Dr. Greenspan argued in 1992 — and the same problems persist today — that childhood diagnoses focus too heavily on behavioral symptoms and checklists rather than the underlying developmental capacities that generate those behaviors. He advocated for comprehensive developmental assessment that considers the whole child: their emotional development, individual sensory profile, and relational history.
Behavioral checklists and symptom counts cannot capture the complexity of a child’s developmental profile. Dr. Greenspan argued that two children with the same diagnosis can have completely different underlying developmental needs, and that treating them with the same protocol will lead to poor outcomes for both. The Greenspan/DIR Model uses functional developmental assessment to understand each child as an individual.
Dr. Greenspan advocated for diagnoses that go beyond labels to provide a functional developmental profile — describing what the child can do at each of the six Functional Emotional Developmental Milestones, their individual sensory profile, and the quality of their relational experiences. This kind of profile, not just a diagnostic label, is what truly guides effective intervention.
Yes. Dr. Greenspan repeatedly noted that the debates of 1992 about behavioral vs. developmental approaches to autism remain unresolved today — with behavioral, compliance-based approaches still dominant despite growing evidence for the effectiveness of relationship-based models like Greenspan Floortime. He saw this as a significant missed opportunity for children and families.