Published online November 1, 2004
PEDIATRICS Vol. 114 No. 5 November 2004, pp. 1400-1406 (doi:10.1542/peds.2004-1721B)
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SUPPLEMENT ARTICLE

Is This a Behavior Problem or Normal Temperament?*

Abbreviations: temperament

The first 300 words of the full text of this article appear below.


   CASE
 
Harry’s parents report concern about him to their pediatrician because the child care worker has told them that he seems "insecure." In the first 3 weeks of the new day care program, this 2-year-old boy separated reluctantly (with much crying and clinging) from his parent in the morning and then remained on the periphery of the activities. He watched quietly but observantly from the sidelines while most of the other children talked and played. He repeatedly resisted invitations from the staff and other children to join in the activities. Yet, he seems interested and does not appear to be unhappy. At home he has 2 playmates in the neighborhood. The child care worker advised professional evaluation for his "emotional insecurity."

The parents of 7-month-old Jimmy come to you in great dismay, saying that he has been "basically screaming since birth." At present he is crying or fussing for well over 3 hours a day. The management strategies that had worked well for their 2 older children seem to be quite inadequate for Jimmy. He is sensitive, irritable, and hard to soothe. The parents are spending much of the day and night carrying him around the house. The previous pediatrician said at 2 months that it was "just colic" and would either get better soon with a special formula or that it would take another month or so to go away by itself. Yet, 5 months later, the fussing and crying are only a little better, although Jimmy does have periods when he smiles and laughs. The parents consulted a psychologist who only told them that Jimmy was developmentally normal. One of the grandmothers recommended marital counseling for the parents because they are arguing over how best to handle their baby. The parents think that they should reject that suggestion because . . . [Full Text of this Article]

Martin T. Stein, MD

Professor of Pediatrics
University of California
San Diego, California

William B. Carey, MD

Division of General Pediatrics
Children’s Hospital of Philadelphia
Clinical Professor of Pediatrics
University of Pennsylvania School of Medicine
Philadelphia, Pennsylvania

David M. Snyder, MD

Medical Director
Department of Developmental-Behavioral Pediatrics
Valley Children’s Hospital
Associate Clinical Professor of Pediatrics
University of California School of Medicine
San Francisco, California