A great many improvements have occurred in recent years, including the fields of obstetrics, neonatology and paediatrics. Nonetheless, mental deficiency and polyhandicap remain as crucial problems for our society. Environmental factors, prematurity, multigemellar and late pregnancies, alcohol and drug addictions, poor standards of
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A great many improvements have occurred in recent years, including the fields of obstetrics, neonatology and paediatrics. Nonetheless, mental deficiency and polyhandicap remain as crucial problems for our society. Environmental factors, prematurity, multigemellar and late pregnancies, alcohol and drug addictions, poor standards of living in developing countries, epidemics such as aids, malaria and rubella still are, among others, major challenges. Against this background, neurology and psychiatry may have a difficult position. First to be mentioned is the lack of neuropaediatricians. On the other hand, one must acknowledge that many handicapped persons, until recently, have been denied any adequate psychiatric follow-up. Adult neurologists have not been trained to the clinical specificities of this population. Some specialised consultants do exist, but the detection of the patients within institutions or from their homes on an ambulatory basis may be questioned. Globally, the basic and continuous training of caregivers can raise discussions. Modern medicine is doing its best all around child birth and during early infancy. Later on, one can observe some demedicalisation, the handicapped person being essentially granted a psycho-paedagogic follow-up. Our observation is that of a too great gap between the institutions’ files and the medical ones. New connections should be sought for between these two specialised worlds that have a historical tendency to ignore each other. Neurosciences have stood out in the past decades with a great deal of original breakthrough on diagnostic and therapeutic levels. These novel techniques must be applied to handicapped persons that were investigated several years ago.This is the case for neuroradiology, pharmacology, genetic counselling, biotechnology, neuropacemakers, communication apparatus and so forth. In no way, the person bearing learning disabilities should be closed into a diagnostic box sticked to routine and defeatism. A way to go through some of these challenges is specific education of medical students, general practitioners, neurologists and psychiatrists themselves, as well as the medical and psycho-educative personnel’s. For example, one must admit that generally, little is teached about child psychology and educational measures to medical students and that psychologists often do not get enough information about neurological diseases and syndromes. Finally, a constant coping of the institutions to the new parameters of aging and greater diversities of these populations is a must. As a conclusion, the great leap forward of medicine in the last century, including for what concerns the complex field of handicap has, from now on, to reinforce itself and invent new strategies: a transversal collaboration on all levels is needed between hospitals and institutions,medical doctors and educational personnel, psychiatrists and school psychologists.The medical secret itself and the many idiomatic languages have often been excuses to stay in one’s own ivory tower. However, things can evolve in the very respect of the patients, their families and the law. This multidisciplinary partnership is a key to a new capillarity of knowledge and its practical applications.
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