Infant and Toddler Models of Service Delivery: Are They Detrimental for Some Children and Families?

The thesis of this article is that current models of intervention for infants and toddlers may be detrimental to some children and families. Theories of human development, recommended by leaders in the field, are described as the framework for analyzing current and future intervention methods. The clinical, research, social, and economic rationales for these service models will be discussed to illustrate the origins of several decades of prac-tice and research. Conflicting research results and practical implementa-tion problems will be described. This provides a context for illustrating how and why service models may fail to provide what currently accepted theories of development and research suggest is necessary for improved outcomes for children and families. Alternative approaches are discussed and include the necessity of comprehensive child and family needs assess-ment, the need for protocols for matching services with needs, interagency service system changes, and a range of service options that facilitate family choice and optimal developmental opportunity for children. The thesis of this article, which is intentionally provocative, is that typical infant and toddler intervention home- and clinic-based models may not help some children and families and may be detrimental to others. In light of currently accepted developmental and ecological the-ories (Bronfenbrenner, 1979; Horowitz, 1985; Samaroff & Chandler, 1975), these service models and their implementations may even be antithetical to those theories and, as such, may preclude optimal progress for many children. These interventions may be mistargeted, misapplied, and may work against just those aspects of family life tha