Leaping Forward # 10: A proper look at systems theory shows the madness of thinking about ‘multiple disability’ in the education of babies and infants

We must resist overloading young children with multiple professionals!

This series of articles is about leaping forward in the development of early child and family support.

Those of us who know babies and infants in their wholeness, because we are, for example, parents, teachers, nursery workers or play workers, understand that separate areas of child development (posture, movement, communication, cognition, emotions, seeing, hearing, etc) are not separate at all. The construct of separateness only becomes useful as children get older.

Babies and infants put all these aspects together as global activity in everything they do - feeding, cuddling, playing, managing clothes… They don’t do this because they can, they do it because they have no choice. So the madness comes when we think the best way to help a child develop and learn when there are plural diagnoses is to provide a separate professional for each of the diagnoses, for each ‘separate’ area of development. Systems theory and common sense tell us that all the child’s abilities and dis-abilities are interconnected and merge together into a whole functioning child. This is the magic of systems.

Providing multiple professionals is the old additive approach. What problems does it cause?

  • The child is physically overloaded and expected to relate to a whole bunch of non-family adults.
  • Parents are overloaded with multiple visits to pediatric clinics and with multiple home programmes.
  • Child and family have to try to integrate all the separate bits practically and neurologically.
  • Professionals, who often believe in and use the additive approach, are stressed, too busy and have long waiting lists.

What is a better way for all concerned? We must begin to think of the infant’s multiple diagnoses as a single unique multifaceted condition. The professionals around each child then integrate themselves into a single unique multifaceted TAC (team around the child). They then decide on a primary worker (interventionist) or keyworker. It is not complicated. In my terms this means growing up and freeing ourselves from the medical traditions of the last century.

This would be an ideal topic for the coming international Portugal 25. My great fear is that the additive approach is being exported from the wealthy West into countries where it makes even less sense because of the shortage of resources. Portugal 25 and similar events should promote a reverse movement in which people from countries that have low income levels come to the West to guide us in a better way to use our resources.

Putting systems theory into early child and family support would be a major leap forward to demolish the additive approach and give each child and family a better quality of life.

Peter Limbrick, May 2024. Your comments welcome.


The Keyworker: a practical guide (in family support)

Primary Interventionists in the Team Around the Child approach. Free PDF of the essay

Early Support for Children with Complex Needs: Team Around the Child and the Multi-agency Keyworker. Free PDF of the whole book

Education, Health and Development: Towards shared language and practice around babies and infants who have a multifaceted condition. A teacher’s view

Early child and family support conference in Portugal (September 2025) by ISEI and Eurlyaid. An opportunity for an evolutionary leap forward. 1

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