible to make early decisions 
on camp applications; this, in turn, 
helped the camp director, who had 
learned a good deal about the camp- 
ers before they arrived. The case- 
workers and groupworkers who co- 
operated in the project made the 
satisfying discovery that their pur- 
poses and goals for children were 
parallel and that they had more 
ground in common than they had 
been aware of before this joint ex- 
perience. 



In his diagnostic thinking the case- 
worker not only should focus one eye 
on the camper as an individual and 
the other on the group with which 
he is going to live, but should then 
accommodate both eyes to the total 
situation. If unconsciously the case- 
worker allows himself to become 
overidentified with the needs of the 
individual child he will lose sight of 
that child as a member of a group. 

Factors like time, sex and age of 
campers, program, budget, and per- 
sonnel may at some time enter into 




Camping can be an enriching interlude, especially for a well-adjusted child. Other children 
can often be helped by a caseworker so that they too can get the most out of camp life. 



An awareness of group dynamics 
and some groupwork experience are 
desirable for a caseworker who han- 
dles intake for a camp. With this 
preparation he will have keener per- 
ception, for example, of the degree 
and kind of aggressive or withdrawn 
behavior that can be handled help- 
fully through a group experience. In 
a casework relationship the child and 
the caseworker are the only two indi- 
viduals involved in the treatment in- 
terviews; but in group relationships 
the child, the other children, and the 
group leader are involved and the 
interaction may be more than the 
child or the group can accept. 



an individual camp decision, but the 
basic consideration is the child. 

Should it be in the best interests 
of the child and the parent for him 
not to go to camp, the caseworker 
should be responsible for following 
through on any necessary referral to 
another agency or a private resource. 
The camp application in itself is a 
helping process, and a placement that 
does not materialize may open the 
way for needed help to a child and 
his family from other sources. 

Role of the caseworker in camp 

The boys' camp operated by the 
Community Service Society of New 



York is for children of families under 
care of its caseworkers and its public- 
health nurses. Some of the young- 
sters who go to camp have already 
been receiving individual casework 
help. 

During the camp season to which 
this article refers, the camp director 
and the caseworker were the only 
social workers on the camp staff and 
both had had groupwork and case- 
work experience. The director, a 
trained and experienced group- 
worker, had done student casework 
in the Society; and the caseworker 
had had training and experience in 
'jroupwork and activity group ther- 
apy. The counselors were college 
undergraduates or graduates, except 
one who was a high-school student. 
All were on the staff for the season 
only. 

In general, the responsibilities as- 
signed to the caseworker in the camp 
were such that they could have been 
carried out by either a man or a 
woman. The caseworker was to be 
the liaison between the camper and 
the Society's caseworkers and nurses. 
The fact that the caseworker in a 
camp for boys was a woman, of 
course, affected her role. 

As caseworker she dealt with chil- 
dren who had difficulties in adjusting 
to group life and who were referred 
to her by counselors for special at- 
tention. Campers came to her on their 
own initiative and also referred their 
friends. In addition she supervised 
the counselors regarding children 
and their needs. She was responsible 
for the use of the "camp summaries" 
and shared pertinent material from 
them with the counselors. (Camp 
summaries are reports sent by the 
agency to the camp to provide infor- 
mation about the individual chil- 
dren.) 

She was available for consultation 
with counselors through regular con- 
ference and as needed. Through her 
supervision they were helped to 
understand to some extent the inter- 
relationships among the children in 
their groups and their own emotional 
involvement in the experience. Al- , 
though she did not attempt to go into 
this deeply, she was able to touch 
on it sufficiently to provide consider- 



146 



THE CHILD VOL 17 NO. 9 



able support for counselors who had 
the maturity to become more aware 
of their involvement. 

The composition of the groups that 
the caseworker had set up was 
worked out in line with the needs of 
the individual campers and the kind 
of supervision that was planned for 
them. The criteria for grouping 
helped some counselors to see the in- 
dividual child as a part of the group 
and to see the group as a whole. For 
example, when the caseworker helped 
counselors to set up the bunk sleeping 
arrangements, they could foresee 
that a belligerent, provocative boy 
placed next to a passive, submissive 
one would set the stage for a bully 
and a victim, or that an all-around 
boy able to defend himself could be 
placed to better advantage to the 
group if he were between a shy, with- 
drawn boy and a fairly aggressive 
one. 

S. R. Slavson, under whose super- 
vision the writer carried on group 
therapy, suggests that camp groups 
be made up on the basis of "interests 
and quality of personalities." "Com- 
mon interests," he says, "are a bridge 
between people * * *. They prevent 
isolation of individuals and fragmen- 
tation of the group." 

Unfortunately, the camp summary 
often is not clear about a camper's 
interests and activities. The summary 
may say that the child likes music, 
but may not tell whether he likes to 
sing, or dance, or whether he can 
play an instrument. It may mention 
that he likes "sports and games" 
without specifying what kind, and 
without saying whether the child 
wants to be a spectator or a partici- 
pant. 

It is possible, however, to learn 
enough from the child himself and 
from his parent or teacher about his 
preferences and his responsiveness 
to creative ideas so that his natural 
interests and talents can be a means 
for satisfaction and achievement. 

The caseworker in camp needs to 
be flexible and to be able to adjust 
his supervision of counselors to their 
experience and emotional equipment. 

Some counselors need direct sug- 
gestions on handling individual chil- 
dren. Help ranges all the way from 



giving very simple suggestions, such 
as casually taking an elusive and 
restless child by the hand when going 
to dinner, to more involved interpre- 
tation of the cause and effect of be- 
havior. For example, the caseworker 
might need to interpret to a coun- 
selor how he might be trapped by a 
child with a neurotic need to provoke 
him. She could then point out to 
him the step-by-step process of be- 
coming aware of this kind of be- 
havior pattern so that he might, in 
the future, be better able to handle 
himself, the child, and his group. The 
caseworker has to gage the all-around 
needs of the counselor in relation to 
his individual campers. 

In the camp mentioned here, the 
agency caseworker was the liaison 
person in relationships outside the 
camp. She kept in close touch with 
the agency's caseworkers and nurses 
during the camp session by means 
of memos and telephone calls to them 
personally or through the agency's 
camp consultant. 

These communications from the 
camp were about adjustment difficul- 
ties that might necessitate a visit 
from the child's caseworker or nurse, 
or about a pending decision to send 
the child home, or achievements of 
youngsters that merited recognition, 
or about any of the myriad problems 
of camp life, such as those concern- 
ing mail, clothing, spending money, 
homesickness, and anxieties about 
the family. 

When counselors wrote their camp 
reports the caseworker on the camp 
staff added comments in regard to 
the child, the group, or the counselor. 
In situations in which she had had 
interviews with the child, or where 
the camp data were of diagnostic 
value, she recommended further so- 
cial, medical, psychologic, or psychi- 
atric study, or consultation with the 
health or casework services of the 
agency. 

One such situation concerned a 
plump boy of 11, who became the 
butt of other campers because of his 
high-pitched voice and effeminate 
mannerisms. Desperately unhappy, 
he came to the caseworker to retrieve 
mail from the outgoing mailbox. He 
had written home that "this place is 



awful," but he said now that he didn't 
mean it. 

The caseworker suggested that 
some things about camp might be dis- 
tressing to him, and he poured out 
his unhappiness and said the trouble 
was "there are too many boys." 

This boy's body build was such as 
to raise the question of glandular im- 
balance. Closely coordinated work be- 
tween the camp caseworker, who 
talked with the boy, and the family 
caseworker, who talked with the 
family, resulted in the boy's return 
home at the end of his first week, and 
he was helped to bear up under his 
experience. The family caseworker 
used the camp observations in consul- 
tation with the psychiatrist. The 
boy's difficulty at camp quickened the 
parents' concern about him, and they 
agreed to the recommendations for 
psychiatric treatment. 

As would be expected, younger 
boys and "mother-dependent" camp- 
ers frequently came to the case- 
worker with problems and often re- 
created the pattern of their mother- 
son relationship. One aggressive boy, 
who had been overprotected by his 
mother, would always come to the 
caseworker for implied "permission," 
whenever he was trying a new ex- 
perience that he feared and wanted, 
such as his first overnight hike. He 
would usually start, "What do you 
say, should I go?" 

When the caseworker happened to 
be on the swimming dock, youngsters 
vied with each other to show her 
what they could do. Adolescent boys 
who were sophisticated in their rec- 
reational tastes felt safe in voicing 
any criticism of program to her as 
a neutral person rather than the pro- 
gram director. 

The caseworker in a camp lives, 
works, and plays with his colleagues 
and with the campers who are his 
temporary clients. He should be an 
outgoing person with a genuine 
warmth for children and an ability 
to share close living with others. 

Professionally he should have some 
group-work philosophy and experi- 
ence that is a part of him. An in- 
tellectual awareness of the group 
process is not enough. He is not a 

(Continued on page 150) 



MAY 1953 



147 



FILMS ON FAMILY LIFE STIR DISCUSSION 



Group leaders use ed 
as a techn 

ESTHER E. PREVEY, Ph.D. 






\HAT'S EXACTLY what my 
oldest girl said when I told 
her to stay home. Remember, 
John?" 

"Well, the father in the movie 
didn't act the way my husband does 
when our daughter answers back." 

Talk like this is likely to start 
when fathers and mothers in a par- 
ent-teacher group have just seen an 
educational motion picture that 
brings up problems of family life. 
And if the group has a leader who 
does her part skillfully, both before 
and after the picture is shown, the 
group members' immediate comments 
usually develop into a rewarding dis- 
cussion. 

That is what we have found in the 
parent-education program of the 
Kansas City, Mo., public schools, in 
which about 100 groups of parents 
meet regularly with leaders who work 
under supervision of the schools' Di- 
rector of Family Life Education. 

The groups are organized by par- 
ent-teacher associations in different 
parts of the city, and they meet in 
their neighborhood schools. 

Techniques vary 

Parent - education leaders are 
women well qualified by education 
and by experience in working with 
groups of adults. A continuous in- 
service training program allows for 
consideration of subject matter and 
techniques of presentation. 



ESTHER ELIZABETH PREVEY, Director 
of Family Life Education, Kansas City Pub- 
lic Schools, received her doctorate from the 
Institute of Child Welfare of the University 
of Minnesota. Previously she was on the 
staff of the Merrill-Palmer School of Home- 
making, Detroit, Mich., as parent-education 
specialist. 

Dr. Prevey is at present serving as chair- 
man of the Committee on Home and Family 
Life for the National Congress of Parents 
and Teachers. 



ucational motion pictures 
ique in parent education 

The subjects, of course, cover wide 
fields, for when we talk about family 
life we may touch on such matters as 
baby-sitting ; parent disagreements 
about bringing up children ; boy-girl 
friendships ; school homework ; 
grandparents in the household — the 
myriad things that enter into family 
life. 

As for techniques, the present ar- 
ticle takes up only motion pictures, 
but the leaders use other media also 
to help them stimulate discussion: 
Books and pamphlets, tape record- 
ings, radio, and other devices, each 
of which deserves a separate article. 
Films, however, seem especially 
popular. 

With scores of films available, we 
have to select those most likely to 
bring about fruitful discussion. 
Among those we show are "Answer- 
ing the Child's Why," "Children's 
Emotions," "Fears of Children," 



"Meeting Emotional Needs in Child- 
hood," "Palmour Street," "Preface to 
a Life," "Social Development," "Why 
Won't Tommy Eat?" and "Your Chil- 
dren's Sleep." Two film lists are on 
sale by the Superintendent of Docu- 
ments, Government Printing Office, 
Washington 25, D. C. One is "Motion 
Pictures on Child Life" (Children's 
Bureau. 61pp. 40 cents). The other 
is "Mental Health Motion Pictures" 
(National Institute of Mental Health. 
124 pp. 30 cents). The latter in- 
cludes suggestions on using films for 
group discussion. 

Leader encourages discussion 

But deciding on films is only one 
step toward our goal. We have found 
that if the parents are to get the 
greatest possible help from a selected 
movie, skillful leadership is needed, 
to channel the group discussion and 
keep it from wandering. 

At the parents' meeting a leader 
prepares the way for the discussion 
by talking informally with the group 
before showing the picture. Since she 
is thoroughly familiar with the se- 



This scene comes from "Preface to a Life," a film used by Kansas City's parent -education 
program. It was produced by the National Institute of Mental Health, Public Health Service. 




