In this lecture, Dr. Milton J.E. Senn leads a discussion about the history of child rearing customs.
WNYC archives id: 67530
(Automatic transcript - may present inaccuracies)
>> Good evening from the auditorium of the New York Academy of Medicine, Your City Station presents another of the Lectures to the Laity. These talks are given under the auspices of the Academy, are a free service to the public, and attempt to present before the layman in layman's language, the results of some of the latest work in the field of medicine. Our speaker tonight is Dr. Milton J.E. Senn. He'll discuss the Art and Science of Growing Up. To introduce the evening's presiding chairman, Dr. Sam Zachary Levine, here's the Chairman of the Laity Lecture Committee, Dr. Harold B. Keyes.
>> Dr. Harold B. Keyes: Good evening ladies and gentleman. Again, on behalf of the Committee on Laity Lectures, it's my pleasure to welcome you here. We're in for another intellectual treat. It is now my opportunity to introduce to you the presiding Chairman of the Evening, Dr. Sam Zachary Levine. Dr. Levine is Professor of Pediatrics at Cornell Medical College and Pediatrician in Chief of the New York Hospital. Dr. Levine.
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>> Dr. Sam Zachary Levine: The prize, ladies and gentleman, Pediatrics is vitally concerned with human growth and development. Pediatricians are aware that the so-called normal stages of physical growth, mental development, and sexual maturation follow a pattern and timetable from both birth through adolescence, which is genetically determined. They also know that this problem in timetable can be nullified by environmental influences such as food, hygiene, and other conditions. Practical application of these principles has lead to great advances in the promotion of somatic growth and physical health, in the prevention of disease, and in the reduction of infant and child mortality. Psychologic principles of human personality development have only recently been applied to pediatric practice to the same extent. In the last 30 years, attention has been reawakened to the basic emotional needs of infants and children, and to their gratifications and repressions by environmental influences. Expectant mothers are now inquiring about natural birth and rooming in accommodations for their newborn babies. Lactating mothers again wish to nurse, and the era of the rigid [inaudible] vigil of infant feeding is being replaced by the flexible self-regulation schedule. The speaker tonight is one of the pioneers who has helped to reorient our thinking about infant care and child rearing. He has pointed out that we cannot treat infants and children unless we understand their successive stages of personality formation, respect their emotional needs, and take account of parental attitudes and social impacts. Every person professionally concerned with the ultimate well-being of children, every parent and prospective parent, in fact, the entire public is deeply interested in this subject. It is a privilege to introduce my friend and former colleague, Dr. Milton J.E. Senn, Sterling Profession of Pediatrics and Psychiatry, and Director of the Child Study Center, Yale University, who will speak to us on the Art and Science of Growing Up. Dr. Senn.
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>> Dr. Milton J.E. Senn: Dr. Levine, colleagues in the academy, and guests, I'd like to spend a short time with you discussing the history of the art and science of growing up in America. At once, I must tell you that the only claim to authority that I have in speaking on a subject with history is that I had the good fortune in the last 40 some years to have lived at a time when there was interest in humanitarianism, and to have been very fortunate that in the middle 1930's, I was at Cornell University and in the midst of a financial depression and a concern about how we were treating our children at Cornell, it seemed to some a university might better learn some new techniques, and we might learn these techniques from the social sciences and from the humanities. I was extremely fortunate in that time in having the faith expressed by Cornell, the Commonwealth Fund, and my friends, particularly, Dr. Sam Levine. So tonight, this marks, in a way, a historical moment, when I come back to New York City, and pay honor and respect to these institutions and these people who had faith in me 20 some years ago. One of the truly phenomenal developments in the United States has been the emergence of a social and psychologic conviction, which affirms that each child is a distinct personality, and as so, to be understood and treated. This conviction is in stark contrast to the view held earlier, which represented the child as being a person occupying a position subordinate to the adult. It is the purpose of my paper to describe briefly how this change of philosophy evolved, and how it is reflected currently in childcare practices and in trends in the fields of Pediatrics, Psychiatry, and Public Health. At the onset, there must be a definition of terms. In this paper, the child referred to is an individual of either sex, when age raises from infancy into adolescence, and whose status represents the total aggregate of his participation in the affairs of our society; in the affairs of family, school, industry, and the nation at large, each of which help to mold him, and was in term influenced by him. The child will be spoken of as a person in general and composite terms, as if they were something like the American child. This is for reasons of brevity and does not imply lack of recognition of the existence of social status systems and the subcultural groupings within the United States of America, which gives special significance to certain children, unfortunately, sometimes to the harm and detriment of these children. Social historians delineate the time from 1700 to 1950 into several eras, such as the Colonial and Early Federal, a period from 1700 to 1830; a Period of the Rise of the Common Man from 1830 to 1850. The Civil War and Reconstruction Period, 1850 to 1870. The Emergence of the Modern America from 1870 to 90. Emergence of America as a World Power, 1900 to 1920, and finally, the so called Modern Age, 1920 to the present. A study of these periods reveals overlapping of one with another, and the continuity of certain events and trends which extend from one era into the other. Such [inaudible] equality may be credited to the broad sweep of trends in childcare and rearing. A survey of the changing status of the American child reveals that from the Colonial Period of the 1700's to the present day, three major epochs stand out clearly. These are the three epochs that I would like to look at closely with you. The first of these may be said to have extended into the 1830's, and may be designated as the Era of Calvinistic Religiosity. The second from the 1830's to the 1890's, may be called the Period of Industrialization, while the last from 1890 to the present, a period contemporary to many of us in this audience, is one of which a variety of names may be and has been applied; Atomic, Age of the World Wars and the Great Depression, Age of Despair and of the Destruction of Mankind. For the purpose of our discussion, this period may be marked out as the one with the greatest humanitarian advance. Let us now examine more closely the first of these eras; 1700 to 1830. It is a theological age. Religion dominated the child's education, recreation, and hygienic care, quite as much as it did with manners and morals.
