The Problem of the Preschool Child: Section Meeting, 1941. Amer. J. of Orthopsychiatry, XII, 1942, pp. 42–68.

Four well-known child psychiatrists meet in this symposium to express their views on treatment problems in children of the youngest age group. Dr. Hyman Lippman opens the discussion with a paper on Treatment of the Young Child in the Child Guidance Clinic. The author reports his observations on fifty children referred from the preschool clinic of a family agency for aggressive behavior and a variety of neurotic symptoms. He believes that aggression and passivity are in part determined by heredity and in part depend upon environmental factors. Aggression is either normal and healthy or else a weapon which the child uses against frustrating rejecting parents. In the first case, direct expression must be curbed so that the child will be socialized when he enters school. In the second case, the aggression should not be restricted unless the family neurosis changes, because it may be the child's only outlet in an unbearable situation. Combinations of open aggression with anxiety are more frequent in the preschool child than is the typical picture of inhibition and passivity seen in older children and adults whose hostilities are firmly restrained by a punitive superego. In respect to treatment, the author recommends early removal from the home when the parents are feebleminded or delinquent or when neurotic parents fail to improve under case work. He favors foster home placement or adoption, provided the personalities of the new parents are rigidly investigated. More help and psychiatric care for the pregnant neurotic woman may lessen her early resentment of the child, thus giving him a better start in life. Lastly, superficial therapy for the disturbed mother, including lightening her responsibilities, day-nursery care for the child, housekeeping service, and financial help, often produces more benefit than one would expect. Such treatment does not cure the parent's basic neurosis but improves her handling of her child. Dr. Lippman emphasizes the need for e