Developmental Systems Approach can make early intervention more effective in children

Jan 14 2011

Viewing early childhood intervention through a systems perspective ties together the wide range of strategies offered to young children facing developmental delays—and may help in developing more effective policies and strategies to help vulnerable children and their families, according to a special article in the January/March issue of Infants & Young Children: An Interdisciplinary Journal of Early Intervention. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, and pharmacy.

Michael Guralnick, Ph.D., outlines the Developmental Systems Approach (DSA) as "an overarching vision capable of organizing and analyzing the many diverse approaches and accomplishments of early intervention within a common framework." Dr. Guralnick is Director of the Center on Human Development and Disability at University of Washington, Seattle, and a past Editor of Infants & Young Children.

Developmental Systems Approach Can Make Early Intervention 'More Comprehensive and Effective'
The early childhood intervention system has evolved to identify and provide services to infants and young children who have or are at risk of children who at risk of developmental delays or disabilities. These children vary widely in the causes and characteristics of their developmental problems, and in the services they require. There's a need for some consistent framework to guide assessment and services for vulnerable children and their families.

Key to Dr. Guralnick's work is the DSA, which he proposed in 2001, which provides an integrated perspective on the needs of children facing developmental delays. In this perspective, the focus is on scientific understanding of how children develop—and the family's critical role in supporting that development. The DSA is thoroughly integrated with the latest work in developmental science.

The DSA highlights the interrelated processes by which infants and young children develop "social and cognitive competence." These processes are strongly dependent on specific categories of family interactions—each of which promote the child's emerging competence if present, or hinder it if absent.

The family's ability to provide the needed interactions is affected by certain types of resources, such as the parents' personal characteristics, material resources, and social support. If any of these resources are lacking, children with developmental vulnerabilities have problems adapting. Compounding the problem, the parents may have difficulty adjusting to their children's characteristics, setting up a cycle of "reciprocal influence of stressors" that increases the child's vulnerability over time.

"For early intervention practices to be comprehensive, it is essential to address as many risk factors as possible at the level of family patterns of interaction resulting from stressors created at the level of child development or due to limited family resources," Dr. Guralnick writes. He believes that the DSA meets the need for an integrated perspective focusing on the critical factors influencing the child's development, and the family's ability to support it.

A critical first step will be reorganization and redesign of tools for assessment of vulnerable children. Using these tools will provide early intervention professionals with basic knowledge of children's developmental characteristics and behavior, which can be translated into well-designed interventions. For example, if the parents are experiencing difficulties in appropriately adjusting to their child's developmental characteristics and behaviors, interventions can be developed to address parent-child transactions, family orchestrated child experiences, and the health and safety of the child. The result is a "coherent and systematic process" to guide selection of early intervention strategies for children and families.

"The DSA provides a framework for understanding why early intervention works in its current form as well as how to proceed in order to create even more comprehensive and effective early intervention programs," Dr. Guralnick concludes. The DSA also focuses on protective factors in assessment and intervention. By providing a systems perspective on the entire field, he believes it can provide "a conceptual and structural framework that can serve as the basis for the design and re-design of community-based early intervention systems."