Illustration of genetic syndromes in the nursery

Reading to children and storytelling has documented developmental benefits. Traditional Nursery Rhymes (Mother Goose tales in North America) encapsulate 'snapshots' of the people described and chronicle their customs, superstitions, and amusements. Art has long been employed to document the impact of human imperfections and diseases. We investigated whether illustrations accompanying nursery rhymes, suggest that any characters illustrated may have had or been based on recognized morphological abnormalities, and if this literature documents a role for grandmothers as storytellers. Archival materials were reviewed at the Victoria and Albert museum and Mary Evans picture library, and via the web. As early as 1695, Perrault included a frontispiece of a mature woman as storyteller in his book of fairytales. Similar scenes by various artists (Boilly, Cruikshank, Guy, Highmore, Maclise, Richter, and Smith) are found consistently from 1744 to 1908. Many illustrators (Aldin, Caldecott, Cruikshank, Doré, Dulac, Gale, Greenaway, Rackham, Tarrant, and Wood) portray infants, children, and adults who are dwarfed, giant, or whimsically grotesque. Many images certainly suggest genetic syndromes, and in some characters consistency of specific features is evident between artists. Our research confirms the wealth of children's nursery rhyme illustrations suggesting pathology; that an authoritative compilation of the morphologies depicted is lacking; and that historically, grandmothers have a central role as storytellers.