Thursday, 28 February 2013

Book Review: Extraordinary Parenting

'Extraordinary Parenting'  is a helpful manual written for parents who have children with chronic physical or medical conditions. The book is set out in a readable format with clearly presented information. You will find simple illustrations, photographs and a bibliography. In addition, it is written in an Australian context.

Ordinary children are faced with extraordinary circumstances and in the book parents are given psychosocial information to support their children. Topics covered are varied and range from looking at a child’s psychological and emotional world to experiences such as hospitalisation, medication taking, sleep overs and camps or life in the school playground.  Extraordinary parenting encompasses child development stages and age appropriate information for up to early teens. There is an emphasis on raising awareness of what a child and family may be experiencing whilst looking at important emotions such as anxiety, self-perception and depression. Parents are encouraged to focus on their “best intentions” rather being caught up in guilt. Find an abundance of practical information, for example throughout the manual at the end of each chapter, readers will find the heading “Psychological protection : what you can do”.  Children and families can build understanding and develop skills for good self-esteem and resilience.

The author draws on her experience of over 20 years from working children, adolescents and adults in the fields of psychology, social work and literature. Dr Bruce works in private practice at the Emotional Health Centre, Cheltenham, Victoria. Extraordinary parenting can be viewed online in chapter format and/or purchased at:

The AWCH library holds two copies and both are available for loan.

Extraordinary parenting : protecting self-esteem and minimising depressive outcomes in pre-adolescent children who have significant medical or physical conditions (Cover title: Extraordinary parenting : a manual for parents of children aged 0-12 with chronic physical or medical conditions). Emotional Health Centre, Cheltenham, VIC. 2007, 168 p.  ISBN 9780980420609.
By Dr Elizabeth J. Bruce PhD, edited by Dr Cynthia L. Schultz, illustrations by Colin Bruce
Subjects:  Chronic diseases in children - Psychological aspects. Chronically ill children - Family relationships.  Chronically ill children - Education. Chronic disease - In infancy & childhood.

Review by:
Jillian Rattray
AWCH Librarian

Friday, 15 February 2013

I felt sure his mother holding his hand and comforting him would have helped…..

Edited excerpt from ‘As it Was – The First 10 years’ by Doris Hart, first Secretary and the first National Organiser of AWCH - the moving force behind the Association's initiatives from 1973 to 1983.
In the newspapers and magazines of the 1960s/70s, information about children in hospital centred around hospital success stories; visits of royalty and film stars; Easter bunnies delivering a surfeit of Easter eggs; and Father Christmas and his helpers with an abundance of toys and good cheer. The stories conveyed images of hospitals working near miracles; of everyone caring about children in hospital and of the kindness shown by hospitals for their child patients. All of this was true but it hid a very dark underside to the hospitalisation of children - long term, often devastating, emotional trauma.

In Australia, the need for change was heralded by the concern expressed in 1970 by the Aust. & N.Z. College of Psychiatrists. Their Position Statement entitled “The admission of mothers to hospital with their young children" accused hospitals of……doing more damage in one year than all the psychiatrists together could undo in several years. . .

That hospitalisation could have such devastating effects on young children was well known to me. In the late 1960's I worked for three years in the children's unit of a psychiatric hospital handling the most severely emotionally disturbed children in the State. Hospitalisation at an early age appeared regularly in the case histories of these children.

One would have expected the psychiatrists' position statement to bring forth cries for an immediate enquiry and remedial action. Instead, it was virtually ignored. The hospitals' case was that parents upset children who were soon settled and better off without them. A fallacy already forcefully disproved by the published works, both written and audiovisual, of James and Joyce Robertson

The "cage” cot with a wire frame 1976
If the mother (or the child's caring person) was not admitted, how did hospitals cope? Nurses did their best in an often impossible situation. For the most part, children simply cried until they became withdrawn and “settled". Distressed toddlers were particularly difficult to manage. In their anguish they often tried to climb out of the cot. Fearing that they would harm themselves they were sometimes put in restrainers. Documented cases of children choking to death in them discouraged the practice. Another method was to put a wire frame over the top of the cot thus making it into a cage. In the 1970's, I saw one of these in a regional hospital in NSW, another one in Victoria. In each case, the hospitals saw the cage as a perfectly valid solution that ensured the child's safety, even though there were empty beds at the side of the cot which could have been used by a parent. Indeed, in Victoria I was told the cage was used because the child was the only one in the ward so, instead of having a nurse there just for one patient, the sister in the adult ward kept popping in. When I asked why they hadn't admitted the child's mother in these circumstances, I was told it wasn't hospital policy. The nurse admitted she would willingly have let the mother stay (had it been allowed) as the toddler was a nuisance disturbing and upsetting her patients all night

Of course, most hospitals did not use restrainers or cages, but there were still very distressing sights associated with necessary treatments. I remember seeing a very young child in a side ward with his eyes swathed in bandages and his wrists tied to the sides of the cot so that he did not pull off the bandages. He was kept heavily sedated but one couldn't help wondering what fears or dreams he was having in that twilight state. I felt sure his mother holding his hand and comforting him would have helped.

Cracking the system
In the literature, the problems of hospitalisation of children had been identified and the solutions outlined. As hospitals failed to implement more humane policies, there were various attempts by individuals and groups to force action but none had been successful. Hospital boards were thought to be omnipotent. To challenge them from inside the hospital was to invite personal disaster career-wise; to challenge from the outside was to invite ridicule as a trouble-maker.
At the first meeting of the group which subsequently became AWCH I voiced my strongly held convictions:
  • that infants and young children needed their mothers in hospital and that need had to be met
  • that parents and professionals must work together publicly if the above aim was to be achieved
I believed that we could do better by drawing upon Australia's egalitarian ethos and creating a platform from which all could speak on behalf of the children, free of professional, personal or vested interests.

Thus AWCH was born in the belief that parents and professionals together could crack the system' for the good of the children.