Developmentally Appropriate Care

Caring for a young person in a developmentally appropriate way is about being sensitive to the ways in which the needs of young people vary to those from children and adults, and the ways these needs change over time as the young person’s development progresses.  Many young people in out-of-home care experience absences and disruption in the social processes that drive development including things such as family and schooling.  This can result in delays and distortions in the developmental pathway of these young people when compared to those on a more typically developmental trajectory.

There are ways you can help provide alternative experiences that help these young people catch up on or reshape areas of development that have been delayed or distorted.  There are a few broad guidelines that can help with this.

Sensitivity to developmental challenges and changes

Be sensitive to the particular developmental stages, transitions, tasks and challenged faced by adolescents, and they ways these change over time as individuals progress through their development.  Like all young people, those in out of home care are working towards achieving a range developmental tasks including:

• Identity formation
• Value clarification
• Cognitive skill development
• Learning consequential thinking and responsible decision-making
• Identifying and understanding vocational strengths and inclinations
• Forming relationships outside of the family

It is important to recognise that most adolescents put a lot of emphasis on these tasks and can experience a lot of anxiety about achieving them.  Being sensitive to these general themes will improve relationships and engagement of these young people.

Responding to alterations in developmental trajectories

For young people in out of home care, who are often struggling with health and behavioural issues, their developmental trajectory has been significantly altered by experiences in their lives.  These are experiences such as family conflict, lack of responsible adult role modelling, frequent physical relocations, lack of a stable and structured learning environment at home, exposure to substance use in the family or parenting that is insufficiently attentive, unpredictable, overly harsh or neglectful.

Each of these issues causes substantial disruptions in the processes that drive development.  The structure and guided experience that young people require is not available.  Instead these young people often have no control over the pace of change and transition and are then highly susceptible to developmental problems occurring (Coleman & Hendry, 1990).  Without the necessary experiences young people’s development can become out of step with those on a more typical developmental pathway.

So the aim for those involved in the lives of these young people, is to provide alternative experiences that help them catch up on, or reshape areas of development that have been disrupted.  Consider:

• Providing regulated experiences, a sense of structure and support
• Providing experiences that correct damage done to identity through their experiences of distorted relationships and rejection – forming a strong positive relationship
• Providing opportunities for learning consequential thinking and responsible decision-making through reflecting with young people on their experiences - why things have happened and gaining insight into the impact of their actions
• Helping young people find meaningful support within their families and social networks
• Recognise the strengths inherent in the coping skills young people have learnt from their experiences -  these may not be usual or socially acceptable however they often hold strengths that can be channeled in more socially acceptable ways
• Recognise the underlying or hidden ‘health-seeking’ purpose of behaviours that are traditionally labeled and dismissed as ‘dangerous, delinquent, deviant and disorder’ (Ungar, 2005b)

Continuous assessment of young person’s capacity

Young people going through adolescence are constantly evolving and can make marked developmental gains in relatively short periods of time.  As such, carers always needs to be aware of young peoples’ emerging development capacity and continually revive their understanding of the young person’s ability to cope with stressors in life, and effectively calculate and respond to risks.

Alternatively, be careful not to assume that older adolescents necessarily have accurate information, knowledge and the skills required for coping.  Young people can often project an image as someone who is ‘in-control’, competent and mature even when they and others realise this is not the case.

Continually assessing the young person’s capacity to cope with stressors and make appropriate decisions will help navigate through the many grey areas and tensions during this period.  One of these tensions is striking an appropriate balance between promoting a young person’s autonomy or self-determination against the need to minimise risk.  Generally, stronger emphasis on autonomy is appropriate for more mature older adolescents, while stronger emphasis on risk reduction and firm guidance is appropriate for less mature adolescents.

Developmentally appropriate expectations

As young people develop and become more competent and mature they will naturally be subject to higher expectations from society and the significant others in their lives. When making expectations, it is important to consider the stage of development and what is appropriate to expect from young people.  Such expectations are around things like how much structure and direction they need or what’s’ their ability to plan for the future and how this impacts on them attending appointments for instance.

It is also really important to remember, that your expectations, even if they are not voiced, will impact on what a young person will believe about themselves and what they can achieve.  Usually people have a tendency to set expectations too low or too high and therefore can stop a young person living their potential or make them feel inadequate or unworthy as they are not ‘living up to expectations’.  Young people can also have very low expectations of themselves so sometimes it is a carers job to help them see that they have the ability to achieve more.  It is hard to find this balance – the more we are aware of where the young person is developmentally, the more realistic we can be.