|Food and Nutrition Bulletin Volume 20, Number 1, 1999 (UNU, 1999, 181 pages)|
|Assessing intellectual and affective development before age three: a perspective on changing practices|
The interactions and relationship between child and caregiver form the foundation of the child's ability to organize and respond to his or her world . Parents are usually more skilled at reading and responding to their child's cues than even the most skilled professionals. However, when the relationship between parent and child is strained or maladaptive and there is no substitute relationship, the long-term consequences for the child can be very negative . Observations of interactions between the child and parent allow professionals to learn methods of intervention from the parent that have proven successful for the family and child, as well as ways in which the professional can offer support for more successful interactions.
Parker and Zuckerman  suggest that one of the goals of the assessment process should be to determine the level of involvement in the intervention process that is most beneficial for the family. For some families, a very active role in the intervention process is constructive. Other families are so overwhelmed by their own and their child's demands that additional roles cannot easily be assumed and are often an additional burden that might seriously strain existing resources.
Assessment itself is an intervention in the lives of family members. Bailey  notes that every interaction with a family constitutes an assessment, and every assessment is itself an intervention. In the process of obtaining and sharing assessment information with families, professionals should communicate the range of development that is seen typically and should provide information about how to determine when a child might benefit from additional intervention. Greater awareness of developmental expectations for children of different ages may be all the intervention some families require. Although research clearly shows that the family relationship is central to children's development [39-43 ], every family is different. There is no single intervention that is applicable to all families or all situations.
Several assessments focus specifically on these issues. For example, the Nursing Child Assessment Feeding and Teaching Scales [44, 45] were designed to highlight the interaction between parents and very young children and have been used in many different research and clinical settings. The scales are intended to capture the reciprocity of communication between child and parent and to explore the range of behaviours available to both members of the dyad. Parents are assessed on four subscales: sensitivity to the child's cues, response to distress, fostering social-emotional growth, and fostering cognitive growth. Children are evaluated on clarity of cues and responsiveness to the caregiver. Performance on these scales has been associated with children's language usage at ages three to five, child temperament, and psychosocial high-risk factors in children's lives. The scales also discriminate among parents with different levels of schooling, those who are at risk for abuse as well as those who actually abuse their children, and those with high family stress. They can be of great utility to intervention programmes seeking to understand some of the difficulties that can potentially emerge between children and parents.