'Emotional abuse' referrals to a Scottish children's panel reporter over five years.
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Biomedical subjects
Publications and source records attributed to P V Dutton.
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Twenty-nine children, consecutively referred to paediatricians following prolonged histories of toddler's diarrhoea and diverse behaviour difficulties, were offered treatment that comprised counselling of parental anxiety towards alleviation of environmental stress and training and support for parents in consistent and effective management of child behaviour. Twenty-one subjects (72%) completed treatment, 20 of whom reached criterion cure of diarrhoea in a mean of 2.19 months; the remaining child also showed marked decreased frequency of diarrhoea. Maternal ratings of children's behaviour before and after treatment indicated significant improvement; observations by clinicians of child behaviour and parent/child interaction concurred. Improvement in both diarrhoea and behaviour was maintained upon reassessment after a further 6 months. This effective treatment method, combined with conclusions from previous investigations suggest a 'psychosomatic' model for the aetiology of toddler's diarrhoea whereby complex environmental influences on the child are mediated through physical processes.
Seventeen children with toddler's diarrhoea showed significantly higher incidence of environmental and biographical indicators of personal or familial stress than a matched group with other physical disorders. An association is suggested between environmental influences and the aetiology and maintenance of toddler's diarrhoea.
From biographical and behavioural data, four clinicians independently rated the degree of stress as either due to general environmental influences or induced by family relationships likely to act upon two groups of children--one with toddler's diarrhoea and a matched control group with other physical disorders. Each clinician rated the experimental group significantly higher on both scales of stress than the control group; inter-rater correlation was positive and significant. The results suggest that environmental stress influences are associated with the aetiology and maintenance of toddler's diarrhoea, and imply that modification of such stress is relevant to treatment of the condition.
Growing evidence suggests that environmental influences are relevant to the aetiology, maintenance and treatment of the common complaint of toddler's diarrhoea. Two presented cases demonstrate systematic fluctuations in frequency of diarrhoea by individual subjects, concurrent with changes of environment.