Crippled Children Research Articles

Maternal and Child Health in the United States and at the Harvard T.H. Chan

This essay frames Marie McCormick’s remarkable career in the context of the history of Maternal and Child Health as an evolving field over the past century, and the parallel development of Maternal and Child Health at the Harvard T.H. Chan School of Public Health. These linked histories are further connected to enduring efforts to draw attention to vulnerable populations and what would come to be considered the social determinants of health. Attention to maternal and child health stemmed in many ways from the apparent effects of late 19th century industrialization, immigration, child labor, and insufficient sanitation. In this context, Lilian Wald famously lobbied for a federal Children’s Bureau, asking in 1903, “If the Government can have a department to look after the Nation’s farm crops, why can’t it have a bureau to look after the Nation’s child crop?”[i] The Children’s Bureau would be formed in 1912, employing fact-finding, advocacy, and action. Its initial efforts were geared towards documenting infant mortality rates, finding that these correlated with housing status, parental earnings, the health of the mother, and local sanitation and milk quality. It would successfully push for child labor and child welfare laws, with this era culminating in the 1921 passage of the Sheppard-Towner Act, providing federal funds to states for child and maternal health programs. While the Act, opposed and characterized as socialist by the AMA, would be repealed by 1929, it would further cement the importance of maternal and child health in the minds of would-be reformers. In this context, the Social Security Act of 1935 included Aid to Dependent Children, Child Welfare, and Title V, which entailed funding for Maternal and Child Health and Crippled Children’s Services.

Being our own sponsors

EnglishIncluded among six non- physicians were the president of Mount Allison University (whose university had been involved with occupational therapy in World War I), the president of the Quebec Society for Crippled Children (now the Quebec Society for Disabled Children), three prominent Canadian women with connections to occupational therapy, and the preeminent American occupational therapist Eleanor Clarke Slagle. Sponsorship from the elite medical community (and other individuals of high status) paved the way for many of the developments of early occupational therapy in Canada: the founding of provincial societies in the 1920s, the establishment of educational programs at the University of Toronto (first in 1918 and again in 1926), the formation of the CAOT in 1926, and the debut of this journal in 1933. The characteristics of the ward aides of World War I who had shown themselves to be so creative, and entrepreneurial, independent, and self-motivated, venturing into unknown territory at every turn, had somehow become masked. francaisEn 1933, lorsque cette revue a ete publiee pour la premiere fois, il ne semblait pas essentiel que les ergotherapeutes jouent un role de defenseur ou de revendication; l'ACE et la sororite externe assumaient la tache d'expliquer la profession aux medecins, aux membres des conseils d'administration des hopitaux et a la population.

‘NOW WALKS LIKE OTHERS’: A PRELIMINARY ENQUIRY INTO THE NORTHAMPTON CRIPPLED CHILDREN’S FUND

Over recent years scholarly interest in the history of childhood, child health and disability has developed and intensified. However, there are still considerable areas which have not been subjected to extensive historical enquiry, such as the treatment and management of ‘crippled’ children in the UK during the late 19th and early 20th centuries. A key opinion in this study is that of Borsay who has stated that the care of poor ‘crippled children’ and their families in Victorian England were ‘subjected to moral condemnation through a surveillance network funded and managed through the voluntary sector’ (). On-going research using a small case series based on material from Northampton Crippled Children’s Fund (NCCF, 1893–1928), Annual Reports dated from 1905 to 1925 and ledgers of surgical records, compared with the monthly contemporary Northampton Neuromuscular Clinic, will challenge this view as being insufficiently nuanced.

“Now walks like others”: a preliminary enquiry into the Northampton Crippled Children's Fund

