The efficacy of behavioural methods of treatment for severe sleep disorders was examined in a pilot study involving 35 children aged 1-5 years. Improvement occurred in 77%. Methodological issues concerning the selection of children for treatment, selecting adequate controls and outcome measures, and using parents as therapists, are discussed.

Over a period of one school year a study was carried out into the feasibility and effectiveness of introducing active teaching methods into primary schools in Tanzania with a view to enhancing health education. The Lushoto Enhanced Health Education Project had as a focus personal hygiene with reference to the control of schistosomiasis and helminth infections. When a randomly selected group of children were compared with a comparison group there was evidence of changes in both knowledge and health-seeking behaviour. The passing of messages from children to the community met with mixed results. The observed changes were still evident over 1 year after the project had ended.

A B S T R A C T This article reviews a child and family service addressing the psychosocial impact of facial (and other visible) disfigurement. The stigma of disfigurement poses considerable challenges in maintaining self-esteem, building self-confidence and coping effectively with the intrusive (and often negative) reactions of others. The charity, Changing Faces, addresses the psychosocial impact of facial disfigurement, promotes better health care and seeks to raise public awareness about the impact of disfigurement. Its clinical service has evolved a model of care including a social skills training component and methods of social skills training, specifically for this client group. Evaluation suggests that this model is helpful and practical, enhancing coping skills and increasing confidence.

SUMMARY Twenty-nine patients with Apert's syndrome were ascertained through hospital records.