Hyperactivity is a potentially confusing concept with different terminology and history in Europe and the U.S.A. There is a certain amount of suspicion among U.K. practitioners as to whether it is appropriate to recognise it as a primary condition. Perhaps because of this, assessment procedures vary between practitioners and centres. Using our experience of running a specialist overactivity and attention disorders clinic (now defunct) at St George's Hospital, London we draw together recommendations for the assessment of this serious clinical problem.

Many studies have demonstrated the short-term efficacy of stimulant drugs in decreasing the symptoms of Attention Deficit Hyperactivity Disorder (ADHD). However, long-term studies have not shown a similar effect. In this study, we report an audit of the medium-term outcome of 50 children with ADHD referred to a mental health service and treated with stimulants for at least 6 months. A poor outcome group was identified consisting of 30% of the children. As a group, they received a significantly higher dose of stimulant. More studies, with prospective design, are required to examine the medium-term outcome of children with ADHD on medication.

Recruiting subjects for follow-up studies in child abuse raises ethical dilemmas. This paper examines the effects of the ethical stance taken in a study of a community sample of sexually abused children. The ethical code adopted required strict confidentiality and active consent to be interviewed from both child and carer, based on full information about the research objectives and method. The response rate was very low. A less rigid stance, which might have resulted in a larger sample, was considered inappropriate. Nevertheless, the quantitative and qualitative data yielded findings of interest to practitioners. Suggestions for future research practice are presented.

This paper reviews the current position of the Milan Approach in the family therapy field. Over the past 20 years this approach has made a major contribution to the development of family therapy theory and practice in the U.K. However, the ideas have been modified in order to fit different client groups in a range of settings; until today, the Milan, or Post-Milan approach is an amalgam of the original concepts and new techniques. This paper describes the development of this approach and highlights the following topics as central to current thinking: language, power, narrative, family resilience, externalising, focusing on change, and solution focused approaches. Several techniques of the Post-Milan approach are demonstrated in a discussion of one case treated by the author.

Looking back, the 1980s was a decade of enlightenment and success in juvenile justice practice in this country; diverting youngsters away from the criminal courts and reducing the severity of response towards those who were prosecuted did not result in crime waves or public demand to stop this lenient treatment of the young. In the 1990s, the whole criminal justice system took a significant turn towards retribution and punishment. The movement may have been aimed initially at certain groups of criminals, particularly the persistent and serious, but swept all in its wake, including children aged 10–14 who were neither. There is little apparent appreciation of the damaging consequences of this trend, not only for individual children but also for the whole concept of childhood. There is now a wide discrepancy between the approach taken by the criminal and civil law towards children which current criminal justice policies indicate is to continue into the foreseeable future.

Plato's view that we should be ruled by philosophers has never really caught on in Britain. Indeed, in recent years, political attitudes to the study of philosophy have resulted in the closure of departments of philosophy in our universities, so that the subject is less studied at undergraduate level than it was 20 or 30 years ago. So it is surprising that the way our generation thinks about education, genetic experimentation, broadcasting, and some of the other most contentious issues of our time should have been so influenced by a professional philosopher whose working life has never taken her out of Oxford and Cambridge.

Mary Warnock has served as chairman of government committees on special education, on animal experimentation, on human fertilisation, and on teaching quality. Further, the recommendations of the committees she has chaired have usually been rapidly adopted by the government of the time and then translated into legislation with bipartisan support and considerable speed. The fate of her reports firmly refutes the commonly held view that governments set up committees to avoid making difficult decisions and then leave their weighty conclusions to sit on shelves, gathering dust until the topics in question have lost the interest of the public.