148 



THE CHILD VOL. 17 NO. 9 



quences, and has discussed them with 
other leaders and with the Director, 
she is able to help the parents look 
critically at the film so that they will 
be more ready to express their ideas 
later, whether they agree or disagree 
with its implications. 

After the film is shown, the leader 
exerts her skill in carrying the dis- 
cussion forward and bringing it to a 
conclusion that is satisfying to the 
group members because they feel 
that they really have gained some 
help that they needed. 

As a step toward improving their 
techniques of leading discussion con- 
cerning films, leaders can refer to a 
memorandum prepared by the Di- 
rector, which reads as follows : 

THE USE OF FILMS 

Educational films on child life are used 
as a device or technique for stimulating 
the discussion of family relationships, 
principles of mental health, and child de- 
velopment. They are not used for entertain- 
ment. 

Preparation 

The group needs adequate preparation 
before seeing the film, but a detailed ac- 
count of what goes on in it should be 
avoided. 

Suggestions for preparation: 

1. When selecting a film, be sure to 
choose one in which the ages of the persons 
shown are related to the interests of the 
specific group. 

2. Mention can be made of what is to be 
seen, as: "You will see instances of disci- 
pline" or "You will see parents' disagree- 
ment." 

3. Emphasize that what the film will show 
will be only one segment of child develop- 
ment, or family relationships, and does not 
represent a complete lifetime, with all its 
ups and downs. Also stress that not all that 
is shown will apply or happen to every 
family or every child. 

4. Bring to the gi'oup's attention that 
the film is not trying to show the only or 
the ideal way to handle certain situations, 
and that the group does not need to agree 
with the people in the film. (In fact, dis- 
agreement will make for more lively discus- 
sion.) 

5. Relate the film to a specific topic or 
idea, such as emotional growth, parents' 
goals, importance of the child's early years. 

6. Clear up points that might be mis- 
interpreted. 

Discussion 

Good questions are needed to stimulate 
discussion after the showing of a film. 

1. Avoid questions that can be answered 
by "yes" or "no," such as "Did you like it?" 



2. Avoid opinion questions, such as 
"Don't you think that is a good film?" or 
"Didn't the mother handle that well?" 

In questions concerning family relation- 
ships and personalities, avoid "It is" or "It 
was," and use "It could be" or "It might 
be." 

Examples of preferred form: 

"What could have made So-and-so behave 
as he did?" 

"What might be some possible causes for 
behavior such as So-and-so's?" 

4. Use questions that will lead the group 
to think: 

Examples : 

"What would you have done if you were 
So-and-so?" 

"How would you have handled [Name 
specific situation] ?" 

"What could have made So-and-so as he 
was?" (Unhappy, angry, resentful, well 
adjusted, and so forth.) 

Summary 

1. Summarize briefly the general prin- 
ciples brought out in the discussion. 

2. Ask the group members whether they 
have any other observations or criticisms. 



On a "Film Evaluation Sheet" the 
leader records a number of items con- 
cerning each showing. This record is 
helpful in planning for future 
meetings. The sheet asks, for ex- 
ample, whether the group had enough 
time for adequate discussion of the 
film. It asks whether the discussion 
was spontaneous and spirited, or 
whether the leader had difficulty in 
keeping it going. Another point to 
be noted concerns devices for the pur- 
pose of starting discussion : Whether 
the leader asked questions — and if so 
what questions she asked — whether 
she set up buzz sessions, and so forth. 

In our family-life program we find 
that films are a particularly valu- 
able discussion aid. When group 
members analyze the problems of 
parents and children in a fictional 
family as shown on the screen, they 
can talk freely without revealing 
that some of the problems might be 
similar to their own. Thus they are 
able to discuss intimate concerns 
without embarrassment to anyone. 

By means of our weekly leaders' 
meetings and such devices as our 
evaluation sheet we are hoping to 
improve our techniques for stimulat- 
ing parents toward gro\\i;h in relat- 
ing to one another and to their chil- 
dren. 



CONTEMPORARY SCENE 

(Continued from page 143) 

diagnostic and treatment measures 
in the cases of such children is not 
only educational waste; it is educa- 
tional malpractice. 

4 The lack of proper care and 
• treatment of the juvenile delin- 
quent also contributes to my discon- 
tent. Individuation of the child is 
probably needed more in this area 
than in any other. And I will state 
that the problem of juvenile delin- 
quency, or rather the problems in- 
herent in the development and ex- 
pansion of suitable programs to care 
for these children, will never be 
solved on a local level, but will be 
solved only when the Federal Gov- 
ernment assumes the responsibility 
of assisting the local areas. 

I say this because every conference 
that has ever been held to set up pro- 
grams in this area has ended on 
the note of emphasis that we just 
do not have the trained personnel to 
do the job required and the unhappy 
sequitur that moneys at the local level 
cannot be used to train personnel. 

It follows in turn that lack of 
highly trained personnel in the field 
— and no way to train them — makes 
for a low prestige-value attached 
to persons engaged in work with 
juvenile delinquents. There is but 
one way to break this vicious cycle 
and provide adequate care for the de- 
linquent child, and that is through 
establishment and expansion with 
Federal funds of training centers 
for the medical, psychological, so- 
cial service, educational, and recrea- 
tional experts that are so sorely 
needed. Such training programs have 
been sponsored in the field of mental 
health in the past 5 years and have 
recruited and trained hundreds of 
men and women for this important 
field. It could and should be done for 
the care of delinquent boys and girls. 

5 1 regret too the preposterous 
• frontierlike attitude that per- 
sists regarding the emergence of spe- 
cial creative abilities in children. 
Such children are not specifically se- 
lected by us and their potentialities 



MAY 1953 



149 



encouraged and nurtured. On the 
contrary, they may very often be 
condemned. 

It seems to me that just as our 
society zealously nurtures the de- 
velopment of future scientific person- 
nel, we in a democratic society have 
every obligation to seek with equal 
assiduousness possible creators in the 
arts — and we need the educational 
machinery to discover such potential 
contributors to our culture to foster 
their growth. 

I am totally unimpressed by the 
argument that such children will bat- 
tle against adversity (or indeed will 
need to battle) to the point of effec- 
tive creativity. And I should add too 
that I am chagrined that colleagues 
in my own field of child psychiatry 
are prone to view all deviance in child 
expression as a personality-destroy- 
ing mechanism, with little or no con- 
sideration of the possibility that such 
atypicality may indicate — or may be- 
come — a creative deviance. 

I will cease the elaborations of 
whatever pessimistic views I have 
of our contemporary scene with the 
added indictment that application of 
what we do know about child care — 
and can do about it — has not been ex- 
tended to large areas and to large 
segments of our population in 
America. This I deplore — and I de- 
plore even more the policy of extend- 
ing such application through a proc- 
ess of expedient gradualism that 
seems to satisfy the thinking and 
feeling of many in our country. This 
thoroughly undemocratic process is 
the despair of us all and calls for a 
complete eradication of it through 
all the destructive means that we can 
apply. 

In conclusion, then, these are my 
estimates of some of the aspects of 
the American scene as they relate to 
child care — good or bad, adequate or 
inadequate. I now reemphasize my 
original feelings, which are essen- 
tially optimistic. I am optimistic be- 
cause in spite of temporary reactions 
that may ensue, our ideal of a uni- 
versal comprehensive child-care pro- 
gram is as sound and as practical as 
the democratic system with which it 
is entwined. 



CAMPING 

{Continued from page 147) 

unit head, nor an administrator; but 
he is closely involved in all parts of 
the camp program, including its 
health and administration phases. It 
is important that he maintain his 
personal and professional relation- 
ships in balance and that he keep 
these clear and distinct as the need 
and occasion demand. He can be a 
friendly person who is easy to live 
with and still be a respected profes- 
sional person who is comfortable to 
work with. 

Possibilities for caseworkers in camp 

There well may be a role for case- 
workers in many private and organi- 
zational camps, and in those oper- 
ated for the special needs of physi- 
cally or emotionally handicapped 
children. For the average comfort- 
ably adjusted boy or girl, too, case- 
workers have an important role to 
play, for we know by experience 
that a little help, when needed, goes 
a long way with these children. 

If schools of social work and camp- 
ing organizations eventually develop 
more camp placements to offer for 
accredited field experience to stu- 
dents in casework and groupwork, 
both will gain. As either student 
workers or regular staff members 
these young men and women would 
share first-hand camp experience 
with their colleagues. In actual prac- 
tice, a caseworker plans camp for 
only a few of the children under her 
care. 

With camps as training centers for 
social workers, camping would de- 
velop its potential as a source of help 
for children, which it has yet to ex- 
plore to the full. 

Although social workers place chil- 
dren in camps for group experiences 
and although some social agencies 
operate camps, social work as a pro- 
fession is not yet involved enough 
in camping. Not yet do camp staffs, 
as a rule, include social workers, 
either groupworkers or caseworkers. 
Yet a camp provides a service for 
children as much as does a child- 
guidance clinic, a casework agency, 
or a neighborhood center, and as such 



it lies within the area of competence 
of social workers. 

Significant trends are beginning to 
be apparent, however: A recognized 
school of social work has offered its 
first course in camping, and a vaca- 
tion association has created the first 
fellowship for advanced study in 
social-agency camping. 

Until social work as a profession 
takes more responsibility for camp- 
ing, the practitioners must pave the 
way and demonstrate the need. 

I hope the day is already here 
when more social workers are join- 
ing camp staffs in various positions 
from counselors on up to administra- 
tors. The more this is done, the 
sooner all of us will use camp experi- 
ence as another means of learning 
about individual and group behavior 
of children of various ages. In a 
children's camp one lives with both 
the inner and outer world of child- 
hood. What a natural opportunity 
for us, as social workers, to live and 
learn ! 




YOUTH, THE NATION'S RICH- 
EST RESOURCE; their educa- 
tion and employment needs. A 
report prepared by the Interde- 
partmental Committee on Children 
and Youth, of the Federal Govern- 
ment. 1953. 54 pp. For sale by 
Superintendent of Documents, 
Government Printing Office, Wash- 
ington 25, D. C, at 20 cents. 

Today — not next year or next 
decade — is the time when we must 
use and cultivate all of- our resources, 
human and material, if we are to sur- 
vive as a democratic society, says this 
report, which, as its title suggests, 
looks on the young people of the Na- 
tion as our richest resource. 

It is the responsibility of the com- 
munity, primarily, to see that its 
young people are prepared to take 
their part in the world, the report 
maintains. To help communities ful- 
fill this responsibility, the report pre- 
sents facts on teen-agers in school 
and at work and on youth guidance, 
counseling, and placement services, 
and sets forth guides for communi- 
ties to use in improving their services 
in these fields. 



150 



THE CHILD VOL. 17 NO. 9 



The guides for improving- school 
programs suggest, among other 
things, that school be related to 
everyday living, that the needs of in- 
dividual students be emphasized, and 
that school-administration policies be 
planned to serve all children; and 
they offer suggestions on steps that 
communities can take toward attain- 
ing these ends. 

Similar guides to improvement are 
given with regard to youth-employ- 
ment conditions, and youth guidance, 
counseling, and placement services. 

Communities are urged to use the 
guides to learn what gaps exist in 
their local programs and then to sur- 
vey their resources to meet the needs. 
After the most urgent needs have 
been decided on, the next step is to 
explore the available financial aid 
from State and Federal resources for 
fulfilling these needs. 

The report suggests various chan- 
nels for information and consultation 
concerning improvement of commu- 
nity programs for youth. Some of 
those listed are : State and local com- 
mittees planning for children and 
youth ; public and private agency 
officials; State youth councils; State 
agencies, including education depart- 
ments, departments of labor, health 
and welfare, employment service, 
apprenticeship councils, and agricul- 
tural extension service; and Federal 
agencies with programs that concern 
children and youth. 

Some of the services available from 
Federal agencies are listed, along 
with some helpful publications. 

The report was developed during 
1950 and 1951 by a Subcommittee on 
Youth Employment and Education, 
of the Interdepartmental Committee 
on Children and Youth. 

REPRINTS AVAILABLE 

A limited number of copies of the 
following reprints from The Child 
are available. Single copies may be 
had without charge until the supply is 
exhausted. 

