Treasured Objects in School-Aged Children

(1)

Treasured

Objects

in School-Aged

Children

Miriam Sherman, MD, Margaret Hertzig, MD, Rochelle Austrian, PhD,

and TheodOre Shapiro, MD

From the New York Hospital-Cornell University Medical College, New York

ABSTRACT. Infants and young children often form

te-nacious, persistent attachments to soft objects. No inves-tigation has focused, specifically, on an older school-aged

population. Data were collected from parents of 171

nor-ma! children between 9 and 13 years of age from the

middk to upper socioeconomic class. The study (1)

corn-pared current behavioral characteristics of children with or without a history of attachment; (2) compared the current behavioral characteristics of the children who have or have not maintained that attachment; (3) ex-plored the relationship between parental attitudes and

the persistence or disappearance of the object; and (4) explored family demographics and object use among sib-lings. Approximately half (54%) had formed an attach-ment to an object in infancy. Of the group of “users” approximately half kept it until age 9 years (49%). There were no significant behavioral differences among those children who were or were not attached to an object, or among those children who continued to use a soft object after age 9 years compared to those who never used one at all. Parents felt they had little to do, directly, with their child’s relinquishing the object. Sibling use, the number of siblings, ordinal rank of the child, parents’ marital status, sex of the child, and history of thumb-sucking were all unrelated to object attachment. Pediat.

rics

68:379-386, 1981; treasured objects, transitional ob-jects, blankets, attachment.

It is well known that infants and young children often form tenacious and persistent attachments to soft objects in their environment. The cartoon

char-acter, Linus, always seen with his “security

blan-ket,” has become the graphic representation of such an attachment. Gesell and hg’ pointed out that many preschool-aged children insist on taking a particular blanket or toy to bed. Clinicians are

aware of the fact that these objects are often used by children, during daytime hours as well. Winni-cott2’3 emphasized the developmental significance

Received for publication Nov 21, 1980; accepted Jan 6, 1981.

Reprint requests to (MS.) New York Hospital-Cornell

American Academy of Pediatrics.

of these early attachments and coined the terms

“transitions.!

objects”

and

“transitional

phenom-ena.” He described these objects as the first “not-me” possessions of a child. He theorized that by the use of these objects and phenomena (eg, the repe-tition of sounds or tunes) the child can symbolically

re-establish

his

union with his mother after

sepa-ration. Wrnnicott felt that as the child grows, the object is not forgotten, but the concern and the affection that the child has invested in his object wifi gradually be transferred to creative play and symbol formation. Winnicott implied that attach-ment to an object was normal, universal, and even necessary for health.

In the 30 years since Wrnnicott’s original papers, other theorists have expanded upon his formula-tions regarding the developmental significance of the infant’s first treasured object. They have linked the first treasured object to many things including object relations and ego development,2’4’5 the

proc-ess of separation-individuation,6’7 psychosomatic symptoms,8 mother-child interaction,9”0 character style,” as well as to language, creativity, and the poetic process.2”2”3

Some theorists have regarded attachment to the first treasured object as positive2’3”4 whereas others

have speculated that children who esteem their prized possessions “excessively” have disturbances in mother-child interaction.9”0

Pediatricians and child psychiatrists have

won-dered about the significance of object use. In addi-tion, they are often faced with the practical problem of advising parents about management when at-tachment to an object persists.

It is remarkable that there have been few inves-tigative studies or normative surveys, despite ele-gant theorizing regarding the meaning and fate of the infant’s first treasured object. Information re-garding prevalence, duration of attachment, family attitudes, variability among socioeconomic groups, and most importantly, outcome data comparing

(2)

chil-dren who were or were not attached to an object since infancy is rare and often conflicting.

The few existing systematic studies have

gener-ally focused on infants and preschool-aged chil-dren.7”4’8 All reports have confirmed the fact that a group of children form an attachment to a partic-ular object during infancy, and this attachment is maintained through the preschool years. However, the proportions of children who do or do not form

this attachment appear to vary in relation to the

cultural milieu.

