The Exceptional Child

The Crippled Child

Produced for the Educational Television and Radio Center by Syracuse University, 1969

Statement and Disclaimer from Thomas Neuville, Associate Professor, Department of Special Education, Millersville University

George: I must learn to walk by myself. I must learn to walk by myself. Some will cry but won't even try, but I will walk by myself.

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Narrator: The exceptional child, a child with differences. It is our hope that through these programs, we might better understand this child and help him.

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Narrator: This little boy is George, and as you've already seen, George is crippled. But a child who is trying with all his strength, and with the help of those around him, to learn to walk and to do things for himself.

George was crippled by polio before the Salk Vaccine, and although polio is rapidly being defeated, it is only one of many such crippling diseases that confront our children.

I'm Ed Jones, your host on these programs, and today we're going to meet and try to understand with greater insight something of the special problems that confront the crippled child.

Besides polio, there are dozens of major diseases and problems which often result in crippling. Crippling of the arms, legs, feet and back.

The children in this physical education class reflect many of these physical limitations. Randy has hemophilia. Jimmy has cerebral palsy and also asthma. James had polio but a long leg brace helps him to walk. Lee has a severe heart condition but an operation has made more active exercise possible. Pat also had polio and needs a long leg brace. Joe has cerebral palsy and his whole left side is affected. Arthur has a foot deformity known as club foot.

These other children have a variety of types of disabilities. Some were present at birth. Others are the result of illness or injury.

Thus, there are varying degrees and types of crippling. How much the child will be limited physically depends on the condition causing the crippling, the severity of the condition, and, of course, the child's health and energy level, as well as his adjustment. But no matter how severe the disability is, the child who is crippled is yet a child whose needs are the same as the needs of all other children.

But the important difference is, the child who's crippled often has a far more difficult time satisfying those needs. His disability does not allow for completely free social or physical movement. Or because of his physical disability, some avenues to achievement and fulfillment are closed to him. A fact which tends to set him apart from others. A fact which can, though need not, cause serious problems resulting in discouragement, sometimes despair, insecurity and anxiety.

More than anything, the crippled child wants to be like others, if not physically, at least socially and personally. If, however, he conceives his handicap as a barrier to the achievement of a happy and full relationship in the world, or if he is made to feel that it is a barrier by others, frustration and serious maladjustment can result. But a crippled arm or a crippled leg does not mean a crippled life. And if we who are not crippled can understand the special problems that confront the child who is crippled, we shall be in a far better position to help this boy obtain a wholesome relationship in life, and a happy, secure life.

With us today is Mrs. Katherine Blake, Dr. Katherine Blake, who is a Research Associate in Education for Exceptional Children at Syracuse University. She has worked for several years with children with neurological and orthopedic difficulties and today will bring into clearer and sharper focus some of the special problems that confront the child who is crippled.

Dr. Blake: Crippling can happen to anyone. It can happen to you and to me. It can happen to our children and our friends and their children. And when it does strike, crippling often poses some serious problems.

If a crippled person is to realize a happy, constructive life, then he must recognize and accept the limitations associated with his disability. And he must learn to channel all of his abilities into learning techniques, which will enable him to satisfy his own personal needs in terms of the requirements of our society. Now, often this is a very difficult task, and although they must take major responsibility for themselves, crippled children and their parents need help.

Realizing this need, several private and governmental agencies have established programs designed to assist parents in the care, treatment and education of the crippled child. Essential to the success of these programs are early discovery and identification of the child; an adequate diagnosis by a team of competent specialists; counseling of the child and of his parents; understanding, acceptance and support by neighbors and by the wider community; and awfully important, a comprehensive program of special services. Prime among these services is physical therapy.

Narrator: An attack of polio when he was less than a year old left George with paralyzed muscles in both legs and in his back, especially the left side. Sitting still for the application of heel cord stretchers is hard for George, as it would be for any active, healthy 7-year-old boy. But he realizes that it's necessary so that his leg muscles will work more efficiently and so that his feet will not be deformed. George has always been limited in the ability to walk and run and play like other children, but through the physical therapy begun when he was four years old, he's learned to do many things. This therapy includes a series of passive and active exercises, and training in the functional skills of daily living.