Aid to Dependent Children Keeps 
Homes Together. By Jane M. Hoey. 

America Welcomes Displaced Or- 
phan Children. By I. Evelyn Smith. 

Attitudes Toward Minority Groups. 
By Annie Lee Davis. 

Boys and Books Get Together. By 
Leita P. Craig. 

Chicago's Public Housing Program 
Helps to Save Babies' Lives. By J. S. 
Fuerst and Rosalyn Kaplan. 

Children Can Be Helped to Face 
Surgery. By Ruth M. Pillsbury, M.D. 

Citizens Help a Juvenile Court. By 
Charles H. Boswell. 



''fi<iiiSf^r'jsi,Avf>'!y . 



CALENDAR 



May 1. Child Health Day. 

May 1-7. National Correct Posture 
Week. Sponsored by the National 
Chiropractic Association. 

May 3-9. National Hearing Week. 
Twenty-fifth annual observance. 
Information from the American 
Hearing Society, 817 Fourteenth 
Street, N.W., Washington 5, D. C. 

May 3-9. National Mental Health 
Week. Fifth annual observance. 
Information from the National As- 
sociation for Mental Health, 1790 
Broadway, New York 19, N. Y. 

May 3-10. National Family Week. 
Eleventh annual observance, by 
Protestant, Catholic, and Jewish 
groups. Information from the Na- 
tional Council of the Churches of 
Christ, 79 East Adams Street. Chi- 
cago 3, 111. 

May 4-6. Society for Pediatric Re- 
search. Twenty-third annual meet- 
ing. Atlantic City, N. J. 

May 4-8. American Psychiatric As- 
sociation. One hundred and ninth 
annual meeting. Los Angeles, 
Calif. 

May 5. Sixth World Health Assem- 
bly. World Health Organization. 
Geneva, Switzerland. 

May 6. Young Women's Christian 
Association. Forty-sixth annual 
meeting of the National Board. 
New York, N. Y. 

May 6-8. American Pediatric Society. 
Sixty-third annual meeting. At- 
lantic City, N. J. 

May 10-14. Boys' Club of America. 
Forty-seventh national convention. 
Buffalo, N. Y. 

May 12-16. American Association on 
Mental Deficiency. Seventy-seventh 
annual meeting. Los Angeles, Calif. 

May 15-17. National Council of the 
Young Men's Christian Associa- 
tions. Twenty-seventh annual 
meeting. Cincinnati, Ohio. 

May 17-22. Tenth North American 
Assembly on YMCA Work With 
Youth. East Lansing, Mich. 

May 18-20. National Congress of 
Parents and Teachers. Fifty- 
seventh annual convention. Okla- 
homa City, Okla. 

May 18-22. National Tuberculosis As- 
sociation. Forty-ninth annual 
meeting. Los Angeles, Calif. 

May 24-27. National Conference of 
Jewish Communal Service. Fifty- 
fourth annual meeting. Atlantic 
City, N. J. 

May 25-27. International Association 
of Governmental Labor Officials. 



Thirty-sixth annual convention. 
Providence, R. I. 
May 25-29. General Federation of 
Women's Clubs. Sixty-second an- 
nual convention. Washington, 
D. C. 
May 27-29. Canadian Welfare Coun- 
cil. Thirty-third annual meeting. 
Ottawa. 
May 30-31. American Diabetes Asso- 
ciation. Thirteenth annual meet- 
ing. New York, N. Y. 
May 31-June 5. National Conference 
of Social Work. Eightieth annual 
meeting. Cleveland, Ohio. 
Some other organizations meeting 
in association with the National Con- 
ference of Social Work: 

American Association of Group 
Workers. 

American Association of Medical 
Social Workers. 

American Association of Psychi- 
atric Social Woi'kers. 

American Association of Social 
Workers. 

Association for the Study of Com- 
munity Organization. 

Child Welfare League of America. 
Florence Crittenton Homes Asso- 
ciation. 

Medical Social Consultants in State 
and Local MCH and CC Programs 
(May 30). 

National Association of School So- 
cial Workers. 

National Association of Training 
Schools. 

National Child Labor Committee. 
National Committee on Services to 
Unmarried Parents. 

National Federation of Settlements 
and Neighborhood Centers. 

National Probation and Parole As- 
sociation. 

Regional conference, American 
Public Welfare Association: 

May 6-8. Mountain Region. Bis- 
marck, N. Dak. 

Regional conferences, Child Wel- 
fare League of America: 

May 18-19. New England Region. 
Swampscott, Mass. 

June 10-12. Southwest Region. Den- 
ver, Colo. 

Regional conference, American 
Public Health Association: 

June 10-13. Western Branch. Los 
Angeles, Calif. 



Illustrations : 

Cover, Esther Bubley. Courtesy of Wes- 
leyan University Press. 

Page 139, courtesy of the Houston Post. 

Page 141, George Jones. 

Page 142, Esther Bubley. 

Page 143, Library of Congress photograph. 

Pages 144 and 146, courtesy of Community 
Service Society, New York City. 

Page 148, National Institute of Mental 
Health, Public Health Service, U. S. Depart- 
ment of Health, Education, and Welfare. 



MAY 1953 



151 



VOL. 17 NO. 9 
MAY 1953 



In This Issue 



Child Health Day, 1953, by the President of the 
United States of America 



To Understand Children Better 
Oveta Culp Hobby 

For Better and Happier Children . . 

Children in the Contemporary Scene 
George E. Gardner, Ph.D.. M.D. 

Social Casework and the Child Camper 
Adelaide Z. Pahimbo 

Films on Family Life Stir Discussion . 
Esther E. Preiey, Ph.D. 



Page 

. 138 
. 139 

. 140 
. 141 



144 
148 



Published 10 times a year by the Division of Reports, Children's Bureau 
Editor, Sarah L. Doran Art Editor, Philip Bonn 

U. S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE 

Oveta Culp Hobby, Secretary 



Social Security Administration 
William L. Mitchell, Acting Commissioner 



Children's Bureau 
Martha M. Eliot, M.D., Chief 



Publication of THE CHILD, monthly bulletin, has been authorized by the Bureau of 
the Budget, September 19, 1950, to meet the needs of agencies working with or for 
children. The Children's Bureau does not necessarily assume responsibility for 
statements or opinions of contributors not connected with the Bureau. 
THE CHILD is sent free, on request, to libraries and to public employees in fields 
concerning children; address requests to the Children's Bureau, U. S. Depart- 
ment of Health, Education, and Welfare, Washington 25, D. C. For others the sub- 
scription price is $1.25 a vear. On all orders of 100 or more sent to one address there 
is a discount of 25 percent. Single copies 15 cents each. Send your remittance to the 
Superintendent of Documents, Government Printing Office, Washington 2.i, D. C. 
Foreign postage-25 cents additional-must be paid on all subscriptions to countries 
in the Eastern Hemisphere and those sent to Argentina and Brazil. Domestic postage 
applies to all other subscriptions. 

THE CHILD is indexed in the Education Index, the Quarterly Cumulative Index 
Medicus, and Psychological Abstracts. 






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JUNE-JULY 1953 




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TOWARD BETTER SPEECH AND HEARING 



Tennessee children are tested by State Crippled Children's Service 

Superintendent of Documents 



ROBERT M. FOOTE, M. D. 

and 
SYLVIA STECHER 

TESTING the children of Ten- 
nessee to discover hearing and 
speech defects is part of an 
over-all State-wide program to find, 
treat, and rehabilitate children and 
adults handicapped by defects of 
speech and hearing. 

The program was started through 
a movement sparked by the medical 
profession. This movement, in 1949, 
led to organization of the Tennessee 
Hearing and Speech Foundation, a 
cooperative nonprofit enterprise 
sponsored first by the Tennessee 
State Medical Association and now 
supported by more than 40 public and 
private agencies and organizations. 
A major function of the Foundation 
is to establish speech and hearing 
clinical centers, to which we shall 
refer later. 

The over-all program consists of 
three phases: The first phase, which 
is the subject of this article, consists 
of finding the children with speech or 
hearing defects. The second phase 
consists of providing medical services 
in some circumstances, and also 
specialized clinical services, such as 
making detailed audiometric studies, 
fitting hearing aids, providing speech 
therapy, and so forth. These special- 
ized services are given through hear- 
ing and speech centers provided by 
the Foundation. These two phases' 
are under the direction of the Crippled 
Children's Service of the State De- 
partment of Public Health. The third 
phase, the education of children with 
hearing or speech defects, is the 
responsibility of the State Depart- 
ment of Education. 

The part played by the Crippled 
Children's Service in this over-all 
program is the result of action by the 
State Legislature in 1951, redefining 
the term "crippled child," to include 



.JUL 15 1S53 

nth speech or hear 



children with'speecli "or hearing han- 
dicaps as eligible to receive service 
under the State program for crippled 
children. The Legislature at the same 
time appropriated funds to finance a 
speech and hearing program for 
children. 

In order to carry out its new duties, 
the Crippled Children's Service estab- 
lished a Speech and Hearing Section, 
with an Assistant Service Director at 



21 years of age, are tested through 
clinics established at local health 
departments. 

Our Speech and Hearing Section 
includes four senior speech and hear- 
ing consultants who hold a master's 
degree, and four junior speech and 
hearing consultants with a B.S. or an 
A.B. degree. The consultants travel 
and work in teams of two, a senior 
and a junior consultant. 




After complete medical, audiological, and social diagnosis, a hearing aid is sometimes rec- 
ommended for a child. This little boy seems to be enjoying his experience with the aid. 



its head. This Section sends into each 
part of the State a diagnostic and 
screening team, consisting of two 
workers. The team is equipped to 
carry out mass or individual audio- 
metric testing, speech recording, 
and other procedures to determine 
whether a child is handicapped by 
any speech or hearing defect. School 
children are usually tested in their 
own schools. Preschool children, and 
boys and girls out of school but under 



During our first year of operation 
the teams traveled over the Statt 
with Nashville as their base. This 
year, however, we have three regional 
offices : one in Johnson City, one in 
Jackson, and one in Nashville. Two 
consultants are stationed in Johnson 
City and cover the northeastern sec- 
tion of the State ; two in Jackson, to 
cover 17 western counties; and four 
in Nashville, to serve the counties in 
middle Tennessee. 



154 



THE CHILD VOL. 17 No. 10 



We plan eventually to divide the 
territory up still further and to have 
regional offices in three more cities, 
Memphis, Chattanooga, and Knox- 
ville. By next year the staff of con- 
sultants will have to be increased, 
since it is impossible for the present 
staff to cover every county in the 
State every year. 

This year we are testing children 
in the counties that we did not reach 
last year. We also are going back to 
the counties that we visited last year 
to retest children who were found to 
have defects. 

Finding the ciiildren 

Our first year of operation was an 
experimental one. Three different 
methods of case finding were tried, 
to determine which was the most 
effective. These methods were: (1) 
Complete survey, as described below. 
(2) Referrals, by the teacher, of 
children who seemed to her to have 
speech or hearing defects. Under this 
plan the teachers sent to the county 
health department, through the edu- 
cation department, a list of the chil- 
dren who seemed to have either 
speech or hearing problems. In most 
cases the children referred were 
brought by teachers or parents to the 
local health department and we tested 
them there. (3) Similar referrals, by 
the teacher, with the aid of "symptom 
sheets," which list things that might 
indicate a speech or hearing problem. 
The children so referred were tested 
just as were those under "(2)." 

Statistics were compiled concern- 
ing all three methods, and, needless 
to say, the complete survey by trained 
consultants ferreted out more prob- 
lems than did either of the other 
methods. The classroom teacher does 
not have much trouble recognizing 
the major problems, but it is very 
difficult for her to detect borderline 
ones, and it is these children espe- 
cially that we want to reach, since 
our program is mainly one of con- 
servation. 

Under the complete-survey pro- 
cedure, which we tried in six coun- 
ties and which involved testing ap- 
proximately 15,000 children, we went 
into every school in the county and 
screened every child in the first eight 



grades for both speech and hearing. 
We used a pure-tone portable screen- 
ing audiometer. 

