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Please mark your letter 'for publication'. Not every letter can be published, but every letter will be considered for publication.

Please note that any opinions expressed here are not necessarily the opinions of the Editor, or Priory Lodge Education Ltd. People are reminded that any advice on these pages should not replace the opinion of your current physician or therapist, whose advice you should always seek.

Emotional abuse and neglect

I am a student at the University of South Florida and also a child advocate in Tampa, Florida. I am looking for any information regarding the effect of emotional abuse and/or neglect on children. I am lobbying against a proposed bill that will remove emotional abuse from the definition of child abuse. Any information is appreciated. Thanks!!

Heather Hunter

Education in Paediatric Psychology

Dear Dr. Tony Roberts,

I found this website and decided to take this opportunity to ask for some information. I am currently a Child Development major at The University of North Texas. I am very interested in continuing my education after I graduate. My interest is in pediatric psychology, but I am unsure of how to achieve that goal. I am not aware of the proper schooling that I will need. I would greatly appreciate any advice that you could give me on how to obtain my career goal. Thank you very much for your time.


Anna Williams

Planning C.A.M.H.S.

Dear Dr. Roberts,

Work is ongoing in Salford to review child and adolescent mental health services adn to plan of the future. I am writing having just found the "Child and Adolescent Psychiatry On-Line" web site.

Salford Community Health Council is working with the Health Authority in this area, but has a particualr interest in how to involve children and young people in planning adn developing C.A.M.H.S.

Do you have any information or contacts who may be able to help us with this or suggest examples of previous good practice?

I look forward to your reply.

Chris Dabbs
Salford Community Health Council
22 Church Street
M30 0DF

Art Therapy

Hello. My name is Emilie Carr and I am doing a report on art therapy that requires an interview. I would really apprecaite it if you, or some one how deals with art therapy, could help me ASAP. I would be very grateful....

Thank you so much.

Emilie Carr

Treatment with Growth Hormone and Concurrent ppd diagnosis

Dear friends:

Does anyone have experience with psychological/cognitive assessment in children receiving growth hormone. I have read somewhere that as the growth hormone is administered, there may be an improvement in cognitive function and or improvement of pervasive developmental disorder (ppd).

Dover, Ohio

Music Therapy

Regarding Karen Vitek's letter (please see below) the National Association for Music Therapy has a useful website whose homepage is, and well worth exploring for those interested. I am sure they would be happy to help if e-mailed with your query.

Tony Roberts

Selective Mutism and Music Therapy

I am a special education teacher working in an elementary school in Poughkeepsie, NY. We have a boy of 8 years who has been diagnosed with elective mutism. He is a very bright child who shows an interest in Music. He also has a younger sister who has been diagnosed with
elective mutism at age 6. Does anyone have information on whether Music therapy has been helpful with these type of children ?

Thank you for your help.

Karen Vitek
Nassau School
Nassau Road
Poughkeepsie, NY 12601

Selective Mutism

There have been several enquiries about selective/elective mutism on this page in recent months. There is however a recent paper on the subject, reference:

Kopp, S & Gillberg, C. (1997). Selective Mutism: A Population-based study: A Research Note. J. Child Psychol. Psychiat. Vol. 38, No.2, p. 257-262.

This paper is not only informative in itself, but has 22 references, and an appendix with information and questionnaire for teachers.

Tony Roberts
Child and Adolescent Psychiatry on-Line


Post-Abortion Adolescents

I am a social work student doing a research project on post-abortion sexual activity of adolescents. Although I have been doing research and found some valuable information, most of it does not pertain directly to adolescents. I would appreciate any references or other information. Especially helpful would be any information about Post Traumatic Stress and post-abortion adolescents.

S. Denney

Oxygen deprivation at birth and mental disorders

I am interested in any studies that might link oxygen deprivation at birth with mental disorders (ADD, ADHD, Oppositional Defiant, Bi Polar etc.)

Thank you,

William Band

Adolescent Friendships


I am a student at the university of Rhode Island. I am looking for information on the topic of Adolescents and the friendships they have. Any references you could provide would be much appreciated.

Thank you.

Daniel Milani

Australia's Youth Suicide Rate


In Australia we constantly hear in the media that this country has the highest youth suicide rate in the world.

I would be very interested to learn of any studies that show the demographic spread of youth suicides - that is, what factors have been identified that indicated the groups most at risk of suicide.

Replies by email to will be greatly appreciated.

Marcus Anderson
President - CYGNET
The Network for Students with a Disability,
Impairment or Medical Condition (Incorporated).

