A number of the papers in the present issue have clinical implications related to the role of families in child development. The first paper by Rutter and his colleagues from the English and Romanian Adoptees study team concerns the impact of gross early privations on subsequent development. The adoption into English families of children from Romanian institutions constituted a most informative natural experiment because horrendous early experiences were followed by placement into rather better than average family circumstances. The paper documents the poor state of most children at the time of coming to the U.K. and the spectacular degree of cognitive, as well as physical, catch-up. The findings attest to the remarkable resilience shown by many individuals, even after quite extreme privation. However, they also show that recovery was not always complete, especially if the privation lasted beyond the early months of life. Because the privation in Romanian institutions was so severe and pervasive it proved difficult to isolate the key element leading to lasting deficits, but the pattern of findings suggests that psychological privations may have been more damaging than nutritional ones. The results highlight the need for clinicians to be alert to the sequelae of serious neglect, but also to be aware that provision of a good rearing environment in a supportive family can do much to alleviate the damage.

Involuntary wetting is one of the most common symptoms of childhood, affecting 10% of all 7-year-olds at night and 3% during the day (Hellström, Hanson, Hansson, Hjälmas, & Jodal, 1990). It comprises a heterogeneous group of disorders that differ regarding aetiology, pathophysiology, clinical symptoms, and therapy. Day wetting was last reviewed in the Journal of Child Psychology and Psychiatry in 1979 (Berg, 1979). In the past two decades a wealth of information on the pathophysiology of nocturnal enuresis, as well as of diurnal wetting, has been won. This annotation will review clinically relevant aspects of both forms of wetting and will concentrate on findings from paediatric urology, paediatric nephrology, genetics, endocrinology, child psychiatry, and epidemiology. Medical and technical terms are explained in the Glossary. Specific child psychological aspects will not be dealt with, as these have been excellently reviewed elsewhere, especially for nocturnal enuresis (Butler, 1987, 1994).

von Gontard's annotation (1998) on day- and night-wetting children takes a paediatric perspective on these prevalent and distressing conditions. This review addresses some of the major psychological issues relevant to nocturnal enuresis. Daytime wetting, which encapsulates a number of conditions each with separate aetiologies, distinct presentations, and specific treatment interventions, has been the focus of two recent reviews (Edens & Surwit, 1995; Robson, Leung, & Bloom, 1996) and will thus not be discussed in this annotation.

The extent of developmental deficit and catch-up following adoption after severe global early privation was examined at 4 years in a sample of 111 Romanian children who came to the U.K. before the age of 2 years, and compared with respect to their functioning at the same age to a sample of 52 U.K. adopted children placed before the age of 6 months. The measures at 4 years included height, head circumference, and general cognitive level (assessed on both the McCarthy and Denver Scales). The children from Romania were severely developmentally impaired at the time of U.K. entry, with about half below the third percentile on height, on weight, on head circumference, and on developmental quotient. Many were also in a poor physical state with recurrent intestinal and respiratory infections. The catch-up in both physical growth and cognitive level appeared nearly complete at 4 years for those children who came to the U.K. before the age of 6 months, despite the fact that their background prior to U.K. entry was similar to the children who came to the U.K. when older. The developmental catch-up was also impressive, but not complete, in those placed after 6 months of age. The mean McCarthy General Cognitive Index was 92 compared with 109 for the within-U.K. adoptees. The strongest predictor of level of cognitive functioning at 4 years was the children's age at entry to the U.K. It was concluded that the remaining cognitive deficit was likely to be a consequence of gross early privation, with psychological privation probably more important than nutritional privation. A further follow-up at age 6 years will determine whether there is continuing recovery after 4 years.

The associations of the mutual mother–child, father–child, and mother–father relationship and various patterns of family relations with child psychopathology were investigated in a sample of 137 families referred to outpatient mental health services. Assessment of the relative association of the different family dyads showed that both the mother–child and the mother–father relationship were related to child problem behaviour. However, whereas the mother–child relationship was consistently more related to externalising behaviour, the mother–father relationship was particularly related to internalising behaviour. Our findings gave clear support for the cumulative risk model: having more negatively qualified relationships was associated with more problem behaviour. Furthermore, our results suggested a protective influence of the parent–child relationship: having one or two positive parent–child relationships was associated with less problem behaviour. No support was found for the cross-generational coalition hypothesis. Implications for future research are discussed.

