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The conception of the "developmental approach" of the book's title is used in several ways. One use is in making connections between symptomatic behavior and the successive developmental phases, as in the chapter on sleep disturbances and the chapter on children's reaction to hospitalization. A second use is in the study of a particular phase of development, such as the chapter on the female adolescent and the one on autoerotic actions and ego development. Another use, in comparison of children and adults, appears the simplest, but is sometimes the source of challenging questions, as in the chapter on insight and the chapter on reactions to the death of important objects. Here, use of the developmental approach yields two questions: "At what developmental phase is insight possible?" and "At what developmental phase is mourning possible?"
Nagera sometimes goes outside psychoanalysis to support his conceptions of development. He gives special attention to brain maturation not being achieved until age two to support his belief that day-care arrangements are potentially harmful to infants. There is a valuable twelve-page section on "Brain Development" in the chapter "Day Care Centers," where he reviews the psychological implications of neurological development. The same point is made more briefly in Chapter 2, "The Normal Child," and Chapter 4, "Vulnerability and Stimulation in Early Life." Then, in Chapter 5, "Self and Object," he turns to Piaget's sensorimotor stages of development to support the conception that "genuine" object relations do not develop until the permanent object (in Piaget's sense) is achieved.
The "childhood psychopathology" part of the book's title applies only in the most general sense. Seven of the chapters are on clinical topics: "Sleep Disturbances," "The Imaginary Companion," "Children's Reactions to the Death of Important Objects," Children's Reactions to Hospitalization and Illness," "Day Care Centers" and "The Primary Caretaker Sep