Book Review

Development through Life: A handbook for clinicians

N Engl J Med 1995; 332:1796-1797June 29, 1995

Article

Development through Life: A handbook for clinicians
Edited by Michael Rutter and Dale F. Hay. 615 pp. Boston, Blackwell Scientific, 1994. $150. ISBN: 0-632-03693-1

The main theme of this handbook for clinicians is the importance of individual differences and mechanisms of development through life. The editors have achieved a surprising cohesiveness among the 22 chapters written by over two dozen contributors. Most chapters are substantial and are enriched by generous and well-chosen bibliographies. Considering the number of contributors and the difficulty of the subject, the readability of the book is above average. Perhaps one flaw is the use of the word “handbook” in the title, because I do not think that this work is best appreciated through topical reading or reliance on its index.

I felt quite comfortable with the chapters dealing with the most scientific aspects of human development. Those on genetic influences and brain and language development stand out as providing excellent reviews and bibliographies. On the other hand, since most of the investigators and their investigations come from the United States and England, some topics unavoidably have a parochial cultural overtone. Discussions about sex, what constitutes a family, the effects of the portrayal of violence on antisocial behavior and physical aggression, the disintegration of neighborhoods, schooling, and so forth are matters perhaps less biologic than sociological and cultural in nature. Furthermore, cultural issues appear to be shown mostly as “belief systems,” and this makes it difficult to disentangle the observed from the observers. In fairness, the contributors draw attention to the fact that behavioral sciences must seek a balance between “biologic determinism” and “environmentalism.” The authors also identify areas where research is urgently needed, address the chronic tension and dichotomy between “splitters” and “lumpers,” recognize that “quantitative genetics is somewhat of a misnomer,” and point out that any unknown source of variability can masquerade as chance. Other topics nicely presented concern creativity and intelligence (with the point made that they are quite independent) and how important meals are as an opportunity for socialization for the elderly (it is noted that over 15 percent of the elderly consume insufficient calories, perhaps an index of their loneliness).

Various readers are likely to find biases in many presentations and perhaps an overemphasis on childhood and adolescence. However, the positions presented are those generally held by most researchers and writers in the field. The heterogeneity and variability of the data make any generalized statement a potential source of disagreement, but this should not detract from the value of this work as a major contribution. To sum up, I recommend this work to pediatricians and others interested in human development. In fact, I will go further and say that some chapters have such elegance, cogency, and cohesiveness as to be appropriate reading assignments for medical students and medical residents.

Wladimer Wertelecke, M.D.
University of Southern Alabama, Mobile, AL 36688-0002