Foundational Capacities for Development (FCD™) Model is Profectum’s Approach to Integration

Development is never straightforward. Neither is intervention. Despite research advances made in the last decade, attempts to translate these into best practice(s) face many challenges and obstacles. While early identification now has some reliable tools and clinical trials are underway in early intervention, it is not yet possible to capture the complexity of autism spectrum disorders and the variability in how different children respond to different interventions, especially as children grow older and become adolescents or adults and outcomes vary so widely. Identifying the potential capacities of each person and guiding their development to realize this potential is the most important goal we have.

Since we are very far from knowing which interventions will benefit which person in this diverse disorder, we must rely on extensive clinical experience and developmental models to guide best practice. Two key principles are relevant.

• First, intervention models must address the unique characteristics of each child and the families and systems they are part of.
• Second, individuals develop across the lifespan and can continue to advance if (or when?) provided with foundational capacities for development to support learning and functioning.

In the last century development began to take on various meanings. For some it was the behavioral and regulatory aspect of growth. For others it involved a progression of skills to support functioning and competence and for still others, the essence was an emotional and thoughtful life with relationships at the center. Development encompasses all of these meanings.

Foundational Capacities for Development (FCD™) Model Explained

At Profectum we believe development advances when experience captures the child’s affects and interests and activates new learning, gets organized through interactions, and gets integrated into the child’s repertoire of thinking, feeling and functioning. These experiences build the foundational capacities for development that carry through one’s lifespan (“Foundational Capacities for Development” or FCD™). They are integrative capacities that go beyond specific sensory motor processing and environmental challenges, as they are more fundamental, dynamic, interactive and underlie how, and to what degree they effectively integrate experience to advance development.

Developmental problems need developmental solutions. Greenspan and Wieder developed an integrated bio-psycho-social framework to profile typical development, which became a guide for assessment and interventions for individuals with special needs. The Developmental, Individual Difference, Relationship based model (DIR®) identified the functional emotional developmental capacities that integrate emotional and intellectual development. Not only did interventions have to be tailored to the unique profile of the child but depended on relationships as the vehicle for learning and affect to engage and give meaning to experiences. This framework provided the anchor for a comprehensive intervention approach that changes as the child grows. The Foundational Capacities for Development (FCD™) model complements DIRFloortime® framework by defining critical elements and experiences, which further enable children to climb the developmental levels.

When development falters in any area, be it physical, emotional, cognitive, communication, or functional competencies, reassessment is needed to identify developmental gaps or other variables derailing or stalling further progress in order to tailor interventions to the current needs of the individual. As children get older more specific learning disabilities and comorbid medical, behavioral and mental health conditions may require revisions in the treatment plan. All relevant approaches and tools complimentary to developmental models need to be considered at such times and integrated into an ongoing comprehensive program.

Decisions regarding comprehensive and integrated intervention require clinical and educational expertise. At younger ages various developmental approaches, such as DIRFloortime®, Joint Attention and Symbolic Play model, ESDM and SCERTS® have supportive evidence, and clinical trials are underway for other methods but it is not possible to say what works best for whom. Adding developmental components such as joint attention and symbolic play to behavioral models have been demonstrated to be very effective. Working more closely with families and home programs also enhance outcomes. The challenges with school aged children and older individuals are more complex. More specific learning techniques may be needed to improve comprehension, visual spatial interventions to improve sequencing and logic, behavioral interventions to support emotional regulation, sensory motor therapies to improve praxis, psychotherapy and medications to deal with anxiety, family support to promote adaptation and coping, etc. Special needs development can be uneven and Profectum holds the promise of progress, embracing the complexity and nuance of every individual.