Piaget's concepts of cognitive stages provide a useful framework for the evaluation of cognitive organization of severely disturbed children. This cognitive developmental perspective complements the psychosexual developmental sequence and the traditional emphasis on the underlying emotional dynamics. A combined use of these frameworks helps to formulate various ways of dealing with behavioral deviations, whether they originate in the child, the family, the teacher, or the school situation. The consulting child psychiatrist serves to synthesize the several perspectives in order to help the teacher develop teaching strategies and tactics consistent with the child's cognitive competence.