OCTOBER 14, 1961 THE MEDICAL JOURNAL OF AUSTRALIA 617 is forthcoming at the appropriate time, physical and emotional development is defective (Gesell, 1947, 1948). The provision at an early age of good training facilities for children selected by proper diagnosis has resulted In development to a standard higher than expected. As these children grow up, they can be gainfully employed in workshops or in industry instead of being a complete burden. When one is certain-but only when one is certain-that significant retardation is present, one should inform the parents. Failure to do so leads to the continuation of false hopes and tends to place the child in a situation with which he is unable to cope. In this way, emotional disturbance is added to his existing handicap and leads to a much more complex state of affairs.

On the one hand we are presented with facts suggesting that brain injury is extremely common and that it starts with very minor defects of brain function barely detectable and often attributed to vague genetic or envtronmental causes. On the other hand, we are told that cerebral damage, when present, is obvious enough and can be diagnosed without much doubt. Improvement may occur quite remarkably in the first few months, thus suggesting the need for great caution In giving a prognosis at a very early stage (Masland, 1958; IlUngworth, 1960).