No investigation has focused specifically on an older school-aged population. In addition, no study

has systematically looked at duration of attachment and use, nor has any study explored the behavioral and personality characteristics of children to

deter-mine whether those who had objects in the past ultimately fared better or worse than those who did not. The present study aimed to do four things: (1) compare the current behavioral characteristics of older elementary schoolchildren with or without a history of an attachment to a treasured object; (2) compare the current behavioral characteristics of those children who have or have not maintained an attachment to a treasured object into the middle school years; (3) explore the relationship between parental attitudes and the persistence or disappear-ance of the treasured object in the school years; and (4) explore family demographics and treasured ob-ject use among siblings.

SUBJECTS AND METHODS

Initial questionnaires (441) were sent to all par-ents of children currently enrolled in grades 4 through 8 (9 to 13 years of age) of a New York City private school for normal children (see Appendix I). This population was selected for study because of the already reported increased object use in urban children of educated parents of the upper

socioec-onomic class.7”6 The group contained a total of 222

boys and 219 girls. Parents were asked to include

information regarding family composition, occupa-tion, education, and marital status; in addition, information was solicited concerning past or current object use of each child in the family, age of attach-ment and disuse for each, as well as the nature of the object of attachment. Parents were also asked to indicate whether they would agree to a follow-up telephone interview. From this initial survey, 171

questionnaires were completed and returned to us,

a return rate of 40% (41% of boys and 36% of girls). It was not possible to secure permission from the

school to conduct a second mail canvass. Although

the school population was almost equally divided between boys (N = 222) and girls (N = 219), the

return sample includes a slight and insignificant

over-representation of boys (54%).

We defined the treasured object as the object to which the child became attached within the first two years of life; the object was in use for at least one year and functioned as a soother, and was neither breast, bottle, pacifier, nor part of the child’s body.

A one in two random sample of 78 children was selected from the entire group of questionnaire respondents for more detailed study as described below.

Semistructured Telephone Interview

This interview was designed to elicit data

con-cerning the history of the treasured object, parent’s

theories and attitudes regarding its use, how the object was given up, as well as developmental

his-tory and personality characteristics of the children.

(see Appendix II)

Child Behavior Inventory

This scale, adapted from Rutter et al,’9 was used in the epidemiologic study of behavior disorders on the Isle of Wight (see Appendix III). Our adminis-tration of the scale differed from that of Rutter and associates in that parents were asked to respond

verbally to the questions as read to them over the

telephone rather than in writing.

As described above, our data were derived from maternal reports and were not validated by either direct observation of, or by interviews with, the children studied. However, Weisberg and Russell2#{176} used a method similar to ours and found that moth-ers’ reports of the use of attachment objects coin-cided with their children’s behavior in a directly

observed experiment. We found that most mothers

understood very clearly the type of object that was being asked about and were able to reply with

apparent assurance about it.

RESULTS

Subjects were divided into three groups: (1) those who never had an object; (2) those who had an object but gave it up before age 9 years; and (3) those who still had an object or kept it until age 9 or beyond-”late users.” This definition of late use was derived from the administrative structure of the school. Children (9 years old) in fourth grade were transferred from the primary school to the middle school. Because we wished to study an older elementary school population, we used this middle school group.

Survey Data

(3)

TABLE I. Use of Attachment Objects

Had (ages 2-8 yr) 10.68 ± 1.70

Had (age 9+) 11.44 ± 1.60

* P value was not statistically significant.

TABLE 3. Distribution of Symptomatic Children (Rutter Scale 13+)

* x2 = 0.521 (Yates correction); dl = 1; P value was not statistically significant.

t x2

= 0.0155 (Yates correction); dl = 1; P value was not statistically significant.

our initial mail inquiry, 54% (N = 92) were reported

to have been attached to a treasured object. Of the

group of users 49% (N = 45) maintained their at-tachment until at least age 9 years. This group of

late users was about equally divided between boys (49%) and girls (51%) (Table 1). Among those chil-dren who had been attached to, but had given up their objects, the median age for giving up was 6 years. The modal age for giving up was 6 for girls and 4 for boys. For the entire sample, the distribu-tion of type of object was: blankets and pifiows, 60.6%; dolls and stuffed animals, 39.4%. Distribution of type of object for the late-use group was essen-tially identical: blankets and pifiows, 63.2%; dolls and stuffed animals 36.8%. Data relating family constellation to treasured object use was not

sig-nificant. X2 tests showed nonsignificant

relation-ships

between treasured object use and birth order,

size of family, parental divorce, or object use in

other family members.