Treatment such as this is a big part of his life. But George's acceptance of his disability and his active participation and cooperation make the task of achieving physical independence easier for his therapist, his parents and himself. One of George's serious physical problems is the curvature of the spine and displacement of his shoulder blades caused by a rather severe muscular paralysis on his left side. Without attention, marked deformity and serious disruption of proper digestion, breathing and heart action might result. However, correct physical alignment is increased when he wears specially constructed braces with a built-up left shoe, a hip pad and a pelvic band.

Another major area of physical therapy consists of functional training in daily life activities. George had not learned to walk before his attack of polio. He had to be taught to walk through a long period of training. With the support of his crutches and braces, George has mastered the four-point gait that enables him to walk long distances without undue fatigue. Stepping over curb stones and managing stairs with braces and crutches is quite a task. But George has worked long and hard and now has learned to do this by himself. Now he can deal with most of the physical barriers in his environment.

Dr. Blake: The only therapeutic requirement for some crippled children is a program of physical therapy. Such a program includes neuromuscular reeducation and training in the basic motor patterns of balance, coordination, relaxation and walking. Others need the help in learning to use their hands in the activities of daily living that they receive in occupational therapy. Some children are more extensively limited. They need both physical therapy and occupational therapy.

Narrator: Sometimes physical disability is centered in the arms. As a result of both Erb's Palsy and cerebral palsy, Harvey is seriously limited in the use of both arms and hands. This hampers his performance of the essential activities of daily living.

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Narrator: There is an extensive program of occupational therapy to help Harvey help himself in dressing and feeding. The simple act of removing his shirt is a very difficult one for him. But Harvey's success and the enthusiasm of the therapist repay his great effort and give him a most necessary feeling of accomplishment.

As he has come to realize he can channel his abilities into doing things for himself, Harvey now takes the initiative in many activities. Putting on and taking off braces at home requires a great deal of his parents' time. Harvey's help will speed up the task and free them for other work. As he gets older, Harvey will assume more and more of the responsibilities for many of the aspects of his daily care.

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Narrator: Communication through writing is another developmental task with which Harvey needs special help. Because of the muscular involvement in his arms and hands, Harvey cannot write legibly with a pencil. However, to do a spelling lesson, he must be able to write words so they can be read and he must write them in a relatively short time.

One way he can cope with this problem is by learning to type. But even to type, Harvey must have special equipment. The keyboard of his typewriter is covered by a metal plate with a small opening for each key. This enables him to hit the keys one at a time, despite excessive and uncontrollable movement in his hand and arms. An arm brace and a specially constructed table are needed, too.

Lacking this special equipment and training in its use, Harvey would have to try everything by hand. The small return for the effort and the time required to do this could lead to frustration, tenseness and fatigue. He might even stop trying altogether.

Even with the typewriter, there are times when it's difficult to get started. But here the therapist's patience and understanding make the problem of getting started easier for Harvey to manage.

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Narrator: Harvey is beginning to master this essential skill. Thus, he'll be able to deal with the requirements of written communication in his schoolwork now and later on, too, in his job, and in the many personal activities for which writing is required.

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Dr. Blake: Harvey works hard, and although it takes him a long time to perform these activities which require the use of his hands, he is making progress. And not only does he use these skills and self help in the occupational therapy room, he also uses them as he participates in the well balance program of the special class. He feeds himself at lunchtime and at mid-morning lunch. He takes care of his coat before and after school. And in addition, there is also a specially constructed table and a typewriter for him to use in his school work.

Thus, occupational therapy is very important in preparing Harvey for the large part of his life, which centers in the school.

Narrator: Some children lack skills necessary for participating in educational activities in a setting with non-handicapped children and special classes are available for them.

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Narrator: Ms. Medvey's class is one of these. It is attended only by children with marked disabilities. They like their teacher and enjoy the many special activities she, with her special knowledge, skill and interest, is able to plan for them. And, of course, learning to work and play with others is very important for the crippled child.

