The Referral of Nursery School Children for Treatment

In these accounts of three very different children, who were referred for treatment, I have described the gradual process of assessment that took place in our nursery school. In each case we were concerned from early on about their development and unfavorable environmental backgrounds; but the actual decision to refer these children for treatment in the Clinic was not reached until after a year or more of continuous observation.

All three children were seen for formal diagnostic assessment in the Clinic following our referral. Valerie's and Jessica's disturbances were considered to be of a transitory nature and classed as by-products of developmental and environmental strain. both children were seen to be in danger of developing permanent drive regressions to established fixation points, which would lead to conflicts of a neurotic type. As such, our referral for psychoanalytic treatment secured for these two children an essentially preventative intervention. In Romela's case, however, as we had anticipated, psychoanalysis was thought necessary for the treatment of a more established disturbance. At the diagnostic conference, there was general agreement that Romela was suffering from primary deficiencies arising primarily from early deprivations which were distorting development and structuralization and producing a nontypical personality.