Over the years, I have found it to be of clinical value to distinguish between two kinds of children whom I have seen either for evaluation or treatment. This division has helped me in a practical way to orient my thinking and my advice to parents as to the management of these two kinds of children. I have arbitrarily chosen to call one kind of a problem, “troubled child,” and the other, a disturbed child.

I see the troubled child as one who primarily has difficulty with his psychological environment; i.e., his relationships with people. The disturbed child, to me, is one who for varying reasons has his primary difficulty in being unable to perceive his physical environment as it really is; thus he reacts to the physical environment with his faulty perceptions, and so continually meets with frustration and anxiety.