Elective Mutism (I)

I need more information about Elective (or Selective ) mutism. Any article, case study is welcome. I'm a Belgian student at university, I study Logopedy and Audiology (better known as Speech Language Pathology and Hearing Pathology).

Isabel Witters
Melkouwen 46
2590 Berlaar

Elective Mutism (II)

I am a teacher who is currently working with a 9 year old girl who has "Elective Mutism". Can anyone suggest where I could find any current information on this subject ? Especially any programs developed to meet the needs of these children.

Geoff Baeck

Depression in Infants

Reply from David Lonie, to original letter:

I notice a letter on depression in infants. Having just found this site, I don't know how long ago it was published, and I can't email the writer direct. If, however, he is still looking for information, I suggest he contact Dr Antoine Guedeney, 4 Ter Passage de la Main D'or, Paris 75011, France, fax 33 1 45 39 00 10. Antoine is very interested in the area of infant depression, gave a very good paper here in Sydney last year. Also the Handbook on Infant Mental Health ed Charles Zeanah is a good source book. Any further information email me direct.

David Lonie

Reply from Debbie, to original letter:

I don't know of any research specifically on infant depression but what about failure to thrive? My experience is in physical disabilities rehab and I've seen several babies with dx of failure to thrive who appear depressed. Maybe check that subject for research.

Occupational Therapist

The original letter follows:

Is there any research material about depression in infants?

Chaplain Dan Ritchie
Sacred Heart Medical Center
Spokane, WA

Elective Mutism

I need any information on elective mutism that anyone is willing to share with me. Thanks!

Deb Peters - Speech Specialist
Washington Elementary School
910 14th Street N
New Ulm, MN 56073-1449

Service Developments in Working with Children with Developmental Disorders

Dear Colleagues,

In my work at a Child Development Centre in South London, I am currently engaged in a number of service developments with colleagues from my own discipline and others, namely:

Has anyone embarked on similar projects to those mentioned above. What were your experiences and what did you find were the main issues you had to tackle in setting up an effective and responsive service?

I'd like to hear your thoughts, comments and ideas.


Paul Dickinson
Clinical Psychologist,
Guy's and Lewisham Mental Health NHS Trust

Prozac Demographics: use by children, adolescents and adults

I am a University of Texas student in need of Prozac user demographics (age, gender, socio-economic status, etc.) for a research project. On-line or hard references would be most appreciated.


J. White

Zoloft (Sertraline) in Treating Adolescent Depression

I am looking for any research that deals with the use of Zoloft in treating adolescent depression.

Thanks - Vicki

Bipolar II In Teens

Dear Colleagues,

I'm looking for information including treatment information about Bipolar II in teenagers. Can you direct me to recent information?


David Hoffman

Studies in Compliance

Dear Brooke,

Thank you for your letter.

I think that the project that you are suggesting is most interesting, and well worth replicating. I can only give you the original references; these are:

ASCH,S.E. (1951) Effects of group pressure upon the modification and distortion of judgements. In Guetzkow, H (ed.) Groups, leadership, and men. Pittsburg: Carnegie Press.

ASCH,S.E. (1956) Studies of independence and conformity: A minority of one against a unanimous majority. Psychological Monographs, 70, Whole No. 416.

ASCH,S.E. (1958) Effect of group pressure upon modification and distortion of judgements . In Maccoby, E.E., Newcombe, T.M., Hartley E.L. (eds.) Readings in social psychology. (3rd. ed.). N.Y.:Holt, Rinehart and Winston.

Clearly these are all the original, early studies; you would be advised to conduct a literature search so as to ascertain what work has been carried out since then.

Best wishes,

Tony Roberts

The original letter follows:


Dear Colleagues,

I am doing a research project on determining whether or not children and young adults (ages 11-18) are influenced by peers as much as society says they are. I plan to conduct this by setting up an experiment that consists of three different lengths of lines like these:

I will bring one child out to look at the lines and tell me which one is the longest.

Then I will bring out two more and ask the same question (the other children will not be present when the first responses are made) .

Now I will tell them that when the fourth student comes out to say that 'line "C" is the longest.'

The new (fourth) student will sit at the end of the line and respond last. Since the other three students have said that line"C" is the longest I will be looking at the last child's answer to see if he/she says that "C" is the longest because their peers did or if they say that "B" is the longest because it clearly is longer than the other two.

What I am looking for is websites, books, articles, etc. on experiments like this on peer pressure.

