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Holistic Approach to Child Development: The PROE Framework

Updated: Mar 2

Holistic Approach to Child Development_ The PROE Framework (Short) - Pathfinder Health
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Parenting is one of the toughest jobs in the world. Not only are you responsible for raising another human being, but you're also constantly bombarded with messages about what you should and shouldn't be doing.

There is currently no single theory that accurately depicts all aspects of child developmnt. It can be difficult for parents to keep up with the latest research and understand how it applies to their children. Additionally, every child is unique and develops at their own pace, so what works for one child may not work for another.

Fortunately, you don't have to be an expert on child development to raise a healthy and happy child – Pathfinder Health took the science behind child development and designed 4 straightforward action-oriented concepts – our PROE child development framework. This comprehensive framework is the result of hundreds of hours of work and analysis of 17 developmental theories.

In this article:

Why are the early years so important?

Child development is a combination of both nature and nurture.

Children are born with certain traits and abilities, but they also learn and grow based on a variety of external factors.

The first five years after your child’s birth are particularly crucial to their health, well-being, and the overall trajectory of their life. In fact, 90% of your child's brain develops by age five. This is the time when the foundations for future learning, health, and behavior are established.

Pathfinder Health is here to help you take the fullest advantage of the many developmental opportunities that these early years present.

What is child development?

We’ve discussed the importance of the early years for a child’s development and the benefits of early intervention. Now let's turn our attention to how your child develops.

If you’ve spent much time reading parenting articles (or taken a freshman psychology class), you have most likely encountered one or more theories of child development.

Attachment theory, Piaget, Erickson, and countless others–what exactly do they say? Does one or more of them resonate more with your personal parenting philosophy and inform how you would like to raise your child? What should you do if one or more theories contradict each other? Should you even subscribe to any particular theory at all?

As it turns out, no single theory accurately addresses every aspect of child development, though many give valuable insights into different aspects.

Every child is unique and develops at their own pace and every family is different, so what works for one child and family may not work for another.

Fortunately, it’s not necessary to be a child psychologist or developmental expert to be the best possible parent to your child. But it is helpful to understand certain key areas of child development and how they generally relate to and influence each other.

Once you have internalized the basics described below, you can go forth and apply them with your own child!

The 4 developmental domains

For simplicity, Pathfinder Health divides child development into four major developmental domains:

  1. Movement,

  2. Social and emotional,

  3. Language,

  4. Cognitive

Other sources sometimes divide these developmental domains differently, so don’t be confused if you’ve seen a slightly different version elsewhere.

Each one of these areas is equally important in helping your child reach full developmental maturity.

By understanding the various processes that occur during childhood, you can better support your child as they grow into a happy and healthy adult.


Movement (sometimes referred to as physical or motor development) involves the growth and changes in a child’s body, including physical abilities, coordination, and balance.

It can be further divided into gross and fine motor skills.

Gross motor skills involve the large muscles in the body, such as those in the arms, legs, and torso, and include crawling, walking, running, and jumping.

Fine motor skills involve the small muscles in the hands and fingers and develop as a child learns to control their movements and use their hands and fingers to do more intricate tasks like picking up small objects or writing.

Believe it or not, in the early years, making sounds and the ability to coo or babble is a fine motor movement skill since your children are starting to learn how to use the small muscles to move their mouth, tongue, and jaw.

Social and emotional

Social and emotional development describes interactions with others and awareness and understanding of oneself. This includes skills like developing friendships, cooperation, and identifying and responding to emotions.


Language development is the process of building communication skills, both verbal and non-verbal (gestures and facial expressions).

This includes acquiring vocabulary (both understanding and using words), learning how to put words together to make sentences, and comprehending others’ communication.


Cognitive development involves the way a child thinks, learns, and solves problems. This includes skills such as reasoning, understanding cause and effect, and thinking abstractly.

The PROE framework for understanding child development

Now that you understand these four developmental domains, it’s time to think more broadly about how they work together.

At Pathfinder Health, we have analyzed 17 developmental theories and distilled them into one unifying framework–PROE–to help you understand how your baby and child learns and grows and why certain developmental milestones are so important.

PROE synergistically brings together classic developmental theories with a revolutionary approach geared to help parents and professionals better understand a child’s development.

— Eric M. Flake, MD, FAAP

The Four PROE Concepts

PROE stands for “Play, Relationships, Observation, Experience” — all of the ways that your child interacts with the world around them.

I think the idea of the PROE framework is great! As someone who works with children (SLP, speech-language pathologist) and who has two young children of my own, it encapsulates what I know as a professional to be important for development while being parent-friendly and easy to understand. It simplifies the many different child development theories into an easily accessible format.