Interest into the history of child health and disability has intensified over the years. However, it is a relatively recent and unresearched area and still in its early development. Care available to poor, “crippled children” in Victorian England is a generally unexplored subject. Before the introduction of universal free access to healthcare, there was little available for those unable to afford it, beside voluntary organisations. One such example was the Northampton Crippled Children9s Fund (NCCF), which from 1893 to 1925, provided care to the “crippled children” of the town. It funded medical and surgical care for children with deformities. Besides operations (which were rare), it also provided surgical boots, carriages and nourishment as well as providing an annual holiday to its seaside “colony” in Llandudno. Primary sources concerning disabled people in history are difficult to find and the study of disability history is challenging. However, this presentation using primary sources from the Archive, Northampton General Hospital will reconstruct such voluntary healthcare provided to “Crippled Children in straightened circumstances living in the town of Northampton under 17 years of age.” NCCF annual reports from 1905 to 1925 include records of treatments, their costs and their dates given to each named child. Within the record books, some individual cases also include early x-rays, hand drawn vignettes pre and post treatment, together with relevant newspaper cuttings. The 1911 census online is also used. In a consecutive case series of twenty children randomly taken from a NCCF record book, the recorded pathologies were: nine rickets (45%), four spinal pathology (20%), three tuberculosis (15%), two paralysis (10%), one hemiplegia (5%), and one carcinoma (5%). Treatments were mainly medical, involving surgical boots but rarely surgical. The NCCF material provides insight into child health and disability and shows considerable potential for further exploration by social and medical historians. Lastly, the NCCF material will also be examined alongside that of other contemporary Charities such as the Birmingham9s Cripples Union, which was founded in 1896. Although there have been considerable advances in clinical science since the early nineteenth century, many of these conditions remain considerable therapeutic challenges in the early twenty-first century.

George Marion Boswell, Jr., MD: A Conversation with the Editor

George Boswell (Figure ​(Figure11) was born near Grand Prairie, Texas, on May 12, 1920. He grew up in Texas, primarily in the Dallas area (Figures ​(Figures22 and ​and33). After finishing high school at age 15, he went to McMurry College for 2 years and then transferred to Texas Tech University, where he received a bachelor's degree in journalism in 1940. The following year he entered the navy as an ensign and II. While in the service, he re-ceived a master's degree in psychology. In 1946, he entered The University of Texas Southwestern Medical School, graduating in 1950. His training in general surgery was at Parkland Hospital, and his residency in orthopaedic surgery included training at Parkland Hospital, the Scottish Rite Hospital for Crippled Children, and Baylor Hospital. After completing his training, he entered private practice in 1956 and rapidly developed an extremely large practice using Baylor Hospital. He has served as an officer in many professional organizations. For his professional accomplishments and his service to his community and church, he has received many honors. He has been married for 44 years and has 3 daughters and 6 grandchildren. Additionally, George Boswell is a great guy and fun to be around.

Perinatal limb ischemia: orthopaedic implications.

Fifteen patients (16 ischemic limbs) who ultimately required amputation for perinatal limb ischemia were treated at The Children's Hospital of Philadelphia and the Shriners Hospital for Crippled Children in Philadelphia between 1980 and 1993. The average birth weight of these patients was 1,870 g, and the average gestational age was 30.8 weeks. Ischemic events occurred at an average postnatal age of 5.4 weeks. The causes of the ischemia included (a) arterial thrombosis as a complication of arterial catheterization (eight patients), (b) thromboembolism resulting from a hypercoagulable state (five patients), (c) intravenous infiltrate (one patient), and (d) in utero arterial thrombosis (one patient). Amputation was required at an average postnatal age of 8.5 weeks. The final patient, with concurrent ischemia involving the right hand and left leg, had complete resolution of the ischemic hand with fibrinolytic therapy alone and required only an amputation of the lower extremity. Eleven of the 15 patients were available for follow-up (two dead, two lost to follow-up), at an average of 4.5 years. Nine of these 11 patients (six lower and three upper extremities) are functioning well in prostheses. The two remaining patients are infants who will be fitted for lower-extremity prostheses when they begin to attempt to walk.

Surgical Treatment of the Duplicated Thumb

Fifteen patients with 18 duplicated thumbs were treated surgically at The Shriners Hospital for Crippled Children, Springfield Unit, between 1925 and 1990. We compared the outcome of patients treated by ablation of the extra thumb with that of patients treated by ablation and radial collateral ligament reconstruction. Three patients with four duplicated thumbs, all from the ablation-only group, required additional surgical treatment for the following reasons: joint instability, contracture, angulation of the digit, and bony prominence. No patient from the ablation-plus-ligament-reconstruction group has required further operative treatment.

Shriners Hospitals for Crippled Children

Shriners Hospitals for Crippled Children

Sever-LʼEpiscopo Transfers in Obstetrical Palsy: A Retrospective Review of Twenty Cases

Since 1963, 25 patients have undergone Sever-L'Episcopo transfers for obstetrical birth palsy at the St. Louis Unit of the Shriners Hospital for Crippled Children. A follow-up of 2-6 years was possible with a retrospective review of 16 patients. Substantial improvement in shoulder external rotation as well as subjective functional improvement was obtained by all patients. Three transient and one permanent axillary nerve palsies resulting from this procedure are reported.

