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Anxiety in children
98
BOOK REVIEWS
V. P. VARMA (Ed.): Anxief,v in Children. Croom Heim, London (1984). 222 Pages. f 14.95. This book contains 12 chapters concerned mostly with the analysis. from wide& differing perspectives and in different situations, of anxiety and fears in children. Only ane chapter, written by Martin Herbert from a behavioural standpoint. tackles treatment of these problems in any extensive and systematic way. The topics include: anxiety about spiritual issues. written by a priest; anxiety about death and illness and its treatment; anxiety about school and learning; family influences on anxiety; and three chapters on investigation by psychometric tests, interview and projective techniques. Many of the contributions appear to be informed principally by clinica! wisdom and in many cases this appears to have been derived second hand, several of the chapters drawing extensively on other authors’ reviews. especially of a psychodynamic nature. Those chapters which could have drawn an extensive empirical research on the treatment of childen’s anxieties are particularly disappointing because they almost entirely ignore such work. The chapters on anxiety about illness and its treatment and about school and learning are particularly disappointing in this respect. This book could be regarded as a source of interesting hypotheses and speculation about childhood anxiety but for more reliable material, especially about the treatment of these problems, there are more helpful books currently in print.
D. J. MULLER (Ed.): Remediaring Children’s Lmguage. Croom Helm, London (1984). 256 Pages. E16.95. Language is a behaviour which finds expression through the workings of voluntary muscles. As such it was exposed to functional an&is by Skinner about 30 years ago. Chomsky’s subsequent attempt to discount this approach, in bvour of a mentaXistic and rationalistic model, met with considerable support, and his views have been widely accepted. This book advocates a revival of the use of Skinner’s operant techniques to rehabilitate early language disorders, and proposes that the child’s familiar daily environment provides the optimal setting for treatment. It is edited by Dave Muller, a psychologist specializing in remediating language, and is divided into three main sections. In the first, language is discussed as a voluntary behaviour which obeys conditioning laws, The second and most readable chapter is written by D. F. Mowrer, and he succeeds in lucidiy condensing complex issues relating to the behavioural model. He then reviews recent work on the application of these methods to the treatment of Ianguage disorders, with an emphasis on educationaf context. The role of social and cultural facsors in speech development is addressed in Chapter 3, and current research in pragmatics, exploring speech as an interactive tool, is presented. While Section 1 orobes the theoretical foundations, Section 2 is devoted to their therapeutic applica6ons. Of particular interest to therapisis and clinicians is the step-by-step guidance through the “Lincoln interact&e Profile”, a means for individual assessment of children either exhibiting, or at risk for. developing a communication disorder. This technique has the advantage of reducing the traditional narrative nature of assessments in favour of objective quantification by one or more clinicians, and lends itself to computerized storage. The importance of the mother or primary caregiver is emphasized, and the screening procedure is centred around the interactive dyad. The relationship between caregiver and child is further explored in a therapeutic context by the next two chapters. Parents are considered as important collaborators in therapy, in the light of their current interaction with the child, and as helpers in treatment. Although improvement of speech is the appropriate goal for much therapy, in some cases dysarthric, dyspraxic or autistic children may benefit more from the introduction of non-speech systems as communication enhancers. Such supplementary systems as picture-boards, cued-speech and various sign languages are briefly defined, and guides for their implementation are set out. In the t’inaf section, four remedial fanguage programmes applicable to the severely mentalfy handicapped are critically evafuated. The Makaton programme, based on British sign language, receives special attention due to its widespread use in the U.K. In the concluding chapter, John Harris supports the case for parental involvement in therapy directed towards facilitating development. He sums up the whole orientation of the book by stating: “The problem for the language clinician is thus not simply one of playing a better game within the established rutes. Instead, it is the more difficult problem of persuading the other players of the need to change the rules.‘” GENA
H.
