Mental and social problems of families with handicapped child.

: Studies were carried out in a series of 100 mothers of children with facial clefts who were treated up to the age of 13 to 15 years at the Department for Plastic Surgery. Clefts were used as a model situation for studies into the response of parents--and especially of mothers--to the birth of a child with an inborn malformation. The main results showed: that three quarters of mothers designated the birth of a handicapped child as a mental shock followed by a variety of neurotic symptoms. A certain proportion of mothers suffered from reactive depression which was not diagnosed and therefore not treated. It was confirmed that the poor mental condition of the mother in the predominant part of the series examined persisted up to the adolescence of the affected child and exerted marked negative effects on the mental prosperity of the child. This resulted in a latent or manifest parental attitude of rejection and in the development of mental handicap in their children (impaired self-esteem, impaired sexual identification etc.). The stress situation was increased by factors including manifestation of stigmatization by the familial environment and by the collective of children which had an adverse effect approximately on about three quarters of mothers and children. The discussed forms of medical care and counselling could in the post partum period and later help to reduce the mental stress experienced by the parents, as well as promote the somatic and mental development of the child.