Opinion/feedback: introduction

Despite of the politique for social inclusion leaded since the last decade, many specialized institutions for disabled children remained in France. This institutional field is varied and heterogenous, so difficult to understand from the exterior, particularly from the healthcare sector. The aim of this study was to evaluate the needs of the children accompanied within the Motor Education Institute of Couzeix in order to identify more precise indications to the placement.

Method

Retrospective study on the candidate files of the 34 children new admitted in the MEI, between September 2013 and January 2016.

Results

These children presented an important motor disability (47% of tetraplegia, 23.5% of paraplegia, 26.5% of hemiplegia), caused by severe pathologies (44.1% of cerebral palsy, 17.6% of myopathy, 14.7% of tumoral pathology, 14.7% of rare diseases, 5.9% of head injury). Mean age at admission was 14.5 years old. The admissions mostly succeeded an anterior specialized accompanying (41.1% of children came from home care services and 29.4% from another MEI) or relayed a hospitalization (8.8%). But in 20.6% of cases, the children received only private duty cares before their admission. The analysis of the candidate motives shows the imbrication of various problematic: needs in rehabilitation cares (97%, of which 14.7% in a postoperative context), school difficulties (82.3%), socio-familial troubles (55.9%), psycho-affective troubles (50%), problems of course or career choice (29.4%), need of preparation in view of an adult life (11.7%).

Conclusion

The specific needs leading to the placement in the MEI of Couzeix are not only important needs in rehabilitation and daily cares, related to the disability severity, but also the necessity of a global and specialized psycho-social support. The admission reasons for schooling or course choice reveal the limits of the actual school inclusion. The direct admissions from the private duty sector without specific accompanying question the healthcare pathway of these children.