>> Children were reminded of the fact that their stay on earth would short, as it well might be. Although families were large, often numbering 25 children, there is a high mortality of children and their mothers. The history of the clergyman, Cotton Mather was typical. Of 16 children, only one outlived him. Nine died in infancy; one before the third birthday, and the rest before reaching the third decade. Children of the American colonists were constantly admonished to spend time preparing for the life after death, and to remember the wages of sin and the rewards of virtue. This was a time when fears were realistically abundant; adults so in fear as such was used as an instrument for teaching discipline and for bringing about obedience of rule and love. Repression of feelings was encouraged; especially those considered to be evidence of human frailty, such as envy, anger, hatred, and feelings of sex. Children were to be seen but not heard. They were tolerated as passive members in a group of adults. As fact, they were considered men and women in miniature. There was a clear line drawn between the roles of the male and female; with strong preference for the former, for by inheritance and training was permitted to occupy a superordinant position in the family and in the affairs of the community. Books for children in this Early Colonial Period, were purely theological in content. The Bible, of course, was most popular for religious education, but quite as much for learning to read and write. Other books, were such interesting typos as "Remember Thy Creator in the Days of Our Youth", "Spiritual Milk for Boston Baby", "War with the Devil", and "A Young Man's Conflict with the Powers of Darkness", designated particularly for the adolescent. "The History of Goodie Two Shoes" were the means by which she required learning and wisdom. Although such stories as "Jack the Giant Killer", were known the early colonists, they were not recommended, because they were not purely of a religious or moral nature. Any books which promised entertainment were considered vain and worldly. Children were not thought of as growing and developing persons with a capacity to learn, but rather as ignorant men and woman. Hence, nothing was written especially for childish interest or intellect. Primers, spellers, catechisms were provided adults and children, without differentiation between the needs of one from the other. Even the textbooks were flavored with pietism. Cotton Mather gave the following as the educational aim of this time. They should read and write and cipher, and to be put in some agreeable calling; not only our sons, but also our daughters should be taught such things, as afterwards make them useful in their places. Acquaint them God and Christ and the mystery of religion, and the doctrines and methods of the Great Salvation. Now medical care of children was based largely on folklore and superstition, with much of the treatment carried on by lay persons, old woman particularly, who were credited with intuitive understanding of children and their needs, and with skill, because of the fact that they had taken care of many children. Even many of their patients died in spite of or even because of the ministrations, this did not detract from their reputation of healers. In spite of deadly epidemics of smallpox, typhoid fever, malaria, and dysentery, there was apathy in matters of public health among lay people, and controversies raised between physicians about the contagiousness or noncontagiousness of disease. This was characteristic of the general indifference of the colonists to the scientific progress, which was beginning on the continent. Seventy-one years after Harvey had described the circulation of the blood, his work was still the basis of questioned debate at Harvard. This no slam at the mother institute of Yale University [laughter]. Much of the disinterest in medical science stemmed from the believe that illness was of divine origin, with intent to punish the child, and to teach him that suffering made him courageous, humane, and better aware of the life in general. Spiritual values were placed on sickness and shocking. The shocking record of infant mortality was accepted as part of God's work, and the dosing of household remedies was believed providence inspired. This is not the place to give a lengthy account of the eating habits of the American colonists, but it may be pointed out that even some foods symbolized morality. Confections were forbidden; not so much because they undermined the health, but because they "destroyed the tone of the mind, and made ungrateful and discontented citizens". Moral reformants said eating of sweets for pleasure paved the way for later evils, such as strong tea and coffee, snarf tobacco, and fermented liquors.
