EVELOPMENTS in the fields of both pediatrics and child psychiatry D have contributed to the present widespread interest in and attention to the impact of illness and hospitalization on the child and his family. In the past 25 years an increasing number of child psychiatrists and other orthopsychiatric team members have become involved in close liaisons with pediatric hospitals and services. Their experiences have complemented those of pediatricians and have added to our knowledge of the meanings of illness to children. Observations of the ways in which the child deals with the new and difficult stresses he encounters as he becomes ill and is admitted to the hospital have supplemented clinical psychiatric observations on the role of these experiences in the development of psychiatric disorders (5, 14, 20, 40). Child psychiatrists and pediatricians have collaborated in the study of the psychiatric aspects of a large variety of disease complexes.Within pediatrics there has developed a concept of comprehensive practice which is far removed from the earlier concentration on diseases of childhood. The pediatrician has been in the van in the application of his knowledge to the prevention of disease and in the development of positive health promotion. A vital interest in the total health of his patients has made him eager to include attention to the emotional implications in his dealings with them (57). Forward-looking pediatricians, here and abroad, have for many years shown an interest in humanizing hospital practices (43, 53). During recent years changes in the patterns of medical care, brought about by the advent of antibiotics and early ambulation, have altered the complexion of children's hospital wards. No longer are the patients confined to their beds for long periods. The increased number of children who are up and about has made it necessary to rearrange programs to meet their needs.Encouraged by their pediatric colleagues, a number of child psychiatrists working in pediatric settings have observed and studied children in hospital and illness situations (3,7,9, 19,22,23,26,28,32,33,34,36,44,45,47,48,49, 55). The anesthesia-surgical hospital experiences of children have also been scrutinized (13, 17, 18, 27, 30, 31, 37,41, 52). The reactions of children to the stress as encountered were described and suggestions made for changes in hospital practices which might tend to minimize the adverse effects on the child. Areas of concern included admission procedures, opportunities for