Telephone Interview Data

The following data are based on the responses of 78 parents obtained during the course of a telephone interview. In this group of children, 31 (40%) never had an object, whereas 47 (60%) did have a prior history of attachment. The proportions of children in the telephone sample who were classified as

“never had” or “ever had” did not differ signifi-cantly from the remainder of the questionnaire respondents

(x2,

2.4044; df,1; P, NS).

Child Behavior Inventory. Mean symptom scores on the behavior scale were calculated according to the criteria set forth by Rutter et al.’9 Results are

shown in Table 2. No significant differences oc-curred between the groups who had never used or had used a treasured object (t, 1.90; df, 76; P, NS) or between early and late users (t, 153; df, 44; P,

NS).

The data were further analyzed to determine whether there was a different distribution of

“symp-tomatic” (ie, Rutter Score 13) children among those with or without reported treasured object use

and early and late users.

x2

analysis was again

nonsignificant (Table 3).

Adaptability and Sensitivity Ratings.

x2

deter-minations were calculated based on parental clas-sification of their children according to the following

dimensions: outgoing-shy, adaptable-nonadaptable, easy or difficult to raise, and flexible-rigid parental

style.

No differences occurred between the “never

hads” and “ever hads” on any of these variables. Children who were treasured object users, however, were described as being more responsive to tactile

stimuli.

N Male

% Fe

N male

%

To

N tal

.

Never had 43 47 36 46 79 46

Had 49 53 43 54 92 54

Total* 92 100 79 100 171 100

Age when dis-carded

<9yr 27 55 20 47 47 51

9yr 22 45 23 53 45 49

Totalt 49 100 43 100 92 100

*x2 = 0.0234; P value was not statistically significant.

t x2

= 0.6763; P value was not statistically significant.

TABLE 2. Mean Rutter Score*

N Mean±SD t dl

Never had Ever had

31

47

11.63 ± 1.77}

10.76 ± 2.66 1.73 76

19

28 45

Symp

N

tomatic

%

Nonsym

N

ptomatic

%

Total

Never had 3 9.68 28 90.32 31

Everhad 4 8.51 43 91.49 47

Total* 7 8.97 71 91.03 78

Had (ages 2-8 yr) 1 5.26 18 94.74 19

Had (age 9+ yr) 3 10.71 25 89.29 28

Totalt 4 8.51 43 91.49 47

When groups of early vs late discarders were compared on the same dimensions, children who

retained objects after the age of 9 years were no

different from those who discarded their objects

before age 9.

Parental Descriptions ofChildren ‘s Personality. Parents were asked to describe their children using

brieflabels.

The parents

used a total

of

115 different

adjectives, which were classified in the following

categories: mood, sociability, intelligence, indepen-dence, and miscellaneous description. Adjectives were classified independently by three raters, with 92% agreement. Differences were resolved by dis-cussion among the raters.

(4)

DISCUSSION

We have shown that within a group of middle- to

upper-middle class city children (N = 171) approx-imately half (54%) reportedly had formed an at-tachment to a treasured object in infancy. The proportion of children with a history of an attach-ment to a treasured object is higher in this sample than in the sample of 3-year-old London children

(N

= 115, 18.4%) reported by Boniface and

Gra-ham’7 but somewhat lower than in the group of Anglo-Saxon children of unspecified age residing in

Rome (N = 56, 61.52%) described by Gaddini and

Gaddini.7 Our data were most similar to the group of middle class US children between ages 7 months and 8 years (N = 169, 54%) reported by Hong and