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>> In the middle of the Colonial Period, marked by the end of the War of Independence, gradual change in the religious and education status of the child developed. The moral and religious standards of the American child were modifying, becoming milder in time, and permitting more pleasure to come into his life. The philosophy of secular utilitarianism in American life began to be practice. If good conduct was practiced, it was said it would bring temporal advances, quite as well as rewards after death. Now some books for children cautioned them to be good; not only to escape the punishment of hell, but also to be prepared for a successful life in this world. In them, children were taught that learning to spell paid off in dividends and rewards of military things. Morality paid off, it was said, in 10 told success. "How to Make Money" was the title of a book for children that summarized the philosophy of Americans who were developing the resources of our country. Even the poorest boy was reminded that he had a chance to become rich, particularly if he was educated, had a trade, and was morally good and of religious bent. The development of deism helped to remove the overtones of fear which were associated with so many of the thoughts and acts of the colonial child and his parents. By 1830, rules of conduct in child rearing following religious principles less than examples of virtue exemplified in stories of men and women who through honesty, thrift, industry, and sobriety achieved success. Standards of discipline changed. Parents became increasingly aware of the fact which today seems commonplace, that coercion itself is not discipline. Reminiscent with present day child rearing practices is the concept expressed in the 1830's that parents should appeal to reason in disciplining and molding behavior of their children, and should spare the rod; this without danger of spoiling the child. Although the colonial education system was originally religiously oriented, and to a great extent, church controlled, after the Revolutionary War, secularization began. And after 1780, vocational training began to be provided in a limited way within the framework of the school system. This development was not accepted readily by many of the professional educators, but with the growth of towns and cities, better methods of communication and transportation and industrialization, public education changed also. Values attributed to recreation and to the function of play were modified only slightly from the beginning to the end of the period we are discussing. The early colonists asked that recreation of the young be lawful, but brief and seldom. By 1830, play was permitted for health reasons, being qualified by the age and sex of the child, and being restricted to moderation. However, the area of childcare which received least benefit of national progress and growth was that pertaining to physical health. While the medical profession had made advances in studies of disease pathology and the beginning control of the communicable diseases, there was still abundant ignorance and superstition both within and without the field of medicine. The beginning was made in public health, as cities took over care of the water supply, paved the streets, and instituted drainage and policies. The pioneers in this public health movement were layman, who more than the physicians, worked for measures in improving community health. The second great period of American history that I would like to review with you extends from the 1830's to 1890. During those years, the colonizing process continued to develop new ways of life and new values, but the Americans continued to borrow ideas and philosophies from the old world, and then to modify them in keeping with their own needs. This is seen particularly in the field of industrialization and in the areas of childbearing and education. In England and on the continent, the great industrial revolution had started. As this influence was felt in America, it changed not only the methods of day living, but habits of family living and childcare, education, and the conduct of business. It was the forerunner of the age of scientific development. With the development of the factory system, the labor market increased and youth at early age went to work outside the family. Children had always been valued asset in the economy of the colonists, and now continued to serve as buffers against financial insecurity. The employment of children in factories caused no shock to the public sentiment, because children had always been expected to work. Few people realized the difference between work on the farm and in the home, and in the factory where they often worked 16 hours a day. There are reports, particularly in the textile and canning industries where children tapped 40 cans per minute, where children of 7 and 8 years worked 12-13 hours a day; sometimes being kept awake by having cold water dashed in their faces. And in New York City it was brought to the attention of the authorities at one time that a four-year-old child was employed making artificial flowers. Children were exploited because of shortages of labor, and their parents were criticized when they counseled adolescence against early marriage. Society had need of children, wanted large family, and aided in the early emancipation of child from parent. This was true not only for boys, but also for girls, because there was a great need of women; not only as the bearers of children, but as workers in factory and on farm. The child was part of the economy. In times of labor shortage, he was exploited, put to work early. In times of surplus, he was kept in school longer; encouraged not to marry, and to remain living within the family. In spite of the need for many children, society did not have the methods of reducing the high mortality of children. Very slowly came the realization of the benefits of conserving the life and health of children. In the children of childrearing, ideas of reformers rose to dominance. Having cause to rebel against what they experienced and witnessed, and inhuman treatment of children, and stimulated by the European writers, Rousseau and Pestalozzi, American authors increasingly criticized the artificial and excessive restraint imposed on children by adults. As a result, greater freedom was permitted children. They were listened to, and attempts were made to treat them more as individuals having a unique status, and as equals, instead of as inferiors. They were accorded rights, more in keeping with their immaturity. Although there was a great difference of opinion still about the proper methods of disciplining children, as there is today, more and more the wisdom of those who oddly were religious dissenters as well, such as the Quakers and the Unitarians risked disciplining by more permissive methods was admitted to be reasonable. The philosophy of moral suasion, appeal to reason, and training in resourceful and independence grew in acceptance; although opponents of these views, as now, claim that it led to indulgence and weakness of the will, and was the cause of not only impudence in children, but to delinquency and national corruption at the time. The Humanitarian Movement, which was to gain great momentum in the next several decades, had its real beginnings in the movement for the abolition of slavery. Influenced by the antislavery movement in Europe, and the stand taken in this country, again primarily by the Quaker, efforts of the abolitionists increased; not only at the eradication of slavery, but also for the improvement of the welfare of Negroes and whites alike. When the 13th amendment was passed by Congress, reformers were free to turn their attention to such matters as temperance, woman suffrage, and care of the unfortunate. Financial panics and the increasing urbanization brought into the foreground now problems of poverty, slum living, public health, and child labor. During the winter of 1864-65, New York City had more than 2,000 cases of small pox with 600 deaths. Philadelphia in the first year after the Civil War, had over 700 deaths due to typhoid and 334 due to typhus. These were followed by years with even greater mortality, due to epidemics of these and other communicable diseases. In 1866, New York City established a Municipal Board of Health, and efforts were made to clean up tenement houses and to vaccinate the citizens. However, care of the indigent, prisoners in jails and the mentally sick continued to be deplorable. Children were not differentiated from adults, as all were thrown