The purpose of this study was to examine prospectively the impact of family transition on deviant development in a sample of 427 French-Canadian boys participating in a longitudinal study from kindergarten onwards. During the course of the study some boys experienced family transition. We grouped the boys by developmental period and number of marital transitions they experienced: divorced between ages 6 and 11; divorced between ages 12 to 15; remarried between ages 6 and 11; and remarried between ages 12 and 15. From ages 11 to 15 we assessed boys' delinquency and their family processes (parental supervision, punishment, and communication) annually. The results suggest that boys who experienced remarriage between ages 12 and 15 are at greater risk for delinquency. In particular, they showed evidence of comparatively more theft and fighting at earlier ages than their peers from families that had remained intact. At similar points in development, they perceived less expressive parent–child relationships. Finally, these boys also perceived less monitoring by their parents, both overall and at different points in adolescence.

We look at the awareness of grammatical distinctions in children with reading difficulties, and at their ability to use this awareness in order to learn about the conventional spellings for morphemes like “ed” at the end of past verbs. Using longitudinal methods we show that, initially, children who are to become poor readers are actually better in this aspect of spelling and also in grammatical awareness tasks than younger children of the same reading level: but they are worse than these other children in tasks that tax their knowledge of phonologically based letter-sound correspondences. Later on, however, the poor readers lose their initial advantages in the conventional spelling of morphemes. We conclude that poor readers are initially held back by a failure to learn about letter-sound correspondences, and that this deprives them of successful reading experience, which in turn hampers the growth of their grammatical awareness and their learning how to spell morphemes.

One commonly cited feature of Williams syndrome is a characteristic dissociation between relatively spared language skills and severely impaired nonverbal abilities. However, the actual evidence for a dissociation between verbal and nonverbal abilities in Williams syndrome is equivocal. In two separate studies we examined these abilities in 16 individuals showing the Williams syndrome phenotype. When considered as a whole, the group did have significantly superior verbal abilities, but this difference was caused by a large discrepancy in abilities in only a small number of individuals. In both studies there was a clear, linear relation between individuals' verbal ability, and the magnitude of their verbal–nonverbal discrepancy. We suggest that these results are best explained in terms of verbal ability developing at a faster rate than nonverbal ability in this disorder. We discuss how this model of differential rates of development has the potential to reconcile the apparently inconsistent findings in this area.

Forty-two (42) children (mean age 10.6 years) from mainstream public (N=22) and therapeutic schools (N=20) completed performance tasks assessing executive and motivational influences on motor responses. In a separate protocol, children underwent physiologic challenges of paced breathing and supine to standing postural change, while heart rate was continuously monitored.

Executive control was associated with vagal modulation of respiratory driven, high-frequency heart-rate variability (t=2.20, p<.03), whereas motivational control was associated with sympathetic modulation of posturally driven, low-frequency heart-rate variability (t=−2.22, p<.03). These findings supported a two-factor solution of inhibitory control derived in a previous study.

A representative sample of 55 mainstreamed 9–10-year-olds with hemiplegia were compared with all classmates on sociometric measures of popularity and friendship, and with 55 matched controls on measures of victimisation. Children with hemiplegia were more rejected and less popular, had fewer friends, and were more often victimised; they were not more likely to be bullies themselves. These differences were not fully accounted for by group differences in teacher-estimated IQ and behaviour. Possible explanations range from neurologically determined deficits in mentalising skills to peer prejudices about children with disabilities. The development of appropriate intervention strategies should be a high priority, particularly since peer problems not only result in current distress but also predict psychosocial problems in the future.

