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Temperament in pediatric practice
with Stella Chess, MD
Clinical applications
Using temperament concepts with clients/patients
Prevention
Assessment
Intervention


Practitioners in several disciplines incorporate temperament concepts into their professional practices...
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For Primary Care Professionals
Normal Misbehavior
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 Temperament-based Prevention

Preventing child-caregiver behavioral issues

If temperament can lead to behavioral issues, can informing families guide them away from problems?


Dr. James Cameron has worked on this problem for many years, in conjunction with Kaiser Permanente, one of the largest health maintenance organizations (HMOs) in the United States. His research replicated and extended the NYLS findings about temperament on over 8000 children studied.

To study the potential of temperament to prevent problems, Cameron and his colleagues worked with pediatric departments to send temperament questionnaires to new parents in the Kaiser HMO and used the results to anticipate parenting issues. For example, if babies and toddlers with low sensory thresholds were more likely to have sleep problems, parents were sent suggestions on how to help babies stay asleep through the night. If high activity level were associated with increased accidents, then ways to eliminate likely causes of accidents were offered. These suggestions were called anticipatory guidance because they anticipated problems based on temperament ratings and gave preventative guidance on how to improve the 'goodness of fit' if they occurred.

In the Kaiser program, parents who were struggling with 'normal' temperament issues were offered temperament counseling aimed at improving the caregiver's awareness of the youngster's temperament and helped to work around problem areas.

Dr. Cameron found that not only did parents appreciate and benefit from the temperament guidance, it reduced the HMO's costs by decreasing the number of checkups needed in the study group compared to groups not receiving guidance.
 
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   Examples:
 
Normal vs. Abnormal
Temperament or Psychopathology?
Temperament can be confused with symptoms of clinical conditions or thought to be indicative of severe emotional or behavioral problems. Learn the difference...
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Preventing Problems
Dr. Jim Cameron's
program provided anticipatory guidance to predict behavioral issues...

Studies showed that the process helped families and conserved professional time.
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Taming a preschooler
A Case Study
More than 10 percent of preschool teachers have reported expelling a preschool-aged child. Grounds for expulsion were largely aggression toward other children-hitting, kicking, biting, hair-pulling...
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Temperament & ADHD
Understanding normal variations
Many children show a few signs of attentional or activity problems. Most don't have ADHD.
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"At-risk" infants
Barbara Medoff-Cooper
Babies who are ill or need surgery
may have a 'difficult' homecoming.
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