together in overcrowded institutions. Throughout the history of this time, one is particularly struck with the great advances made in New York City, and over the years, particularly the past years, one has been encouraged by the remarkable advance of the New York City Department of Health. It is with great regret then that I come back to New York City to find this very admirable Department of Health underpaying many of its workers, not doing the job it seems to me is able to do, and it is to be regretted, I think. This city that has in the past sponsored and fostered this developed of health so admirably is now not receiving at least the municipal support it deserves. The first organized protection of children was the outgrowth of humane measures improving the care of animals. In 1874, a girl of 9, beaten and starved by her foster mother was carried into court here in this city as an animal, on complaint of the Society for the Prevention of Cruelty to Animals, because there was no law for the protection of children against cruelty. In that court was organized the New York Society for Prevention of Cruelty to Children. Other organizations aimed at improving the welfare of children were developed. Many of them were part of church and religious movements, such as the nondenominational YMCA. Private philanthropists sponsored the establishment of public libraries, schools, and colleges. However, social needs continued to outrun social provision in meeting them. This was partly due to the poor management of public institutions that were set up to care for the needy. An important development in the 1870s was the setting of social agency which attempted to bring order and good management to private and public charity organizations. Among the most prominent examples of social agencies dealing with children was the settlement house known as Howell House in Chicago, which started kindergartens, clubs, a day nursery for children of working mothers, and a penny savings bank. Welfare workers could not avoid recognizing the fact that the people they dealt with were usually victims of social and economic forces which were inhumane. This led welfare workers, despite ridicule and taunts, which labeled them socialists, anarchists, and atheistic meddlers to support all movements of social uplift, such as the abolition of child labor, sanitary house, penal and public health reform, and campaigns against municipal corruption. Through the 1890's, the people of the United States of America were imbued with the feeling that although the greatest of centuries was coming to a close, still a greater were yet to come. Evaluation of greatest had different meaning to industrialists, factory worker, public health official, physician, social worker, and the humanitarians in general. To the latter, it meant more opportunities to cure the abusers and injustices of society. Life in America had become complex. As then Professor Woodrow Wilson observed in a paper title "On Being Human, 1897", "once it had been easy to be human, but haste, anxiety, preoccupation, the need to specialize and make machines of ourselves, have transformed the once simple world". As the 20th century started, a paradox was apparent. Capitalists, who were accused of greedy and ruthless exploitation of working men, women, and children lavished millions of dollars on hospitals, libraries, schools, churches and museums. You may remember the gospel of wealth of Andrew Carnegie, as he said, the millionaire is but a trustee of the poor. As panic turned out hoards of unemployed, philanthropic efforts rose, and the lot of the common man in general seemed improved by the multitude of new mechanical inventions, through labor saving within the home and in industry, through improved plumbing and sanitation, fire protection, water and food purification, and public hygiene. More schools were being built in the cities and country, and a high school education was sort of a normal expectation. There was a deepening conviction that ethical and humanitarian measures had a vital relationship to economics.
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And that if this kinship was not respected, it may lead to economic disequilibrium. The third and last period to be discussed in this paper covers the first half of the present century. The last 50 years have condensed time, as Henry James predicted. The past 40 years have witnessed terrifying changes. Before the First World War, our people, along with all of Western Civilization were profoundly optimistic and confident the progress of the preceding century would continue. Only a few historians and a few novelists foresaw the confusion, violence, and death ahead, and few social scientists foresaw what would happen to children. Although everything that befalls adults, also influences the lives of children, only a few of the major forces will be reviewed here as having specifically modified the status of children in the past four decades. An impression of economic and social realities of American life at the beginning of the 20th Century may be gained from statistic shows the distribution of wealth. At that time, 1% of the people owned as much as the remaining 99% owned together, and 80% of the people lived a marginal existence. Wages were low, yet standards of living constantly improved, because of the use of machines and large scale manufacturing, which decreased the cost of production. [Inaudible] industrialization, the nation's wealth advanced tremendously, and in time, this was reflected in higher wages and in greater expenditures for public schools, roads, and sanitation, while the new millionaires contributed to higher education and medical research. Despite the criticism of a few muckrakers, there was only mild questioning by the people generally of the ethics of a civilization which allowed a few men to accumulate much of the wealth, and then dole small portions of it back to charity, and that it was filled with contradictions. On the one hand, there were unparalleled wealth and natural resources; yet these were unevenly distributed. The lot of women in the home was better, because of labor saving inventions. Yet social legislation affecting woman lagged behind that of other nations. Children fared better as a whole; yet child labor practices continued to be horribly inhumane. There was a larger leisure class and more individual leisure; yet a large segment of the population worked at least 12 hours daily 6 days a week. Chaotic as all this was, it bred a social consciousness, which led to the greatest humanitarian movement of all times. It was natural that the drive for social justice should embrace the rights of children. Encouraged that the life of children was increased, and the practice of birth control, which was beneficial in reducing the stress and strain which often came to all members of families of many members, too many members, which made the individual child much more precious to his parents, and therefore, an object of more concentrated care and attention. Along with these feelings of parents for their children came greater anxiety to the parents, who began to doubt their own abilities in childrearing. Young parents approached parenthood with exaggerated apprehension, which made childrearing unpleasant for parent and child alike. Minuchin's Normal Behavior came to be looked upon with concern by mothers, who too often were led to believe, sometimes by the experts, that they were responsible for these so-called problems; a feeling I regret to say still is too present among mother's today. It is natural that persons consumed with improving the life of children should turn for aid to the sciences. Big business then in the United States of America had learned that scientific research fostered bigger business, and gave industry advantages in competition. Scientific research became a form of business pioneering. The physician, like the farmer, merchant, and the industrialist, became aware of the usefulness of science solving his problems. Medical research became scientific instead of remaining empirically clinical. As a result, contagious disease began to be attacked with new weapons forged out of the discoveries of Pasteur, Lister, and Koch. Out of these attempts to control disease and to reduce infant mortality, arose the Science of Pediatrics. Pediatricians, along with colleagues in the public health movement, have consistently fostered prevention, as well as control and eradication of disease, and success of these efforts is easily measured. In fact, one of the scientific advances of this century was the development of more accurate