His play life in his early years has been curtailed by physical limitations. The warm, happy responses fostered in group activities such as these contribute to the fulfillment of the child's needs for satisfying personal relationships.

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Narrator: Margaret, who is confined to a wheelchair, must be allowed to stand with her braces locked for a part of each day. The standing table is good for Margaret because it relieves the tedium of long hours when she must remain seated in her wheelchair. Time spent in the standing table also helps to strengthen the muscles in Margaret's legs and to improve circulation. This is a way in which the work of the physical therapist and the classroom teacher overlap in a cooperative way.

Time spent in the standing table is not wasted for Margaret. She's working to develop some of the skills which form an important part of the kindergarten program. Finger painting is helpful in improving muscular coordination in the fingers and arms, and in exploring the medium of art as a means of expression. It's also lots of fun.

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Narrator: This is one of the many other kindergarten activities that can be provided in this primary special class. They're important in establishing readiness for the academic subjects and the vocational pursuits these children will acquire as they grow older.

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Dr. Blake: These children must have the controlled environment of a special class in order to be able to participate in school at all. Home-teaching is available for children who are confined to their beds and cannot go out. Classes are also taught in hospitals and convalescent centers.

Some children are less seriously crippled and need none of these types of special services, while others must attend the special class until they develop certain self-help skills and maturity. Then, they can transfer and participate adequately in a regular class with non-physically handicapped youngsters.

Narrator: There's nothing special about teaching arithmetic to a child with paralyzed legs. Donna has had polio. She has a hard time walking. She knows asking Miss. Lariston to come to her would be easier but she's learned she cannot use her disabilities as an excuse for unnecessary demands for help. She must do things for herself, must show initiative, be independent.

George and Randy need a sense of security. Learning to function within the limitations of their disabilities contributes to this. Here the school has a major responsibility, but crippled children like George and Randy, can do much to help themselves and each other, and the rest of the class.

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Narrator: Stevie has had to spend several long periods of time recuperating from operations. In a small reading group, he can get the intensive help he needs to catch up.

Limitations in physical ability do not always mean limitations in educational ability. But the crippled child may need more time and special equipment. And granting certain essential self-help skills, there's no reason why he cannot manage effectively in a regular class. Here, he can learn to understand and live in harmony with his nondisabled fellows, and they can learn to understand and live in harmony with him.

Dr. Blake: The crippled child requires many services. Doctors, therapists, and teachers must be consulted. Thus, crippling often becomes a double-edged parent, a problem for the child's parents. They must discover and obtain these services. At the same time, they're often undergoing severe emotional strain. The social worker plays an important role in assisting parents of crippled children. She assists them in obtaining these services. She counsels them, attempting to help them understand and gain insight into the implications of crippling for the child and for the rest of the family.

Counselor: Mrs. Bailey, we've been talking about George slowing down and walking, and you've indicated that you're quite concerned about this. We seem to pretty well have pinned this down, at least for the time being, on the fact that he just got new braces and it's just possible that these don't fit properly.

Mother: No, he's been complaining about them, and we are a little discouraged.

Counselor: Well, it might be that we could plan to see the brace man, perhaps, and the doctor, and just see what may be wrong with them. We may find that once they are properly fitted, he'll do much better in his walking.

Mother: Yes, I think that will do it. They probably need just a little adjustment.

Counselor: You know, we were talking the last time I saw you about your being discouraged. Do you remember when he came back from the convalescent home and there was a period there where he had had a cold or something and you felt that he had slowed down then? Do you feel that this kind of happens every so often with George?

Mother: Yes, I do. He has his ups and downs. One day he'll do a lot better than other days, and...

Counselor: And you have to learn to kind of adjust to this, don't you?

Mother: That's right.

Counselor: That there will be these times that will come with him.

Mother: Yes.

Counselor: How do you handle this with George?

Dr. Blake: Not every statement can be taken at face value. Often parents come to the social worker with a neutral, more superficial problem and go on to express deeper anxiety and discouragement. If the social worker fails to recognize the actual problem, then the parent may leave feeling even more dissatisfied and anxious. Information getting without personal counseling is of relatively little value.

