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Shopper, M. (1984). Psychopathology and Adaptation in Infancy and Early Childhood. Principles of Clinical Diagnosis and Preventive Intervention: By Stanley I. Greenspan, M.D. New York: International Universities Press, Inc., 1981. 263 pp.. Psychoanal Q., 53:122-127.

(1984). Psychoanalytic Quarterly, 53:122-127

Psychopathology and Adaptation in Infancy and Early Childhood. Principles of Clinical Diagnosis and Preventive Intervention: By Stanley I. Greenspan, M.D. New York: International Universities Press, Inc., 1981. 263 pp.

Review by:
Moisy Shopper

Greenspan's monograph is an auspicious beginning for the series planned by the National Center for Clinical Infant Programs. The work stems from Greenspan's commitment to the longitudinal research study of the variables in the infinitely complex parent-infant milieu, combined with the dedication to effectively intervene when parent-infant pairs show signs of stress. It contains not only an amalgam of research and treatment but also a concerted attempt to correlate clinically observable data within a theoretical structure.

The theoretical structure developed by Greenspan is what he calls "the developmental structuralist" approach. This rests on two assumptions: that the child's organizational capacity changes over time to higher levels, so that stimuli (internal and external) of increasing complexity are processed in such a way as to lead to the development of structures of parallel complexity; and that each succeeding stage of development epigenetically builds on the resolution of the characteristic tasks of the preceding stage. A succession of five stages is presented: (1) Somatic Level of Organization, Phase I, Homeostasis (from birth to three months); (2) Phase II Attachment (two to seven months); (3) Phase II Somatic-Psychological Differentiation (three to ten months); (4) Phase II Behavioral Organization, Initiative and Internalization (nine to twenty-four months); and (5) Representational Capacity, Phase I, Representational Differentiation and Consolidation (thirty to forty-eight months).

The attainment of an "optimally adaptive structure" at each developmental stage facilitates and is prerequisite to further development. Since each stage has an expected organizational character, diagnostic assessment is based not solely on individual symptoms or behavior but on the totality of the child's development viewed in the context of the expected normal. Once the disordered development has been identified, preventive intervention is planned and tailored to the uniqueness of the child and of the caretaker.

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