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The practising paediatrician struggles to combat the effects of acute illness and disease in babies and older children. The pattem of hospital admissions has changed dramatically since I first qualified over 25 years ago. Neonatology is a relatively new branch of paediatrics and achievements in neonatal intensive care have been exciting and little short of astonishing. However, like the poor, children with chronic disabilities are always with us. Sadly, modern mainstream medical progressive thinkers regard as much less prestigious the work done in the field of 'handicap'. Thanks to inspirational paediatricians, like Ronnie McKeith, Trevor Wright and Ray Remboldt (great teachers all, and wise counsellors to leamers like myself), the needs of children with developmental disabilities have been highlighted. Moreover, the importance of a holistic approach to these children, their families and their teachers has been emphasized. In the Child Development Centre at Y ork, a multidisciplinary team attempts to define as accurately as possible the nature and severity of the problems facing a child, but the child's predicament and how to solve or alleviate it remains the key issue. A full team assessment which does not lead to any practical help for the child and bis farnily is merely an academic exercise and a disgrace to the many different professions involved.
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