306 lines
17 KiB
Plaintext
306 lines
17 KiB
Plaintext
From timl@maxwell.concordia.ca Sat Sep 22 10:54:08 1990
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From: timl@maxwell.concordia.ca (Tim Lapin Concordia University)
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Subject: Childhood disease?
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Keywords: smirk
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This was sent to me from a friend who does not have USENET access:
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(Reportedly authored by BBS user "Nick O' Teen" -- real author's name
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unkown.)
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--------------------------------------------
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The Etiology & Treatment of Childhood
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Jordan W. Smoller
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University of Pennsylvania
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Childhood is a syndrome which has only recently begun to receive
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serious attention from clinicians. The syndrome itself, however, is not at
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all recent. As early as the 8th century, the Persian historian Kidnom made
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references to "short, noisy creatures," who may well have been what we now
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call "children." The treatment of children, however, was unknown until
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this century, when so-called "child psychologists" and "child
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psychiatrists" became common. Despite this history of clinical neglect, it
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has been estimated that well over half of all Americans alive today have
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experienced childhood directly (Suess, 1983). In fact, the actual numbers
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are probably much higher, since these data are based on self-reports which
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may be subject to social desirability biases and retrospective distortion.
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The growing acceptance of childhood as a distinct phenomenon is
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reflected in the proposed inclusion of the syndrome in the upcoming
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Diagnostic and Statistical Manual of Mental Disorders, 4th edition, or DSM-
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IV, of the American Psychiatric Association (1990). Clinicians are still
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in disagreement about the significant clinical features of childhood, but
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the proposed DSM-IV will almost certainly include the following core
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features:
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1. Congenital onset
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2. Dwarfism
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3. Emotional lability and immaturity
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4. Knowledge deficits
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5. Legume anorexia
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Clinical Features of Childhood
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Although the focus of this paper is on the efficacy of conventional
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treatment of childhood, the five clinical markers mentioned above merit
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further discussion for those unfamiliar with this patient population.
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CONGENITAL ONSET
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In one of the few existing literature reviews on childhood, Temple-
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Black (1982) has noted that childhood is almost always present at birth,
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although it may go undetected for years or even remain subclinical
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indefinitely. This observation has led some investigators to speculate on
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a biological contribution to childhood. As one psychologist has put it,
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"we may soon be in a position to distinguish organic childhood from
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functional childhood" (Rogers, 1979).
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DWARFISM
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This is certainly the most familiar marker of childhood. It is widely
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known that children are physically short relative to the population at
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large. Indeed, common clinical wisdom suggests that the treatment of the
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so-called "small child" (or "tot") is particularly difficult. These
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children are known to exhibit infantile behaviour and display a startling
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lack of insight (Tom and Jerry, 1967).
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EMOTIONAL LABILITY AND IMMATURITY
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This aspect of childhood is often the only basis for a clinician's
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diagnosis. As a result, many otherwise normal adults are misdiagnosed as
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children and must suffer the unnecessary social stigma of being labelled a
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"child" by professionals and friends alike.
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KNOWLEDGE DEFICITS
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While many children have IQ's with or even above the norm, almost all
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will manifest knowledge deficits. Anyone who has known a real child has
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experienced the frustration of trying to discuss any topic that requires
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some general knowledge. Children seem to have little knowledge about the
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world they live in. Politics, art, and science -- children are largely
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ignorant of these. Perhaps it is because of this ignorance, but the sad
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fact is that most children have few friends who are not, themselves,
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children.
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LEGUME ANOREXIA
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This last identifying feature is perhaps the most unexpected. Folk
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wisdom is supported by empirical observation -- children will rarely eat
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their vegetables (see Popeye, 1957, for review).
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Causes of Childhood
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Now that we know what it is, what can we say about the causes of
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childhood? Recent years have seen a flurry of theory and speculation from
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a number of perspectives. Some of the most prominent are reviewed below.
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Sociological Model
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Emile Durkind was perhaps the first to speculate about sociological
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causes of childhood. He points out two key observations about children: 1)
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the vast majority of children are unemployed, and 2) children represent one
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of the least educated segments of our society. In fact, it has been
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estimated that less than 20% of children have had more than fourth grade
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education.
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Clearly, children are an "out-group." Because of their intellectual
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handicap, children are even denied the right to vote. From the
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sociologist's perspective, treatment should be aimed at helping assimilate
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children into mainstream society. Unfortunately, some victims are so
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incapacitated by their childhood that they are simply not competent to
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work. One promising rehabilitation program (Spanky and Alfalfa, 1978) has
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trained victims of severe childhood to sell lemonade.
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Biological Model
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The observation that childhood is usually present from birth has led
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some to speculate on a biological contribution. An early investigation by
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Flintstone and Jetson (1939) indicated that childhood runs in families.
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Their survey of over 8,000 American families revealed that over half
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contained more than one child. Further investigation revealed that even
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most non-child family members had experienced childhood at some point.
