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You

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You

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This is Susan as she was when admitted to Children's Memorial Hospital at the age of 22 months weighing 15 pounds

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The average weight of a five-month-old infant her height was 28 inches the average height of a 10-month-old infant

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She was unable to speak or even babble and her motor development was severely

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Retarded with no performance in any area that even approached the one-year level

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Medically the problem could be clearly stated. What was the etiology of this profound and generalized retardation?

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It was clear from the outset that the parental attitude toward this child was atypical as

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Exemplified by the fact that the father brought the child for admission gave a history and then left

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For the next three weeks. There was no contact of any sort from the family

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When the social worker called the mother reluctantly agreed to come in some weekend

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The parents ages 25 and 24 are both personable middle-class and of above-average intelligence and education

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The mother in discussion with the social worker readily reported that babies always repulsed her

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She said I looked at babies and thought that they were a poor excuse for human beings

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She could not understand why other mothers talked of the thrill of holding infants

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Religious beliefs dictated against avoiding a pregnancy

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The mother grimacing described how repulsive Susan is to her just the way she is the way she looks

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In the hospital when Susan was left alone. She rarely exhibited any emotion the bulk of her time was spent in rocking

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occasionally she showed a mild and unorganized interest in toys a

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Thorough physical and laboratory evaluation failed to reveal a cause for Susan's marked and generalized retardation

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However, her negative response to people was quite striking

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This is dr. Wolf a pediatric resident who has seen Susan before

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Yet the child seems unable to tolerate any approach even though well-intentioned

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She does not respond to objects

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Note however that she does respond to objects she takes the blocks but avoids the fingers

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Although Susan's lack of cooperation precludes complete developmental evaluation at this time her finger dexterity is the most advanced performance

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The

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Mother reported the same negative reaction when she stated that Susan did not like to be held or even have her diaper changed

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She could not pick her up without her crying

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Susan's cry was very irritating to her almost a fake cry. She said with no tears

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She scratched and plodded things and always had a blank expression

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The mother went on to say that since Susan seemed to like being alone

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She gave up trying to make contact with her

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She said it was all I could do to take care of her and I don't ever want to do that anymore

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Susan is unable to stand and is thrown into a rage by the attempt

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Further attempts to snuggle are to no avail

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The diagnosis of maternal deprivation syndrome was made and it was decided to employ the services of a mother bank volunteer

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This program utilizes the services of a grandmotherly woman with strong maternal instincts

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She spends six hours a day four or five days a week all with one baby and continues as long as necessary

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This amount of time considering that it is all spent in mothering with no housekeeping chores or other children to take care of

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Represents a good deal of mothering

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Even more remarkable is the voluntary nature of the program

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Mrs. Schiller has been involved with this program for twelve and a half years

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Here for the purpose of the film

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She is forcing her attention on Susan to a greater extent than would usually be the case

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The child responds with panic and rage

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The mother bank program is well accepted by the staff

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In fact there was a tendency to spend a great deal of staff time with the mother bank babies

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Particularly on shifts when the bank mother is not there

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The staff identifies warmly with such babies and attempts to make up for the lack that is perceived

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This reaction was quite typical of the way in which Susan dealt with all people

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Dr. Wolf is shown with Susan only two weeks after the initial films

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She had become quite attached to Susan and spent long periods of time developing a relationship

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The profound effects of lack of emotional care are obvious and impressive

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Evidence has been presented in the medical literature

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Which demonstrates that the body diminishes its production of pituitary growth hormone in response to maternal deprivation

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The measurement of growth hormone requires a long period of time strapped to a metabolic frame

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We felt that this was contraindicated by Susan's acute need for mothering

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Susan still maintains an interest in objects

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Susan is seen here with Mrs. Schiller three and a half weeks after the first time she met her.

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It is clear that Susan quickly became a new child.

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Her world became one filled with people who could be trusted, and affectionate needs became evident.

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The prior negative response to people and the seeming satisfaction of being left alone were clearly defensive reactions to maltreatment and massively underlying affectionate needs.

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Feeding, which had been indifferent, also became a source of pleasure and a medium for emotional exchange.

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Susan enjoyed being fed, as well as learning to feed herself.

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It is of interest that the growth spurt lagged behind the emotional response.

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This is consistent with the hypothesis that the emotional deprivation leads to a diminution in production of growth hormone.

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Seemingly there is a lag in the restoration of this mechanism to normal functioning.

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The remaining film was taken two months after they first met.

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The highly developed affectionate response is dramatic and evident.

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Susan reached the point of spending considerable periods of time in giving and receiving affection, and became proficient at the art of flirting.

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By the time of discharge, she had gained six pounds, an increase of over one-third of her body weight, and had grown two inches, four times the expected growth rate at this age.

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There was also a commensurate increase in her motor ability.

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Although Susan has improved dramatically, she is still markedly retarded.

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Language development proceeded to the point of understanding a few phrases and responding appropriately, and Susan started babbling, but there are no words.

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There is no way of being certain that she retains the ability to become completely normal.

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Susan learned to crawl efficiently and to walk holding on.

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The delight in these newly acquired skills is evident.

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Susan also learned to relate to relative strangers without fear.

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There is great concern as to whether the mother will ever be able to relate to her in a normal manner.

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Unfortunately, this situation is not resolved.

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Susan moves to an uncertain future, an eloquent testimony to the pervasive power of love.