
speech and reading problems in childhood.
the following communicative disorders
have been discussed: functional articulation
defects, delayed speech development,
stuttering, hearing loss, cleft palate,
neurological disorders, and reading disorders.
these disorders rarely have a
single cause.  they are the result of an
intermingling of many factors, some physiological
and some psychological, some
residing within the child and some in the
parents and environment in general.  delayed
or defective speech is a cause for
great concern to most parents and teachers.
the public health worker who listens
with an attentive and sympathetic ear may
allay some of this anxiety and thus help
foster healthy emotional development in
the child.  the existence of a more serious
condition underlying the presenting communication
problem, even if sensed by the
parents, is frequently denied.  the public
health worker can assist the parents in
the painful process of facing up to their
fears.  a child with a communication problem
is still a child and the public health worker
by simply reflecting this to the parents
and advising them on normal child-raising
practices can, again, be of help to the
child.  children with speech deviations are
exposed to an overabundance of well-intentioned
speech correction at home.
most of it is ineffective; some of it, unfortunately
is harmful.  while the worker
may not be in a position to offer specific
advice on a particular child, the manner
in which the parents and teacher are handling
the child's communication problem
can be explored and damaging practices
possibly eliminated.  the fact that there
may be a diagnostic and treatment center
to which the child can be referred does
not vitiate the public health worker's role.
the public health physician and public health
nurse have a valuable contribution
to make in helping the parents, school,
and child accept the chronic nature of the disorder.