Counselor: And we're talking about the other children in the home -- well, your own children and others that may come in to play with him. Are there times when George may feel that he either can't keep up with them or they may not be too considerate of him?

Mother: Yes, that has risen in George's eyes. He has been told that he's been crippled and he resents it.

Counselor: This really hurts, doesn't it?

Mother: Yes, it does.

Counselor: When it's a child who doesn't understand --

Mother: That's right.

Counselor: The situation. And it's apt to hurt you, too, to feel that he is --

Mother: Right.

Counselor: Disturbed.

Mother: Yes.

Counselor: How do you handle this, Mrs. Amelie, with George?

Mother: Well, I've taken George aside and explained to him that it's a condition he will have to live with, and he has pointed out --gone as far as to look ahead and ask us if he's able to make a living with his condition, and we have pointed out to him that he must go to college like his dad did, and it will come --

Counselor: He really is looking a long way ahead, isn't he?

Mother: Yes, as young as he is, he has thoughts of that.

Counselor: Well, do you feel that you are able to help him accept his limitations? I mean, in terms of perhaps never being able to get around quite as well as other children or maybe do some of the things that other children do?

Mother: Yes, I -- he has done very well up 'til now.

Counselor: You feel his attitude is pretty good.

Mother: Oh, yes, he has a wonderful disposition.

Counselor: Is he doing fairly well in school so that you might look ahead, really, to college and --

Mother: Yes, he does very well in school. He's a bright little child and we feel that if he does keep on, why, he won't have any trouble as far as an education is concerned.

Counselor: But the important thing all along the way is to help him to accept the places where he may slow down and not be doing as well.

Mother: That's right.

Dr. Blake: The outlook for George seems positive. He and his parents are facing many of the limitations associated with his disability. They're trying to cope with the problems that arise from day to day, and they're beginning to plan for the future.

A number of highly trained personnel working together as a team have assisted George and his parents in this process. And of great importance to George and to his family, the children in his neighborhood and in his school, and their parents, too, do not look at George only in terms of his crippling. Instead, they see him as a pleasant fellow, a good friend who is full of ideas and fun to be with.

Now, not all physically limited children are as fortunate as George. Some are more seriously crippled. Others do not have and have not had the special services that they need. If these children and all crippled children are to realize the achievement possible to them, we must all work together and contribute to their well-being. They, in turn, must try to help themselves.

They must recognize and accept their limitations and learn techniques which will enable them to deal adequately with a variety of physical barriers and problems. They must build their lives around their assets, by channeling all of their abilities into the performance of the essential activities of life. They must have the security and encouragement supplied by families who love and understand them, and who assist them in the difficult task which they face.

Narrator: Every child has his own pattern of growth. And when that child has a specific handicap, such as a crippled arm or crippled leg, that pattern, of course, is somewhat more complicated. But partial incapacity does not mean total incapacity. His disability curtails his social and physical movements.

But these restrictions need not cause inadequate personality growth or fulfillment. And while it is the primary responsibility of any parent for his own child, we all come to share this responsibility more and more.

Bye, George.

George: Goodbye, Mr. Jones.

Narrator: The treatment that any crippled child receives from his parents, from his playmates and from society as a whole can determine to a large extent the happiness and usefulness of this child. It is up to all of us to try to understand the very real and complex problems that face the child who is crippled, and to try to help him in every way possible to find a full and positive relationship in life.

Next week, we shall try to understand the relationships of the child with cerebral palsy.

Remembering that a child with a handicap is yet a child, an exceptional child with a life that may be restricted, even somewhat distorted, but one that can grow and continue to grow toward fulfillment. As we know more about the growth and development of children with handicaps, we shall be able to help the handicapped child more and more in his quest for happier and more secure relationships, in the hope that if he cannot completely eliminate his handicap, he can effectively reduce the restrictions they cause.

A child is born, new life begun, a life which may be exceptional but need not be without beauty and achievement.

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Speaker: This is National Educational Television.