Book review

The Irreducible Needs of Children. What Every Child Must Have to Grow, Learn

and Flourish

T. Berry Brazelton and Stanley I. Greenspan. Oxford: Perseus Publishing, 2000. ISBN 0-

7382-0325-4 Hardback £13.5

Berry Brazelton is probably best known to paediatricians as the author of a widely used

method for neurobehavioral assessment of infants, his Neonatal Behavior Assessment

Scale, but many will also be aware of his numerous books for parents about childcare and

family life. Since he retired from his clinical practice, he has become very active in

organizations supporting parents and children, such as the ‘‘Touchpoints’’ network, as well

as in national organizations like the (USA) National Commission for Children. In this new

book, he joins psychoanalyst and child psychiatrist Stanley Greenspan (who has also

authored popular books for parents) in describing their seven ‘‘irreducible needs of

children’’. Their starting point is the belief that in the USA, and presumably elsewhere,

few families can face the tensions and stresses of contemporary life without outside help

and support in childcare. Their claim is that if this is not forthcoming, and patterns of child

rearing continue to change, we will rear children who will increasingly show antisocial and

violent behavior and involvement in illicit drug use. Parents, the authors confidently assert,

want to know how to rear happy, confident and creative children who are intelligent and

emotionally healthy and who will be reflective enough to lead a diverse world into the

future. The authors see ‘‘worrisome trends’’ in child rearing even in the most economically

privileged communities of the USA, with high rates of very young children in substitute

care of one kind or another and a shift towards ‘‘more impersonal, rather than emotionally

nurturing caregiving’’ by parents. Families are ‘‘overly scheduled’’ and education is be-

coming more impersonal. E-mails are replacing lunches together and the time in front of the

TV screen is eclipsing many other forms of personal family interaction.

The seven irreducible needs of children that they describe are for ongoing nurturing

relationships; physical protection, safety and regulation; experiences tailored to individual

differences; developmentally appropriate experiences; limit setting, structure and expect-

ations; stable support communities and cultural continuity; and a continuation of world-

wide social, political and economic progress that would ensure all the other needs of

children are met.

The book has a somewhat unusual structure with chapters in which an essay by the two

authors describes and discusses each of their irreducible needs of children, followed by a

dialogue between the two authors and, finally, a rather detailed list of prescriptions for

parents to meet each of the needs for their children.

It would be hard not to share the authors’ concern about the necessity of meeting the

basic needs of children. While we might want to describe these in somewhat differing

PII: S0378 -3782 (01 )00250 -X

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Early Human Development 68 (2002) 65–66

ways, most would include the areas of largely psychological development which are

highlighted here. Indeed, it might seem churlish to be critical of any aspect of a book that

is so strongly on the side of children and families. However, I suspect there might be a

good deal of dissent about the often highly prescriptive recommendations the authors

provide. Would we agree, for example, that TVand computer time should be no more than

1 h per day for ages 6–9 and no more than 2 h for 10–16 year olds? Also, would we agree

that class sizes in elementary school and high schools should not exceed 12–16 or that all

newborns should be examined with the Brazelton Neonatal Behavioral Assessment Scale

in the presence of parents? Perhaps these things would improve the well-being of children

but we are given no justification for these specific recommendations, beyond the point that

they are ‘‘based on a synthesis of our clinical and research experience rather than a review

of studies of the topic’’. The history of medicine is, of course, replete with examples of

well-meaning interventions based on clinical experience, which on systematic evaluation

turned out to be ineffective, or much worse. Psychosocial interventions have fared no

better.

My other complaint is that the authors provide little or no analysis of why the rearing

conditions of children may have deteriorated—if indeed they have in all the ways the

authors claim. I could counter the authors’ experiences with one of my own. I am writing

this review in rural France where daily I can watch school children with their mothers or in

small groups walking home from school for their midday meal. Or are they simply

returning home to log on and forego their family lunch?

But I don’t want to appear to trivialise the problem. The poor get poorer and the rich get

richer in many countries. The industrialized world increasingly has work-rich and work-

poor families and though the work-rich have the physical necessities of life and much

more, their working hours increase. They may well have less time for their families and

children. It would seem that the global industrial economy is as rapacious for the workers’

time for family life as it is for the diminishing physical resources of our planet.

Perhaps Brazelton and Greenspan are right, there is an emotional and social chilling of

family life and child rearing. Could it be that this is correlated with the climatic warming

of our planet and with both stemming from the same economic and political processes?

These are the areas that deserve close analysis and long and hard thought. While the

authors of ‘‘The Irreducible Needs’’ deserve our respect for the ways in which they

highlight the needs of children on their very broad canvas, I am not sure that their

diagnoses of the causes of current problems are correct or that their prescribed treatments

will be effective.

Martin Richards

Centre for Family Research

Free School Lane,

Cambridge CB2 3RF, UK

Book review66