ABSTRACT
Some thirty years ago, as a child psychiatrist working in a children’s hospital, he noticed that out of his first just over two hundred consecutively referred children, eleven had a particularly puzzling clinical picture. Many of their behavioural difficulties were exactly the same as those of other children attending the child psychiatry department, but the child’s life history and family circumstances did not, as they usually do, reveal the explanations for the disorders. Most psychiatrically disturbed children have suffered from traumatic life events or chronic social, family or educational adversity, often from both, and their parents are only too aware of what the causes of the trouble might be. In a very few children disturbed behaviour is clearly due to some organic brain impairment; but these eleven children were physically healthy and only a few of them had been exposed to adverse circumstances.