If you have any ideas, suggestions, or constructive criticism that will help my project please feel free to give them to me, and e-mail me at the address below,

Thank you,

Brooke Winters

Developing Child and Adolescent Services

Dear Colleagues,

I work for a UK NHS Trust. We are currently reviewing our provision of Child and Adolescent services and would like good suggestions, ideas and literature on the shape of such services - we already have and are using the HAS Thematic review which will be familiar to UK readers.

Specifically, the trust serves a large rural/urban area where transport can be a problem. What sort of services should be available in terms of quantity - equity of access to local expertise, access to beds etc? What should be available in terms of disciplines and specialisms - we are thinking along the lines of a minimum of 1 Specialist Nurse, 1 specialist Doctor, 1 Social Worker and Psychologist per local area supported by centrally based specialist therapies.

All thoughts and ideas from home and abroad welcomed.

Mike Blank
General Manager
Psychotherapies and Substance Misuse Directorate
Derwen NHS Trust.

Voluntary mutism

I have noticed a letter addressing voluntary mutism, and would very much like to get some information on the this subject also. It seems that the definition and treatment strategies have changed a little recently. I had heard that Columbia U. (or maybe Cornell) was doing some research on new treatments. Can anyone suggest some current literature, research, or specialists in this field?

Thanks for your help.

Judy Scheer

The original letter follows:

Elective mutism

I am a student nurse who is working in a partial hospitalization outpatient program for children and teens with psychiatric disorders. We recently admitted a 16 year old boy with elective mutism. He speaks in "yes"/"no" answers to his families, but refuses to speak to us or the other patients. Any ideas for working with him?

Tim & Kathleen Allen,

ADHD in the UK: an urgent need to establish protocols of good practice for assessment and management.

Dear all,

I am a clinical child psychologist working at the Wilfred Sheldon Child Development Centre in London, employed through Lewisham and Guys Mental Health NHS Trust. My specialty is child development and I have special interests in autism and pervasive developmental disorders and hyperkinetic disorder (ADHD).

I have read with interest the various letters colleagues have written on the nature and management of ADHD, as people working in the USA, Australia and elsewhere may be aware the whole issue of the diagnosis and management of this condition has stirred up some controversy in the UK.

My own department has embarked on a programme of training and debate on this issue so that we can provide effective psychological services to children and young people with a genuine developmental condition. We do have a number of concerns however; in particular we are increasingly worried by the trend in some quarters for quite powerful medication to be used in the management of very young children (sometimes under 6) without a full multi-disciplinary assessment and an attempt to exclude other pathologies. Recently I came across a case where an rising eight year old child was prescribed Ritalin on the basis of her presenting symptoms but without any thorough taking of her history or assessment of her management and the parenting skills of her carers. She responded very poorly to the medication and her behaviour which was already challenging deteriorated markedly. The situation almost broke down completely necessitating social services child protection services involvement.

I am sure there are a number of families who have struggled to manage children with a genuine disorder who have not received appropriate treatment and feel both inappropriately blamed and aggrieved at the poor service they have received. I have come across a not insignificant number of "false positives" in my practice so far however, where on careful assessment a diagnosis of conduct disorder or emotional and behavioural disturbance seemed much more appropriate. In one case I saw recently the child was clearly displaying the symptoms of Asperger's syndrome but was referred to me with a query diagnosis of ADHD, and being considered for a trial of Ritalin.

I believe with the increasing media and public attention directed to this diagnosis there is an urgent need for service providers in the UK to establish protocols of good practice in the assessment and management of this disorder. An emphasis on high quality multi-disciplinary assessment is essential if we are to avoid medicating children inappropriately, simply because they display challenging behaviour which may be an entirely developmentally appropriate outcome given their history and circumstances, and to give high quality services to children who are genuinely suffering from a developmental disorder.

Paul Dickinson
Clinical Child Psychologist

Art Therapy for Children with Post Traumatic Stress Disorder

I am a student doing studying prerequisites in psychology, for graduate work in Art Therapy.

I am doing a small paper on the effects of art therapy in children suffering from post traumatic stress disorder. I have been having trouble finding information on case studies. If anyone has information to share, or advice on a direction to go in, this would be greatly appreciated.


Anne R

Oral and Non-Oral Feeding in Children.

Dear All,

I'm a French student of psychology in Paris, France, preparing my thesis about anorexia and childhood. Unfortunately, I was unable to get some of articles I need. Perhaps somebody would kindly send me such documents or locate the Web site or Usenet Group I could contact in order to get them ?