Testing was done under a variety 
of circumstances: 

In one-room schools we usually 
tested in the classroom, with all the 
children in the room at one time. This 
eliminated individual explanations to 
each child. The testing procedure 
was explained once, and then each 
child was screened in turn. In the 
larger schools we used the quietest 
room we could get: clinic, library, 
gymnasium, auditorium — stage and 
dressing rooms — lunchroom, or any 
other quiet location. 

When a school had no electricity, 
which is needed for operating our 
equipment, we tested in a nearby 
church, and now and then even in a 
farmhouse. 

In all our testing we found only one 
school in which we could not manage 
somehow to give an audiometric test. 
That was a one-room mountain school 
at the end of a precariously steep 
ascent. There was no electricity any- 
where on the ridge, and taking the 
children down from the mountain 
was not feasible. But all in all very 
few of our rural schools do not have 
electricity, and we managed to get the 
children in these schools tested some- 
how. 

An example of such a situation 
comes to mind, which shows how 
eager the teachers are to have the 
children tested. We were working in 
Fayette County in southwest Tennes- 
see — a county with a predominantly 
Negro population. One school had no 
electricity, and so the teacher was 
told to take her children to another. 
When we arrived there we were told 
that the teacher had sent word that 
she could not get transportation for 
her children, but that they would 
walk 214 miles to a church where 



ROBERT M. FOOTE, M.D., is Medical 
Director of Crippled Children's Service, 
Tennessee Department of Public Health. 
Na.shville. 

SYLVIA STECHER is Assistant Service 
Director of the Speech and Hearing Section 
of the same Crippled Children's Service. 

This paper was presented to the Section 
on Testing Programs in Speech and Hear- 
ing at last year's meeting of the Speech 
Association of America, Cincinnati, Ohio. 



JUNE-JULY 1953 



there was electricity. We drove on to 
the church only to find that it was 
occupied — a revival was in progress 
— but again we had a message from 
the teacher. She would 'take her 
children to a farmhouse a mile down 
the road. We finally found her and 
24 children, and we tested them in 
the bedroom of a tenant farmer's 
home. So you see there is always a 
way. 

On the basis of our first year's find- 
ings we set up what will be our 
regular yearly procedure from now 
on. In every county we test the hear- 
ing of every child in the second, 
fourth, and sixth grades. In this way 
every child will be tested every other 
year. In the second grade the children 
are also checked for speech. We test 
children in any of the other grades, 
including high-school grades, when 
the teacher refers them to us. 

The second, fourth, and sixth 
grades were selected because accord- 
ing to our findings more significant 
hearing problems occur in children in 
these age groups than in others. 

Most children outgrow baby tall( 

For speech testing, the second 
grade was selected rather than the 
first, because, although many young- 
sters still use baby talk when they 
enter the first grade, they are likely to 
overcome this through being in school, 
learning to read, talking with other 
children, and just growing up. If 
they have not overcome it by the time 
they reach the second grade, they 
probably need some special training. 

The children who fail to pass the 
initial screening test for hearing are 
recalled and given a more thorough 
test ; and, if necessary, an audiogram 
is made and the child is referred to 
a doctor. For children with speech 
defects the procedure is similar. 

At first we used to screen all the 
schools and then go back to retest. 
But we found that this took up too 
much time, and so we now retest 
while we still are at the school. 

In each county we work through 
the local public-health department 
and department of education. Several 
weeks before work is begun a plan- 
ning meeting is held. At the meeting 
the medical director of the county 

155 



health department, the public-health 
nurse, the school superintendent, and 
teaching supervisors are present. In 
addition anyone else who is to work 
on the program or who is interested in 
it may come — the attendance teacher, 
school principals, the welfare worker, 
and at some meetings even the county 
judge. 

At this planning meeting the senior 
speech and hearing consultant ex- 
plains fully the workings of the pro- 
gram and the services available for 
the children. According to the num- 
ber of children to be tested, dates are 
set up. The public-health nurse and 
the teaching supervisor are usually 
the ones who work out the schedule 
for testing, and in most cases, it is 
tlie teaching supervisor who goes 
M'ith us to the schools. 

When we go into a county to test 
under this plan we prefer not to go 
to a school where there are fewer 
than 20 children to test ; it takes too 
much time to set up our apparatus 
and to go from one school to another. 
Therefore we like to have these 
children brought in to one of the 
larger schools nearby. All the coun- 
ties in which we have worked so far 
this year have been most cooperative 
about this. As many as 50 children 
have been brought to a central loca- 
tion from one school. This makes it 
possible for us to test more children 
in a day. We have found that a good 
daily average for two consultants, 
counting screening and retesting, is 
about 200 children. 

Next year, when we hope to have 
more consultants, we will also retest 
in every school all the children for 
whom we made medical or clinical 
referrals this year. That will become 
our established procedure — screening 
for hearing all childi'en in the second, 
fourth, and sixth grades, testing the 
speech of all second-graders, recheck- 
ing children placed under observa- 
tion, checking teacher referrals from 
other grades, and retesting the chil- 
dren referred to doctors or clinics in 
the previous year to see whether or 
not their condition has improved. 

When we leave a county, we give 
the department of education and the 
public-health department a complete 
list of the children that we have found 



to have speech or hearing problems. 
This list includes not only children 
with serious difficulties, whom we 
have referred to a doctor or to a 
center, but also children with less 
severe problems for whom we feel 
that such a referral is not called for 
at the time, but whom we place under 
observation. For example, we usually 
put a first-grader with a speech 
problem under observation unless his 
speech is completely unintelligible. 
Other children are placed under ob- 
servation if they have one or two 
slight deviations. A second-grader 
with a slight speech problem is 
checked again when he reaches the 
fourth grade and notation is made as 
to whether he has improved or not. 
We consider a speech problem serious 
enough for referral to a speech and 
hearing center only when it inter- 
feres with adequate communication 
and is causing maladjustment in the 
child. 

Public-health nurse plays a key role 

The referrals are left with the 
county public-health department, and 
it is the duty of the public-health 
nurse to follow these up and see that 
the children receive the recommended 
examination and treatment. Refer- 
rals are marked with a first, second, 
or third priority, depending upon the 
severity of the problem. No. 1 indi- 
cates that the child should have im- 
mediate attention ; No. 2, that he 
needs attention, but that the need is 
not pressing ; No. 3, that he does not 
need attention now but may need it 
in the future. 

If a child has a hearing loss the 
nurse visits his parents, and discusses 
the case with them. She suggests that 
the child be seen by the family doctor, 
who may recommend a specialist if 
he thinks it necessary. If the family 
cannot afford to pay for medical serv- 
ice the public-health nurse completes 
an application for such service, which 
is sent to the regional office of Crip- 
pled Children's Service through which 
she works. 

In the regional office an authoriza- 
tion is issued and the child is seen by 
one of the ear specialists who are 
working with us on this program. If 
he recommends a series of medical 



treatments, Crippled Children's Serv- 
ice pays for these; also for surgical 
or radiological treatments if the spe- 
cialist recommends these. (We do not 
provide for surgery unless the ear 
specialist feels that the child's hearing 
will be improved by it.) If the child 
needs a hearing aid and his family 
cannot afford to buy one, Crippled 
Children's Service will buy it for him, 
and if necessary, service it. If the 
child's hearing is impaired so much 
that speech training is advisable, this 
is made available through the facili- 
ties of the nearest hearing and speech 
center. 

Children with organic speech prob- 
lems are, of course, referred to the 
proper specialists. Repair of cleft 
palate, a condition that causes much 
speech difficulty, has long been a 
function of Crippled Children's Serv- 
ice. Children with cleft palate are | 
seen by the plastic surgeon, the ortho- ! 
dontist, the prosthedontist, and the 
pediatrician, as well as the speech 
correctionist. Speech correction goes 
hand in hand with repair of the 
child's cleft palate. 

Purely functional speech problems 
are referred to an ear, nose, and 
throat specialist before the child is 
admitted to the center for treatment. 

We have referred several times to 
speech and hearing centers, and we'd 
like to tell a little about them. 

The first one of these centers estab- 
lished in the State is the one at Nash- 
ville. It is housed in the Tennessee 
Hearing and Speech Foundation 
building, provided by the Vanderbilt 
University School of Medicine. It is 
located directly across the street from 
Vanderbilt Hospital, and it is equip- j 
ped with every modern device neces- I 
sary for the efficient functioning of 
a speech and hearing center. Last 
year this was the only such center we 
had, and service was available mainly 
to children within a convenient radius 
of Nashville. 

This year another such center is in 
operation, in Johnson City, under the 
sponsorship of East Tennessee State 
College, and children in eastern and 
northeastern Tennessee are served 
through it. 

Another center is being established 



156 



THE CHILD VOL. 17 No. 10 



in Jackson, in Madison County, west 
Tennessee. This center has a wide 
and varied sponsorship. The building 
has been provided by the county — a 
building which, incidentally, has 18- 
inch concrete walls, ceilings, and 
floors, these are a great aid to sound- 
proofing. One of the leading ear 
specialists in Jackson is president of 
the Jackson Hearing and Speech 
Center. The city of Jackson and 
Madison County contributed $2,000 
apiece toward the cost of the center. 
Each of the 16 other west Tennessee 
counties whose children will receive 
service at this center contributed 
$500, and this $500 was raised in 
various and sundry ways — by PTA's 
and by civic clubs, and through pri- 
vate donations, county funds, and so 
forth. A group of ladies comprising 
the Jackson Service League under- 
took to get the building ready for use. 
They were very successful in obtain- 
ing donations of both material and 
labor. This center is truly a regional 
project. 

Centers open to all 

Crippled Children's Service does 
not operate any of these centers. Our 
role is merely one of stimulating in- 
terest, assisting in planning, recom- 
mending standards, and aiding in 
getting centers opened. 

The State health department has 
helped by purchasing a considerable 
amount of equipment for each center, 
and for a limited time will pay the 
salary of one therapist. The equip- 
ment is on loan as long as the center 
is in operation. After a center is 
established we purchase service from 
it for children whose parents are 
unable to pay. 

These centers offer complete speech 
and hearing diagnostic service, a full 
program of speech therapy, hearing 
evaluation, auditory training, speech 
reading (formerly called lip i-eading), 
and psychological testing. They are 
open to all, regardless of race, creed, 
color, or age. They accept children 
referred by private doctors, as well 
as those referred by Crippled Chil- 
dren's Service. State services for 
crippled children are extended only 
to persons under 21 years of age. 
However, the State Vocational Re- 



habilitation Service is available to 
persons 21 or over. 

Memphis already has its own 
speech and hearing center, organized 
about 5 years ago, and we hope 
eventually to have speech and hearing 
centers in Chattanooga and Knox- 
ville. Then every child in the State 
will be within easy reach of speech 
and hearing service. Of all the handi- 
capped children, those with speech 
handicaps can be most readily helped 
if help is made available. 

During our first year of testing, it 
was frustrating at times to find so 
many severe speech problems and to 
know that nothing much could be done 
for the children since they were too 
far from the center at Nashville, and 
very few counties had speech correc- 
tionists. Now, however, the State 
Department of Education has a 
scholarship plan, whereby a teacher 
who is interested in the field of speech 
correction may go to summer school 
for four summers; thus she can 
qualify as a speech correctionist and 
get a master's degree at the same 
time. Each year when she returns to 
her county she takes on a little more 
responsibility. After the fii'st summer 



she works only on simple problems of 
articulation. The following year she 
takes on more serious cases, and so 
on. Through this system we hope to 
have speech correctionists in many 
more counties in Tennessee. 

Another of our functions is parti- 
cipation in monthly cleft-palate 
clinics, which are held in Memphis, 
Nashville, and Knoxville. We test the 
child's speech and hearing at the 
clinic. This we usually do in the 
morning, and in the afternoon the 
child is brought before a group of 
specialists for complete study. 

In Jackson we take part in a 
cerebral-palsy clinic, which is held 
once every 3 months. 

We feel that finding children with 
hearing or speech defects is the 
foundation of Tennessee's speech and 
hearing program. The program aims 
to reach, before long, every child in 
the State who has a defect either in 
his speech or his hearing, so that no 
Tennessee child will be hampered by 
this type of defect in obtaining an 
education leading to eventual self- 
support and responsible citizenship. 



This is part of the equipment used at hearing and speech centers in diagnosing. The photo- 
graph was taken at the Speech and Hearing Center, Johns Hopkins University and Hospital. 




