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September 9, 1974

Minimal Brain Dysfunction: Management of Family Distress

Author Affiliations

From the Division of Child Psychiatry of the University of Washington, Seattle.

JAMA. 1974;229(11):1454-1456. doi:10.1001/jama.1974.03230490042021

The diagnosis and adequate treatment of minimal brain dysfunction (MBD) requires very early identification of neurophysiologic and behavioral disturbances. Comprehensive care of this disorder requires early involvement of parents in understanding the diagnosis and its implications and in learning about infant management. We must understand that whether stimulant medication works or not, the very early socialization patterns which govern reactions to discipline, learning, and interpersonal relations, once acquired, are difficult to change and affect the child's entire life. The physician's old aphorism, "Don't worry, the child will grow out of it," is very harmful when applied to the MBD child. Mothers need help with management of their infants. Sharing the problems such an infant brings to the family is most effective in an organized program.

The physician must help parents with the frequent feelings of blame, and must serve as a model of how the child's problems can be openly and honestly discussed with him. Comprehensive care makes it possible for parents and child to share their problems with others when they are under stress.

(JAMA 229:1454-1456, 1974)