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Developmental Assessment and Early Intervention Programs for Young Children: Lessons Learned From Longitudinal Research

We have good evidence that quality early intervention programs can be of considerable benefit to many children with established handicaps and their families and to children and families exposed to environments that severely restrict their opportunities to participate in development-promoting activities (Table). However, because a child's developmental status at any one time is the result of a complex interaction between the biologic characteristics of the child and his or her social environment and because development appears to progress over time through a series of mutually influencing "transactions" between the child and his or her caretakers rather than as a straight line from one point

[See table in the PDF file]

to another, we cannot accurately predict in which children problems will develop in the future. We do know that some children with mild and even moderate signs of neuromotor dysfunction "outgrow" them or at least compensate for them adequately without treatment, provided they are being reared in a development-promoting and emotionally supportive environment. We have also learned from studies of classroom settings and from our own clinical programs that monitor at-risk children for long periods of time that we can negatively influence a parent or child's perception of his or her normality and create a self-fulfilling prophecy.

Our proposal for handling this dilemma is to put more emphasis on prevention by seeing that every family in a community has access to the basic parent education and support services that can prevent many of these problems from occurring in the first place and/or can help those with mild to moderate signs of dysfunction effectively compensate for them. Therapy-oriented specialists can provide consultation to these programs to help children with special needs. Finally, to ensure that families in need actually connect with these preventive and/or treatment programs, the primary care providers, school personnel, and community health nurses need to work together in a communitywide screening/monitoring/referral System.

This article has been cited by other articles:

				R. S. Kirby A Parable Wrapped in an Enigma: Population-Based Assessments of Outcomes Among High-Risk Neonates Are Even Less Achievable in the Age of Clinical Informatics Arch Pediatr Adolesc Med, August 1, 1999; 153(8): 789 - 792. [Full Text] [PDF]