This report describes a constellation of clinical features found in 25 children with a history of an illness or accident from which they recovered, despite their parents' anticipation of a fatal outcome. The paper proposes the hypothesis that children who are expected by their parents to die prematurely often react with a disturbance in psychosocial development that is rooted in the parent-child relationship, which the authors characterize as avulnerable child syndrome. The essential features of the proposed syndrome include difficulty with separation, infantile behavior, bodily overconcerns, and school underachievement. The paper provides an overview of predisposing factors and determinants of the presenting symptoms, along with suggestions for both clinical management and primary prevention.

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