Leaping Forward # 13: PART 2 - A proper look at systems theory helps get the therapist to the child, not the child to the therapist.
Leaping Forward in the development of early child & family support and protecting childhood
This is the second part of the 13th article in the 'Leaping Forward' series.
In Part 1 of this piece I suggested using systems thinking to reduce children’s visits to paediatric therapists in hospitals, clinics and centres. This followed articles I wrote in 2020 describing hospitals as unfit places for children who have challenges to their development and learning. I argued babies and infants should not be made to visit these medical settings on a regular basis for therapy. (Of course, very many sick children who need treatment for their illness will have no option but to attend hospital if there is one available, but disability is not an illness.)
For more information, see the series: Positive environments for early child and family support. Part 1: Hospitals are often neurotic environments and are therefore to be avoided.
Reinforcing my concerns is the following quote from Humphries and Bystrianyk’s book, ‘Dissolving Illusions’:
‘The bad news is that in the year 2000 the Institute of Medicine released a report showing that hospitals and doctors are the third leading cause of death in the United States, only after cancer and heart disease:
The combined effect of errors and adverse effects that occur because of iatrogenic damage not associated with recognizable error include:
12,000deaths/year from unnecessary surgery
7,000 deaths/year from medication errors in hospitals
20,00 deaths/year from other errors in hospitals
80,000 deaths/year from nosocomial infections in hospitals
106,000 deaths/year from nonerror, adverse effects of medications
‘The above numbers are thought to be an underestimate of the actual damage. The modern outpatient setting was also noted to be dangerous in the IOM report:
It concluded that between 4% and 18% of consecutive patients experience adverse effects in outpatient settings, with 116 million extra physician visits, 77 million extra prescriptions, 17 million emergency department visits, 8 million hospitalizations, 3 million long-term admissions, 1999,000 additional deaths, and $77 billion in extra costs (equivalent to the aggregate cost of care of patients with diabetes).’
[From Barbara Starfield, MD, ‘Is US Health Really the Best in the World?’ Journal of the American Medical Association, vol 284, no. 4, July 26, 2000, pp483-485.]
I see a clear and urgent imperative for pediatric therapists supporting babies and young children who have challenges to their development and learning to get out of hospital and visit children in their homes, kindergartens, nurseries and schools. Then they can cooperate with others helping children with cognition, communication, movement, etc. in Systems of close teamwork. This would seem to be the healthier option and better for everyone.
This move will be helped when we see a baby and young child's learning and development as more of an educational concern than a medical one
Peter Limbrick, August 2024.
Comments welcome.
