Abstract:
This historical study examines the factors that led to the creation of a federal program of services for crippled children in the United States during the 1930s. Established as part of the Social Security Act (SSA) of 1935, the Crippled Children Services (CCS) program was one of the first medical programs for children supported by the federal government. As early as the 1890s, many state and local governments developed services for crippled children through private and public efforts, making the federal government a relative late comer to supporting the needs of children with significant physical handicaps due to disease, birth defects and accidents. The development of a national reform agenda based on state and local efforts for crippled children began during the Progressive Era and culminated during the New Deal Era with the passage of the SSA. Several factors influenced the creation of the federal CCS program including the role of reformers and professional groups, the role of state-level private charities and children's institutions, and the increasing authority of the federal government in social programs. Under the SSA, states and territories quickly developed state-level CCS programs during the late 1930s. The United States Children's Bureau (USCB) administered the program for the federal government and helped states to incorporate preventive services and interdisciplinary approaches to service provision into state-level CCS programs. Factors that influenced the implementation of these programs included the availability of matching state funds, the establishment of state programs for crippled children prior to the SSA, and the accessibility of qualified health care professionals and facilities. The United States entry into World War II in 1941 slowed the growth of state-level CCS programs until 1945, and serves as a natural end point to this study.
