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About Medford mail tribune. (Medford, Or.) 1909-1989 | View Entire Issue (Feb. 28, 1960)
1 1 i? I I rippled Children's DIvi8ion ; Work- Organized in Five Programs . i n-nraflnwriii mn lririimrrmiii ml li fliii ninm naf a' fill il 1 r TiiTfTTW'i r fiiyrif " M in 4: a t. Team Approach is Fundamental for All Clinic Work (Editor's note: This is the - third la a series of articles oa xha research and public ' service projects being car ried on by the state's col leges and university. The articles are written by Mrs. Wilma Morrison, longtime reporter of Oregon educa tion, for the state's system of higher education.) By MRS. WILMA MORRISON - "It is an axiom in medicine il one congenital malforma tion exists to be more suspi cious of another." This statement In a report of the crippled children's di vision at the University of Oregon medical school is par tial explanation of the divi sion's now focusing almost its full attention on the congeni- tally handicapped-the birtn damaged who now survive in much greater numbers than thev did before the era of antibiotics. The division's work, the cases it accepts and the pio neering research and medical training it fosters, is set up under five Droerams. or clin ics. These are: the othropedic (the group which once consti tuted the whole focus of the division); the cerebral palsy cases; the dental-plastic-speech (mostly cleft-lip-and- palate); the congenital hearts, and the premature Da Dies. Fundamental Approach In all of these clinic pro grams the team approach is fundamental. The old coesept of a single doctor dealing with an isolated deformity has giv en way to one that marshals many medical specialists, speech and physical thera pists, and frequently social and welfare agencies, on each case. One of the division's team programs in particular, treat ment of the cleit-iip-ana-paiaie children, has set a national pattern. The troubles of these children come in multiples, and are compounded by the physical changes that come over 15 to 20 years as the child grows. The plastic sur gery that closes the lip and palate, and usually is done be fore the child is two, is only the beginning. There are con tinuing severe speech, hearing and dental problems. What is done to correct the plastic damage may prevent the later correction of jaw and teetn; lack of speech-hearing treat ment in infancy may block thtriDT when the child reaches school age. As answer to what has in the past been a hit-and-miss attack, the division has insti tuted a team treatment that brings the child and his par ents together with pediatri cian, plastic surgeon, several dental specialists, speech tner- aDists. psychologist, as soon - - . f iter - - - , - s f y Y, f lJ-. I ' ' 1 til ;'! v - V- J f K . , f-. SPEECH TESTS Scott Anderson, cerebral palsy patient at the crippled children's divi sion, goes through speech tests with Mrs. Doris Bradley, therapist, right, while his mother watches. Speech and hearing trou bles are common accompaniment of many kinds of congenital defects. Correction is slow and involved. TEAM DIAGNOSIS Team diagnosis and treatment has become standard at the Crip pled children's division at the medical school since overwhelming majority of CCD patients now are victims of compounded congenital damage. This is typical cerebral palsy clinic session with psychiatrist, occu pational, physical and speech therapists as well as' medical specialists involved. as the baby is born. Diagnosis and a plan of surgery, speech training and dental correction is laid out that frequently ex tends through adolescence. In past five years, the divi sion has supervised and treat ed 294 such cases. "One in about 660 births is a cleft-lip-and-palate child," Dr. Richard Sleeter, division director, said. "We regard speech as just as much a medical field as psy chology," the director said. And the speech therapists at the crippled children's divi sion, headed by Dr. Herold Lillywhite, are central to the rehabilitation of cleft-lip-and palate children. One of the five speech and hearing cen ters maintained by the state's special education department is at the crippled children's division building on Marquam hill. Others are at Monmouth, Eugene, Ashland and La Grande. : For Oregon's crippled chil dren whose handicaps fall into one of the division's five treat ment categories (listed above), there are two kinds of serv ices offered by the division. Diagnostic Program The first is the diagnostic one, a case-finding type of program.. Any child under 21 thought to be suffering from one of these conditions may be referred for a diagnostic work-up (the term used for the whole comprehensive process of data collecting and multiple examinations by spe cialists). This diagnosis, which usually calls for two days at the clinic, is available with' out regard to the family's ability to pay. - "You can't buy this kind of diagnosis and treatment recommendation," the direc tor said. "It just isn't on the open market." When it comes to the second division service-treatment, in cluding surgery if surgery is called for-payment is accord ing to ability. The division pays all or part, according to need, but parents pay full costs if they are able. Wher ever possible the child is re ferred to private