Fw: The Etiology of Childhood

H. C. Covington (ach1@sprynet.com)
Sat, 27 Dec 1997 17:27:05 -0600


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 onself-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 indefinitely.
This observation has led some investigators to speculate on a biological
contribution to childhood. As one psychologist has put it, we may soon be
in a position to distinguish organic childhood from functional childhood
(Rogers, 1979).

DWARFISM

This is certainly the most familiar marker of childhood. It is widely known
that children are physically short relative to the population at large.
Indeed, common clinical wisdom suggests that the treatment of the so-called
small child (or tot) is particularly difficult. These children are known to
exhibit infantile behavior and display a startling lack of insight (Tom and
Jerry, 1967).

EMOTIONAL LABILITY AND IMMATURITY

This aspect of childhood is often the only basis for a clinicians
diagnosis. As a result, many otherwise normal adults are misdiagnosed as
children and must suffer the unnecessary social stigma of being labelled a
child by professionals and friends alike.

KNOWLEDGE DEFICITS

While many children have IQs with or even above the norm, almost all will
manifest knowledge deficits Anyone who has known a real child has
experienced the frustration of trying to discuss any topic that requires
some general knowledge. Children seem to have little knowledge about the
world they live in. Politics, art, and science children are largely
ignorant of these. Perhaps it is because of this ignorance, but the sad
fact is that most children have few friends who are not,themselves,
children.

LEGUME ANOREXIA

This last identifying feature is perhaps the most unexpected. Folk wisdom
is supported by empirical observation children will rarely eat their
vegetables (see Popeye, 1957, for review).

Causes of Childhood

Now that we know what it is, what can we say about the causes of childhood?
Recent years have seen a flurry of theory and speculation from a number of
perspectives. Some of the most prominent are reviewed below. Sociological
Model Emile Durkind was perhaps the first to speculate about sociological
causes of childhood. He points out two key observations about children:
1) the vast majority of children are unemployed, and
2) children represent one of the least educated segments of our society.

In fact, it has been estimated that less than 20% of children have had more
than fourth grade education. Clearly, children are an out-group. Because of
their intellectual handicap, children are even denied the right to vote.
>From the sociologists perspective, treatment should be aimed at helpin
gassimilate children into mainstream society. Unfortunately, some victims
are so incapacitated by their childhood that they are simply not competent
to work. One promising rehabilitation program (Spanky and Alfalfa, 1978)
has trained victims of severe childhood to sell lemonade.

Biological Model

The observation that childhood is usually present from birth has led some
to speculate on a biological contribution. An early investigation by
Flintstone and Jetson (1939) indicated that childhood runs in
families.Their survey of over 8,000 American families revealed that over
half contained more than one child. Further investigation revealed that
even most non-child family members had experienced childhood at some
point.Cross-cultural studies (e.g., Mowgli & Din, 1950) indicate that
family childhood is even more prevalent in the Far East. For example, in
Indian and Chinese families, as many as three out of four family members
may have childhood. Impressive evidence of a genetic component of childhood
comes from a large-scale twin study by Brady and Partridge (1972). These
authors studied over 106 pairs of twins, looking at concordance rates for
childhood. Among identical or monozygotic twins, concordance wa sunusually
high (0.92), i.e., when one twin was diagnosed with childhood, the other
twin was almost always a child as well.
-------------------------------------------------