Symptom evaluation and treatment selection in the latency-aged child.

Most latency children referred to the non-psychiatric physician with behaviour disorders do not suffer from classical neuroses, brain syndrome, retardation or psychoses. In evaluating the significance of disturbance two questions must be answered. I. Does the child have significant symptoms? This requires assessment of parental objectivity, knowledge of normal development, familiarity with developmental tasks of the period and ability to draw conclusions from observations of the child. II. How disturbed is the child? Here the basic questions are: 1. To what extent are the difficulties reactive to current stress rather than internalized? 2. How serious are the symptoms themselves? Criteria for answering these questions are provided. Comments are made on history-taking and a guide to the clinical examination is presented, together with findings indicating whether the disturbance is mild or serious. Principles for rational intervention are discussed and various treatment options are examined. Methods relatively economical of the physician's time are indicated unless clear reasons for more intensive treatment are present. If very definite improvement has not taken place within six months, psychiatric consultation should be sought.