JUNE-JULY 1953 



157 



FOSTER PARENTS SPEAK UP 



Children's agency welcomes 
their participation in planning 



ESTHER S. MELTZER 

and 

MIRIAM WANNE 



LIKE most foster-home agencies, 
the Jewish Children's Bureau 
of Cleveland for years tradi- 
tionally gave an annual tea or dinner 
for foster parents (usually the 
former, out of consideration for the 
agency's budget) . 

The purpose of the annual social 
event was twofold : ( 1 ) To give foster 
parents an opportunity for identifica- 
tion as a group and as a part of a 
larger whole, and (2) to give the 
agency staff and board an opportu- 
nity to give recognition to them for 
the important role they play in the 
agency's service to children. 

But this once-a-year social gather- 
ing, we began to realize, was doing 
nothing to help the foster parents 
deal with their difficulties and uncer- 
tainties regarding their relationship 
to the agency, which they knew only 
through their contacts with various 
caseworkers. 

Before it was time to plan the 1948 
annual get-together, we of the agency 
realized that just another social meet- 
ing would not suffice. We felt that 
foster parents ought to be given a 
chance to know more about the whys 
of the work in which they and we 
were mutually engaged. They needed 
to know more about such things as 
why some parents cannot provide 
homes for their children, so that the 
children need foster care; why the 
agency functions as it does ; why chil- 
dren behave as they do; why foster 
children at times are very much like 
one's own children and why at other 
times they are incomprehensible 
strangers. 

We decided to offer a brief study 
course made up of lectures on child 



development and child behavior, and 
we took our plans to our case con- 
sultant, who had done considerable 
work in group education. After a 
vigorous discussion, we recognized 
that we had again fallen into the 
standard attitude of workers toward 
foster parents, that is, thrusting the 
foster parents into the role of pas- 
sive onlookers. Such a program would 
not encourage striving for answers 
to questions. 

Our next plan was a variation of 
our original proposal. This time we 
decided to hold a series of monthly 
meetings at which there would be no 
outside speakers. The foster parents 
themselves would determine the 
range and depth of the discussion. 
A planning committee composed of 
two staff members and seven or eight 
foster parents would meet before 
each general meeting to draw up the 
agenda. The case consultant would 
lead the group discussion, and after 
each meeting a staff committee would 
analyze the progress we had made. 
What we would deliberately seek 
would be an exchange of knowledge 
and experience that should lead us 
all to a better understanding of why 
foster-home placement is needed for 
some children and how foster parents 



ESTHER S. MELTZER is now with the 
Spence-Chapin Adoption Service, New York 
City. Before that she was a district super- 
visor with the Jewish Family and Children's 
Bureau of Boston. At the time the program 
described here was started. Miss Meltzer 
was a caseworker with the Jewish Chil- 
dren's Bureau of Cleveland. This article is 
based primarily on a paper that Miss Melt- 
zer Rave at the Ohio State Welfare Con- 
ference when the program of foster-parent 
meetings had been going on about a year 
and a half. The article is planned to show 
the dynamics of the program's start. 
MIRIAM WANNE, who is a caseworker 
with the Jewish Children's Bureau of Cleve- 
land, has contributed additional material to 
show some of the later developments in the 
foster-parent meetings. 

Concerning the more recent stages of the 
program much still remains to be told. 



and caseworkers can best work to- 
gether for the greatest benefit of these 
children. 

The meetings were to be held at 
night so that foster fathers, too, 
could come. 

This plan was put into effect in 
April 1948. The response of the foster 
parents was electrifying. All of us 
— foster parents and staff — were 
fired with enthusiasm to wrest from 
each meeting the maximum in learn- 
ing from one another and in finding 
out how to translate our knowledge 
into more fruitful cooperative work. 

For members of the planning com- 
mittee we chose some foster parents 
who had had long service with the 
agency and whose foster children 
were representative, in age and type, 
of the children generally served by 
the agency. About half these couples 
had European children in their 
homes. We sought people who would 
be able to speak up in the group with- 
out hesitation or embarrassment, 
since the committee members would 
act as co-leaders in each discussion 
and at times would have to take a defi- 
nite assignment to prepare to focus 
discussion on a certain point. We 
asked the staff to recommend foster 
parents who in their opinion meas- 
ured up to these requirements. We 
included foster fathers as well as 
foster mothers. 

The Sterns were our first and unan- 
imous choice, a couple in their early 
forties, with two children of their 
own, a boy of 13 and a girl of 4. They 
were then entering their third year 
as foster parents and had in their 
home four foster children. They were 
people of moderate means, with only 
a sketchy formal education, and they 
had an earthy, natural dignity. 

Mrs. Stern was a truly maternal 
person, who liked children. She saw 
in foster parenthood the opportunity 
to provide companionship for her 
own youngsters, as well as to add to 
the family income. During her con- 
tact with the agency she had demon- 
strated capacity to serve youngsters 
of varying capacities and behavior 
patterns. She was completely identi- 
fied with the agency and eager to 
participate in planning. In spite of 



158 



THE CHILD VOL. 17 No. 10 



the assurance she had of the agency's 
confidence in her, she found it diffi- 
cult to express negative feeHngs 
about the children or to take excep- 
tion to the agency's planning for 
them. 

Mr. and Mrs. Hart were also 
among our oldest foster parents in 
length of service. They too were in 
their early forties, and they had one 
adolescent daughter. They had been 
outstandingly successful with their 
one foster child over a period of sev- 
eral years. Mrs. Hart, characteris- 
tically, was the dominant member of 
the family. She was a person who ex- 
pressed herself easily. There was a 
forthrightness about her comments 
that was provocative and challeng- 
ing. Midway in our program the 
Harts dropped out, partly because 
their foster daughter became finan- 
cially independent. Another factor 
in the Harts' withdrawal, we believe, 
was the fact that Mrs. Hart's out- 
spokenness in the meetings created 
negative reactions in the group to- 
ward Mrs. Hart, which she could not 
tolerate. 

The Harts were replaced by the 
Pearls, a younger couple with two 
small girls of their own and one 
foster child, an adolescent girl. 

Mrs. Pearl, like Mrs. Hart, was the 
dominant person in the family group, 
but Mr. Pearl was more articulate 
than Mr. Hart and expressed himself 
more freely in the group. Mrs. Pearl, 
a practical, thoughtful, even-tem- 
pered person, contributed a matter- 
of-fact objective mood to committee 
meetings. 

European child welcomed 

Mr. and Mrs. Robins were of the 
newer foster-parent group, the post- 
war applicants. They were in their 
middle thirties, with three children 
of their own. Their foster child was a 
displaced European girl. Mr. Robins' 
experience with the Army of Occu- 
pation in Germany, when he came 
in contact with the "lost" children in 
the concentration camps, stimulated 
his interest in providing a home for 
a youngster from Europe. He was a 
quiet young man, apparently secure 
in his familial and marital relation- 




A good foster mother gives the child the same personal care she would give her own child 



ships. Mrs. Robins shared her hus- 
band's interest in serving, but she 
was a less relaxed person and one 
more concerned with matching 
reality to the ideal. Their earnestness 
bore fruit in the success they had 
with the displaced youngster they 
took into their home. 

The Millers could be described as 
the most challengingly outspoken of 
our foster parents. They had an 
intense interest in the agency's pro- 
gram, and Mrs. Miller, active in Jew- 
ish community life, had a keen under- 
standing of the professional point of 
view and consciously tries to make 
use of it in her work as a foster 
parent. They had begun to provide 
an infant home for us about 10 years 
before this program began, and, 
after a lapse of more than 5 years, 
applied again, this time for adoles- 
cent foster children. We now use 
their home as a small group home for 
children of all ages. 

Mrs. Tager was a woman in her 
late 50's, bright but unschooled, with 
real liking for children and sensi- 
tivity to their needs, but little interest 
in or concern about the agency's con- 
cepts. She "indulged" the workers 
just as she did a foster child. She at 
the same time demonstrated tremend- 
ous tolerance and warmth for a 
youngster with serious behavior 
difficulties. 

This then was really the beginning 
of our program — a program that falls 
into three distinct periods. The first, 



May to July 1948, was a period of 
groping and free discussion ; the 
second, October 1948 to July 1949, 
was the period when the areas of 
interest and concern were more 
clearly identified and formulated ; and 
the third, October 1949 to the present, 
when foster parents have partici- 
pated actively in the selection of the 
subjects to be considered and in long- 
range planning of discussions. The 
foster-parent meetings today are 
much more the group's own program 
than was possible at the outset, be- 
cause today we have in the group a 
large enough nucleus of foster par- 
ents who have been active in the 
program and through it have gained 
experience in self-scrutiny and self- 
expression, so that continuity and 
direction can stem from the group. 

When we suggested the plan of 
monthly foster-parent meetings to 
the group of four couples, Mrs. Stern, 
always eager to express approval of 
the agency, thought it would be a 
wonderful idea. Mrs. Robins wanted 
to know the precise arrangements, 
and her husband said it was a good 
plan if we could really work it up. 

Then Mrs. Hart spoke her mind, 
prefacing her remarks with her usual 
"You won't like what Pm going to 
say." She wanted to know how we 
could expect foster parents to be 
completely honest, to tell what prob- 
lems they really have, and to confront 
the caseworkers and the agency 
openly with criticism of their 



JUNE-JULY 1953 



159 



methods. It might be a good idea, 
she said, like many of the agency's 
other ideas, but she for one doubted 
that it would work. Then, as an 
afterthought she quietly remarked 
that it wouldn't hurt to try. 

A general, free-for-all discussion 
followed, with the foster parents com- 
miserating with one another on their 
"problems" and occasionally remem- 
bering to reassure the two staff mem- 
bers who were present with: "We 
think the agency does a wonderful 
thing, the way you give the children 
everything." 

First general meeting planned 

After some time, the chairman re- 
marked that what we hoped to do in 
a more organized fashion in the 
larger meeting had been done here in 
some slight degree — we had found 
some mutual problems and questions 
and had engaged in a lively discussion 
of them. The value such meetings 
might have for all of us was pointed 
out. The kind of frankness Mrs. Hart 
had displayed was good, and we hoped 
that eventually all our foster parents 
would feel equally free to share their 
reactions and feelings about the work 
we were doing together. Gradually, 
as each member expressed himself, 
enthusiasm seemed to develop within 
the group about the program we had 
suggested, and the committee began 
to plan thoughtfully for the first gen- 
eral meeting. 

Our first meetings were held in the 
homes of staff members. A generally 
social air predominated and a note of 
informality developed around re- 
freshments served at the end of each 
meeting. 

About 30 foster parents came to 
the first meeting. We were struck by 
their reaction to one another. Be- 
cause of the close ties in Cleveland's 
Jewish community, few of the group 
were really strangers to one another. 
Visible on many of their faces was 
the question that one or two blurted 
out. "Are you a foster parent, too?" 
We saw some instances of bridling 
embarrassment, but after the first 
brief period of constraint and tension 
the group relaxed. 

The group was formally greeted by 
our director, who stressed the im- 

160 



portance of the work in which we 
were mutually engaged and expressed 
the hope that our meetings together 
would prove helpful in improving the 
quality of our service to children. The 
case consultant then took over the 
meeting. He outlined the purpose of 
the meeting as seen by our staff and 
the group of foster parents who had 
met with the staff in an advisory 
capacity; and then he encouraged 
discussion and questions on the pro- 
posed program and on our work in 
general. 

What questions did they have about 
the agency, about the children, about 
their work as foster parents? The first 
uneasy response was volunteered by 
one of the committee members, and 
the way was opened. How can you 
satisfy an adolescent girl about the 
amount of clothing she asks for? Why 
do the children seem to resent the 
agency at times? Why is it you can 
say anything you want to your own 
children, but can't to a foster child? 
Why are there certain rules about 
parents visiting? And wouldn't it be 
better if some parents didn't visit at 
all? Just what do the social workers 
do with the children in their offices? 

There were comments, tentative at 
first, then more and more bold. Some 
foster parents seemed fearful of im- 
plying any criticism of the agency 
and were lyrical in their declaration 
that all is right with the foster child's 
world so long as he is in the foster 
home; others, of a more aggressive 
bent, sounded a critical note. The 
greater number, however, were silent 
in the meeting, but later, over the 
coffee cups, expressed interest in 
further meetings. 