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Cross-cultural studies (e.g., Mowgli & Din, 1950) indicate that family
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childhood is even more prevalent in the Far East. For example, in Indian
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and Chinese families, as many as three out of four family members may have
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childhood.
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Impressive evidence of a genetic component of childhood comes from a
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large-scale twin study by Brady and Partridge (1972). These authors
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studied over 106 pairs of twins, looking at concordance rates for
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childhood. Among identical or monozygotic twins, concordance was unusually
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high (0.92), i.e., when one twin was diagnosed with childhood, the other
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twin was almost always a child as well.
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Psychological Models
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A considerable number of psychologically-based theories of the
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development of childhood exist. They are too numerous to review here.
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Among the more familiar models are Seligman's "learned childishness" model.
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According to this model, individuals who are treated like children
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eventually give up and become children. As a counterpoint to such
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theories, some experts have claimed that childhood does not really exist.
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Szasz (1980) has called "childhood" an expedient label. In seeking
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conformity, we handicap those whom we find unruly or too short to deal with
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by labelling them "children."
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Treatment of Childhood
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Efforts to treat childhood are as old as the syndrome itself. Only in
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modern times, however, have humane and systematic treatment protocols been
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applied. In part, this increased attention to the problem may be due to
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the sheer number of individuals suffering from childhood. Government
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statistics (DHHS) reveal that there are more children alive today than at
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any time in our history. To paraphrase P.T. Barnum: "There's a child born
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every minute."
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The overwhelming number of children has made government intervention
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inevitable. The nineteenth century saw the institution of what remains the
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largest single program for the treatment of childhood -- so-called "public
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schools." Under this colossal program, individuals are placed into
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treatment groups based on the severity of their condition. For example,
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those most severely afflicted may be placed in a "kindergarten" program.
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Patients at this level are typically short, unruly, emotionally immature,
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and intellectually deficient. Given this type of individual, therapy is
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essentially one of patient management and of helping the child master basic
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skills (e.g. finger-painting).
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Unfortunately, the "school" system has been largely ineffective. Not
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only is the program a massive tax burden, but it has failed even to slow
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down the rising incidence of childhood.
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Faced with this failure and the growing epidemic of childhood, mental
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health professionals are devoting increasing attention to the treatment of
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childhood. Given a theoretical framework by Freud's landmark treatises on
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childhood, child psychiatrists and psychologists claimed great successes in
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their clinical interventions.
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By the 1950's, however, the clinicians' optimism had waned. Even
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after years of costly analysis, many victims remained children. The
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following case (taken from Gumbie & Poke, 1957) is typical.
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Billy J., age 8, was brought to treatment by his
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parents. Billy's affliction was painfully obvious. He
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stood only 4'3" high and weighed a scant 70 lbs.,
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despite the fact that he ate voraciously. Billy
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presented a variety of troubling symptoms. His voice
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was noticeably high for a man. He displayed legume
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anorexia, and, according to his parents, often refused
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to bathe. His intellectual functioning was also below
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normal -- he had little general knowledge and could
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barely write a structured sentence. Social skills were
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also deficient. He often spoke inappropriately and
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exhibited "whining behaviour." His sexual experience
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was non-existent. Indeed, Billy considered women
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"icky." His parents reported that his condition had been
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present from birth, improving gradually after he was
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placed in a school at age 5. The diagnosis was
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"primary childhood." After years of painstaking
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treatment, Billy improved gradually. At age 11, his
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height and weight have increased, his social skills are
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broader, and he is now functional enough to hold down a
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"paper route."
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After years of this kind of frustration, startling new evidence has
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come to light which suggests that the prognosis in cases of childhood may
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not be all gloom. A critical review by Fudd (1972) noted that studies of
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the childhood syndrome tend to lack careful follow-up. Acting on this
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observation, Moe, Larrie, and Kirly (1974) began a large-scale longitudinal
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study. These investigators studied two groups. The first group consisted
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of 34 children currently engaged in a long-term conventional treatment
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program. The second was a group of 42 children receiving no treatment.
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All subjects had been diagnosed as children at least 4 years previously,
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with a mean duration of childhood of 6.4 years.
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At the end of one year, the results confirmed the clinical wisdom that
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childhood is a refractory disorder -- virtually all symptoms persisted and
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the treatment group was only slightly better off than the controls.
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The results, however, of a careful 10-year follow-up were startling.
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The investigators (Moe, Larrie, Kirly , & Shemp, 1984) assessed the
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original cohort on a variety of measures. General knowledge and emotional
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maturity were assessed with standard measures. Height was assessed by the
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"metric system" (see Ruler, 1923), and legume appetite by the Vegetable
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Appetite Test (VAT) designed by Popeye (1968). Moe et al. found that subjects
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improved uniformly on all measures. Indeed, in most cases, the subjects
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appeared to be symptom-free. Moe et al. report a spontaneous remission rate
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of 95%, a finding which is certain to revolutionize the clinical approach to
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childhood.
