Abstract
Adolescence has long left the silent zone and is a well studied phenomenon. The child entering this extended developmental stage is confronted by a world of rapid uncertain change, social and cultural upheaval, expanding technology with complex vocational pressures. In his search for identity, he can expect and is expected to go through a period of turmoil, where the boundaries of normality and pathology are notoriously indefinite to health professionals, society and even to the adolescents themselves.
The family of the adolescent and society itself, responds to the unfolding development, the sexuality, the drive for independence, the emerging intellectual and vocational potential, the search for trustworthy humans and belongingness with peers, society, and humanity, with responses ranging from healthy empathy to seduction, envy, and undue expectations often of stereotypic proportions. From a controlling apprehension about this emergence, the child can often be viewed with unreal dependence as the new hope for the better world.
Entry to puberty and adolescence has deep significance throughout the history of mankind. The modern day child may well approach the task with more anxious expectations, and may well wonder what roles he will have to fulfil, what options will be possible, and what lies ahead. He has been drafted compulsorily—how will he serve?
In the biologically intact child, where there has been a nurturing and facilitating environment developmental lines flow in genetic continuity. Physical, intellectual, emotional, and social parameters each show spurts and lags varying in timing and intensity. Earlier delays, deviations and defects may become relevant once more or be relegated to the past by new healthy adaptations.
In this period the child is vulnerable from within and without to the manifestation of intensified biological drive, psychological growth and social demand. Family and social responsiveness must be matched by competence and availability of health professionals.
Crises—whatever their origin—are a turning point between further continuity or pathological development.—and require the establishing of healthy adaptive inter-relationships with family, peer groups, school and community. This paper will illustrate current crises and clinical disorders which necessarily present to paediatric psychiatric services whose role may be crucial in offering diagnostic and therapeutic intervention for the child and family, ranging from crisis intervention models to extended care for the child and family.