methods for collecting vital statistics pertaining to our national health. From these we learn that infant mortality for the first year of life decreased from 100 per thousand live births in 1915 to 32 per thousand live births in 1948. This saving in lives was due in the control of diarrhea and the communicable diseases of the respiratory tract, particularly pneumonia and influenza. Childbearing became safer. Public health measures almost wiped out smallpox, typhoid, and diphtheria. In more recent years, medical science has been evermore successful in the management of physical disease, because of the discovery of the antibiotics, and because of biochemical and biophysical approaches to the diagnosis and treatment of physical pathology. Concurrent with these developments in medicine and public health, have come advances in nursing, education, and psychology. Education and psychology were at first quite apart from medicine, but later these disciplines brought together their theories and knowledge, and exchanged ideas and techniques. One example of such an interchange has been witnessed in the development of American Child Psychology. Psychologists and educators together; method like G. Stanley Hall, Thorndike, William James, John Dewey, and others, through their work; first on learning, often first in animal psychology, and then later work dealing with the learning of humans, basically altered the ideas of child development, and set apart child psychology from the rest of psychology. The psychiatrist, Adolf Meyer, and the founder of psychoanalysis, Sigmund Freud, although representing different philosophies, were in agreement that personality is a summation and synthesis of all aspects of life; biologic, economic, cultural, sociologic, and psychologic. And these great men stressed the importance of early childhood in the development of happy adults. As time went on, this concept led the foundation for a new teaching in childcare for parents, as well as for professional workers in medicine, nursing, social work, public health, education, the clergy, and the law. Indeed, psychology seemed to be the concern of everybody, and many people turned to it for personal, as well as professional guidance. Freudian psychoanalysis ended up removing some of the taboos regarding human behavior, and deemphasizing the need for punishment in character development. Most hoping to eliminate potent sources of unreasonable fear and guilt, which have become recognized as prominent symptoms of the neuroses. Today, dynamic psychiatry, just as some religion before it and now, aims at helping individuals solve psychologic conflicts, and more important solves psychologic conflicts, and more important, emphasizes the importance of providing a happy and health childhood in which capacity to love and to be loved is learned early through experiences with one's parents. Childhood is appreciated as a valuable phase of development in itself, not an ordeal to be speedily passed through in order to attain a more blissful state in adulthood. In the manner of the teachings of Rousseau, the modern parent is encouraged to rear his child in a simple natural environment in keeping with his special needs and his immaturity, so that he may have the advantages of having lived a life of his own. The child is encouraged now to have contact with other children, whom he is not afraid to challenge, when he can define and who can define him, so that out of these experiences, he may become socialized, and may develop that sense of reciprocal relationship with his fellows, which fosters a self-imposed desire for fair play. Interesting child psychiatry and its application to medicine, education, and childcare, receive impetus from efforts of dealing with juvenile delinquency, which caused so much national sentiment after the First World War. Out of this concern developed an active mental hygiene program, and the establishment of the first child guidance clinics. Although national organizations promoting physical hygiene had been established before this time, such as the Child Health Association for example. Now, official bodies, such as the as the National Committee for Mental Hygiene, assisted financially by the Commonwealth Fund, fostered in an effective manner, progress in helping children who are mentally disturbed and in trouble, or seem destined to become emotionally sick. Emphasizing the importance of the teacher and the school of helping children grow emotionally, as well as intellectually and socially, the Child Guidance Clinic were more than treatment centers, and for the past 30 years have continued to serve a broad function of work with children, including parental guidance and the training of professional persons in psychiatry, social work, psychology, pediatrics, nursing, and public health. Such a widening of scope and interest as exemplified by the present day child guidance clinics, characterizes the merging of interests and the interdisciplinary character of other childcare programs. Today, the United States Public Health Service is supporting this child psychiatric program in a creative manner and on a national scale. It would be very remiss if mention were not made of the work and influence throughout our country of the Federal Children's Bureau. Established in 1912 to study problems of child labor and to foster a systematic inquiry into child life generally, this agency of the government has most effectively stimulated and developed welfare programs of every variety, which have become models for other nations, and which may yet prove to be more effective agents for winning international peace, and are our most modern weapons of warfare. The work of the United States Children's Bureau has been highlighted each decade since it was set up by a White House Conference; the last White House Conference being held in 1950. Exemplifying again the interest and trends in childcare work, that conference emphasized the importance of the whole child, his individual worth, and his proper development emotionally and physically, and brought forth recommendations from professional persons in many disciplines and from parents, and from youths themselves, which are to serve as signposts in years ahead for all workers with children and those most responsible for their rearing and care. It is recognized that comparatively little is known about the personality development of children, and hence it was concluded that concerted efforts by professional persons in different disciplines should be focused on study of the child in as scientific and objective manner as possible. As a consequence, there is a renewed interest in the establishment of child study centers at a few America Universities where medical science, education, the social sciences, and the humanities may combine in a comprehensive program of study and teaching about children and their development and behavior, which it is hoped would benefit not only professional persons and parents, but which will contribute the advancement of social progress in this country and of the world. As an example of the function of such a child study center, I may best describe the work at Yale with which I am associated, and which really started at Cornell, as I indicated before. The Child Study Center at Yale was developed as a central agency from the University for teaching and research dealing with the growth and development of infants and children. Its staff consists of physicians, particularly pediatricians and psychiatrists, psychologists and social workers, educators, psychoanalysts, and a sociologist. There is readily available cooperative assistance from other departments in the University representing other fields. We are particularly concerned with the training of medical and nursing personnel and school teachers, who represent disciplines responsible for most of the professional care of children in our country. We are convinced that if the teacher with a pediatrician, nurse, social worker and others has a greater understanding of and feeling for the principles underlying growth and development, and of the dynamic quality and interrelativeness of the processes involve, there would result more effective childcare and teaching than we now provide. Accordingly at Yale, there have been set up programs for a postgraduate training of pediatricians, public health personnel and educators, which have a common focus. Attempts are made to help these students acquire knowledge of the biologic, psychologic, and social mechanisms, which operate together in a well-ordered and regulated manner, and which result in various behavioral patterns.