specialists in his community. Close cooperation is main tained with the various pri vate and public agencies these five are likely to have been seen by private physi cians who can refer them to the division." "The involvement of pri vate physicians in these cases," the director said, "is most important. These are rare cases. The average doctor in his own office may see one to . three congenital hearts a year, where the division sees 10 a week. He may see one muscular dystrophy every four or five years, and deliver a clef t - lip - and - palate child once in three years . . ." The crippled children's cen ter with its medical school resources is a source of in formation. The individual doc tor must have confidence and a cooperative interest in the procedures available to his pa tients there. To this end, the division director, who was a practicing pediatrician him self several years, said, "We feel the private physician must never be the fourth car bon copy on an institutional report." Sunday, Feb. 28, 1960 MAIL TRIBUNE, Medford, Or. 11 NO SPARKS! NO SMOKE! NO FLOOR DRAFTS! LOWERS FUEL BILLS! Uniform hM trom floor m oriling. Sara wood, prto.lo9 m briqorK. T control firo . . . yoor koo cmd fooiilf or SEND FIHEPUCE WIDTH ant HEIGHT. RECEIVE Celortol looWel rr" or Phone SP 2-7166 Easy Terms Smith-Dynge Lmbr. Co. Corner of 8th and Fir PALSY VICTIM Little Bill Gallup is a victim of cerebral palsy, the type called right hemoplegic, meaning the right side of his body is affected because the left side of the brain is damaged. Here he plays with Miss Virginia Hatch, occupa tional therapist, on regular visit to crippled children's center at the medical school. But the "play" is with "bilateral" play things and has a corrective purpose. through whom help is avail-1 able to these children andl their families. There were I about 2,800 children diag nosed or diagnosed and treat ed last year at the crippled children's building at the medical school or by private consultants to the division. . "We look at these children as a straight-away invest ment," Dr. Sleeter said. Watching the division's cen ter at the medical school, it it plain that the immediate salvage of the handicapped children themselves is only a part of the investment's profits. This pool of congeni tally crippled youngsters makes possible research ad vances and teaching that are keys to medical discoveries and to better doctors. Two of many large research grants which have - come to the medical school involve the crippled children's division and the pool of handicapped children being treated there. They are the heart laboratory which is responsible for 102 open heart operations in the past year, and the mammoth nationwide Collaborative Project on Cerebral Palsy and Other Neurological Disorders of Childhood. This is the 810,000,000 five year study of 40,000 mothers and their babies that is being carried on in 16 medical cen ters. It is aimed at discovery of prenatal and birth causes of congenital defects. Participa tion of the medical school in this huge clinical research project has brought about $750,000 in its first three years. It has added the serv ices of some 30 additional pro fessional and technical staff and is paying for the com plete remodeling of the pedi atric and obstetrical depart ments at the outpatient clinic on Marquam hill. Two b a 8 l c philosophies make Oregon's crippled chil dren's division different from the great majority of state CCD operations-its concentra tion on children with severe congenital handicaps, and its "f all-o v e r-backwards" insist ence on inclusion of private physicians on the diagnostic and treatment teams. On both these scores the division comes in for some criticism. There are those who feel the division should act more as a screening agency, taking all children, regardless of whether their troubles are minor or severe. This has been the emphasis of the U.S. children's bureau which pays one-fourth of the division's budget. However, the chil dren's bureau is now mate rially aiding in treatment of severe conditions. A second criticism comes from some of the social and welfare agencies who feel the division staff should treat all the crippled who fall within its five treatment areas,, in cluding those whose parents are able to pay for it. There is a limit to the vol ume of cases the division can handle and the staff believes the severe congenital cases are the major problem as well as the group that is most promising of medical teaching and research profits to future generations. These are the children whose complicated problems can't be handled except through the team resources of the division and medical school. "We don't feel we can af ford to see 40 children with minor troubles in order to pick up five severe cases when 100 WOOL A New Sensation In Carpet At A Fabulously LOW PRICE and EXCLUSIVE at Laurine's Floorcovering 520 S. Riverside Merely Phone SP 3-5182 for FREE ESTIMATES The Carpet Pictured Here Is Only SALE-IIUDnV - ; ; ; 1 . 1a C. i iztr 1 ' I jimoM"ro""ooow" HAVE THAT Glamorous 'Country Club' Texture in your own Home at a new low price. This long all wool Pile creates a casual Texture that lends Any decor an atmosphere Of casualness yet a Wonderful sense of luxury. 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