The Touchpoints Approach: Value Disorganization

TBBT. Berry Brazelton, renowned pediatrician and author, developed the Neonatal Behavioral Assessment Scale. The scale assesses newborns’ physical and neurological responses as well as their emotional well-being and individual differences. Brazelton’s greatest achievement, however, has been to raise awareness for the ways that children’s behavior, activity states, and emotional expressions affect their parents, and the ways that parents’ reactions and behaviors, in turn, affect their children.

At birth, babies are ready to build relationships with parents. Their early emotional experiences are powerful enough to become embedded like architecture in their brains. To capitalize on this, Brazelton created the Touchpoints Approach.

Touchpoints are predictable periods of regression and disorganization that occur before bursts in development. What happens between children and their parents at these times? Often, it’s parental frustration and self-doubt, exacerbated by disruption in family relationships. If parents could be warned about these developmental transitions, Brazelton believed they could better understand their children’s behavior, feel more competent, and react positively.

The most critical step in this approach is accepting that development is not linear. The succession of touchpoints in a child’s development is like a map that can be identified and anticipated by parents and providers. Regression, while natural, can cause disorganization. Parents and providers need to embrace the disorganization and value it is a stepping stone—it’s likely a precursor to success. This perspective can change the way parents react to their child, which, in turn, can change the child’s outcome.

Many families of children with delays or disabilities can feel isolated or unsupported. The Touchpoints Approach reinforces providers’ desire to join parents as allies interested in empathetic, not objective, involvement. The approach presents a paradigm shift. It asks us to move from a linear model of development to a multidimensional one. It asks us to focus on parents’ strengths, acknowledging them as the experts on their children. It asks us to see parenting as an ambivalent process built on trial and error. In this way, providers who work with children and families collaborate rather than prescribe, support rather than fix.


The Touchpoints Approach is an evidenced-based way of understanding and being with families. Providers join the family’s system of care rather than the family joining the providers’ system of care. The child focuses on learning new skills, the parent focuses on developing competencies, and the provider focuses on supporting parents, developing skills, and overcoming assumptions. Goals are optimal child development, healthy and functional families, competent professionals, and strong communities.

While all children develop at their own pace, these Touchpoints typically precede a burst in development and can cause disorganization for the child and family:

  • The Ideal Baby – Pregnancy  TP book
  • The Real Baby – Newborn
  • The Energy Sink – 3 wks
  • The Rewarding Baby – 6-8 wks
  • Looking Outward – 4 mos
  • Up at Night – 7 mos
  • The Pointer – 9 mos
  • The Walker – 12 mos
  • The Clinger – 15 mos
  • Rebel with a Cause – 18 mos
  • Getting to “No!” – 2 yrs
  • “Why?” – 3 yrs
  • What I Do Matters – 4 yrs
  • Who I Am Matters – 5 yrs
  • Entering the Real World – 6 yrs