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An important part of the training is received through direct observation of children of all ages, both well and sick, in different settings, such as the well baby clinic, the nursery school, the elementary school and high school, and the hospital, where the same children may be observed over a period of time; the longer the better, and where each trainee is provided with supervisors who by experience and knowledge can help the student observe, record, contemplate, and understand what is noted. It is hoped that through these supervisors, who represent different disciplines, a translation and application of this new knowledge may be made within the framework of childcare, whether this be medical care, nursing care or classroom teaching, and that physicians, nurses, and teachers would become alerted to the emotional implications of everything they do, and yet coincidentally, will become aware of their limitations with the psychologic aspects of childcare, and they will not strive to be amateur psychiatrists. As an outgrowth of these experiments in teaching graduate students at Yale, we have come to the beginning attempts to modify the training of medical undergraduates. Without underestimating the need to continue studies of disease by a microscope and animal experimentation or by clinical examination, nevertheless, it is our belief that psychologic and sociologic studies of the human being, well and sick, are equally important, and that in medical education, this approach must not only be taught to student by formal teaching exercises, but must be demonstrated by precept and example. This being much more difficult to do than a lecture arrangement. This is not easy to do, because students and faculty frequently feel uneasy when participating in a break with tradition which emphasizes methods of patient study and care from which results are less tangible than statistics marking a fall in death rate or the recovery from illness. The trend nevertheless, seems to be in the direction of a greater alliance between the humanistic sciences and the medical sciences throughout the training period of the medical student. A slogan came out of the last White House Conference, which had been unspoken and taken for granted for a long time. As children go, so goes the nation is the watchword. Militarists and those concerned with fortifying a nation against warfare, have long been aware of the need to protect the young, to conserve their health, and to provide them with the right kind of education. But there are others, the nonmilitarists, who strive for peace, who aren't fully aware of the need to strengthen youth and help develop it in a healthy fashion; not because of the older view of economic necessity, but rather for the very purpose of promotion peace and preventing war. A child came to the serious attention of our society as an object of reform with the rise of science, attention focused on him as an object for scientific study; first in the realm of his physical self, his intelligence, and his learning, and then more lately in the sphere of his emotional and social development. Business and industry have long proclaimed, and to a degree proven, that modern man is master of his economic and physical fate; that more exact knowledge about emotional development and behavior has come a similar believe about the predictability of his future as a feeling, acting, and thinking human being. It has been said that if we could raise a single generation of children who infancy and childhood had experienced a lessening of repression of the natural tendencies of love, sympathy, and coordination, there would result not only a greater expression of humanitarian endeavor, but a social order at home, which might help modify social order abroad. The difficulty is that at the present time, each year seems to bring greater obstacles which interfere with our attempt to give children love and security, out of which they may in turn develop the attributes enumerated before. Many of us are disturbed by the frequent breakdown in family life, by the intolerance of difference in religious beliefs, and may be disturbed most of all by the witch hunts aimed at any person who today professes greater desire for peace than for war, and for international goodwill than for nationalistic enterprise. Whether the convictions that many of us hold regarding the importance of children and the plastic nature of their characters in terms of indoctrination for a peaceful, healthy, and creative group living are borne out, depends on many things. That the child will continue to be considered an object worthy of care and study seems certain, but hopefully aim for this conservation, as well as the products of our efforts will be depends in the last analysis, it seems to me, on you and me; the parents and the parent surrogates of our nation's most valued resource, our children.
[ Applause ]
>> Dr. Sam Zachary Levine: I'm sure I express the sentiments of the entire group of roughly 600 people or more when I say that the provocative comments by Dr. Senn, which were so well-documented historically should elicit a great deal of thought, and challenge the imagination of all of us here. There are a few moments available, I'm told for questions, and Dr. Senn has been kind of enough to consent to answer some of them. The first question occurs to some of us is that in view of the historical description of the growth of a nation, as well as the growth and development of each child, I should like to ask Dr. Senn what he visualizes the future trends are in terms of the art and science of the growth and development of individual children in this country.
[ Background conversation ]
>> Dr. Milton J.E. Senn: Well, I can't answer this question. I am not a historian, nor am I a soothsayer. It's very obvious that I would be subjective in my prediction. I would tell you what I hope would develop. I would hope, for example, that there would be many changes in education at every level. I would hope that we might do more for the education of the parent than we do today. I would hope that could, for the parents particularly, take out more of the worry, the concern that they face in the rearing of infants and children. Efforts are being made in this direction, but we still have the young person approaching parenthood feeling insecure. It seems to me that unless we dissipate this for him, he will take on this childrearing with insecurity, manifested to the infant, so that I would certainly place great hopes in our ability to change all education. In terms of the welfare of the human being, I would hope that we could provide better physical care.
>> You've been listening to a talk on the Art and Science of Growing Up, given by Dr. Milton J.E. Senn, Director of the Child Study Center of Yale University. This has been another in the series of lectures to the Laity, presented by the New York Academy of Medicine as a public service. The next in this series of free talks will be offered on Wednesday evening, January 30, at 8:30 here at the Academy of Medicine, and will be broadcast again by your city station. We bid you a very pleasant good evening now, and return you to our studios in the Municipal Building. This is the Municipal Broadcasting System.
