PEDIATRICS Vol. 83 No. 3 March 1989, pp. 355-363
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Is My Child Normal Yet? Correlates of Vulnerability

Ellen C. Perrin MD, MA1, Pamela D. West PhD1, and Barbara S. Culley RN, MSN1

1 The Departments of Pediatrics, and Psychology and Human Development, Vanderbilt University, Nashville, Tennessee

There are some children whose parents believe them to be unusually susceptible to medical or developmental problems—"vulnerable"—despite a lack of objective evidence of any difficulty. The "vulnerable child syndrome" refers to a constellation of behaviors that are thought to develop as a result of this excessive parental anxiety and subsequent difficulties in limit setting. In this study, the sense of vulnerability expressed by mothers concerning their healthy 3-year-old children is explored; children born prematurely and with considerable neonatal morbidity are compared with children born at full-term. Sense of vulnerability is assessed through the use of a simple instrument, the use and validity of which are described. Mothers of premature infants described a significantly greater sense of vulnerability concerning their children than did mothers of full-term infants. Mothers with more education described a greater sense of vulnerability than did less well-educated mothers, although mothers who claimed greater well-being and marital satisfaction described a lesser sense of vulnerability. Mothers with a greater sense of vulnerability concerning their children also reported more behavior problems, especially in the sphere of discipline, peer relationships and self-control, and in internalizing and somatic symptoms. Pediatricians can intervene in the development of the vulnerable child syndrome by recognizing those children at special risk and helping their parents to nurture their health and independence.

Key Words: vulnerable child syndrome • parental anxiety

Submitted on January 27, 1988
Accepted on March 31, 1988




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