Planning committee meets again 

At the second meeting of the plan- 
ning committee, only cautious ap- 
proval of the first general meeting 
was expressed. Each committee 
member launched into a discussion of 
his own experiences with his specific 
foster child and caseworker, as 
though testing the tolerance of the 
group for real questioning and nega- 
tive feelings. It was only after free 
expression had been given to this that 
the group was able to settle down to 
considering a topic for the next gen- 



eral meeting. The subject which 
seemed of most urgent interest to the 
group was "the caseworker": What 
is the role of the caseworker? What 
happens in the individual conferences 
between the caseworker and the 
child? Why does the child so often 
come away from his contacts with 
the caseworker so upset? And on and 
on. 

Thus "the caseworker" became the 
subject of the second general meet- 
ing. For the group to understand the 
role of the caseworker it was felt that 
it would be important and helpful 
for them to study, not only the case- 
worker, but themselves, in relation to 
the total agency structure and net- 
work of services. The director there- 
fore was asked to explain the agency 
organization to the group. He ex- 
plained the foster-home-care depart- 
ment of the agency and its relation- 
ship to the agency's institution and 
its day nursery. He explained then, 
in considerable detail, the specific role 
and training of the caseworker, her 
responsibility in approving and su- 
pervising foster homes, and the im- 
portance of her work with children 
who are in placement, and with their 
parents. He mentioned, too, the State 
licensing procedures. 

The foster parents then were 
encouraged to give their impres- 
sion of the role and function of 
the caseworker. One foster parent 
described the caseworker as a 
"referee" between the foster parent 
and the child; another spoke of the 
caseworker as the person to whom 
the child can go "to get things 
off his chest"; still another saw 
the caseworker as the person 
whom the child "plays against" the 
foster parents. It was apparent that 
the foster parents had much ques- 
tion about the need for and the use- 
fulness of the caseworker. There was 
some suggestion, even, that the case- 
worker was a source of confusion and 
disturbance to all concerned, particu- 
larly in such matters as allowances, 
jobs, and dating. 

The discussion branched into a 
consideration of why and how chil- 
dren come to the attention of the 
agency and how parents and chil- 

THE CHILD VOL. 17 No. 10 



dren are helped to use its services. 
There was discussion, too, of the 
part the caseworker plays in the 
selection of foster homes. And out of 
this evolved the question: "Why do 
people become foster parents?" a 
basic question which made up one of 
the many recurrent themes of the 
meetings that followed, but one which 
at this point had in it a bombshell 
quality. 

A foster mother who had one of 
our babies in her home replied, "We 
want to help children." Mrs. Tager 
said, "We want to do a good deed, 
like the Bible says." But our forth- 
rij:ht Mrs. Hart stated bluntly, "We 
do it for selfish reasons. We can't 
love the children because we don't 
know them before they come to us. 
I had only one child and I wanted 
a companion for her, but we also do 
it for the money; let's not forget 
that!" 

There was an audible silence, a 
momentary gasping for breath as 
though reacting to shock, and then 
an outburst of protestation. One 
foster mother went so far as to assert 
vehemently that the agency should 
not accept foster parents who said 
they were interested in the money. 
Others weren't sure. One ventured 
that if a foster mother was honest 
enough to indicate that she was inter- 
ested in the money, when that was 
the situation, she would also be honest 
with the child. She thought that if 
the family met the agency's other 
qualifications, their interest in fi- 
nances should not disqualify them. 

It was at this point that the dis- 
cussion leader raised the question 
about whether it was so wrong to be 
interested in earning extra money. 
The rest of us, referring to case- 
workers and other members of the 
staff, get paid for what we do — why 
should there be any question about 
money as a motive for foster parent- 
hood? Being paid does not take away 
from the special nature of the job; 
nor does it matter that while we may 
be earning extra money we may at 
the same time be meeting o'.her 
needs, such as the need for compan- 
ionship. 

After this outburst and sorting out 
of feelings, it seemed that the dis- 




Many factors, of course, enter into a couple's reasons for taking a foster child into their 
hdme. Often the most important factor is enjoyment of the child's companionship. 



cussion of what goes into the agency's 
selection of foster parents, which fol- 
lowed, took on new meaning. The 
group was obviously impressed and 
intrigued with the fact that the staff 
saw foster parenthood as a form of 
employment and felt that work 
should be paid for. They became 
curious about how the agency decided 
which couples to accept and which to 
reject. This gave the staff an oppor- 
tunity to discuss our intake proced- 
ures, our study of the foster homes, 
and our use of references. 

Over the coffee cups after this 
meeting there was more than in- 
formality and cordiality. There was 
an air of elation as foster parents 
talked with other foster parents and 
with agency staff. As one foster 
mother put it : "I never knew so much 
time and thought went into the work 
we are doing together." Staff mem- 
bers, in their home calls after the 
meeting, were unanimous in their 
feeling that "something had hap- 
pened" to level away the barrier that 
had always seemed to exist between 
foster parents and staff. There was 
a quality of togetherness that had 
never been so apparent before. There 
was a clearer understanding on the 
part of foster parents of their place 
in the total agency organization, a 
new feeling of status, and of appre- 
ciation of the real importance of the 
job they were doing. 

Our third meeting continued what 



might be called our stream-of-con- 
sciousness discussion. It was held at 
the beginning of the summer-vacation 
period. The staff committee planned 
it as a party. The one bit of serious 
business would be in the form of a 
parlor game. We presented to the 
group six situations : Three in which 
a foster child needed placement, and 
three in which foster parents were 
awaiting placement of the kind of 
child they had requested. We asked 
our foster parents to match children 
to homes. From the discussion 
evolved such questions as : 

Could you love a foster child as much as 
you love your own? Perhaps not, but you 
could try not to show favoritism in front 
of the children. 

A foster child ought to be placed in a 
home where he would not have to compete 
with an "own" child near his age. 

Maybe the agency does have a hard time 
if we foster parents limit them too exactly 
in the kind of foster children we ask for. 

In the kind of things they expect and 
demand from adults, in the way they talk 
to adults, foster children aren't much dif- 
ferent from our own children. 

An adolescent girl may be better off with 
a young foster mother, who can remember 
her adolescence and act as an older sister, 
rather than with a motherly older woman. 

Perhaps there is not much difference 
between the .American child and the dis- 
placed European child. 

The meeting ended with eagerly 
expressed anticipation of the begin- 
ning of the .series in the fall. 

(To be concluded in the next issue) 



JUNE-JULY 1953 



161 



FOR MORE REWARDING SUMMER RECREATION 

A city health department provides consultation services to day camps 



LILLIAN MARGOLIN 

IN A CROWDED CITY, children 
need opportunities for the kinds 
of summer recreation that are 
safer, more healthful, and more con- 
structive than haphazard play on the 
street. During the school-vacation 
months, many groups and some indi- 
viduals in New York City attempt to 
supply such opportunities by offering 
children a wide variety of organized 
recreational programs, known in gen- 
eral as day camps. It is estimated 
that nearly 600 such camps are open 
in the city for about 8 weeks each 
summer. (These do not include year- 
round day-care centers, nor mass 
recreation programs such as the va- 
cation playgrounds provided by the 
Board of Education and by the De- 
partment of Parks — programs in 
which the children may not be regu- 
larly enrolled.) 

Sponsorship varies 

Such organizations as settlement 
houses, Boy Scouts and Girl Scouts, 
religious groups, and various social 
, agencies sponsor some of the day 
camps. The municipal government is 
responsible for some, through its 
Board of Education, its Housing 
Authority, and its Youth Board. 
Others are operated by private indi- 
viduals, and by cooperative groups of 
parents. Some landlords have estab- 
lished day camps for the children of 
their tenants. The large majority of 
the camps are run by nonprofit 
groups; less than a quarter of them 
are commercial. 



LILLIAN MARGOLIN is Head of the Day 
Camp Unit, Bureau of Child Health, New 
York City Department of Health. During 
the past 1.5 years Miss Margolin has held 
various executive positions in the field of 
social group work, including- that of director 
of resident country camps and day camps, 
in New York Citv. 



Each summer at least 100,000 
children under 16 take part in these 
day-camp programs. With such a 
large number of children involved, 
the Bureau of Child Health of the 
city's Department of Health natu- 
rally is concerned about their physi- 
cal, mental, and emotional health. 
And for the past 2 years the Bureau's 
Division of Day Care and Foste'r 
Homes has had a special Day Camp 



this service we also collect complete 
data on the camps, such as their 
location, the number and ages of chil- 
dren attending, the number and quali- 
fications of staff, the hours per ses- 
sion and number of sessions per week 
and the fees paid by parents. 

Because changes cannot be made 
easily while the children are at the 
camps, our consultation service is 
most effective when given during the 




A good day camp offers a relaxed atmosphere, where children may use their own initiative. 



Unit, including three social group 
workers and a public-health nurse. 
This Unit works to help camp opera- 
tors and directors offer children ex- 
periences that are safe, healthful, 
and happy. 

As a step in this direction we of 
the Day Camp Unit observe and 
evaluate the programs while they are 
in operation, and give year-round 
consultation service. To help us give 



periods of pre-season planning and 
post-season evaluation. 

In evaluating the day-camp pro- 
grams and recommending changes, 
we have found helpful a set of mini- 
mum standards that have been recom- 
mended by the Welfare and Health 
Council of New York City. These 
standards, dealing with health serv- 
ices, physical facilities, sanitation, 
food, program, transportation, per- 



162 



THE CHILD VOL. 17 No. 10 



sonnel, insurance, and records, were 
described in The Child, October 1951. 

Besides giving consultation service 
to the directors of individual camps, 
the staff members of the Day Camp 
Unit hold conferences with represent- 
atives of the large organizations 
whose affiliates conduct day-camp 
programs, and of the private day- 
camp associations. At such a meeting 
we analyze the particular situation of 
the group and seek solutions to its 
problems ; we enlist its cooperation in 
improving practices in its camps ; we 
explain the recommended standards, 
distribute literature, and answer 
questions. 

In our consultations we make every 
effort to preserve the individuality of 
each camp. The help given depends 
partly on the basic philosophy of the 



tempt to stereotype the programs, 
nor do we assume that only one 
method of operation is sound. 

With some camps it is necessary 
for us to start our consultation with 
recommendations concerning basic 
minimum needs, such as for main- 
taining cleanliness, providing an ade- 
quate number of toilets and wash- 
basins, controlling flies and vermin, 
providing shelter for the children 
during inclement weather, and 
arranging for them to have whole- 
some food. 

Other camps may not need help in 
such elementary matters, but may 
need help in developing a sound 
health program. To the director of 
such a camp we might explain the 
value of pre-season health examina- 
tions for campers and staff. Also we 




Mature, creative leadership is an essential for a successful day-camp program for children. 



agency that operates the camp, the 
type of program, and the director's 
readiness to accept help. Each camp 
has its own set of problems, its own 
philosophy and objectives. Despite 
this variety, however, some basic 
common denominators of sound prac- 
tice and principles of good living and 
good health apply to all the camps, 
for they apply to all children in all 
situations. Our Unit makes no at- 



might show why the camp needs to 
have a physician .study the results of 
these examinations and make recom- 
mendations concerning them. An- 
other point on which we might advise 
the director is in regard to making 
provision for individual children with 
specialized needs, such as a child with 
epilepsy, or with a crippling condi- 
tion, or with an emotional disturb- 
ance. Together with the director we 



might work out methods for daily 
inspection to detect signs of illness, 
and plan for dealing with accidents 
and sudden illness. We might sug- 
gest routines including rest periods, 
and offer ideas for interesting and 
nutritious meals. 

Often, after the consultant has 
made recommendations of this kind 
to a camp director, other important 
aspects of the program will come 
under discussion, such as camp per- 
sonnel. Our Unit constantly stresses 
the importance of having warm, 
friendly, mature staff members, who 
understand the growth and behavior 
of children. We emphasize that the 
previous training of these workers 
should include some study in the field 
of education, or of recreation, or of 
social work, as well as experience 
with children in groups. 

The Unit realizes that it is not 
always enough to convince a camp 
director that a day camp should have 
well-qualified personnel ; it is often 
desirable also to help him make the 
best use of the funds budgeted for 
staff salaries, and to suggest sources 
for recruiting workers. The consult- 
ants are ready also to help a director 
develop in-service training programs 
and methods of supervision, and to 
assist with personnel practices in 
general. 

