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Theo is an aggressive and anxious little boy. He appears to be having difficulty in moving into the next appropriate stage of development. The Profile will highlight the factors that have contributed to this picture and consider what help we might offer.
The family's general practitioner sought our help for Theo when the child was 3 years 7 months. The boy's mother had turned to her doctor following a complaint from Theo's nursery school that he was aggressive and difficult and they doubted whether they could keep him.
Theo and Mrs P were offered an immediate appointment in our Well-Baby Clinic as it wasevident that the family was in a crisis; indeed, Theo had been excluded from the nursery the day before our preliminary consultation.
In the Well-Baby Clinic we were concerned over Theo's indiscriminate, restless, rough, potentially aggressive behaviour. We noted his perseverative questioning and short attention-span. His mother was distressed, described him as unmanageable and said that her husband was also aggressive and difficult. She was relieved when we said that Theo needed further assessment, and could listen when we advised her not to seek another nursery placement until we were clearer about his needs.
Theo is a sturdy, strongly built child, in danger of becoming overweight. He was appropriately dressed on all visits to the Centre: corduroys or jeans and checked shirt. His clothes looked serviceably tough and boyish. He has dark eyes and dark wavy hair down to his collar. When he smiles he is appealing, but often he looks angrily troubled or blankly belligerent. The impression is of a child who expects unpleasantness and is ready to do battle.
Theo is observant and has a good memory, and his use of language is well developed. His endless and repetitive questioning is anxiety-driven and conveys vividly his lack of a feeling of safety. The