Townes.’6 Our data, in addition, revealed a surpris-ingly high frequency (26%) of object use among the entire group of older children (ages 9 to 13). These

children

continue

to use the

object

as a soother

at

bedtime or during periods of stress or inactivity. Although we did not specifically seek information concerning the intrapsychic significance of these objects, we have been able to determine whether those children who had been attached to objects during infancy were perceived to be more or less well adjusted as they grew older. Horton et al2’ suggested that a lack of attachment to a treasured object may be associated with personality disorders in adults. Our study did not reveal an increase in

symptoms among nonusers of treasured objects, at

least in this age group. We found no significant

differences

between

users

and nonusers

with respect

to either behavioral or somatic symptoms, ease of “raisabiity,” adaptability, or independence. These

data are in accord with the findings of Winnicott,2 who regarded “transitional phenomena” as neces-sary for healthy personality development, yet did not regard the use of an object itself as essential.

In addition, our data are consistent with Winni-cott’s22 view that the “object” is not forgotten but rather relegated to limbo. The persistence of active object use into the tenth year of life and beyond in almost half of the children who had become at-tached during infancy suggests that the process of emotional detachment from the object is a slow one for a substantial number of children. The object may not be used regularly but may be kept in an accessible place and resorted to only briefly on particularly stressful occasions. This is in accord with Gay and Hyson’s report’4 of four young chil-then who used “security blankets” in response to tension, uncertainty, conflict, and other stressful states. For example, one mother in our study re-ported that her 10-year-old daughter had discarded her blanket and kept it in her closet. She had not used it for about a year. The night before she was

to leave for summer camp her mother observed that

she had retrieved it and was soothing herself with it. The child explained its reappearance with no apparent embarrassment by reporting to her mother that she was “nervous” and “scared” and

needed her blanket. She left willingly for camp the

following morning without her blanket.

Moreover, our failure to find an increase in signs of behavioral disturbance in this group of late users

suggests that an extended period of object use is not specifically pathologic. In addition, late users did not differ with respect to other characteristics such as adaptability, sociability, independence, or mood from either those who never had or those who relinquished their objects earlier in life.

Because we were not able to document significant differences in personality or behavioral

character-istics that correlated with attachment to, or

main-tenance of attachment to, an object we suggest that prior theories of its effect on development require

modification. We further wonder, as does Brod?

if the developmental significance of the “transi-tional object” has been idealized.

Among this sample of middle-upper middle class mothers, great acceptance of and even delight with the awareness of the child’s attachment to and continued use of a treasured object were evident.

This may reflect parental “psychological minded-ness” and familiarity with psychological theory, or cultural determinants that reflect parental aware-ness of the commonness of the phenomenon in this

culture. One parent, for example, who described

herself as a “Scandinavian foreigner” felt that her

11-year-old American-born daughter maintained her nine-year attachment to a blanket because it

was an “American custom.” Testimonies to this

view are frequent-eg, a 10-year-old boy, attached to a blanket, did not take it with him to camp because he believed that his peers would tease him.

The first letter home contained a plea that the

blanket be mailed promptly. This request followed the child’s realization that many of his peers had brought their own tattered, treasured blankets and so it would be “safe” to have his.

One mother, a psychologist, worried that her infant son did not become attached to an object, provided him with a series of blankets and stuffed animals. Her attempts were futile, but her anxiety was allayed when she noted he sang the same tune prior to sleep each night. She reassured herself that

this was a manifestation of a “transitional phenom-enon” which she sought to foster. Another mother proudly attributed her 10-year-old child’s avid in-terest in primates to his five-year attachment to a stuffed monkey.

(5)

relinquishing of an object. Either the object was stuffed animal, toy, etc that he is or was attached to

spontaneously, gradually given up by the child, or an outside “authority”-dentist (when it was asso-ciated with thumb-sucking), or a pediatrician-was instrumental in effecting its disuse by direct

sug-since he was an infant or young child?

Yes ( ) No (

If your response is No-the questions asked below will not apply. Please return questionnaire. Would you mind receiving a phone call from us, if we desire further infor-gestion.

