CHAPTER 33
Nature and Nurture
Until recently, many studies of children and adolescents’ difficulties as-
sumed that poor outcomes were due to the unsatisfactory conditions in
which they were raised. In fact, the picture may be much more complex.
Consider, for example, possible interpretations of the finding that children
who are poor readers are more likely to come from homes where they
do not spend much time reading to their parents. This finding would lead
many to conclude that the children’s lack of interest and ability in reading
stemmed from a lack of parental attention and encouragement (one can
almost hear the cries of ‘that’s only common sense’). However, there are
many other plausible interpretations. One possibility is that although the
parents love books and are good readers themselves, the child may have
some constitutional reading difficulty (‘dyslexia’) which means that he
finds being encouraged to read very unpleasant, as he cannot do it nearly
as well as his younger sister. His parents will soon learn to back off to avoid
the whining, resentment and misery they cause! Another possibility is that
the parents and child all have genetically determined reading difficulties so
that they all avoid anything to do with reading. A third possibility is that
both parents and children could easily read if they had the opportunity,
but they live in an environment where there are no books and the video
is king. And of course more than one of these three explanations may be
operating at the same time.
Sorting out what is cause and what is effect is no mere academic matter.
If we are trying to improve people’s lives, it is essential we get it right.
At an individual level, there is no point, for example, in trying to teach
a ‘refrigerator mother’ holding techniques to ‘get through’ to her autistic
son if in fact he has a genetically determined inability to communicate
which has consequently led his entirely normal mother to give up trying.
At a policy level, there is little point in rebuilding a sordid estate in order
to eradicate the high rate of child abuse and schizophrenia found there, if
in fact the reason people with these difficulties have ended up living there
is because of their multiple social handicaps, which they will take into
any new situation, and which should be addressed in their own right. (It
might be a good idea to rebuild the estate for lots of other reasons though.)
Child and Adolescent Psychiatry, Third Edition. Robert Goodman and Stephen Scott.
©c2012 Robert Goodman and Stephen Scott. Published 2012 by John Wiley & Sons, Ltd.
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