This study was an investigation of the relationship between family variables and the perceived quality of parental involvement following parental notification of an adolescent's decision to have an abortion. Demographics, family religiosity, and family functioning variables were examined. Pregnant adolescent clients from seven abortion clinics in three states completed a survey assessing their perception of the quality of parental involvement and the family variables. Only family functioning variables were significantly related to the perceived quality of parental involvement. Family adaptability (the family's ability to change its power structure, role relationships, and relationship rules in response to situational and developmental stress) was the most predictive. Adolescents from adaptable families had a more positive experience with parental involvement than adolescents from less adaptable families.

In a test of Patterson's Coercion Theory with young children, 156 children (82 boys and 74 girls) were studied to assess the extent to which parenting and child variables, assessed at 18 months, would predict teacher ratings of externalizing child behaviors at age 5. Child playgroup behavior, parent coercion during home observations, and marital status each emerged as predictors, whereas child temperament, attachment classification, and gender did not. At age 5, the correlates of externalizing behaviors differed for boys and girls. Boys rated higher on externalizing behaviors by the teachers presented many problems in the home and school, whereas externalizing girls did not. In fact, girls rated higher on externalizing behaviors performed better on an intelligence test, yet the girls perceived themselves as less competent.

Variations in children's problem behaviors associated with ethnicity and other demographic variables were examined in 6–18-year-old children (N=804) residing in a multicultural environment. The Child Behavior Checklist–Teacher's Report Form was used to compare the frequency of behavior problems among clinic-referred and nonreferred children of Hawaiian, Asian, and Caucasian ethnicities. Children who were male, clinic-referred, or of Caucasian or Hawaiian ancestry experienced greater levels of behavioral problems. Explanations concerning ethnic variations in children's problem behaviors include: teacher's perceptual bias, differences in teacher threshold to report problem behaviors, and/or true variations in children's behavior.

In order to find out whether parents and teachers report depressive symptoms in children with self-reported depression and which features are connected with sought psychiatric care, a sample of 5682 prepubertal children was assessed with the Children's Depression Inventory (CDI), the Rutter A2 scale (RA) and Rutter B2 scale (RB). In stepwise regression analysis of parent report, depressed mood, unpopularity, social withdrawal, disobedience, inattentiveness, and stealing were associated with high CDI scores. The items of the teacher report associated with high CDI scores included poor school performance, restlessness, somatic complaints, unresponsiveness, being bullied, and absenteeism from school. Although the parents and teachers readily saw and reported depressive symptoms in children, only for a small minority of children with multiple depressive symptoms had psychiatric care been sought or even considered. The symptoms associated with sought psychiatric care for depressed children were somatic (soiling, asthma) and behavioural (disobedient, restless). The results indicate that a large number of children with multiple depressive symptoms are left without necessary psychiatric assessment and help.

Children's judgements about pain at age 8–10 years were examined comparing two groups of children who had experienced different exposure to nociceptive procedures in the neonatal period: extremely low birthweight (ELBW) [les ]1000 g (N=47) and full birthweight (FBW) [ges ]2500 g (N=37). The 24 pictures that comprise the Pediatric Pain Inventory, depicting events in four settings: medical, recreational, daily living, and psychosocial, were used as the pain stimuli. The subjects rated pain intensity using the Color Analog Scale and pain affect using the Facial Affective Scale. Child IQ and maternal education were statistically adjusted in group comparisons. Pain intensity and pain affect related to activities of daily living and recreation were significantly higher than psychosocial and medically related pain on both scales in both groups of children. Although the two groups of children did not differ overall in their perceptions of pain intensity or affect, the ELBW children rated medical pain intensity significantly higher than psychosocial pain, unlike the FBW group. Also, duration of neonatal intensive care unit stay for the ELBW children was related to increased pain affect ratings in recreational and daily living settings. Despite altered response to pain in the early years reported by parents, on the whole at 8–10 years of age ELBW children judged pain in pictures similarly to their term peers. However, differences were evident, which suggests that studies are needed of biobehavioural reactivity to pain beyond infancy, as well as research into beliefs, attitudes, and perceptions about pain during the course of childhood in formerly ELBW children.

I should like to make two comments on the paper of Zucker et al. (1997).

James (1998) had two comments about our recent article on the sibling sex ratio of boys with gender identity disorder (Zucker et al., 1997):