A conceptual model for tracking high-risk infants and making early service decisions

Recent passage of PL 99-457, the Education of the Handicapped Amendments of 1986, has presented a unique opportunity for physicians and educators to work together on behalf of very young children who are at risk for, or are known to have, handicapping conditions. A conceptual model for systematizing, tracking, and making early intervention service decisions for infants born at risk for developmental problems is described. The model is contrasted with others recently proposed, particularly by Aylward and Kenny (1979). The model proposed conceives of risk as additive across areas at any given time, but not cumulative over time. It provides for (1) assessment of risk status at several times during early development, (2) assessment of risk in several areas at each time, (3) differential weighting of risk in each area depending on the time of measurement, and (4) allows for the fact that individuals move in and out of risk at various times. Research ideas are addressed, along with a practical suggestion for use of the model.