The Editor, Sir:

I have been reading Tara Clivio's articles on education with interest. A recent one titled 'Why an 11-year-old must cry' was a poignant rendering of something that we (3D Projects) have been seeing for over 25 years in our clinics and which has not yet been adequately tackled.

We run clinics in different parts of the island intended to help children with disabilities and their families.

These children fall into two main groups, children with obvious visible disabilities, whether physical, speech, intellectual, hearing and less commonly, visual. These children are usually present during the preschool years, the most severe ones presenting earliest. They are either referred by health care workers and doctors or by their parents directly.

The other group appears from about age seven onwards and is referred by teachers from primary schools. They usually come with a parent or a concerned relative, who may or may not realise the child has a problem. The problem is invariably failure to learn in school - reading and writing - usually accompanied by behavioural and/or emotional problems. Sometimes, they have conditions such as attention deficit disorders, more frequently they are very backward in school, functioning at the four- to six-year-old level, as Mrs. Clivio described.

Problems missed in early years

They were sometimes recognised as being slow in basic school, but nothing was done about it. More often, no one realised that anything was wrong. There was no history of any problem in the early years that could have caused the learning delays, which we would normally find in children in the first group described above and no definitive diagnosis is made. These children usually come from poor backgrounds where the mother has to work, there is no father, no books and few toys.

Mrs. Clivio mentioned their very limited exposure to language. You have only to listen to the average verbal exchange between mother and child to understand the deficiencies in their environment. A colleague who has done much child development research in Jamaica once observed that the mothers had just as much difficulty with the tests for three- to four-year-olds as did the children!

They may have experienced neglect, child shifting, inconsistent or deficient care or other negative situations. Characteristically, they are subjected to much punishment, physical, verbal and emotional, both at home and at school. There is very little one can do at this stage because their intellectual difficulties are not severe enough to warrant them attending the School of Hope, nor do they need to. The problem is that there is usually no other option. The Ministry of Education does have a few special classes and resource rooms in some primary schools. If the child is lucky, he (and they are usually boys) may have such a school in his area. After primary school, there are virtually no provisions for these children, so they end school illiterate, with no self-esteem and presumably enter the ranks of unemployable adolescents and criminal gangs. In the latter case, they may be easily led and exploited by more intelligent boys.

Nothing wrong with them

This problem can be prevented. These children did not have anything wrong with their brains at birth, it was their environment that was at fault, the child-rearing practices that were used before they went to school and the lack of any programmes when they started school to detect and remedy the situation. And so, they continue through the school system without any help, falling further and further behind until they have reached age seven or eight and someone realises they cannot read, or they have developed unacceptable behaviour problems that the staff cannot manage.

We have known of these problems for 20-30 years or more. Jamaica has an extensive body of research and the problem has been quantified. I was involved in a study 20 years ago that showed that from 17 to 30 per cent of children between three and nine years old had mild intellectual disabilities. These were more common in boys than girls and they increased in frequency with age. More recent unpublished research on children entering basic school shows that between 15 and 25 per cent - depending on the area - had delays in development suggestive of potential learning problems and a slightly higher per cent were thought by their parents to have behavioural problems.

We have the capability to prevent these problems. Jamaica has had early intervention programmes for children with disabilities for more than 30 years. They need to be expanded to include these children as well.

I am, etc.,

Dr. MARIGOLD J. THORBURN

25 Paddington Terrace

Kingston 6