AN EVALUATION OF THE TREATMENT OF PROBLEM CHILDREN AS DETERMINED BY A FOLLOW-UP STUDY
Howard W. Potter M. D.1, and
Henriette R. Klein M. D.1
1 New York, N. Y.
To recapitulate, this is a report of the outcome of 175 problem children whose maladjustment in the majority of instances was so severe that it necessitated hospitalization. No case included in this report had been out of the hospital for less than one year; well over half of the patients had been out three years or more. So far as the treatment accorded is concerned, it may be said that it was widely conceived and was both extensive and intensive except for those 64 cases belonging to the Organic reaction group. There were 64 cases in the organic reaction group; ten of these were making a satisfactory social adjustment at the time of the follow-up contact. We wish to state, however, that for administrative reasons, we found it inadvisable to attempt a long term treatment of these cases. More adequate treatment might have resulted in a larger number of social recoveries.
The results in the situational reaction group (conduct disorders, personality and habit problems and psychoneuroses) were gratifying, as 55 out of a total of 97 were making a good social adjustment when the follow-up contact was made. The percentage of children making a satisfactory social adjustment was definitely higher in the psychoneurotic group. It is our impression that children who have superior intelligence, who are in the prepubertal years (10 to 13), who show a definite response to treatment during the first six months, and whose parents, although having faulty attitudes, are free from well defined neurosis or psychosis, have the better prognosis.
The outcome of the schizophrenic reaction group is exceedingly poor; only 1 out of 14 has made an at all satisfactory readjustment; the remainder became progressively worse. This certainly emphasizes the constitutional inadequacy factor, whatever it may be, in those cases which we call schizophrenia in children.
