4 - Children in danger

Summary

A conceptual framework

Traditionally in medicine, knowledge about harmful agents arises within the context of an accepted scheme for classifying disorders. For most diseases a single harmful agent, e.g. a virus, bacterium, or toxin, has been identified. This agent is usually necessary for the condition to occur, though actual appearance of the condition will depend on a host of other factors as well. Nonetheless, consideration of prevention and treatment focuses especially on the specific agent responsible. This model of causation has its limitations, but it has proved valuable and has produced clinical advances.

Classification of childhood behaviour and emotional problems is now more widely agreed upon than was previously the case. There are two rather similar major schemes for classification: the International classification of diseases, 9th edition (ICD-9) and the Diagnostic and statistical manual of mental disorders, 3rd edition (DSM-III). Both recognize the importance of considering separately a number of types of disorder in children – namely (in the case of ICD-9), mental disorders, intellectual and learning deficits, developmental delays, physical disabilities, and psychosocial disadvantages. Unfortunately, classification of child mental disorders does not usually lead to any clear-cut implications for causation, prevention, or treatment. The major types of problem behaviour in children (preschool management problems, emotional disorders, antisocial behaviour, psychoses, etc) do not have any single aetiology, and causation needs to be considered in a more complex manner, for a number of reasons:

1. Known causative influences are not specific to particular disorders. For example, parental attitudes are likely to be of importance in a variety of conditions.

2. […]