Our data show that number of siblings, object use

mation?

Yes ( ) No (

by a sibling, ordinal rank of the child in the family, III. If one of your children has or had a favorite object

parents’ marital status, sex of the child, history of parental object use, history of thumb-sucking, and

to which he is or was attached since he was an infant

or as a younger child, please indicate below:

ease of care of the child in infancy were all unrelated Name of Present Nature of Age He Age Ob-to attachment to an object.

The theoretical conceptualizations and evolution of thought regarding children’s object use, appear to be analogous to the evolution of thinking regard-ing another commonly observed

phenomenon-Child Age Object (Blan-ket, Animal,

etc)

Became Attached

ject Was Given Up

1. 2. 3.

thumb-sucking.

Despite

the early

theoretical

attri-

4.

butions of an association between psychological 5.

problems in children and thumb-sucking’25 later Would you mind receiving a phone call from us, so that investigative studies clarified the fact that the

prob-lem of thumb-sucking had been overemphasized and that no correlation existed between psycholog-ical problems and thumb-sucking.26

Similarly, our study does not substantiate earlier

we may find out more information about the history of the treasured object and its use?

Yes( ) No(

Again, thank you for your help.

Please return questionnaire in the enclosed envelope.

theoretical formulations on treasured object use in relation to psychological health or ifiness. We have documented no significant differences between those children who were and those who were not

APPENDIX 2. Parent Questionnaire for Telephone In-tel’View Transitional Objects in School-Aged Children

attached to a treasured object, or in those children who continue to use a soft object after age 9 years compared to those who never had a treasured

ob-ject. I. Demographic Data

This study highlights, once again, the diversity

and richness of individual experience that falls

within that larger category called “normal.”

1. Informant 2. Name of child 3. D.O.B. Age 4. Sex

5. School grade

6. Family Composition: (Check if lives in household) (If

APPENDIX I. Parent Questionnaire on Treasured

Ob-jects in School-Aged Children

I. Demographic Data

Name:

Address:

Phone no: Family composition:

Father: Age Occupation

not how and when left?)

Father: ( Mother: (

Siblings: (list in order of age; indicate sex) (

(

( (

7. Father: Occupation Education

Education 8. Mother: Occupation Education

Mother: Age Occupation

Education

9. Family income level Under 10,000

Marital Status: Married Single

_io,ooo-i,ooo

Separated Divorced _{20,000-29,000}

30,000-39,000

Sex Age School Grade

1.

40,OOO49,0OO

50,000+ 2.

3. II. History of Treasured Possession

4. 5.

II. Does or did your child have a particular blanket,

10. Did (name of child) have a favorite or trea-sured possession as an infant or young child? 11. What was it?

Children: First Name

(6)

Age Rating 12. When did he get it? (his/her age)

(from whom?)

13. When did you notice (s)he was attached to it? 14. How did you know it was special to him?

(proves-when did (s)he use it? eg, sleep, upset, separation from mother etc. Did (s)he use it for other than comfort? Did you take it places? What happened if it was lost even temporarily).

15. Why do you think (s)he became so attached to it? 16. How did you feel about it? (probes-normal phase,

felt (s)he needed it, unconcerned, worried etc) 17. What happened to it? (if still in use skip to question

22)

18. If original object is no longer used when did child stop using it? (age)

19. How did this come about?

20. How did you feel about his giving it up? (probes-relieved, he’s growing up, worried, etc)

21. Was there a substitute(s) ie, other possessions that seem to be used in same way or circumstances)? What is it (they)? a series?

22. Did (does) he suck his/her thumb? 23. When? (with object?)

Ill. Present Status

24. Is he/she attached to anything now? What? (if not the original object elicit history of this attachment eg, when did he get it? how old? from whom, etc) 25. How do you know it’s important to him?

26. When and why does he use it? (probes-comfort, relaxation, to sleep with, play, etc).

27. Does he suck his thumb with object? at other times? 28. How do you feel about it? (probes-embarrassed,

concerned, annoyed, angry, unworried-he’ll give it up when he’s ready).

