Tommy becomes "deaf, dumb, and blind" at a particular moment in British medical history. In the early 1940's, medical science was in the midst of what has been a century of exponential growth so rapid that a the decade prior could seem downright primitive. For example, autism - a mental disorder afflicting young children which Tommy's condition closely resembles - was not given diagnostic criteria until 1943. Tommy's first visit might very well have baffled his examiners since only the most advanced specialist would have the knowledge necessary even to attempt diagnosis of his problem.

Gaining access to such a specialist became considerably easier in the 50's as a result of Britain's massive health-care innovation in social medicine, the British National Health Service. State-salaried specialist were no longer confined to the great teaching institutions, and significant barriers such as money ceased to be insurmountable obstacles for people needing specific medical advice- people such as the Walkers.

Unfortunately, support and guidance for parents like the Walkers lagged behind medical advances. Counseling and special peer groups for parents with autistic children, for example, did not begin to emerge until the late 60's. In the interim parents were left to their own recourses in dealing with their children's special needs, often with only each other to rely on; a situation which frequently resulted in relationships strained by feelings of guilt and blame.

Parents who struggle with the idea of placing their child in an environment that, while alien to them, may help their child live a more fully realized life, are not uncommon. Speaking as a mental health professional, I can tell you that parents of the mentally handicapped often (though by no means always) feel a certain amount of distrust toward people working in the human service field.

The parents are afraid to send Tommy away. There is a strong stigma attached to mental heath facilities, and if it's strong now, I can only imagine how bad it must have been 50 years ago. There is a worry that the patient won't be looked after properly or given the attention they need. There are concerns about abuse (both physical and mental). There are concerns about what type of medication the patent will be given. It's a hard thing to think about and many parents will keep their child at home much longer than they should. Please don't think I'm saying that a "staying at home" arrange can never work out, because it can. It can be wonderful. But for many, especially as the parents age, it is not in the child's best interest and this is certainly true for the Walkers.