Vulnerability, stress, and resilience in the early development of a high risk child.

A young girl at risk for schizophrenia is admitted for inpatient evaluation at age 30 months with growth failure and psychosocial retardation. Her history suggests that adverse environmental experiences, particularly the traumatic loss of primary caregivers around age 15 months, resulted in symptoms consistent with the clinical picture of anaclitic depression and associated psychosocial dwarfism. Intervention in the form of hospitalization and placement by "prescribed" adoption into a favorable caregiving environment produced dramatic recovery in growth and psychological functioning. Follow-up data document sustained positive development 3 1/2 years later. This case illustrates the power of a developmental perspective on psychopathology for conceptualizing and planning treatment for an individual child.