ABSTRACT
A roundtable discussion involving 2 educators and 4 pediatricians with widely varying experience sounded out the negative (pathogenic) and positive (healthy) influences to which a child is exposed in school and which decisively shape his/her physical, mental and psychic development. Concrete case reports and a systematic compilation of harmful factors show that this institution poses major threats to children's health of which pediatricians should be aware. An important cause of childhood suffering is the discrepancy between the uniform and inflexible institutional structures and the variability of children's needs conditioned by biology and social origin. Between ideal visions and the consequent school structures on the one hand, and social reality on the other hand, there are notable contradictions which must be recognized, lived with and--if possible--resolved by reforms. If he believes in the reformability of school, the pediatrician can make essential contribution to promoting health during school age.