CO~JNALLY
Transient psychosis is a concept embodying widely disparate elements, including ‘micropsychotic episodes’ lasting, perhaps, a few hours and ‘acute exacerbations of schizophrenia and mania’. In attempting to produce a concise account of the subject, the editors must therefore be credited with great courage. To the proMem of definition must be added the difficulty that as an episode of psychosis can only be described as transient once it is over, the diagnosis of transient psychosis can never be made in a patient actually suffering from it. Lastly, the book addresses itself lo the group of patients known as ‘borderline’ and admits that about this group there is ‘conceptual, diagnostic, etiofogical, therapeutic and prognostic confusion’. The authors do littfe to improve this sorry state of affairs. it may reasonably be supposed, therefore, that the
BOOK REVIEWS
V. P. VARMA (Ed.): Anxief,v in Children. Croom Heim, London (1984). 222 Pages. f 14.95. This book contains 12 chapters concerned mostly with the analysis. from wide& differing perspectives and in different situations, of anxiety and fears in children. Only ane chapter, written by Martin Herbert from a behavioural standpoint. tackles treatment of these problems in any extensive and systematic way. The topics include: anxiety about spiritual issues. written by a priest; anxiety about death and illness and its treatment; anxiety about school and learning; family influences on anxiety; and three chapters on investigation by psychometric tests, interview and projective techniques. Many of the contributions appear to be informed principally by clinica! wisdom and in many cases this appears to have been derived second hand, several of the chapters drawing extensively on other authors’ reviews. especially of a psychodynamic nature. Those chapters which could have drawn an extensive empirical research on the treatment of childen’s anxieties are particularly disappointing because they almost entirely ignore such work. The chapters on anxiety about illness and its treatment and about school and learning are particularly disappointing in this respect. This book could be regarded as a source of interesting hypotheses and speculation about childhood anxiety but for more reliable material, especially about the treatment of these problems, there are more helpful books currently in print.
D. J. MULLER (Ed.): Remediaring Children’s Lmguage. Croom Helm, London (1984). 256 Pages. E16.95. Language is a behaviour which finds expression through the workings of voluntary muscles. As such it was exposed to functional an&is by Skinner about 30 years ago. Chomsky’s subsequent attempt to discount this approach, in bvour of a mentaXistic and rationalistic model, met with considerable support, and his views have been widely accepted. This book advocates a revival of the use of Skinner’s operant techniques to rehabilitate early language disorders, and proposes that the child’s familiar daily environment provides the optimal setting for treatment. It is edited by Dave Muller, a psychologist specializing in remediating language, and is divided into three main sections. In the first, language is discussed as a voluntary behaviour which obeys conditioning laws, The second and most readable chapter is written by D. F. Mowrer, and he succeeds in lucidiy condensing complex issues relating to the behavioural model. He then reviews recent work on the application of these methods to the treatment of Ianguage disorders, with an emphasis on educationaf context. The role of social and cultural facsors in speech development is addressed in Chapter 3, and current research in pragmatics, exploring speech as an interactive tool, is presented. While Section 1 orobes the theoretical foundations, Section 2 is devoted to their therapeutic applica6ons. Of particular interest to therapisis and clinicians is the step-by-step guidance through the “Lincoln interact&e Profile”, a means for individual assessment of children either exhibiting, or at risk for. developing a communication disorder. This technique has the advantage of reducing the traditional narrative nature of assessments in favour of objective quantification by one or more clinicians, and lends itself to computerized storage. The importance of the mother or primary caregiver is emphasized, and the screening procedure is centred around the interactive dyad. The relationship between caregiver and child is further explored in a therapeutic context by the next two chapters. Parents are considered as important collaborators in therapy, in the light of their current interaction with the child, and as helpers in treatment. Although improvement of speech is the appropriate goal for much therapy, in some cases dysarthric, dyspraxic or autistic children may benefit more from the introduction of non-speech systems as communication enhancers. Such supplementary systems as picture-boards, cued-speech and various sign languages are briefly defined, and guides for their implementation are set out. In the t’inaf section, four remedial fanguage programmes applicable to the severely mentalfy handicapped are critically evafuated. The Makaton programme, based on British sign language, receives special attention due to its widespread use in the U.K. In the concluding chapter, John Harris supports the case for parental involvement in therapy directed towards facilitating development. He sums up the whole orientation of the book by stating: “The problem for the language clinician is thus not simply one of playing a better game within the established rutes. Instead, it is the more difficult problem of persuading the other players of the need to change the rules.‘” GENA
H.
CO~JNALLY
Transient psychosis is a concept embodying widely disparate elements, including ‘micropsychotic episodes’ lasting, perhaps, a few hours and ‘acute exacerbations of schizophrenia and mania’. In attempting to produce a concise account of the subject, the editors must therefore be credited with great courage. To the proMem of definition must be added the difficulty that as an episode of psychosis can only be described as transient once it is over, the diagnosis of transient psychosis can never be made in a patient actually suffering from it. Lastly, the book addresses itself lo the group of patients known as ‘borderline’ and admits that about this group there is ‘conceptual, diagnostic, etiofogical, therapeutic and prognostic confusion’. The authors do littfe to improve this sorry state of affairs. it may reasonably be supposed, therefore, that the