For most breakfast seminar attendees, an important aspect of FAST was the setting of standards to use in assessing behavioral and emotional concerns such as sleep practices, self-regulation issues like crying and tantrums, and the progress of eye contact and social engagement. Most of the FAST items of this kind are not only focused on birth to age three, but provide information on developmental sub-periods, as sleep practices or concerns with crying are very different for young infants than they are for toddlers. For example, with respect to sleep issues, one item is specifically designed for babies from birth to four months of age, the period when death from SIDS is by far the most likely. During this age period, babies’ sleep situations may be evaluated as having 0 or 1 concerns, in which no changes are needed, or they may be ranked as having moderate or significant concerns, and therefore needing to have this issue included in the individual family plan.
Concerns about crying in young babies and tantrums in toddlers are carefully defined in the FAST approach. If infants aged 1 to 5 months are moderately easily soothed, this concern is a minor one, but there is much more concern if a baby cries for extended periods and does not soothe, especially if the caregiver gets no breaks from responsibility. The concern with tantrums focuses on children from about 12 months to 5 years of age. No problem is indicated if these are brief outbursts that are resolved in 10 minutes or so, and if they are triggered by age-appropriate issues like power struggles or crankiness. There is slight concern if tantrums occur more than 5 times a day and if they resolve in 10 to 15 minutes. Moderately concerning tantrum behavior involves tantrums more than five times a day, lasting more than 20 minutes, or involving aggression or head-banging on soft surfaces. Significant reason for concern exists if tantrums are intense and the child hysterical and inconsolable for long periods, and where there is abrupt head-banging on hard surfaces. In the last case, planning should include investigation of developmental disorders like language delays, or reminders of past trauma as reasons for significant tantrums.
The FAST birth-to-five module presents an extremely useful definition/checklist approach that should be of great value to professionals doing individual family plans.