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These recent results suggests that the prognosis for victims of
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childhood may not be so bad as we have feared. We must not, however,
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become too complacent. Despite its apparently high spontaneous remission
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rate, childhood remains one of the most serious and rapidly growing
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disorders facing mental health professional today. And, beyond the
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psychological pain it brings, childhood has recently been linked to a
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number of physical disorders. Twenty years ago, Howdi, Doodi, and Beauzeau
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(1965) demonstrated a six-fold increased risk of chicken pox, measles, and
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mumps among children as compared with normal controls. Later, Barby and Kenn
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(1971) linked childhood to an elevated risk of accidents -- compared with
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normal adults, victims of childhood were much
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more likely to scrape their knees, lose their teeth, and fall off their
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bikes.
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Clearly, much more research is needed before we can give any real hope
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to the millions of victims wracked by this insidious disorder.
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REFERENCES
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American Psychiatric Association (1990). The diagnostic and statistical
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manual of mental disorders, 4th edition: A preliminary report.
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Washington, D.C.; APA.
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Barby, B., & Kenn, K. (1971). The plasticity of behaviour. In B. Barby &
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K. Kenn (Eds.), Psychotherapies R Us. Detroit: Ronco press.
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Brady, C., & Partridge, S. (1972). My dads bigger than your dad. Acta
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Eur. Age, 9, 123-126.
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Flintstone, F., & Jetson, G. (1939). Cognitive mediation of labour
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disputes. Industrial Psychology Today, 2, 23-35.
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Fudd, E.J. (1972). Locus of control and shoe-size. Journal of Footwear
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Psychology, 78, 345-356.
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Gumbie, G., & Pokey, P. (1957). A cognitive theory of iron-smelting.
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Journal of Abnormal Metallurgy, 45, 235-239.
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Howdi, C., Doodi, C., & Beauzeau, C. (1965). Western civilization: A
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review of the literature. Reader's digest, 60, 23-25.
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Moe, R., Larrie, T., & Kirly, Q. (1974). State childhood vs. trait
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childhood. TV guide, May 12-19, 1-3.
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Moe, R., Larrie, T., Kirly, Q., & Shemp, C. (1984). Spontaneous remission
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of childhood. In W.C. Fields (Ed.), New hope for children and
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animals. Hollywood: Acme Press.
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Popeye, T.S.M. (1957). The use of spinach in extreme circumstances.
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Journal of Vegetable Science, 58, 530-538.
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Popeye, T.S.M. (1968). Spinach: A phenomenological perspective.
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Existential botany, 35, 908-813.
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Rogers, F. (1979). Becoming my neighbour. New York:Soft press.
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Ruler, Y. (1923). Assessing measurements protocols by the multi-method
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multiple regression index for the psychometric analysis of factorial
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interaction. Annals of Boredom, 67, 1190-1260.
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Spanky, D., & Alfalfa, Q. (1978). Coping with puberty. Sears catalogue,
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45-46.
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Suess, D.R. (1983). A psychometric analysis of green eggs with and without
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ham. Journal of clinical cuisine, 245, 567-578.
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Temple-Black, S. (1982). Childhood: an ever-so sad disorder. Journal of
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precocity, 3, 129-134.
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Tom, C., & Jerry, M. (1967). Human behaviour as a model for understanding
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the rat. In M. de Sade (Ed.). The rewards of Punishment.
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Paris:Bench press.
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FURTHER READINGS
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Christ, J.H. (1980). Grandiosity in children. Journal of applied
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theology, 1, 1-1000.
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Joe, G.I. (1965). Aggressive fantasy as wish fulfilment. Archives of
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General MacArthur, 5, 23-45.
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Leary, T. (1969). Pharmacotherapy for childhood. Annals of astrological
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Science, 67, 456-459.
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Kissoff, K.G.B. (1975). Extinction of learnt behaviour. Paper presented
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to the Siberian Psychological Association, 38th annual Annual meeting,
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Kamchatka.
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Smythe, C., & Barnes, T. (1979). Behaviour therapy prevents tooth decay.
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Journal of behavioral Orthodontics, 5, 79-89.
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Potash, S., & Hoser, B. (1980). A failure to replicate the results of
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Smythe and Barnes. Journal of dental psychiatry, 34, 678-680.
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Smythe, C., & Barnes, T. (1980). Your study was poorly done: A reply to
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Potash and Hoser. Annual review of Aquatic psychiatry, 10, 123-156.
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Potash, S., & Hoser, B. (1981). Your mother wears army boots: A further
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reply to Smythe and Barnes. Archives of invective research, 56, 5-9.
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Smythe, C., & Barnes, T. (1982). Embarrassing moments in the sex lives of
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Potash and Hoser: A further reply. National Enquirer, May 16.
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***
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--
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Edited by Brad Templeton. MAIL your jokes (jokes ONLY) to funny@looking.ON.CA
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Attribute the joke's source if at all possible. A Daemon will auto-reply.
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Jokes posted instead of mailed often don't have a valid reply address.
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