Experience with this group of 206 children with retrolental fibroplasia has indicated that the majority of parents, with supportive treatment, are able to make a satisfactory adjustment to the child's blindness and do not break down either physically or emotionally. In instances where they have been too disturbed to cope with the anxiety centered about the blindness, there have been special circumstances which have created too great an emotional burden. In these cases, with casework help, one or two parents were able to accept psychiatric treatment. In situations in which the child has developed obvious behavior problems which have appeared to be based on the parent-child relationship, a number of parents have been able to accept psychiatric treatment for the child with the caseworker offering a supportive service to the parent. In other instances where psychiatric treatment for the child was too threatening, parents have been able to accept foster home care. Foster home placement of blind children has been used primarily to provide the child with a warm, accepting relationship which offers the security necessary to stimulate the child's growth and development. Through this study it was learned: 1. That a home environment that contains a warm parent-child relationship offers the blind child maximum opportunity for development, physically, emotionally, and mentally. In an accepting home environment the blind child lags a little developmentally behind the normal. Without stimulation and security, he is apt to be grossly retarded developmentally. 2. That most parents, like Mrs. A, originally feel ambivalent toward their blind child. They need assistance with handling their anxieties before they can form warm relationships with the blind child. Since the mother-child relationship is the most influential factor in a child's life, the role of the caseworker working with the preschool blind is focused on the mother, with the goal of developing a sound parent-child relationship. 3. That many of the children who appear retarded have “caught up” by the time they are of school age. 4. That training problems, which create considerable anxiety for the parents, may be greatly reduced by making available services of experts in the preschool educational field when the parent is ready to use such service. 5. That nursery schools for the sighted have offered many blind children stimulation and satisfying relationships outside their homes. At the same time, they relieve the mothers and begin the child's adjustment to a sighted world at an early age. 6. That early association between the blind child and the seeing community is possible and profitable as preparation for his later adjustment to society. 7. That community attitudes toward the blind child can be changed by persistent efforts to interpret and individualize the child and his needs. Blindness, because of its permanency and the dependency it creates, evokes emotions of pity, frustration, and the feeling of insecurity in people who are unfamiliar with blind people and their capacities. This reaction is found among professional persons as well as the general public; however, careful scrutiny of these feelings and knowledge regarding blindness will enable the caseworker to see the blind child and his parents as individuals with both strengths and weaknesses. Although there is much to be desired in the knowledge and attitudes of both lay and professional persons regarding young blind children, the social caseworker in any agency can be helpful to the individual child and thus contribute to the solution of a larger problem. In our experience probably the most helpful contribution of the caseworker was the ability to dissociate the child and his blindness and to see him as a child—as an individual with all that that implies—rather than as one of a class. The fact that the caseworker, because of his self-discipline, can do this carries over to the parents, who in turn can begin to think less of the blindness and more of the child. They can thus begin to have natural parental reactions to the blind child rather than reactions that are first colored by the child's blindness. This recognition of the child himself can also be carried beyond the parents to the neighborhood, to the nursery school, and to others in the community with whom the caseworker has contact. The caseworker is effective also through his understanding of the parents’ problem and through enabling them to use him in a helpful way. Many parents have excellent impulses in regard to their blind child, but have no authoritative person with whom they can discuss their plans and who can help them carry them out. They are offered advice by many uninformed people about what is best to do for the blind in the way of education and training. As a result, they are fearful that their own instincts to keep the child at home, or to refrain from pushing the child's general training, will result in damage to the child later. The caseworker can reinforce the parent's desire to be a parent to the blind as well as to the seeing child, taking both the responsibilities and pleasures that are entailed. We have found that parents who have experienced the consistent interest and support of the caseworker and observed his efforts to open up opportunities for their children have been able to release their own energies in constructive action rather than passive acceptance. The strengthening of the parent-child relationship is accomplished by the same method in any casework situation, although a different body of knowledge is required for different problems.
Body composition: population epidemiology and concordance in Australian children aged 11–12 years and their parents