ROUND TABLE DISCUSSION

Chairman Gesell: Custom has it that the Chairman should launch the discussion with an introductory statement. I shall be brief because behavior problems are numerous enough. Besides we propose to divide this session into two parts. At the end of the first half, Dr. Amatruda, who has had an incomparably rich experience with all sorts of infants and children, will make a statement introducing the subject of developmental defects and deviations, Although we shall touch upon a wide variety of problems during the morning, we shall probably not wander very far from the central theme of growth and development. All children, whether normal, subnormal, atypical, or superior are confronted with the universal problem of development—of growing up. The most serious behavior problems are those which interfere with optimal development, taking as a base line the natural growth potentials of the child. Many problems may seem serious and may be very troublesome, without greatly harming the child's fundamental welfare. The degree of troublesomeness often depends upon the attitude of the parents. This business of growing up applies to the parent as well as the child. She (or he!) may not take a mature grown-up attitude toward the child's conduct. The problem is thereby aggravated or even created. Change the attitude and the problem evaporates—disappears in thin air. In our discussion we shall have to reckon with the parent-child relationship as a clinical reality, as a bundle of symptoms which register the actual state of affairs. Problems cannot always be solved by direct frontal attack. They must be approached peripherally via the parents' psychology. The most magic cures which the pediatrician can effect in the field of behavior disorders may be achieved by altering the parents' philosophy. Every parent has a philosophy of child care. It may not be formulated in words, but it expresses itself in actions, attitudes, in alibis, in questions, in misgivings, in protests. Even before the child is born the expectant mother may reveal her general outlook, and may profit from a hint or two by way of psychologic orientation to the tasks of parenthood which lie ahead. In fact, this Round Table might give brief consideration to the possibility of prenatal guidance in the primipara, assuming the aid and acquiescence of the obstetrician.