Largo R H
Universitäts-Kinderklinik Zürich.
Monatsschr Kinderheilkd. 1993 Sep;141(9):698-703; quiz 704, 721.
Most developmental and behavioural disturbances paediatricians are faced with are not due to organic lesions of the central nervous system. They occur at a distinct age and are of limited duration, reflecting a strong maturational nature. The disturbances can be related to the following three factors. (1) Extreme behaviour within normal variability; the variant may consist of an extreme manifestation of a certain behaviour (e.g. excessive crying during the first 3 months of life) or of a maturational delay (e.g. primary nocturnal enuresis). (2) Lack of fit between child and environment (e. g. a child sleeps less than his/her parents expect). (3) Impaired psychic and/or somatic well-being of the child (e. g. following the loss of one parent). Since any one developmental and behavioural disturbances may be caused by different endogenous and exogenous factors, careful investigation is required to determine what appropriate educational, medical and social measures are appropriate.
儿科医生面临的大多数发育和行为障碍并非由中枢神经系统的器质性病变引起。它们发生在特定年龄，持续时间有限，反映出强烈的成熟特性。这些障碍可能与以下三个因素有关。（1）正常变异性范围内的极端行为；这种变异可能包括某种行为的极端表现（例如生命最初3个月内过度哭闹）或成熟延迟（例如原发性夜间遗尿症）。（2）儿童与环境不匹配（例如，儿童睡眠时间比父母期望的少）。（3）儿童心理和/或躯体健康受损（例如，父母一方去世后）。由于任何一种发育和行为障碍都可能由不同的内源性和外源性因素引起，因此需要进行仔细调查，以确定哪些适当的教育、医疗和社会措施是合适的。
