Negative hospital environments: Is it appropriate to de-medicalise early child and family support? A summary so far

This support for disability and development disorders is not a medical issue

Peter Limbrick writes: In my serialised essay (starting here) I have been looking critically at the support offered when babies and young children have disabilities and special needs that will impact on their development and learning. The essay is evolving rather than pre-planned so it might be a good idea to state briefly and clearly what it is saying to date. Its main points are:

• The phrase ‘early child and family support’ is preferable to ‘early childhood intervention (ECI)’ by being less intrusive and more in the spirit of respectful empathic partnership.
• When a child needs repeated support sessions during months or years to help with development and learning, these should NOT be offered in hospitals, hospital units or clinics. Instead, support should be offered at home and/or in educational settings.
• We can think of effective early child and family support being made up of health services, education services and family support. If a child has health needs then visits to a hospital as inpatient or out-patient might be necessary to treat illness and disease as with all children (when there is an available hospital).
• Disability and development disorders are best thought of as education issues that require the support of practitioners who are trained in how babies and young children learn. The teaching/learning that might be required includes relationship, movement, communication, cognition, dexterity, looking, listening, planning, confidence, self-esteem....This support for disability and development disorders is not a medical issue.
• We need to think more clearly about the role of paediatric therapy. My perception is that there is a dual role; an essential medical one of giving treatment and an equally essential educational one to promote the learning listed in the previous bullet.
• In the effort to avoid unnecessary visits to hospitals, paediatric therapists who are supporting this development and learning should work in family homes and/or educational settings (e.g. children’s centres and nurseries).
• Education staff members do not have the deep knowledge and skills that paediatric therapists have. Paediatric therapists do not have the knowledge about how babies and young children learn that teachers have. Effective early child and family support will bring parents, teachers and therapists together to create collective competence.
• There might be economic benefit in bringing this development and learning into education settings and freeing up hospital time and space. But I am not an economist and this should not be the driver to change.

The next part of the essay series (Part 6) will describe and contrast an educational approach to helping a child move on the floor with a therapy approach.

Your comments are welcome.