Any family knows the problems which arise when a child is ill and must be kept quiet, even for a brief time. The convalescent period, when a child is well enough to be restless but not well enough to get up, is especially hard on everyone. The child may become bored and unmanageable, his mother harassed and irritable, and the whole family disturbed.

When illness is short, and convalescence a matter of days, a few amusement "tricks" will help keep a child occupied and quiet. The difficulties are temporary, the family manages to live through them, and life soon returns to normal.

But when the child is homebound, restricted to bed or wheel chair by severe illness, for a long period of time, the situation is serious, sometimes even grim. All problems of a short illness are intensified many times over; in addition, the child and his family face a number of other problems, practical and emotional, which are special and difficult.

If a child has been handicapped since birth, he has never known any of the normal contacts of childhood -going to school, playing with other children, talking to neighbors and tradespeople, taking trips with his family and friends. He may not miss normal play activities a great deal, for he has never known them; but he may be timid and withdrawn when he meets other people, lacking in initiative, imagination, and self-confidence.

If a child has become homebound by illness after part of a normal childhood, he finds himself suddenly cut off from most of his previous life. His world has shrunk to four walls, and it seems to go on shrinking. The friends and relatives who visited him often when he was first sick may come less frequently. The children he used to know drift away, and he has fewer and fewer playmates. Active games and sports are a thing of the past-in short, he must suddenly live an entirely different kind of life from before, the kind of existence he can contrive for himself in bed or a wheel chair.

He is far more dependent on his family than other children are; if they accept the child as he is, give him affection without pity, use imagination in dealing with his recreational needs, he is fortunate. If the family is unable to acquire a wholesome attitude the child is helpless to escape. As a child and as an adult he may find it difficult to become well adjusted-and therefore be unable to lead a satisfying life.

In some communities the Board of Education supplies a visiting teacher to meet the homebound child's scholastic needs. Most children have a radio and many now have a television set. But these things are inadequate substitutes for the normal childhood activities of which such a child is deprived.

The child's family may be unable to cope with the situation. Over months and years the family may become used to his condition and fail to realize his need for continuous help and stimulation. Even parents who are deeply conscious of the child's need and eager to help may not know how to do so; or they may do things from loving solicitude that hinder the child. Perhaps they are overprotective and reluctant to let the child learn to do things even when he can, thus encouraging the child to be too dependent on them. The mother who bears the brunt of the child's care may be busy with housework and therefore must leave the child to his own resources. Even though she may be able to give thought and effort to the recreational needs of her child, eventually, she may feel unable to do more; she comes to the end of her ideas, or feels that the child has tired of her as a companion.

A homebound handicapped child desperately needs two things-recreational activities which will take the place of usual childhood play and contacts with the outside world. The latter point cannot be over emphasized: the homebound child needs to see people other than his own family. Visits by outsiders, young and old, are extremely important. And they benefit not only the child but his mother as well; she is often as homebound as he is and feels that both are forgotten by the busy world.

Some parents are aware of problems like these. But to those who are not it is encouraging and often surprising to learn that their child, even confined to bed or wheel chair, can live a constructive and rewarding life. The problems are not too great to overcome. The child need not be bored, nor the parents overwrought. There are many ways to make life brighter and more comfortable for the child. There are many ways in which a mother can make her added responsibilities less wearing and the family less disturbed. This book tries to point out what some of the ways are.

You may feel that you need only the suggestions given in one or two of the following chapters, such as the one called "Toys and Playthings. " However, it is always advisable to think in terms of the whole family. Such chapters as "Family Group Activities, " "How Father Can Help, " and "The Child in Bed Can Help, " may open doors to many new ideas.

This book will be most helpful to you if you realize that almost all the ideas presented can be adapted for use by either boy or girl. For example, Item 103 suggests that dolls can be made from socks. Usually dollmaking is considered an activity for girls only. But a boy can be encouraged to make such a doll for his sister, thus taking the process out of the "sissy" category. In the same way, the basic idea in many of these suggestions can be adapted to various ages; Item 125 suggests that cookie cutters are useful to a small child for tracing and coloring; but they can also be used by a child of any age in making greeting cards.

Every child's personality is different, and every home has its own routine; therefore there are no hard-and-fast rules about the activities to undertake with an ill or homebound child. A few new ideas may be all that is necessary to relieve the situation during a slight illness. But when a child is "vegetating" in bed or wheel chair, it often takes a while to arouse interest and enthusiasm-especially if the child has been without adequate stimulation and encouragement for some time. Sometimes much experimenting must be done to discover what new things will be most interesting and helpful to the child. Bear in mind the basic purpose: that the child needs to forget what he cannot do in the pleasure of finding out what he can do.

A child who is ill, or who has had a severe illness, often enjoys activities that are below his or her age level in years. Therefore it should be the child's interests, degree of mental activity, and type of disability- not his chronological age-which determine his recreational activities. Be sure that you understand from your doctor exactly what your child can do without endangering his health. Then, within those limits, encourage him or her to undertake more difficult activities as time goes on.

Even though his disability is severe, do not be surprised if his interest and your encouragement in developing a skill or accomplishing a task overcome his physical limitations. If you help him to have an interesting, well-rounded life, and encourage him to "stretch his wings" as much as he can, the chances are that he will be motivated to do all sorts of things that originally seemed beyond his power.