29. Have you ever tried to get rid of it? (probes-why? how? what happened?)

30. Have you ever tried to limit its use? (probes-how?

where is it kept? other rules? what happens?) 31. How do other people react? (probe-father? other

relatives? friends and neighbors? do they know? is he teased?)

32. How does the child feel? (probes-does he talk about it? What does he say? Is he embarrassed? Do his friends know? Do they tease? Does this bother him?) 33. Has the child ever tried to give it up or limit its use?

(why? how? what’s happened?)

34. Has he ever been separated from it for a period of time (sleep other house, camp, vacation) what’s hap-pened? does he go back to it?)

IV. Characteristics of Child

35. How would you describe (child’s name)? What kind of a person is he/she?

36. Does he move into a new situation easily or does it take him a while to warm up? (probes-new place? new school? will he try new foods? strange adults? strange children? is he different with peers and

adults?)

37. Would you describe him/her as: (1) very out-going, (2) moderately out-going, (3) moderately shy, (4) very shy?

38. How easy or hard is it for him to get used to changes? (probes-changes in routines? being comfortable in strange places? a new school? eating food he initially disliked?)

39. How about using a cup? How old? Any prob-lems?

40. How about toilet training? How old Any prob-lems?

41. Would you describe him/her as: (1) very adaptable, (2) moderately adaptable, (3) moderately nonadapt-able, (4) very nonadaptable?

42. Does he tend to respond to touch and the way things feel or does he seem to ignore it? (probes-is he a cuddly kissy child? does he like soft things? does he complain about clothing being tight, itchy, or uncom-fortable? do you have to wash new clothes before he will wear them?)

43. Would you describe him/her as: (1) very unrespon-sive, (2) moderately unresponsive, (3) moderately responsive, (4) very responsive?

V. Other Family Members and Their Objects

44. Do (did) any of the other children have a blanket or other treasured object? (probes-who? what? what happened? if given up, at what age?)

45. Do you remember having a special object as a child? (probes-what? what happened?)

46. Was (is) it surprising to you that this child was (is) a blanket child?

VI. Parent-Child Interaction

47. Was there anything in your life or family situation at the time of this child’s birth that made him/her special in any way?

48. Some parents are more comfortable with infants-some with older children, is this true of you? With what age child are you most comfortable?

49. Would you describe this child as: (1) very easy, (2) moderately easy, (3) moderately difficult, (4) very difficult to raise?

50. How about the other children? (obtain a rating on each).

Age Rating

F

51. In raising this child would you describe yourself as: (1) very easygoing and flexible with few rules (health and safety), (2) moderately easygoing and flexible with some rules, (3) moderately rigid with a consid-erable number of rules, (4) very rigid with rules to cover most situations.

52. How about the other children? (obtain a rating on each child)

(7)

Age Rating

(i)

Never in the last

year (ii) Less of-ten than once per

month

(iii)

At least once per

month

(iv)

At least once per

week

APPENDIX 3. Child Behavior Inventory-for

Tele-phone Interview: Transitional Objects in School-Aged

Children (Adapted from Rutter et al19)

Miriam Sherman, MD

Margaret E. Hertzig, MD

To Be Completed by Parents STRICTL Y CONFIDENTIAL

Name of child

_______________________________

Boy/Girl

Date of Birth Age

How to fill in this form:

The questionnaire asks about various kinds of behaviour that many children show at some time. Please cross the answers according to the way your child is NOW.

Health Problems

Below is a list of minor health problems which most children have at some time. Please tell us how often each of these happens with your child by putting a cross in the correct box.

