Psychosocial and emotional deprivation are commonly recognised in infancy and childhood. Infants suffering from maternal deprivation display behavioural abnormalities such as apathy, watchfulness, and autoerotic activity, as well as delayed developmental behaviour. There is often a history of maternal rejection or neglect, non accidental injury, or lack of physical handling. Emotional deprivation in childhood may lead to small stature (Fig. 14.17), retarded skeletal maturation and, in older children, delayed sexual maturation. Endocrine function may also be abnormal in affected patients, who may additionally have high levels of fasting GH and also cortisol non responsiveness with the insulin tolerance test.
