PEDIATRICS Vol. 30 No. 6 December 1962, pp. 995-999
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A NOTE ON HOSPITALISM

Phillip E. Rothman M.D.

IT IS GENERALLY agreed that infants and children deprived of a normal home life and placed in badly-supervised orphanages and residential nurseries may show certain changes in behavior as the result of emotional deprivation and absence of sensorial and social stimuli. With the aid of commonly used tests, it has been possible to demonstrate a statistically significant retardation in development which varies with the age, length of stay, degree of isolation of the children, the number of personnel taking care of them, and the emotional attitude of these persons. The changes that occur involve language, social adjustment neuromuscular development, and, in some instances, acquired attitudes that are said to persist into adult life. If the children are returned to a good home in the care of a capable and affectionate parent or substitute, the obvious changes usually disappear and retesting shows rapid progress in development. This disorder has been named "hospitalism" or "hospitalismus." The purpose of this communication is to suggest that similar disturbances in children observed in modern teaching hospitals may be due to causes that differ from those formerly responsible.

Following World War II, hospitalism was studied intensively, and a complete history is contained in Bowlby's report. The risks of emotional trauma in connection with hospitalization of children were emphasized by Bakwin, Spence, Wallgren, and others. Finally pressure from various groups interested in child psychology plus public enthusiasm forced the medical profession, to some extent, to include in the routine of the best pediatric centers certain measures designed to prevent emotional disturbances in the hospitalized child.