Theoretical and practical aspects of risks and vulnerabilities in infancy

There is substantial agreement about the basic concepts of vulnerability and at-risk conditions in childhood in the context of what constitutes healthy development. Health is characterized by a progression of maturation and development in mental and emotional as well as in the physical spheres. When there is a failure of developmental progress that is more than transient, the expert observer ideally would detect it before the deviation creates its own complications. If the child and parents start off with the child poorly or incompletely equipped, or with the parents unable to respond with competence and affection to a healthy child, the vulnerability of the child or the at-risk environment created or unrelieved by the parents may set up a deviant or impaired development that has its own momentum and pattern. Thus, vulnerability refers to the weaknesses, deficits or defects of the child, whereas risk refers to the interaction of the environment and the child. Vignettes are presented to illustrate alternate patterns of parent-child interaction and how risk and vulnerability must be viewed together as a dynamic interchange between equipment and environment.