>> Dr. Milton J.E. Senn: If I were dare to make predictions, that I would hope certainly that as the years went on, we could modify people change, we could modify people's ideas about the difference in color and religion. We still are most intolerant of each other's beliefs; whether they be religious or political. In our own work at Yale, we are trying, because it is primarily a teaching institution, to do what I've indicated a moment before, improve our teaching, not only in the curricular changes, as important as this is, but we are becoming aware that the students, not only the undergraduates, but the students in the professional schools are today insecure and are looking to the teachers, not only as professional persons for guidance, but coming to them as people with whom they may talk about their personal self, their personal problems. We need to bring a closer relationship between the teacher and the student. This is not easy to do when we have few teachers, when we have many students, but anything that can be done to bring about a closer interpersonal relationship, I think at the professional and lower educational level would be important.
[ Applause ]
[ Pause ]
The first question reads, when a problem presents itself, how or when can you tell whether you need the aid of a psychologist, or whether the problem is transitory. This is the question of the well-meaning, hardworking parent of today; constantly confronted with this question. I think first of all, we need to know that just growing up around ordinary average growing up, there are problems. These are mostly transitory. They are problems to somebody, but if we could realize that the processes of growth proceed in certain ways that around these processes frequently results physical and emotional change that maybe because of the newness causes concern because of the fact that it was unexpected causes concern. If we could first realize that normal growth and development brings about many changes which are normal, but which would in themselves, disappear in time. I do not know of any line, list of symptoms that I could present in the discipline of psychiatry today. More and more, we are realizing, in terms of the children, the behavior that they show, experienced in adults would be abnormal, but coming in childhood are normal, so that at the period of some years ago when it seemed easy to distinguish the child who was in difficulty, the child who was psychotic or neurotic, today, the professional psychiatrist has greater difficulty in delineating the psychotic and the neurotic one from the other, and more and more, we are finding that some of the ordinary behavior, such as bedwetting, sucking thumb, not eating, are not abnormal in the sense of implying a nervous breakdown. What people, I think, should have available to them when this kind of question comes, is a physician, a visiting nurse, some professional person in whom they would have confidence and assurance, with whom they could talk, could get an understanding of what the behavior means. Very frequently then, this professional person could discover whether the more extensive treatment were indicated. I think that it would not be wise for me to say for example when I thought enuresis was a symptom of pathology or when it was a normal manifestation of certain periods of life. Again, it isn't that easy. At one time we thought we could simplify these things. What we need particularly, I would like to emphasize is resources in the community where people who have questions, who have concerns, may go and receive help; resources that they have faith and confidence in. Since they turn so frequently for help to the pediatrician, the general practitioner, the nurse, these people particularly then should be aware of what constitutes normal development and the usual deviancy.
>> Dr. Sam Zachary Levine: I think we have time for a few more questions, and perhaps represent some that will require a briefer answer.
>> Dr. Milton J.E. Senn: Would recommend the introduction in the school system of a course in mental hygiene administered by a trained person? I believe, that there should be, as part of the training of every school teacher, a course on human development, physical development, psychologic, social development. Today, there are courses given in education in psychology, which I believe frequently are outmoded. They are still concerned with testing; the testing of intelligence. They are still concerned with animal experimentation or almost a neurology approach. I would highly recommend that in our teacher training, there be better courses on the child, what he is like physically, psychologically, and socially.
>> Dr. Sam Zachary Levine: A specific question.
>> Dr. Milton J.E. Senn: Do you consider adults with a fear or negative thoughts of parenthood a good source for an educational program, and can these fears and negative thoughts be corrected?
[ Pause ]
These fears and negative thoughts can be corrected, I think, partly by good educational programs. Education can be helpful in removing fear; sometimes more is needed, however.
>> Dr. Sam Zachary Levine: Another question on education.
>> Dr. Milton J.E. Senn: In changing educational methods, what shall be the ultimate goal in the education of a girl and boy? Well, my own goal would be certainly broader than that, which we once had, of teaching him certain facts, and hoping that he will remember them so that one day he can regurgitate them and get a high passing mark. Certainly, we want him to have facts, to learn how to reason, how to think, how to use facts, but certainly much more, we need to help him grow and respond in his own way. Too often we set about a program for him without taking into consideration his own aptitudes, his own needs. I would certainly consider as part of the educational system; helping him grow emotionally. There's no better place for him through a relationship with an understanding teacher than to grow emotionally. Certainly, the opportunities to grow socially also should exist in a good educational system.
>> Dr. Sam Zachary Levine: A rhetorical question with a certain amount of cynicism.
>> Dr. Milton J.E. Senn: Don't you think that more important than this scientific study of the growth and development of children is the problem of creating a peaceful world, so that when they reach maturity, they can stay alive? [Laughter]
[ Applause ]
>> Dr. Sam Zachary Levine: A specific question in an attempt to help a specific mother.
>> Dr. Milton J.E. Senn: What can be done in a case where a three-and-a-half-year-old boy is extremely jealous of his one-and-a-half-year-old brother? [Laughter] And shows his jealousy by constantly beating the baby and depriving him of any toy he may touch? If this questioner will see me at the end of the session [laughter], I will give references, referral agencies in this city that can certainly help her.
>> Dr. Sam Zachary Levine: There are number of others of that type that I'll refer to Dr. Senn for after the lecture.
>> Dr. Milton J.E. Senn: What do you recommend the Board of Health should do now that you said they did in its earlier days of its existence? I think the Board of Education should provide more personnel of higher quality by providing them with more salary, with more money, by giving these people an opportunity to spend more time with the patients when they come to the clinic. I would hope that the Board of Education might encourage some of the programs of education, community education, which they did so well several years ago, which has lessened in effectiveness because of the extra demands made on a staff that is getting smaller and smaller.