III. Does he/she ever steal things?

( ) No ( ) Yes-occasionally ( ) Yes-frequently If ‘Yes’ (occasionally or frequently),

when he/she steals, does it involve

( ) minor pilfering of pens, sweets, toys, small sums of money, etc

( ) stealing of big things

( ) both minor pilfering and stealing of big things when he/she steals, is it done

( ) in the home ( ) elsewhere

( ) both in the home and elsewhere when he/she steals, does he/she do it ( ) on his/her own

( ) with other children or adults

( ) sometimes on his/her own, sometimes with others

Iv. Does he/she have any eating difficulty? ( ) No ( )Yes-mild ( ) Yes-severe If ‘Yes,’ is it

( ) faddiness

( ) not eating enough ( ) eating too much

( ) other, please describe: ______________________

A. Complains of head-aches

B. Has stomachache or vomiting

C. Complains of nausea

V. Does he/she have any sleeping difficulty? ( ) No ( ) Yes-mild ( ) Yes-severe

(iv) If ‘Yes,’ is it difficulty in

At least

( ) getting off to sleep

once per

week ( ) waking during the night

_____

( ) waking early in the morning

( ) ( ) other, please describe:

____

( ) Below are a series of descriptions of behavior often shown by children. After each statement are three columns-( ) ‘Doesn’t Apply,’ ‘Applies Somewhat,’ and ‘Certainly Ap-54. How about the other children? (obtain a rating on

each child).

55. Was there anything special about this child that concerned you at any point in his development? What?

56. Any problems during pregnancy, delivery-early in-fancy?

57. How much did he weigh when he was born?

_____

58. How has his health been? serious illness? accidents?

operations?

59. How old was he when he: sat by himself

_____

walked , talked in sentences _____

VII. Sleeping Arrangements

60. When you first brought him home where did (s)he sleep?

61. If initially slept in parents room ask how old he was when this arrangement was changed? and to what? 62. Where does he/she sleep now?

VIII. Assessment of Mother

63. Comment on impressions of mother.

(i)

Never in

the last year

(ii) Less of-ten than once per

month

(iii)

At least

once per

month

D. Wets his/her bed or

pants

E. Soils him/herself or loses control of bowels F. Has temper tantrums (that is, complete loas of temper with shout-ing, angry movements,

etc)

G. Had tears on arrival at school or refused to go into the building H. Truant from school

Habits

Please place a cross against the correct answer. I. Does he/she stammer or stutter?

( ) No ( ) Yes-mildly ( ) Yes-severely

II. Has he/she any difficulty with speech other than stammering or stuttering?

( ) No ( ) Yes-mild ( ) Yes-severe If ‘Yes,’ is the difficulty

( ) ‘lisping’

( ) cannot say words properly

(8)

Please put one cross against each statement

Statement Doesn’t Applies Certainly

Apply Somewhat Applies

Signature: Mr/Mrs/Miss

Thank You Very Much For Your Help

plies.’ If your child definitely shows the behaviour de-scribed by the statement place a cross in the box under

‘Certainly Applies.’ If he or she shows the behaviour described by the statement but to a lesser degree or less often, place a cross under ‘Applies Somewhat.’ If, as far

as you are aware, your child does not show the behaviour,

place a cross under ‘Doesn’t Apply.’

1. Very restless. Often running

about or jumping up and down. Hardly ever still 2. Squirmy, fidgety child 3. Often destroys own or

oth-era’ belongings

4. Frequently fights with other children

5. Not much liked by other children

6. Often worried, worries about many things

7. Tends to do things on his own-rather solitary 8. Irritable. Is quick to ‘fly off

the handle’

9. Often appears miserable,

un-happy, tearful or distressed

10. Has twitches, mannerisms or tics of the face or body 11. Frequently sucks thumb or

finger

12. Frequently bites nails or

fm-gem

13. Is often disobedient

14. Cannot settle to anything for more than a few moments 15. Tends to be fearful or afraid

of new things or new

situa-tions

16. Fussy or over-particular child

17. Often tells lies

18. Bullies other children

Are There Any Other Problems?

