Second Chance

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You You This is Susan as she was when admitted to Children's Memorial Hospital at the age of 22 months weighing 15 pounds The average weight of a five -month -old infant her height was 28 inches the average height of a 10 -month -old infant She was unable to speak or even babble and her motor development was severely Retarded with no performance in any area that even approached the one -year level Medically the problem could be clearly stated.

What was the etiology of this profound and generalized retardation? It was clear from the outset that the parental attitude toward this child was atypical as Exemplified by the fact that the father brought the child for admission gave a history and then left For the next three weeks.

There was no contact of any sort from the family When the social worker called the mother reluctantly agreed to come in some weekend The parents ages 25 and 24 are both personable middle -class and of above -average intelligence and education The mother in discussion with the social worker readily reported that babies always repulsed her She said I looked at babies and thought that they were a poor excuse for human beings She could not understand why other mothers talked of the thrill of holding infants Religious beliefs dictated against avoiding a pregnancy The mother grimacing described how repulsive Susan is to her just the way she is the way she looks In the hospital when Susan was left alone.

She rarely exhibited any emotion the bulk of her time was spent in rocking occasionally she showed a mild and unorganized interest in toys a Thorough physical and laboratory evaluation failed to reveal a cause for Susan's marked and generalized retardation However, her negative response to people was quite striking This is dr.

Wolf a pediatric resident who has seen Susan before Yet the child seems unable to tolerate any approach even though well -intentioned She does not respond to objects Note however that she does respond to objects she takes the blocks but avoids the fingers Although Susan's lack of cooperation precludes complete developmental evaluation at this time her finger dexterity is the most advanced performance The Mother reported the same negative reaction when she stated that Susan did not like to be held or even have her diaper changed She could not pick her up without her crying Susan's cry was very irritating to her almost a fake cry.

She said with no tears She scratched and plodded things and always had a blank expression The mother went on to say that since Susan seemed to like being alone She gave up trying to make contact with her She said it was all I could do to take care of her and I don't ever want to do that anymore Susan is unable to stand and is thrown into a rage by the attempt Further attempts to snuggle are to no avail The diagnosis of maternal deprivation syndrome was made and it was decided to employ the services of a mother bank volunteer This program utilizes the services of a grandmotherly woman with strong maternal instincts She spends six hours a day four or five days a week all with one baby and continues as long as necessary This amount of time considering that it is all spent in mothering with no housekeeping chores or other children to take care of Represents a good deal of mothering Even more remarkable is the voluntary nature of the program Mrs.

Schiller has been involved with this program for twelve and a half years Here for the purpose of the film She is forcing her attention on Susan to a greater extent than would usually be the case The child responds with panic and rage The mother bank program is well accepted by the staff In fact there was a tendency to spend a great deal of staff time with the mother bank babies Particularly on shifts when the bank mother is not there The staff identifies warmly with such babies and attempts to make up for the lack that is perceived This reaction was quite typical of the way in which Susan dealt with all people Dr.

Wolf is shown with Susan only two weeks after the initial films She had become quite attached to Susan and spent long periods of time developing a relationship The profound effects of lack of emotional care are obvious and impressive Evidence has been presented in the medical literature Which demonstrates that the body diminishes its production of pituitary growth hormone in response to maternal deprivation The measurement of growth hormone requires a long period of time strapped to a metabolic frame We felt that this was contraindicated by Susan's acute need for mothering Susan still maintains an interest in objects Susan is seen here with Mrs.

Schiller three and a half weeks after the first time she met her.

It is clear that Susan quickly became a new child.

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

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.

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

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

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

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

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

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

The highly developed affectionate response is dramatic and evident.

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

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.

There was also a commensurate increase in her motor ability.

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

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

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

Susan learned to crawl efficiently and to walk holding on.

The delight in these newly acquired skills is evident.

Susan also learned to relate to relative strangers without fear.

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

Unfortunately, this situation is not resolved.

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

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