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Little Children Who Kill : HIGH RISK Children Without a Conscience <i> by Dr. Ken Magid and Carole A. McKelvey, foreword by Rep. Patricia Schroeder (Bantam: $18.95; 361 pp., illustrated)</i>

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“Infants who do not receive a warm welcome into the world will seek their revenge.” With this dire warning the authors, an experienced clinical psychologist and a veteran journalist, warn American society of a dramatic increase in violent anti-social behavior, even among the very young.

The thesis of this interesting work is that the perpetrators of such offenses, categorized as suffering from Antisocial Personality Disorder (APD), popularly known as psychopaths, are growing in numbers and threaten the fabric of our society to an unprecedented degree. The cause, they assert, lies in the failure of the attachment or bonding process in infancy.

Magid and McKelvey cite the cases of such notorious offenders as Charles Manson and Ted Bundy, and others less well known.

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A grim example of what may transpire when such bonding has not taken place is provided by an anecdote describing a callous murder committed by a 9-year-old child. The killer sat by a Florida swimming pool watching his 3-year old victim struggle and drown in the water into which the older boy had pushed him. The authors believe that contemporary America has become a breeding ground for conscienceless psychopaths.

Early chapters define the nature of the disorder and its victims. After dealing with the characteristics and sequence of the bonding cycle, they describe the results of breaks in the cycle and the consequence for society.

Sections dealing with treatment remind us of the general failure of traditional therapies. Such persons are generally only treatable in closed inpatient facilities.

The powerful (but controversial) technique of Rage Reduction Therapy (forcing the patient to successfully complete the attachment cycle) is described in detail: The disturbed child is held physically by a trained team of helpers and confronted face to face. The therapist controls resistant response and provokes rage reactions by stimulating the patient’s rib cage with his fingers. Eventually reasonable behavior starts to emerge as the child surrenders to the control of the therapist. Parents are specifically warned never to attempt to stimulate a child in such a manner since it can cause severe trauma if not done properly. The reviewer recalls seeing a form of such therapy in a film made in a treatment setting for disturbed children in Eastern Canada.

Techniques used abroad are described, such as the Japanese “Naikon Therapy,” with its sequence of recognition of guilt, expression of grief, and desire to make restitution. It would seem unlikely that this method would prove useful with most older patients.

The countertransference issue, wherein the therapist (often negatively) responds to these manipulative and sometimes threatening patients is discussed in this section.

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The authors cite a CBS report comparing the top seven problems reported by schools in 1940 and in 1987. How innocent the difficulties of four decades ago! They included: Talking out of turn; chewing gum; making noise; running in the halls; cutting in line; dress code infractions and loitering. This has changed in 1987 to: drug abuse; alcohol abuse; pregnancy; suicide; rape; robbery and assault.

Later sections of the book focus on prevention, which holds the greatest promise for effective remedial action.

The authors believe, supported by recent research findings, that effective therapy for the unattached should optimally be commenced prior to 7 years of age. It is rarely successful after the age of 11. While this is a disturbing thought it will hardly surprise veteran mental-health, educational or police personnel familiar with the problem.

These children, whose developmental needs have not been adequately met, are psychological and sociological casualties lacking in primal trust and fellow-feeling for those they encounter. Lacking a benign, constant, internalized parental image, they are emotionally crippled. While they often appear superficially charming, they exploit others in a chilling, unrepentant and sometimes lethal fashion.

A useful feature of the final sections are the comparative checklists of low-risk and high-risk characteristics for persons in relationships with possible APD individuals. They also serve as guidelines for treatment professionals and assessment of foster families and day-care settings.

The authors urge that, “for a change, Americans need to copy someone who is doing a better job.” They cite the example of Sweden, where a far greater amount is proportionately spent on preventive measures, such as adequate child care for working parents. There is a far lower incidence of persons diagnosed as suffering from Antisocial Personality Disorders in that country. There are doubtless other contributory factors related to this, such as the more cooperative cultural stance referred to by Herbert Hendin in his “Suicide in Scandinavia.”

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The lamentable condition of most child-care facilities is explored. According to the authors the optimal number of infants per care giver should be not more than three to one. In fact it may go as high as 10 times that number.

Congresswoman Schroeder, who wrote the foreword to this book, has long fought for preventive improvements on the macro level. She recognizes the seriousness of breaks in the bonding process and has supported bids to provide for adequate parental leave and improved conditions in adoption and foster-care agencies.

In a final chapter titled, “Educating the Experts,” the authors deal with the vital need for better training and facilities for those professionals who must work with persons suffering from Antisocial Personality Disorders. Even experts are frequently deceived by the plausible manner and fake sincerity of this class of individual. At present no such extensive training programs exist.

While certain issues, such as the noxious influence of TV “modeling” of explicit sex and violence, and the repercussions of aspects of the “postindustrial era” on unemployment and chronic poverty are minimally touched upon, this is a potentially useful and timely book for layman and specialist alike.

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