Adolescence, anxiety, and adaptation: preparing for posterior spine fusion with instrumentation.

HE PRIMARY GOAL of health care workers involved in the care and treatment of adolescents with scoliosis at Shriner’s Hospital for Crippled Children in Portland is to positively reinforce the adolescent’s self-esteem, body image, and sense of independence. Preparing the adolescent and the family through preoperative teaching and age-appropriate handouts appears to decrease anxiety and facilitate the adolescent’s adaptation to surgical correction of their scoliosis. IDIOPATHIC SCOLIOSIS AND ADOLESCENTS The adolescent with idiopathic scoliosis has several important adjustments to make. The body distortion that accompanies scoliosis is incompatible with the adolescent’s dream of the ideal physique. The increased sensitivity of a teenager with scoliosis to body changes is demonstrated through exaggerated concerns of body mutilation, fear of the loss of sexual attractiveness, and fear of abandonment by peers. These feelings are very real and age-appropriate. Adolescents conceptualize being diagnosed with idiopathic scoliosis in terms of what it will mean to their body images and the feelings they have about themselves. Teenagers may also feel the potential loss of peer acceptance that can lead to further devaluation of the body image and a diminished sense of self-esteem. The ability to

Canadians Generate Blissymbolic Communication Development

Blissymbolics, a comprehensive core communication system through which non-speaking people are able to communicate, has been developed and made available throughout Canada and the world by the Blissymbolics Communication Institute in Toronto, Canada. In addition, Canadian users of the system have become leaders in helping to increase universal awareness of the intellectual, social, emotional and communication needs of communicatively impaired and disadvantaged people.Charles K. Bliss who was born in Australia and now resides in Australia, originally developed Blissymbolics between 1942 and 1965 as an international communication system to promote better understanding among people. The system was first successfully applied during the early 1970’s by a multidisciplinary group of specialists at the Ontario Crippled Children’s Centre in Toronto to cerebral palsied, school-aged, non-speaking children. This graphic and meaning-based system provided them with a means of more grammatically complete communication than picture or word boards.Since its first application, Blissymbolics has been expanded to many other applications and populations. Today it is used as an augmentative communiation system with cognitive and language development programs to support reading and pre-reading activities. Its users include people who are retarded, multiply-handicapped, autistic, aphasic and stroke victims.As experimentation and the use of Blissymbolics increased during the 1970’s, the need for training programs and instructional materials, for information about ongoing programs, for more symbols and for a structure to maintain a standard form of Blissymbols also grew. In order to meet and co-ordinate these requirements the Blissymbolics Communication Foundation was established in Toronto in 1975. The Foundation, through a licensing agreement with Mr. Bliss, obtained the exclusive mandate to co-ordinate the applications of Blissymbolics with non-speaking people around the world. Its mandate was to maintain symbol standards and to provide training and material for the increasing number of people applying the system with non-speaking people. The Foundation was re-named the Blissymbolics Communication Institute in 1978 to better represent its role as a central, co-ordinating educational organization.

Music as a feedback mechanism for teaching head control to severely handicapped children: a pilot study.

Five profoundly mentally retarded cerebral-palsied children were studied in order to determine the effectiveness of music as a biofeedback mechanism in the training of head control. The method used a Head Position Trainer and Time Event Counter, developed at the Ontario Crippled Children's Centre in Toronto. Improvement was obtained in three of the five children in their ability to control their head movements when music was used as the biofeedback stimulus. However, these results should be treated cautiously because the sample was small and the training period was brief.

The handicapped child in school

Handicapped children include children with. phys|c:.!, mental and zoclo, economic handicaps. From the medical point of view, the term implies a physical or mental defect i~ot compatible with usual activity or expected achievement. (Nelson 1969). Amongst the physically handicapped, the blind and the deaf and dumb are of special importance as they require special schools and ~eir problems will not be dealt with here. ~owadays, the term 'handicapped' is often ~ c l = i n a broader sense to include among ii~ors chronically sick children-suffering f/-om cardiac diseases, tuberculosis of bones and joints etc. In a study on the morbidity trend among children attending the B.C. Roy Polio Clinic and Hospital for Crippled Children, Calcutta, the following conditions were found responsible in the great majority of cases. (Basu 1968). (1) Paralytic poliomyelitis (2) Cerebral palsy and related disorders including mental retardation, convulsive seizures, and behaviour problems. (3) Congenital anomalies. (4) Rheumatic diseases. (5) Hemiplegias and paraplegias. (6) Osteomyelifis, arthritis, synovitis etc. (7) Tuberculosis of bones and joints. (8) Facial palsy. (9) Muscular dyst.ophy. (10) Rickets and rachitic deformities.