>> Dr. Sam Zachary Levine: A question which requires, I think, an hour's lecture to answer. [Laughter]
>> Dr. Milton J.E. Senn: What are the characteristics of grownup person [laughter]?
>> Dr. Sam Zachary Levine: A question involving a specific answer, which Dr. Senn may wish to discuss privately later.
>> Dr. Milton J.E. Senn: I am a divorcee for the past 2-1/2 years, now working. My daughter, age 12, is left alone a good part of the time. Will this have any damaging effects on her since this is so recent that she has been completely on her own? I would believe that a 12-year-old should be capable of being left alone increasingly. I do not think about the question about the danger about being left alone is the important part of this consideration. I am concerned more about the fact that a 12-year-old child has but one parent to relate to. A 12-year-old girl needs to have two parents, and if she cannot have her own two parents, I would hope that she would have very capable parent substitutes who stand in.
>> Dr. Sam Zachary Levine: A question I'm sure that interests all parents of school children.
>> Dr. Milton J.E. Senn: Do you agree that school has required too much homework of children, [Laughter] shortening their leisure time for hobbies, play, and fresh air? I am completely in agreement with the belief that too much homework is now required. I think that we have again brought into our thinking some of this old colonial theological way of looking at things. It's almost sinful to give a child a little extra time. We better make him realize that this school is important by making it hard for him, making it unpleasant. We still suffer from the mistaken notion that learning come best when it is associated with much suffering. Now if this child with the extra leisure time when he gets less homework is provided by so many hobbies by his parents, again, I would say I hope that these may be reduced [laughter].
>> Dr. Sam Zachary Levine: A Christmas question.
>> Dr. Milton J.E. Senn: Have you any rules, suggestions concerning Santa Claus and his trusting children? There's such a great need for it. I'm one of the old school who believes it's very important to let fantasy and to have symbolic figures that we trust and believe in, and I believe that Santa Claus serves a very important and useful function, service in this regard. [Applause]
>> Dr. Sam Zachary Levine: A question on adolescence.
>> Dr. Milton J.E. Senn: Do you feel it is necessary to be demonstrative towards our children during their adolescence? Is it necessary to put into words our love for them, or do you not, I guess, show this? I believe that the adolescent is made rather embarrassed when we deliberately show our feelings for him, our emotions for him. Whatever the age of our children, I think it is always well if we are natural and show the feelings that we have for them, but much more important than demonstrating it in words or even in such mannerisms as caressing, I think there is something else that they feel when we love them. I don't think it's in the demonstration of this in the overt demonstration that's important, it's rather how we feel and how we are natural about showing not only mood and the affect of love, but also if we show them the other feelings that we have. It is certainly healthy for our children to realize that we get angry, that we hate, that we are envious. I would hate to think, myself, that our child were growing up about being able to hate the things that I want her to hate. It would be very sad if she didn't hate war, for example.
>> Dr. Sam Zachary Levine: This question I'm going to read, but I'm going to ask Dr. Senn to answer it later. Just a little knowledge on Tay Sachs disease. Thanks from the bottom of my heart. I'm sure Dr. Senn would be happy to see the person who asked this question, but I don't think it has specific general connotations to present before the group. You refer to the antibiotics generally, generally aureomycin, terramycin, etc. are placed in this case, but were not any formal medications also antibiotics?
>> Dr. Milton J.E. Senn: Yes, there were other antibiotics before. These are the common ones that we know. Historically penicillin was before aureomycin and terramycin. The great advances now are, of course, in these newer antibiotics.
>> Dr. Sam Zachary Levine: Are child guidance centers applicable to large groups of the population?
>> Dr. Milton J.E. Senn: Not generally over the country, but there are more and more child guidance clinics being set up. Furthermore, the kind of work, specifically in therapy now that is going into the child guidance clinics is aimed at group work, whereas one day attempts were made to deal with individuals. Now, more and more, because the need is great and the number of child guidance clinics continue to be too small, there is a tendency towards group work with parents and with children.
>> Dr. Sam Zachary Levine: I've been informed we have time for just two more questions, and the first one is, I think, one you'll all be interested in. Does the insecurity of the world situation manifest itself to parents in the child's emotional insecurity to a large degree?
>> Dr. Milton J.E. Senn: It seems to us, many people believe, I believe, that the insecurity of the world situation does manifest itself to parents, to children; not only through the words that parents say, not only through the talk that goes on in the home, but I think that we must ever realize that the infant, already the infant is very sensitive to our feelings, and when we are disturbed by war, by any of the other fears and worries that have always beset us, the children do sense it. We know this with infants. Mothers tell us that when they are feeding babies frequently, the child seems to sense it. There now arises a temporary feeding difficulty. This is the kind of problem that I meant when I spoke before; a problem arising now for the moment, a temporary problem around a situation that may not be persistent. So, I would say that there are many ways in which we as parents show our insecurity. Children do feel it, respond to it in various ways.
>> Dr. Sam Zachary Levine: And to end the questions on a facetious note. Do you agree with the popular belief that Dr. Spock's book is the new mother's bible [laughter].
>> Dr. Milton J.E. Senn: I do. I certainly do agree and am proud to say that Dr. Spock, a former associate of Dr. Levine's and mine has created one form of modern bible.
[ Applause ]
>> Dr. Sam Zachary Levine: Ladies and gentlemen, may I make one announcement. I wish to remind you that on January 30th, the last of the Laity lectures will be given by Dr. Russell M. Wilder on the title, "The Evolution of Nutrition". You're all cordially invited to be present.
[ Applause ]