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December 17, 1982

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JAMA. 1982;248(23):3095-3096. doi:10.1001/jama.1982.03330230017015

In Reply.—  Being damned for what one says is easier to contend with than being damned for what one doesn't say. The first response to our critic is to agree with her perspective but add that our perspective is different. Her response seemed to be stimulated by the phrase "to wait with the family and observe." She has drawn from this statement several negative implications: therapeutic nihilism, indifference to multidisciplinary evaluations or ignorance of them, and interventions and medical preoccupation with diagnostic precision.We did not state or intend to imply that a comprehensive assessment of handicapped children is unnecessary or unproductive. Obviously, one tries to obtain as much relevant data as possible about the child, his condition, and the family. Many professionals participate in the evaluation process. In our own setting, the assessment may include the disciplines of pediatrics, pediatric neurology, child psychiatry, developmental psychology, social work, education, speech