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The leading controversial question among educators, as among hospitalization authorities, involves the relative expediencies of centralized or decentralized facilities. As among the institutions caring for and curing crippled children, the weight of argument is with the decentralized plan. Parents will move their families to hospital facilities more readily than they will travel long distances for the purpose of living near central educational institutions. Moreover, it is an injustice to move the children of indigent families many miles from their parents for long periods of education. Centralized educational facilities simply do not function. Michigan, which has provided for a state public school with special provision for crippled pupils, has found it necessary to erect a number of local schools to solve the problem. The enrollment of crippled pupils at the State School, at Coldwater, has always been small.

Until recent years the notable deficiency of the special educational systems for crippled children has been the fact that these advantages ceased upon the completion of eight grammar school grades of instruction. Several cities, including Chicago, Los Angeles, and Philadelphia are now extending these facilities to junior high school and senior high school education. It is to be hoped that this program will be adopted by other Boards of Education and that the universities will co-operate with the civilian rehabilitation bureaus to provide education for crippled advanced students.

The instruction provided in the various occupational arts and sciences has physical as well as vocational value. In the convalescent and acute institutions it serves to provide an interesting and engrossing source of occupation for the children. It trains them in the use of muscles which might otherwise remain inactive. In addition, this instruction guides them to a source of permanent income. Some of the industries in which these children may be instructed are sewing, lace making, chair caning, burnt woodwork, stenography, typewriting, simple carpentry, pottery, basketry, brace making, cobbling, cooking, printing, bookkeeping, the manufacture of artificial flowers, millinery, knitting, leather work, crocheting, novelty, and favor making. Quoting from the 1922 annual report of the Massachusetts Hospital School, "When a child is admitted, doctors, nurses and teachers study his case from every point of view. If his disability is temporary, he is placed without loss of time in a class where he is enabled to keep well abreast of a child of his own age in a public school. If he is permanently crippled, he soon finds work to which he is best adapted, voluntarily working side by side with the wage earners."

Some classrooms provide long tables at which the children place themselves comfortably. Other facilities are very simple. A blackboard and a desk for the instructor complete the equipment. Periods are short, and are arranged in a rotating fashion to provide instruction for one group while a second group is given the various types of medical treatment suited to the needs of each child. Some institutions have their own libraries and furnish books for the pupils as they are needed. Many arrange with the local public libraries or book stores to supply texts and extra-class reading matter when called for by the teachers.

Grading of students receiving bedside instruction, either at home or in institutions, is generally credited in a different manner from the class room system. One hour of such instruction is credited as equal to two or sometimes three hours of normal education. This is done because the children are receiving individual and concentrated attention, and do much of the work by themselves under periodical guidance.

When the crippled child has received remedial treatment, convalescent care, and has completed a thorough educational period, society has done all that it can to help him. If, after that time, business and professional men will consider him on his own merits and give him an equal chance to obtain employment and demonstrate his fitness to cope with the problems of a normal life, the magic pathway is completed and the handicap is at an end. From that time on, the "cripple" joins with his normal companions to further the prevention of those conditions which are favorable to causing deformities in other children, and, like Michael Dowling,-1- the great Minneapolis philanthropist, is probably doubly active in aiding his less fortunate little brothers. Everyone concerned is happier. Progress has been achieved.

-1- The late Michael Dowling of Minneapolis, Minis., rendered great service by aiding crippled soldiers during the World War. He was himself a cripple, supported by two artificial legs and capable of using only one arm. Mr. Dowling passed away in 1921. Some of his great fortune was left to the Dowling School for Crippled Children. In Minneapolis, Minnesota.