The emotional and social development of girlswith heart disease

Abstract

Summary For the past fifteen years we have had an opportunity to study a large group of girls with rheumatic heart disease. In addition to the physical problems arising from their cardiac disease, the emotional and social development of these children offers an interesting field for study. A group of 21 girls, who at the present time range between twelve andeighteen years of age, were selected for study. The age of discovery of the heart disease varied from two to ten years, with an average age of seven and one-half years. All of these children had a residential period at the Theresa Grotto Residential School for Cardiac Children at Caldwell, N. J. The average length of this residential period was fourteen months. The average age on admission to the cardiac home was eight and one-half years. The average age of the 21 children in the group studied at the time of the final study was fifteen and one-half years. Complete social service and psychiatric studies were made on all of these children on admission. These preliminary studies to which were added complete long-time observation and control, which included physical, economic, and psychiatric details, furnished the background for the present study. The time interval between the preliminary studies and a final survey varied from two to eleven years. Two methods of obtaining the data were utilized. The first was a critical study of all the material in the files over the entire period during which the child had been under observation, checked and correlated with a final psychiatric study by the interview method on each child. These studies were felt to be of particular value as these children had been under the personal control and medical supervision of the observer for periods ranging from three to fifteen years. The second method utilized was the testing of the entire group by the “Bell Adjustment Inventory” and the “Thurstone Personality Schedule.” These objective tests gave ratings that corresponded very well withthe ratings given by the first method, and may be summarized in the following conclusions: 1. Although the child from a very early age has knowledge of the disability and the limitations which it imposes, in some instances even greater than the limitations imposed by visible physical deformities, it has been our observation that the presence of these handicaps has not caused any marked deviation from the standards of ordinary conduct or any disturbance in the development of normal social relationships. 2. That one of the important factors in the development of emotional and social difficulties in these children has been the sense of guilt of the parents. 3. That another major factor in the development of these difficultieshas been the attitude of overprotectiveness in the home based on the fear of the cardiac disease. 4. The utilization of a residential school for cardiac children offers anopportunity for the establishment of a successful mental hygiene program and leads to the disappearance in most of these children of undesirable mechanisms established in the home.