Conceptions of mental illness in children are bound by cultural and social conventions of whatconstitutes healthy and unhealthy development. To understand current conceptualizations ofdisorders in children, we review the history of these conceptualizations from three intertwinedperspectives: a sociopolitical history of American children and families, the history of the mentalhealth fields and scientific disciplines involved in diagnosing children, and the evolution ofchildren's role in the Diagnostic and Statistical Manual of Mental Disorders. Wereview where the field has been in its conception of childhood mental illness throughout the pastcentury, where we believe it is now, and raise questions about the direction in which childdiagnosis may be headed as we enter the new millennium. We conclude with social policyrecommendations based on theory and research regarding mental disorders in children.