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THE ETIOLOGY & TREATMENT OF CHILDHOOD


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"Edward S. Hume, M.D., J.D. General Adult Psychiatry  THE ETIOLOGY & TREATMENT OF CHILDHOOD Jordan W. Smoller University of Pennsylvania Childhood is a syndrome which has only recently begun to receive serious attention from clinicians. The syndrome itself, however, is not at all recent. As early as the 8th century, the Persian historian Kidnom made references to "short, noisy creatures," who may well have been what we now call "children." The treatment of children, however, was unknown until this century, when so-called "child psychologists" and "child psychiatrists" became common. Despite this history of clinical neglect, it has been estimated that well over half of all Americans alive today have experienced childhood directly (Suess, 1983). In fact, the actual numbers are probably much higher, since these data are based on self-reports which may be subject to social desirability biases and retrospective distortion. The growing acceptance of childhood as a distinct phenomenon is reflected in the proposed inclusion of the syndrome in the upcoming Diagnostic and Statistical Manual of Mental Disorders, 4th edition, or DSM-IV, of the American Psychiatric Association (1990). Clinicians are still in disagreement about the significant clinical features of childhood, but the proposed DSM-IV will almost certainly include the following core features: 1. Congenital onset 2. Dwarfism 3. Emotional lability and immaturity 4. Knowledge deficits 5. Legume anorexia Clinical Features of Childhood Although the focus of this paper is on the efficacy of conventional treatment of childhood, the five clinical markers mentioned above merit further discussion for those unfamiliar with this patient population. CONGENITAL ONSET In one of the few existing literature reviews on childhood, Temple- Black (1982) has noted that childhood is almost always present at birth, although it may go undetected for years or even remain subclinical inde"
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