ABSTRACT
Epidemiological, service utilization, educational, judiciary, and other types of data document the large and increasing numbers of children whose lives are burdened by developmental and psychiatric difficulties. They are found in every type of family and community context, in every social class, and among all ethnic groups. There are, however, some groups that are at particular risk, where multiple factors combine to make children and adolescents particularly vulnerable. Thus, at this moment, mental health clinicians are particularly aware of the cumulative trauma of multigenerational adversity and poverty in the inner city, the problems of the rural poor and of recent immigrants, the strains posed by homelessness and family breakup, and the impact of various toxins and infections (including HIV/AIDS, cocaine, alcohol, tobacco) on the development of children (National Commission on Children, 1991). As risk factors accumulate, the probability of disorders increases.
