ABSTRACT
When children with severe disabilities, such as autism, Down's syndrome, congenital or hereditary syndromes or mental handicaps, are referred to the clinic, the help that under fives' counselling can offer is limited. It does not aim at modifying such severe conditions, but to help both parents and children to live together in a more tolerable and even satisfactory way, despite the disability. The "secondary handicap" consists of a psychological problem that is superimposed by families and carers on the original, primary handicap. The "secondary handicap" can cause far greater distress and destruction than the original handicap, but it is this that can be treated, differently from the primary handicap, which may be ameliorated only in some cases. To be aware that the child with a handicap is still a human being with feelings and reactions, and to begin to understand his or her apparently inexplicable behaviour, can be a first step towards integration and a happier relationship with that child.
