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In the areas of extreme deprivation, handicapped children should be served along with all other children in the mass programs in nutrition, health, and sanitation -- they should not be excluded from such programs merely because of their handicap. Obviously the actual delivery of specialized services for handicapped children in these deprived areas, be they in health or in education, will have to wait, but what is essential is that those charged with the planning and development of education, health, and welfare services for the general population must be aware that, as conditions improve, an increasing number of handicapped children will have to be served, and that it will be more costly and in the long run far less effective to have services develop as a separate, segregated system. In the meantime the services being developed in the cities will fulfill an important function: They can serve as demonstration projects to develop appropriate practices indigenous to the country, as teaching laboratories and study centers, providing knowledge which can later be applied in the more deprived areas.

There are two factors that need to be stressed in thinking about initiation of services for handicapped children. The first is that long before a country of limited means can establish a full service pattern, significant work can be done on a simplified and partial basis. A fully equipped screening mechanism reaching all children ages one, two, and four will for most developing countries be a far distant goal, but good deployment of public health nurses will permit a good bit of partial or pre-screening, and indeed parents can be instructed to watch for certain indicators of trouble ahead, and, when they occur, communicate with the public health nurse or a similar health resource.

UNICEF, in similar fashion, has undertaken in several countries a nutritional program teaching parents good diet ideas for small children, and better utilization of local food resources. Obviously, member associations of the League can be of considerable assistance in such a program. A good example of opportunity for effective parent education would be combating the kind of specific and tragic problem created in developing countries by the promotion (by Nestle or other companies) of dried milk products to the exclusion of breast feeding, although it is not always easy to have a somber warning about probable damage and death compete with the colorful enticement of the commercial corporation.

During this Year of the Child there has been in many aspects a renewed emphasis on the role of the family, both in the area of prevention and early intervention. In many ways, parents can be helped to work with the pre-school handicapped child, avoiding the pitfalls which have occurred in the well-to-do industrialized countries, where for some quite inexplicable reason early intervention was generally neglected until the recent past, and where organized programs started with school age or a bit later. The practical aspect of this is that much of the work in early intervention (avoidance of overprotection, exposure to stimulating experiences, speech encouragement, socializing contacts with other children and with adults) can in most instances be arranged with very modest expense and yet great effectiveness, as compared with the maintenance of large institutions, extensive testing programs, or routine comprehensive diagnostic studies.

Quite obviously here is an opportunity for the League's member societies to demonstrate such services on a limited basis and to push for their adoption by their government, while the League's Secretariat, supported by a relevant Committee, should pursue this matter on the United Nations level.