To meet needs of different children 

Planning for staff is necessarily 
related to the number and the age 
group of children for whom the 
worker will take responsibility, as 
well as to the program he will con- 
duct. In discussing the daily routines 
of the group, the consultant and the 
director will give consideration to the 
need for balance between activities 
and quiet intervals ; and to the need 
for offering a variety of experiences 
to meet the needs of children with 
different interests. These experiences 
might include swimming, group 
games, arts and crafts, hikes, picnics, 
study of nature lore, music, dra- 
matics, and so forth. 

"Program" includes the entire 
range of activities, relationships, in- 
teractions, and experiences, both in- 
dividual and group, which the direc- 
tor plans and carries out with the 



JUNE-JULY 1953 



163 



help of the counselor to meet the 
needs of the individuals and the 
group. 

To help with program develop- 
ment, the Day Camp Unit compiles 
reading lists and offers equipment 
lists, and also makes specific sugges- 
tions, according to the location and 
resources of the particular camp. 

In a play school in a congested slum 
area, for example, a plan was de- 
veloped through joint conferences for 
regular weekly trips to State parks, 
to farms, to the agency's resident 
camp, and to other rural spots. For 
many of these children these trips 
were their only opportunity to know 
at first hand the feel of earth and 
grass, to wade in a brook, to see a 
frog or a salamander hop out of a 
puddle, to climb a tree, and to know 
the freedom of unencumbered space. 

Conditions improve 

An earnest attempt is made by the 
consultants to consider the particular 
problems of a group, in relation to 
limitations of physical facilities, re- 
stricted funds, location of the camp, 
and the nature and extent of the serv- 
ice, as well as the needs of the com- 
munity. At the suggestion of a 
consultant, concrete assistance has 
been given in many situations by the 
Bureaus of Sanitary Engineering and 
Sanitary Inspections, both of the De- 
partment of Health. Advice is given 
by the representatives of these 
bureaus on how to make the best use 
of what is available, and this, of 
course, need not result in large finan- 
cial expenditures. Methods of obtain- 
ing improved light and ventilation 
are suggested, along with procedures 
for sanitary maintenance, for proper 
garbage disposal, and for efficient 
dishwashing and food storage. The 
know-how of experts has repeatedly 
resulted in improved conditions. 

Representatives of the Department 
of Health's Bureau of Nutrition are 
also called in by our consultants to 
advise many directors of day camps. 
Again, no stereotyped or rigid pro- 
cedures are suggested by these nutri- 
tionists. Many factors are taken into 
consideration in making recommend- 
ations concerning the children's nu- 
trition. The agency's food budget is 



taken into account, as well as the 
cultural habits and needs of the 
children served, and the camp's facil- 
ities for cooking and serving food. 
Many agencies are thus helped to 
provide interesting, well-balanced, 
nutritious meals for the children 
at a reasonable cost. Since in some 
camps the children bring box lunches 
from home, the Day Camp Unit, 
in cooperation with the Bureau of 
Nutrition, has published a leaflet 
entitled "Box Lunches and Snacks 
in Day Camps and Summer Group 
Programs." This pamphlet is avail- 
able to the camps for distribution to 
parents. In addition the Unit con- 
sultants and the nutritionists meet 
frequently with parent groups to 
discuss the food needs of children in 
day camps. 

The work of the Unit is helped 
immeasurably through the broad re- 
sources of the Department of Health. 
Specialized assistance is available 
from other bureaus of the Depart- 
ment — not only the three bureaus 
mentioned previously, but also the 
Bureaus of School Health, Public 
Health Nursing, Public Health Edu- 
cation, Preventable Diseases, Records 
and Statistics, Foods and Drugs, and 



the unit devoted to public relations 
and publicity. 

Our consultation service is in effect 
an educational process, and we estab- 
lish ongoing relationships with many 
groups. In some instances the camp 
operators request our help; in others 
the consultant takes the initiative. 
In no case has any group refused to 
discuss its operation of a camp or to 
permit observation or inspection. 

We prepare for follow-up 

The information secured during 
consultation conferences and obser- 
vation visits is noted in case records. 
These records enable us to compile all 
known data, to give a complete picture 
of each agency concerned, in order to 
help in follow-up in the future and in 
over-all comparative studies. 

During the months of July and 
August the Unit's year-round staff of 
four consultants is augmented by a 
part-time staff of school physicians 
assigned by the Department of ! 
Health, and by several sanitary in- 
spectors. This staff, working some- 
times in teams, sometimes individu- 
ally, carries on carefully planned field 
visits. The physicians observe, evalu- 
ate, and make recommendations re- 



Each summer 100,000 New York City children under 16 go to day camps. And the city's 
Department of Health is concerned about their physical, mental, and emotional health. 




164 



THE CHILD VOL. 17 No. 10 



garding the health program; the 
sanitary inspectors concentrate their 
attention on sanitation and physical 
facilities ; the consultants observe all 
aspects of the program. After each 
visit to a camp, a conference is held 
with the director or other person in 
charge of the camp, an evaluation is 
given, and recommendations made. 
We follow each visiit with a letter 
summarizing the recommendations. 

Standards and practices in day 
camps can be improved only as 
parents become aware of the need for 
such improvement. It is therefore 
necessary to keep parents informed 
about good standards and the value 
of having good programs. 

Most parents have at least some 
concern about the need for clean sur- 
roundings, attractive facilities, and 
sufficient, nutritious food. But they 
are somewhat less aware of what con- 
stitutes a creative, well-rounded, well- 
balanced program; what qualifica- 
tions a competent staff should have ; 
what materials and equipment ought 
to be available. Parents need to be 
kept informed about new concepts of 
child development and modern 
methods of recreational program- 
ing. 

Some parents do not realize how 
a highly competitive atmosphere, for 
example, affects their youngsters. In 
fact parents themselves frequently 
insist that their childi-en bring home 
evidence of their accomplishments in 
the form of such things as a finished 
ash tray or a decorative pie plate ; 
that they receive marks of achieve- 
ment in medals and awards ; and that 
their interest and enthusiasm be 
maintained by spectacular events 
such as carnivals. 

Some parents, remembering their 
own camp experience, demand for 
their children the same regimented, 
readymade, overorganized programs 
they have known about in the past. 

When parents understand the 
fundamental needs of children, they 
will not be satisfied unless the pro- 
gram offers a relaxed, informal at- 
mosphere, where children are per- 
mitted to use their own initiative, 
where there are opportunities for 
adventure, where the activities are 
interesting but not predigested and 



routinized, and where the leadership 
is mature and creative. 

The Day Camp Unit has tried to 
spread these ideas by means of meet- 
ings with parents' associations; 
through careful guidance of parent 
cooperatives that sponsor day-camp 
programs; through radio broadcast- 
ing and newspaper publicity; and 
through preparation and distribution 
of printed materials. It should be 
noted that parents have been very 
receptive to information about ac- 
ceptable standards, are extremely 
eager to be informed, and are con- 
stantly seeking help in selecting day 
camps for their children. The De- 
partment of Health's folder, "Point- 
ers for Parents," which lists factors 
to be considered in picking a summer 
day camp for children, has been 
widely used. 

As a result of the keen interest of 
various associations and councils con- 
cerned with recreation programs for 
children, our Day Camp Unit receives 
a great deal of help. These groups 
help to locate and identify camps ; 
they distribute the pamphlets that 
the Department prepares for camp 
operators and for parents ; and they 
help to publicize the recommended 
standards. They also explain the 
work of the Day Camp Unit to their 
affiliates, and they make valuable sug- 
gestions to the Unit as to methods of 
approaching the problem as a whole. 
These groups have organized con- 
ferences and panels on day camping 
and similar programs, and have in- 
vited staff members of the Unit to 
take part. 

Toward raising standards 

In offering consultation service to 
the many day camps in the City of 
New York, the Day Camp Unit has 
worked to meet the needs of parents, 
of operating groups, of community 
agencies, and especially of the chil- 
dren attending these camps. Our 
experience shows that such service, 
given by experienced professional 
workers who are concerned with all 
aspects of recreational programs for 
children, is one way to bridge the 
gap between theory and practice, and 
is a practical approach toward 
raising day-camp standards. 



FOR YOUR BOOKSHELF 



RESIDENTIAL TREATMENT OF 
EMOTIONALLY DISTURBED 
CHILDREN; a descriptive study. 
By Joseph H. Reid and Helen R. 
Hagan. Child Welfare League of 
America, 24 West Fortieth Street, 
New York 18, N. Y. 1952. 313 pp. 
$3.50. 

In this report of 12 centers for 
treatment of children with severe per- 
sonality disorders the Child Welfare 
League of America gives a detailed 
description of each center, written by 
a study team that spent 1 to 3 weeks 
at the center, observing practice, in- 
terviewing key personnel, and read- 
ing reports. Each report includes also 
an evaluation or critique, written by 
the center's director. 

These descriptions offer readers an 
opportunity to evaluate programs un- 
der different types of auspices. Thus, 
the report should be useful in pro- 
moting better understanding of resi- 
dential clinical services and of the 
various studies of such services. 

Treatment in residence of emotion- 
ally disturbed children is the major 
function of each of the 12 centers se- 
lected for study. Each provides direct 
psychotherapy integrated with a 
therapeutic living milieu. Each has 
control over what children should be 
admitted. All are considered by the 
workers who made the study as rep- 
resentative of the field. "The number 
of treatment centers in the United 
States, other than these 12, is not 
large," says the report, "and few, it 
is believed, have developed resources 
comparable to those described here." 

Seven of the 12 centers can be con- 
sidered medical programs and are ad- 
ministered by physicians. Five are 
social-agency programs, administered 
by social workers. Some of the pro- 
grams were established principally 
for disturbed children for whom fos- 
ter care also must be provided. Other 
programs assume no responsibility 
for the child's foster-care needs be- 
yond the period he is in treatment. 

Differences also may be seen be- 
tween centers that offer essentially 
service programs and those that have 
a major training and research respon- 
sibility. A later publication of the 
Child Welfare League of America will 
analyze and evaluate some of these dif- 
ferences in function and organization. 



JUNE-JULY 1953 



165 



RESIDENTIAL TREATMENT 
CENTERS FOR EMOTIONALLY 
DISTURBED CHILDREN; a list- 
ing. Federal Security Agency (now 
the Department of Health, Educa- 
tion, and Welfare) , Social Security 
Administration, Children's Bureau. 
1952. 78 pp. 25 cents. For sale 
by the Superintendent of Docu- 
ments, Government Printing Office, 
Washington 25, D. C. Single copies 
available from the Children's Bu- 
reau without charge. 

To obtain information that would 
be helpful in answering questions 
from agencies and parents about pro- 
grams for children with emotional 
disturbances, the Children's Bureau 
has assembled information from 36 
centers whose directors reported that 
the center's primary purpose was 
treatment of emotionally disturbed 
children. The Bureau has listed these 
36 organizations, along with a brief 
description of the services, staff, and 
facilities of each, in the hope that it 
will be helpful to professional workers 
using these services. 

The information reflects the cen- 
ters' services as of the spring of 1952. 
No attempt has been made to evalu- 
ate the programs, and inclusion of 
them in this directory does not consti- 
tute an endorsement by the Children's 
Bureau. 

AN APPROACH TO MEASURING 
RESULTS IN SOCIAL WORK; a 
report on the Michigan reconnais- 
sance study of evaluative research 
in social work sponsored by the 
Michigan Welfare League. By Da- 
vid G. French. Columbia Univer- 
sity Press, New York. 1952. 178 
pp. $3. 

This study will be of interest and 
value to all persons — lay and profes- 
sional — who have had occasion to ask 
one or more of the following ques- 
tions : "Are people being benefited by 
social-work services in the way they 
need to be benefited? Is the money 
which the community is investing in 
social-work services producing results 
that justify continuing or extending 
these services? What kinds of im- 
provements are possible in making so- 
cial-work services more effective?" Al- 
though the study does not purport to 
answer these questions, it is directed 
toward a better understanding of 
what is involved in obtaining the 
answers. Because the report is writ- 
ten with clarity and with a notable 
absence of technical jargon, it may be 
read with ease and profit by both 
research and nonresearch people. 

