Medical, psychologic, and legal aspects of child custody disputes.

An increasing number of children seen in pediatric practice are children of divorce. The child is often involved in the conflict between his parents in regard to custody and visitation. The physician will want to be familiar with the historical background of child custody decisions and the present guidelines the courts are using in determining custody and visitation, together with the newer and controversial proposals concerning the elusive concept of "best interests of the child." It is important that the pediatrician recognize the usual phenomenology of the young child's response to family disruption, lest he ascribe it to some fault on the part of the current caretaker. Some children respond to disruption in the family with symptoms that warrant intervention directed toward helping the child. All cases warrant intervention designed to enhance the parenting ability of the custodial parent and to enlist the cooperation of the noncustodial parent to minimize adverse influences on the child's developmental agenda. The physician should be well prepared if he participates in court procedures regarding custody and visitation controversy.