The papers are :

- DUNBAN S.B. & JARVIS A.H., "The transition from non oral to oral feeding in children", 1m. J. Occup. Ther., 45 (5), 1991, pp 402-408

- MORRIS S.E., "Development of oral motor skills in the neurologically impaired child receiving non oral feedings", Dysphagia, 3, 1989, pp 135-154

- SRIRAM K., "Suppression of appetite by parenteral nutritions in humans", J. Am. Coll. Nutr. 3 (4), 1984, pp 317-323.

- BLACKMAN J.A. & NELSON C.L.A., "Rapid introduction of oral feedings to tube-fed patients", Dev. Behav. Pediatr., 8, 2, 1987, pp 63, 67.

Olivier Magnan

Community Child and Adolescent Nursing

I have recently commenced a new job working within child and adolescent nursing. The post is a new development for this department. I am based with a multi-disciplinary team, but located primarily within a primary health care team.

The emphasis of the post has changed proportionately, in that whilst I would still have face to face clinical contact with people, a greater proportion of time is given over to consultation, liaison and teaching. Attempting to maintain a balance, without becoming overwhelmed by clinical work, feels as if it will be the most difficult to achieve.

I would be interested to hear peoples views, and whether or not this is a model that has been used elsewhere. If so with what degree of success, and in particular some of the potential pitfalls ( I would hate to hear that it was all pitfalls !).

I would be interested in people's views more generally on topics related to child psychiatry.

Jeanette Scott

Attention Deficit Disorder

Dear All,

Concerning Fran Duane's letter (titled "ADHD Children and Over-Medication"):

Concerning Brian Boetchher's letter (titled "Attention Deficit Disorder"):

Marcelo Caixeta,MD
Psychiatry Service,
ASMGO Medical Center
Federal University of Goias PS HC Brazil

Sexual disorders and medication

Dear All,

Concerning Lorne Brandt's letter (titled "Sexual Disorders"):


Marcelo Caixeta,MD
Psychiatry Service,
ASMGO Medical Center
Federal University of Goias PS HC Brazil

Conversion hysteria

I am a registered clinical social worker who looking for information on conversion hysteria in children. I am especially interested in how childhood trauma plays a part in such symptoms. I would appreciate any information or areas to research.


Panic Attacks in Childhood

Dear colleagues:

I am a Psychiatrist, and I am interested on knowing how many adults with panic attacks suffered it from childhood. Do you think that if panic attacks is a chronic disease, it begins in childhood?

Thanks for your help

Dr Josi Ramsn Comas Viqas
Hospital General de Acapulco
Acapulco, Mexico

Visit to UK from Australia

Dear Sir/ Ms,

My name is Bill MacDonald. I am a senior psychiatric nurse manager/ practitioner currently working as the manager of Nursing Services and Unit Manager of the Inpatient Unit, Child and Adolescent Psychiatry Services at Monash Medical Centre (MMC), Melbourne, Victoria, Australia.

MMC is a large (in Australian terms) general medical/ surgical hospital with a Division of Psychiatry of which Child and Adolescent is one part. The Hospital is closely affiliated with Monash University and the Division with the Department of Psychological Medicine. Monash also has a School of Nursing within the Faculty of Medicine.

I have recently been engaged co-ordinating a significant expansion of Child and Adolescent inpatient services at MMC and more recently working as a consultant to the Department of Health and Community Services in relation to a revision of inpatient service delivery. I am currently completing a policy document that prescribes guiding principles for the development of C & A Inpatient Services across the State of Victoria - both urban and rural.

I am applying for a grant to travel to travel to both America and the UK later this year. My itinerary is not yet fixed and I would appreciate any recommendations for other site visits to innovative psychiatric service delivery models for young people and Child and Adolescent Psychiatric Nurse education programmes in the UK. I would be happy to forward more details regarding my interests and a detailed list of objectives if you feel this would be of assistance.

Since the timelines for organising my schedule are tight, I would appreciate any information regarding recommendations for visits and other contacts as soon as possible.

My contact information is as follows:
Phone: Bus Hours 03 9550 1328
Phone: After Hours 03 9499 3009
Fax: 03 9550 6929
Postal Address:
Unit Manager, Child and Adolescent Psychiatry
Monash Medical Centre,
246 Clayton Road
Clayton 3168

Thanking you in anticipation,

Bill MacDonald.

Sexual Disorders


Dear colleagues:

I am looking for advice on the treatment of a adolescent with FAS who has strong obsessions that lead to sexual offending. I have tried him on Prozac as an anti-obsessional with no real gains. He is in a 24 hour custodial living arrangement because of his risk. This is no life for a teenager. I am loath to consider IM anti-androgens in this age group. Is there something else?