Rather than undertake another 
venture in evaluating some aspect of 



social service, the Michigan Welfare 
Board, which sponsored the study, 
decided in favor of the necessity of 
learning more about the basic issues 
and problems involved in measuring 
the effectiveness of practice. In ful- 
filling this charge, Mr. French an- 
alyzes critically past efforts at evalu- 
ation, the obstacles which these 
efforts have met, and the many con- 
siderations to be faced in planning 
for a continuing program of evalua- 
tive research. The material for this 
"reconnaissance" was obtained from 
a review and careful study of the 
literature on social work and social- 
work research, supplemented by a 
series of individual and group con- 
ferences designed to elicit material 
not available in printed form. 

The findings of this exploratory 
study indicate not only that those re- 
sponsible for social-work programs 
have many questions about the effec- 
tiveness of welfare services, but that 
they look to research for the answers. 
A review of the questions raised by 
social workers brought out that some 
may appropriately be answered by 
research ; others not. 

Questions about the goals and the 
values of welfare services must be 
considered by means other than re- 
search. As a matter of fact, one of 
the greatest obstacles to evaluative 
studies has been the lack of agree- 
ment about goals. Evaluation of prac- 
tice can only be in terms of the ends 
which it seeks for both the client and 
the community. Others among the 
questions raised by social workers 
can ultimately be answered by objec- 
tive research. 

Mr. French's material clarifies two 
essential tasks which come before re- 
search as such : (1) The need to make 
explicit the assumptions and theories 
on which social-work practice is 
based; and (2) the need to phrase 
the questions in research terms and 
to organize them into a proper se- 
quence. 

Assuming that these tasks can and 
will be accomplished, the next steps 
in a program of evaluative research 
are, in Mr. French's opinion: (1) An- 
alyzing the problems with which the 
service deals; (2) describing and 
standardizing the service; (3) meas- 
uring the degree of change brought 
about by the application of the serv- 
ice; and (4) determining whether the 
change observed is the result of the 
service or is due to some other cause. 
The realization of such a program 
will require, according to the author, 
interchange of ideas and skills among 
administrators, practitioners, social 
scientists, and social-work research 
workers. 



Research into the effectiveness of 
social-work practice requires many 
things: (1) A desire for the answers, 
(2) funds, (3) know-how — to men- 
tion a few. More than anything else, 
however, an objective evaluation of 
social work demands a willingness to 
face basic issues and to raise funda- 
mental, and sometimes unsettling, 
questions. Mr. French has done a real 
service in making this very clear. 

Sophie T. Cambria, Ph.D. 
Hunter College, New York City 

NOTE: Although this report deals 
with the measurement of social work, 
it contains much that will be of in- 
terest to those concerned with pub- 
lic-health services. Similar needs for 
measurement of results, justification 
of expenditure, and increasing effec- 
tiveness exist in both fields. And, as 
Mr. French says, certain steps are 
essential to evaluative thinking, what- 
ever the subject under consideration. 
Marian M. Crane, M.D. 

RECIPES FOR NURSERY 
SCHOOLS AND OTHER GROUP 
CARE CENTERS. Compiled by 
Edna Mohr. Elizabeth McCor- 
mick Memorial Fund, 848 North 
Dearborn Street, Chicago 10, 111. 
1951. Processed. 52 pp. 50 
cents. 

Recipes that have been used suc- 
cessfully in many nursery schools 
are offered in this publication to 
help directors of child-care centers 
and their cooks. The recipes give 
the amounts of ingredients neces- 
sary for serving 25, 50, and 100 
children. 

Catherine M. Leamy 



IN THE NEWS 



Juvenile delinquency. Through a new 
grant from the Field Foundation, the 
life of the Special Juvenile Delin- 
quency Project that is working closely 
with the Children's Bureau has been 
extended until January 1, 1954. Sup- 
ported by voluntary contributions dis- 
bursed by the Child Welfare League 
of America, the Project aims to im- 
prove treatment services for delin- 
quent children. 

For its final 6 months' activity, 
with an enlarged staff, the Project 
hopes to bring to conclusion the work 
it has undertaken along with the 
Juvenile Delinquency Branch of the 
Bureau in developing new standards — 
or statements of desirable practice — 
for training schools for delinquent 
children, juvenile courts, and juve- 



166 



THE CHILD VOL. 17 No. 10 



nile-police services. Specialists from 
all over the country are cooperating 
in this work. 

Addition of the new staff will per- 
mit the Project to step up its coopera- 
tive efforts with the various National, 
State, and local groups that have been 
participating in the campaign for 
better services for delinquent chil- 
dren. 

The Project grew out of a Confer- 
ence on Delinquency Control held by 
the Children's Bureau in Washington 
in April 1952. It is hoped that the 
Project can conclude by recalling the 
members of this 1952 conference in 
order to report to them on work 
accomplished and what remains to 
be done. 



SUMMER COURSES 

Columbia University. New York 
School of Social Work. New York 28, 
N. Y. 

Two series of summer institutes in 
social work. Some of the courses : 
Series I (for graduates of schools of 
social work) : Social treatment with 
the adolescent; Social work with the 
ill and handicapped. Series II : The 
psychosocial development of the nor- 
mal child ; Casework with unmarried 
mothers ; and Casework with children 
in their own homes and in substitute 
homes. Series I, July 6-17. Series II, 
July 20-31. 

Louisiana State University and A. & 
M. College. School of Social Welfare, 
Baton Rouge. 

Some of the short courses: Work- 
shops: Children in foster care (June 
5-26) ; Children and public welfare 
(July 20-Aug. 7). 

Nursery Training School of Boston. 

Boston 15, Mass. 

For experienced nursery-school 
teachers : Child growth and guidance 
— a seminar ; Teacher education 
through nursery school — a workshop ; 
Nursery-school education for the 
physically handicapped child — a 
workshop. Also a try-out course for 
high-school students and others who 
are considering entering the field of 
early-childhood education. (June 29- 
Aug. 7.) 

Smith College. School for Social 
Work. Northampton, Mass. 

Graduate seminars for experienced 
social workers : Advanced casework ; 
Supervisory method in social case- 
work ; Ego psychology ; Psychodyna- 
mics of delinquency; Casework inter- 
pretation and writing; and Educa- 
tional methods in teaching casework. 
(July 20-30.) 



University of Chicago. School of 
Social Service Administration. Chi- 
cago 37, 111. 

Some of the workshops : Casework 
with children and adolescents (June 
29-July 11): Work with parents of 
children in placement (July 20-25). 
Special lectures (daily) : Adolescence 
as a phase in the development of the 
ego. (July 6-10.) 

University of Minnesota. Minneapo- 
lis, Minn. 

Under the sponsorship of a number 
of the University's colleges and 
schools, including the School of Social 
Work, the Family Life Division of 
General Studies, the Institute of Child 
Welfare, and others, the Family Life 
Workshop will emphasize the value of 
teamwork among professional work- 
ers in family-life education — teach- 
ers, marriage counselors, social 
workers, public-health workers, re- 
search personnel, and others in the 
family-life field. (July 6-24.) 

University of Pennsylvania. Philadel- 
phia 4, Pa. 

The eleventh annual course in 
Family living and sex education is 
sponsored by the School of Education 
and the Institute for the Study of 
Venereal Diseases, University of 
Pennsylvania, in cooperation with the 
Public Health Service, Department of 
Health, Education, and Welfare; 
Pennsylvania State Department of 
Health ; and the American Social Hy- 
giene Association. It is intended for 
public-health workers, counselors, 
teachers, religious leaders, nurses, so- 
cial workers, group leaders, and par- 
ents. (June 29-July 31.) 



CALENDAR 



Aug. 16-22. World Federation for 
Mental Health. Sixth annual meet- 
ing. Vienna, Austria. 

Aug. 25-28. American Dietetic Asso- 
ciation. Thirty-sixth annual meet- 
ing. Los Angeles, Calif. 

Aug. 30-Sept. 1. American Socio- 
logical Society. Forty-eighth an- 
nual meeting. Berkeley, Calif. 

Aug. 31-Sept. 2. National Council on 
Family Relations. Annual confer- 
ence. East Lansing, Mich. 

Aug. 31-Sept. 3. American Hospital 
Association. Fifty-fifth annual con- 
vention. San Francisco, Calif. 

Aug. 31-Sept. 3. American Legion. 
Thirty-fifth annual national con- 
vention. St. Louis, Mo. 



Sept. 1-30. Sight Saving Month. In- 
formation from the National So- 
ciety for the Prevention of Blind- 
ness, 1790 Broadway, New York 19, 
N. Y. 

Sepf. 3-8. United States Assembly of 
Youth. Sponsored by the Young 
Adult Council of the National Social 
Welfare Assembly. Ann Arbor, 
Mich. 

Sept. 4-9. American Psychological 
Association. Sixty-first annual con- 
vention. Cleveland, Ohio. 

Sept. 6-11. National Urban League. 
Annual conference. Philadelphia, 
Pa. 

Sept. 10-12. American Political Sci- 
ence Association. Forty-ninth an- 
nual meeting. Washington, D. C. 

Sept. 13-20. World Assembly of 
Youth Rural Youth Conference. 
Host : The Italian national commit- 
tee for the World Assembly of 
Youth. (The Food and Agriculture 
Organization of the United Nations 
is assisting in the preparatory ma- 
terials.) Address inquiries to: 
World Assembly of Youth, 6 rue 
Ampere, Paris 17, France. 

Sept. 17. Citizenship Day. Informa- 
tion from the Citizenship Commit- 
tee, National Education Associa- 
tion, 1201 Sixteenth Street NW., 
Washington 6, D. C. 

Sept. 17-19. National Conference on 
Citizenship. Eighth annual meet- 
ing. Washington, D. C. 

Sept. 25-27. American Society of Den- 
tistry for Children. Twenty-sixth 
annual meeting. Cleveland, Ohio. 

Sept. 27-Oct. 4. Christian Education 
Week. Sponsored by the National 
Council of the Churches of Christ, 
79 East Adams Street, Chicago 3, 
111. 

Sept. 28-Oct. 1. American Dental As- 
sociation. Ninety-fourth annual 
session. Cleveland. Ohio. 

Sept. 28-Oct. 2. National Recreation 
Association. Thirty-fifth National 
Recreation Congress. Philadelphia, 
Pa. 

Regional conferences, American 

Public Welfare Association: 

Sept. 9-11. West Coast Region. Los 
Angeles, Calif. 

Sept. 24-26. Northeast Region. Wash- 
ington, D. C. 

Sept. 30-Oct. 2. Southeast Region. 
Jacksonville, Fla. 



Illustrations: 

Esther Bubley. Pittsburgh Photographic 
Library. 

Pp. 154 and 157, Archie Hardy. 

I'. 159, Esther Bubley. 

P. 161, Philip Bonn. 

Pp. 162-164, courtesy of the author. 



JUNE-JULY 1953 



167 



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Government Printing Office 

DIVISION OF PUBLIC DOCUMENTS 

Washington 25, D. C. 

OFFICIAL BUSINESS 



If you do not desire to continue receiving 
tiiis publication, please check here: □ ; 
tear off this label and return it to the above 
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(GPO) 



JUNE-JULY 1953 



VOL.17 NO. 1 




In This Issue 



Toward Better Speech and Hearing .... 
Robert M. Foote, M.D., and Sylvia Steelier 



page 
154 



Foster Parents Speak Up 

Esther S. Meltzer and Miriam IVanne 



158 



For More Rewarding Summer Recreation 
Lillian Margolin 



162 



Published 10 times a year by the 
Division of Reports, Children's Bureau 

Editor, Sarah L. Doran 
Art Editor, Philip Bonn 



U. S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE 

Oveta Culp Hobby, Secretary 



SOCIAL SECURITY ADMINISTRATION 
William L. Mitchell, Acting Commissioner 



CHILDREN'S BUREAU 
Martha M. Eliot, M.D., Chief 



Publication of THE CHILD, monthly bulle- 
tin, has been authorized by the Bureau of 
the Budget. September 19, 19.50, to meet the 
needs of agencies working with or for 
children. 

The Children's Bureau does not necessarily 
assume responsibility for statements or 
opinions of contributors not connected with 
the Bureau. 



THE CHILD is sent free, on request, to 
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For others the subscription price is $1.25 a 
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THE CHILD is indexed in the Education 
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