General revenue sharing funds for the health care of mothers and children.

In a study of the use of General Revenue Sharing (GRS) funds by the states and by cities of 100,000 and over in the United States for fiscal years 1973 and 1974, we found that few states and large cities allocated or requested GRS funds for Maternal and Child Health (MCH), Crippled Children (CC), and related services. One third of the states and cities reported suggestions for use of GRS funds for MCH, CC, and related services.

Communication Aids for the Non-Verbal Severely Handicapped Child, a Multidisciplinary Challenge

This paper focuses on the particular communication needs of the non-verbal cerebral palsy child and describes several of the aids which have been developed to meet these specific and often highly individualized needs. A joint project was established through the combined efforts of the Occupational Therapy Department of the Montreal Shriners Hospital for Crippled Children and the McGill University Department of Engineering. Twenty-three undergraduate engineering students, as part of their mechanical design course requirement, undertook the design and implementation of communication aids for non-verbal handicapped children. The results of this project appear to indicate the value of a multi-disciplinary approach in confronting the variety of complex problems encountered in the clinical setting.

A Case of Diastrophic Dwarfism

Diastrophic Dwarfism was described in 1960 by Lamy and Maroteaux. This syndrome is characterized by short limbed dwarfism, club feet, distinctive deformity of the hands and external ears, cleft palate, progressive scoliosis sometimes combined with kyphosis, limitation of mobility and tendency to subluxation and dislocation of many joints.Case 1, T. I., a 17-days-old male, was admitted to the Adachi Gakuen, Crippled Children's Hospital. He was the product of 9-months pregnancy. He weighed 2800gr, at birth. The multiple deformities of the typical Diastrophic Dwarfism was found.He was treated with serial casts applied to feet and additional posterior release for equinus deformity.

Children and Youth in America: A Documentary History

PART 5: Juvenile Delinquency 1. Inertia and Innovation in the Care of Juvenile Delinquents A. Continuing Problems B. New Approaches 2.The Federal Government and Juvenile Delinquency A. Juvenile Delinquency as a National Concern B. Congressional Action 3. The Juvenile Court and Legal Issues A. Debate over the Court B. Legal Rights of Delinquents PART 6: Health Care for Children Old Problems and Youth 1. Development of Federal-State Programs in the New Deal and World War 2 A. Maternal and Child Health and Crippled Children's Services in the Social Security Act B. Child Health in World War 2 and the Postwar Era 2. Health Problems and Services for Children and Youth Since World War 2 A. Progress and Problems B. Expansion of Federal--State Maternal and Child Health and Crippled Children's Programs C. additional Programs and National Research Institutes 3. Mental Health and Retardation A. Mental Health B. Mental Retardation PART 7: Education 1. The Roosevelt Era A. Education in Depression and War B. Theories of Education 2. Education of Children of Minority Groups: New Trends and Old Problems A. Educational Experiences of Black Children B. Outlawing School Segregation C. The Education of Indian Children 3. Education Adjusts to the Cold War A. The Issue of Loyalty B. The National Interest in Educational Improvement C. New Programs for Government 4. Education and Reform A. Federal Initiatives in Support of Education B. Desegregation of the Schools C. Church and State D. Higher Education E. Education of Handicapped Children Chronology: Event Relating to the History of the Health, Education, and Welfare of Children and Youth, 1933-1973 1868 Selected Bibiliography 1915 Index 1958 1987

Action for improved maternal and child health

Recommendations of the Conference on the Role of Maternal and Child Health and Crippled Children's Programs in Evolving Systems of Health Care, held at Ann Arbor, Michigan, March 23 to 25, 1970.

Xq- TURNERʼS SYNDROME

Genetics Clinic, Crippled Children's Division, Department of Pediatrics, and Division of Medical Genetics, University of Oregon Medical School, Portland, Oregon, and the Department of Pediatrics, Permanente Clinic, Portland, Oregon

22 Osgood-Schlatter??s Disease

* Director of Orthopedic Surgery and Education, Crippled Children's Hospital, Unit of United Hospitals of Newark, N.J.; attending Orthopedic Surgeon, St. Barnabas Medical Center, Livingston, N.J.; Office Address: 40 Union Ave., Irvington, N.J.; Associate Clinical Professor of Orthopedic Surgery, New Jersey College of Medicine, Newark, N.J.