Back to Blaming Parents?

Abstract

I was distressed to see the understanding and management of children with behavior and/or learning problems set back 20 years by Dr James S. Miller's article (Pediatrics 61:217, 1978). The unifying concept of minimal brain dysfunction arose in the 1950s for three main reasons: (1) many children seen clinically for family, school, and/or peer problems showed a mixture of both hyperactivity and learning disability in a wide range from mild to severe1-3; (2) most of these children, as Dr Miller states, had no history even suggestive of brain damage4; and (3) most of these children were treated as though their hyperactivity and cognitive deficits were caused entirely by interpersonal, family relationships, thus reinforcing parental guilt and making psychotherapy for the parents and child the usual treatment of choice without consideration of other causes and treatments.5