Please correspond personally or to this On-Line for the benefit of our colleagues.


Lorne Brandt
Brandon, MB,

Treatment Plans

Does anyone know where inpatient treatment plans can be obtained in written or computer form?

Robert Lowenstein
Board Certified Child Psychiatrist

Community Psychiatric Initiatives Involving School Nurses

I am currently developing an adolescent psychiatry service so that it works more efficiently at a community level.

The model is about providing the training and clinical supervisory structures so that school nurses working in high schools can identify and manage psychiatric problems of mild to moderate severity. The programme will be nurse-led from the training point of view but training staff would be part of a cohesive consultant-led multidisciplinary team.

Please contact me. I am interested to find out about child and adolescent community psychiatric initiatives.

Tim Gillett
Consultant Adolescent Psychiatrist
Sir Martin Roth Young People's Unit

ADD/ADHD Children and Over- medication

Dear Sirs:

I am working with a young patient (age 11) who was placed on Ritalin at age 8. He currently weighs 50 pounds. It appears that the Drug ( last reported dosage was 60mg daily,) has stunted his growth. He appears to have missed at least 2 growth spurts. At this time, I have ruled out ADD/ ADHD and have diagnosed with Major depression, mixed emotional features. I would be interested to hear from someone who has seen similar behaviors.

I would also be interested to hear from people about the rash of ADD and ADHD children and over medication.

Thank you for your time.

Fran Duane or Bruce Duane

Psychiatric Nurses in Child and Adolescent Psychiatry

I am currently researching the the role of psychiatric nurses working with children and adolescents in the community. I am particularly interested to hear from any psychiatric nurse worldwide who can answer some questions about their work:

If you have some experiences to share, and would like to tell me about the way you work, please e-mail me at

Neil Chell
Clinical Nurse Manager
Child and Family Guidance Service
Rockingham Forest NHS Trust, UK

Stalking/Erotomania in Adolescents

I am a psychologist working in an urban school system. I have come across several cases of obsessive behavior involving young adolescents. These have taken the form of preoccupation with opposite sex or same sex students. This preoccupation has usually included behavior not unlike that exhibited in adult erotomania. I am wondering if anyone can point me to a reference on this unusual topic. My most recent case concerns an 11 year old Hispanic boy who is pursuing an 11yo male and states the reason as, "He has a nice face. I like him. He's pretty." Send any useful info to: David J. Carey, Psy.D. at

Thank you.

David J Carey

Attention Deficit Disorder


I am currently doing my masters in Criminology and am a Forensic Psychiatrist. Working in prisons I have been struck by the large number of prisoners , both male and female , who give a history of Attention Deficit Disorder (ADD). It seems to me that Adolescents with ADD can go in several directions depending on the parenting/ teacher/ other interactions they have and one of these is criminality and rebellion leading to Sociopathic Personality Disorder and another is Avoidant Personality Disorder and there may be plenty of others.

Can someone direct me to literature on this or make other comments.

Dr Brian Boettcher


Sexual Risk Taking in Adolescents

I am a student at Washington State University in the United States, majoring in Human Development.

I am doing a research paper and project on Sexual Risk-Taking and Adolescents. I would like to educate myself on this topic, in particular to further my understanding of how and why adolescents take such risks. I also hope to use this information in the future in my job.

I am wondering af anyone would give me any information, or direct me to sources of useful information ?

The outline of my proposed paper is as below:

I. Introduction
II. Body
A. Effects on Physical Development ( Biology)

B. Effects of the environment (context)

C. Implications of Early Sexual Behaviour

III Conclusion
If you have any information that does not fit into this outline, but is about Sexual Risk-Taking in Adolescents, please include it in the information that you give me.

Ms Courtni A. Bailey

Adolescent Sexual Assault (Victim and Offender)

Is there any possibility of addressing child and adolescent sexual abuse from the point of view of the victim/survivor and the offender ? I am the Sexual Assault Treatment Director at Hillcrest School, which is part of the Oregon Youth Authority, in Salem, Oregon (USA). I have been working with adolescents in this area and at this location since 1985. I probably have information that would make a meaningful contribution. I am also interested in networking with others with interest in the area of sexual abuse from a psychiatric focus.

Please feel free to contact me at my e-mail address: or at Hillcrest (503) 986-0413.

Dennis Bucklin, LCSW
Treatment Director

Art Therapy for Terminally Ill Children

Please help direct me toward any research, papers, regarding Terminally Ill Children and the use of Art Therapy by them coming to terms with their Death and Dying.

Thanks :)

Jeannie Killian



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