REFERENCES

1. Gesell A, hg FL: The Infant and Child in the Culture of

Today: The Guidance ofDevelopment in Home and Nursery

School. New York, Harper & Row Publishers Inc., 1943 2. Winnicott DW: Transitional objects and transitional

phe-nomena. mt j Psychoanal 34:89, 1953

3. Winnicott DW: Preface to 0 Stevenson’s “The first treasured

possession.” Psychoanal Study Child 9:199, 1954

4. Greenacre P: The fetish and the transitional object. Pay. choanal Study Child 24:144, 1969

5. Kestenberg J: From organ-object imagery to self and object representations, in McDevitt JB, Settlage CF (eds):

Sepa-ratinn-Individuation. New York, International Universities Press, 1971, pp 75-99

6. Spitz HA: A Genetic Field Theory of Ego Fonnatwn. New

York, The New York Psychoanalytic Institute and Interna-tional Universities Press, 1959

7. Gaddini R, Gaddini E: Transitional objects and the process

of individuation: A study of three different social groups. J

Am Acad Child Psychiatry 9:347, 1970

( ) 8. Gaddini R: Transitional object origins and the

psychoso-matic symptom, in Grolnick 5, Barkin L (eds): Between

Reality and Fantasy: Transitional Objects and Transi-( ) tional Phenomena. New York, Jason Aaronson, mc, 1978 pp

( ) 111-131

9. Dicks R: Parents, transitional objects, and childhood fet-( ) ishes, in Grolnick 5, Barkin L (eds): Between Reality and

Fantasy: Transitional Objects and Transitional Phenom.

ena. New York, Jason Aronson, Inc., 1978 pp 363-378 ( ) 10. Sperling M: Fetishism in children. Psychoanal Q 32:374,

1959

( ) 11. Abrains S, Neubauer PB: in Grolnick 5, Barkin L (eds):

Between Reality and Fantasy: Transitional Objects and

( ) Transitional Phenomena. New York, Jason Aronson, Inc.,

1978, pp 135-144

( ) 12. Deri S: Transitional phenomena: Vicissitudes of symboliza-tion and creativity, in Grolnick S, Barkin L (eds): Between Reality and Fantasy: Transitional Objects and Transi-( ) tional Phenomena. New York, Jason Aronson, Inc., 1978, pp

45-60

( ) 13. Miller R: Poetry as a transitional object, in Grolnick S, Barkin L (eds): Between Reality and Fantasy Transitional

( ) Objects and Transitional Phenomena. New York, Jason

Aronson, Inc., 1978 pp 449-468

( ) 14. Gay EL, Hyson, MC: Blankets, bears and bunnies: Studies of children’s contacts with treasured objects, in Shapiro T ( ) (ed): Psychoanalysis and Contemporary Science, ed 5. 1977,

pp 271-316

( ) 15. Busch F, Nagera H, McKnight J, et al.: Primary transitional objects. JAm Acad Child Psychiatry 12:193, 1973 ( ) 16. Hong KM and Townes BD: Infant’s attachment to inanimate

objects, a cross cultural study. JAm Acad Child Psychiatry

15:49, 1976

( ) 17. Boniface D, Graham P: The three-year-old and his attach-ment to a special soft object. J Child Psychol Psychiatry 20:

( ) 217, 1979

( ) 18. Passman RH, Halonen JS: A developmental survey of young children’s attachment to inanimate objects. J Genet Psychol 134:165, 1979

19. Rutter M, Tizard J, Whitmore K: Education, Health and

Behavior. London, Longman Group Ltd, 1970

20. Weisberg P, Russell J: Proximity and interactional behavior

______

of young children to their “security blanket.” Child Dev 42:

1575, 1971

21. Horton PC, Louy JW, Coppolillo HP: Personality and tran-sitional relatedness. Arch Gen Psychiatry 30:618, 1974

22. Winnicott DW: Transitional objects and transitional

phe-nomena, in Through Pediatrics to Psychoanalysis. New York, Basic Books, Inc., 1975

23. Brody S: Transitional objects: Idealization ofa phenomenon. Psychoanal Q 49:561, 1980

24. Levy DM: Thumb or finger sucking from the psychiatric

angle. Angle Orthod 7:100, 1937

25. Roberts E: Thumb and finger sucking in relation to feeding

in early infancy. Am J Dis Child 68:7, 1944

(9)

1981;68;379

Pediatrics

Miriam Sherman, Margaret Hertzig, Rochelle Austrian and Theodore Shapiro