Hand in Hand Developmental Support Resource Kit

The Hand in Hand Developmental Support Resourceis designed for use with children at risk, particularly children involved with child welfare, and was created as a part of the Infant Mental Health and Family Law Initiative (FLI) under the auspices of the Infant Mental Health Promotion at The Hospital for Sick Children in Toronto. Contributing authors were Nadia Hall (Editor), Chava Kulkarni, Carmela Paolezza and Mary Rella.  

The Resource responds to concerns raised in the 2011 Early Years Study:

“Across Canada, more than a quarter of children are vulnerable before they even get to school. Most vulnerable children are not poor. This high rate of early vulnerability imposes social and economic costs.”

A Developmental Support Plan (DSP) is an individualized plan developed to monitor and support the growth of a child in key areas of child development, namely: communication, problem-solving, personal-social, gross motor and fine motor.

The purpose of a DSP is to:

  • Support the child’s development
  • Provide strategies that can foster child’s development while he or she may be waiting for further assessment or referral to specialists
  • Provide simple everyday strategies and activities to help a child reach appropriate developmental goals in a culturally appropriate and strength- based way
  • Provide an opportunity for caregivers and staff members to collaborate on a child’s development
  • Helps parents and/or caregivers understand the type of experiences their child needs to meet their next developmental milestone

The goal of this intervention model is to implement the use of standardized screening tools and the creation of interim strategies to support early development when working with children who may be at risk for social-emotional or developmental concerns (particularly those involved with child welfare).

The model involves developmental screening, a semi-structured interview with the child’s caregiver, floor time observation of the child (45 min- one hour), a team debrief, and referrals. The individualized care plan is then developed for the child and share with the primary caregiver. A determination with the family of whether any other child in the family requires a DSP, and a list of key contacts is agreed. A follow up re-screening is scheduled for 3-4 months after the previous screen to capture and track the child’s developmental progress. This process is to be continued until the child receives the referred support services or diagnosis.

The detailed plan involves the following steps:

  1. Gather information
  2. Identify the areas of concern
  3. Identify strengths
  4. Identify resources
  5. Identify goals
  6. Develop strategies for Daily Routines and Plananed Activities with the following guiding principles:
    1. Strategies have to be relationship based
    2. Strategies have to be simple and realistic
    3. Strategies have to be integrated into everyday routines
    4. Strategies are about action
    5. Strategies have to reflect the family’s culture
    6. Strategies should not include technical jargon
    7. Providing at least 3 strategies per goal
    8. Identify the benefits of the strategies
    9. Huddle!”: Consult with other professionals throughout the creation of the plan.  Professionals involved in this consultation would include: Children Service Worker, Family Service Worker, Resource Worker, Foster Parent Support Worker, Supervisors, public health nurses, , medical team (clinical staff), speech and OT therapists, etc.
    10. Finalize the Hard Copy of the DSP

Two templates are available, the full DSP and the one-page “Fridge” version, both of which are considered essential for families. The manual stresses that, “Both versions are written from the perspective or ‘voice’ of the child. This is helpful to prevent the strategies from being overly directive or prescriptive, and helps the parent connect with and personalize the suggested strategies as something that their child needs.”

Outside of a clinical setting, the resource materials presented from the “voice” of the child, are particularly well structured and presented for use in developing parenting skills. These resources are grouped by:

  • Social Emotional Milestones
  • Supporting Social and Emotional Development
  • Communications Strategies
  • Gross Motor Strategies
  • Fine Motor Strategies
  • Problem Solving Strategies
  • Social Emotional Strategies


  • Developmental Support Plan SAMPLE – Baby
  • Developmental Support Plan SAMPLE – Toddler
  • Developmental Support Plan – Blank Template
  • Developmental Support Plan – “Fridge Version” Blank Template