— Molly D., Parent


(Supported by cognitive development theory, maturational, and sociocultural theory.)

Play is essential for children's healthy cognitive, social and emotional, and physical development. It allows children to explore their creativity, practice new skills, and develop a sense of self. It also helps them to build social skills and learn how to cooperate with others.

While it may seem like children are just having fun when they play, they are actually doing a lot of learning.

Through play, children can experiment with different roles and try new ways of thinking and behaving. This helps them understand their world and themselves.

Children play in a variety of ways that each promote different types of development.

In pretend play, children use their imaginations to create make-believe scenarios. This type of play not only develops their creative thinking skills, but helps them make sense of the adult world and build emotional knowledge, emotional regulation, perspective-taking, and cooperation with others.

Physical play is any activity that gets kids moving, and it can be as simple as running around outside. Physical play is important because it helps with coordination, balance, and strength, among other motor abilities. Interactive play involves interaction between two or more players and can involve anything from playing catch to making up a story together.

Interactive play teaches children to take turns, share, and cooperate, builds language skills, and helps to build strong relationships through collaboration.


(Supported by attachment theory, psychosocial development theory, and behavioral learning theory.)

Relationships provide the foundation for children to develop a sense of self and others and encourage their earliest communication. Building relationships with others helps kids develop both interpersonal and intrapersonal skills.

Interpersonal skills refers to your child’s ability to interact with others. This includes things like taking turns, sharing, and cooperating. A nurturing relationship with their caregiver is especially important for a child’s social, emotional, and language development. This relationship helps children feel safe and secure and provides them with a sense of trust and stability. When children have strong interpersonal skills, they are more likely to have successful relationships later in life.

Intrapersonal skills involve being able to understand and regulate one's own emotions. This includes things like recognizing one's own feelings, setting goals, and managing stress.


(Supported by Behavioral Learning theory, Social Learning theory, and Attachment theory.)

Children use all of their senses in observing their surroundings and are constantly observing new things that help them learn.

Allowing your child to watch you talk, cook, clean, or work on a project gives them a chance to see how adults interact with their environment. It also provides valuable lessons in cause and effect–as they watch you complete a task, they can begin to understand how their actions can affect their world.

This extends to observing social interactions, which allow them to see how their own emotions can affect others. Children also learn communication skills by observing others’ conversations.

I think this is a concise, helpful way to conceptualize four pillars of child development. It's a helpful reminder to add diversity to my baby's daily schedule, and also reminds me that it's okay (and important) for baby to also observe. We often feel like we constantly need to play with our baby and provide experiences, but the relationships and observation are also important for growth.

— Nicole R., Parent

In addition, observing their surroundings can help children develop important critical thinking skills. As they take in new information, they will start to ask questions and form hypotheses about how things work. This process of active learning will help them grow into well-rounded, inquisitive adults.


(Supported by sociocultural theory, behavioral learning theory, psychosocial development theory, and cognitive development theory.)

Children build knowledge and developmental abilities through their interactions with the world around them.

Try to expose your child to new things and experiences on a regular basis and encourage them to explore their surroundings.

They learn and adapt their thinking with each new experience and develop problem-solving skills that they can apply to other experiences.

They also learn how their actions and bodies impact the environment around them, teaching them self-awareness and cause and effect.

Trying new experiences and taking risks builds confidence, which encourages your child to try more experiences.

Putting it all together: The big PROE picture

Play, Relationships, Observation, and Experience explain how children grow in the four developmental domains described above.

Parents, as non-developmental experts, might think of each developmental domain as a separate, linear progression where a child achieves certain milestones sequentially–they sit, crawl, then walk and they coo, babble, then speak.

And children do generally progress through milestones in each domain in a particular order.

But their overall development is much broader than that. Each milestone achieved contributes to the way that your child interacts with the world and people around them, which in turn guides future development.

We’ll use two examples from our Pathfinder Health clinical team to explore how PROE can help you understand the interconnectedness of child development and how you can encourage your child’s growth through all four domains.

Example 1: The impact of sitting

Sitting is generally classified as a movement, or gross motor, milestone. It strengthens a baby’s core muscles and improves their sense of balance, which will be essential for later milestones such as walking.

But sitting has less obvious benefits and implications as well.

Sitting opens up your baby’s world immeasurably. Just think: for the first six months or so of their life, your baby spends much of their time lying flat, either on their back looking up at the ceiling or on their tummy looking at the floor or lower part of a room.

But once they learn to sit, a baby can see around an entire room. They can observe people standing farther away and watch them move. They can observe objects from a greater distance, even things higher up. They can turn their heads and see things to the left and right. And they can experience objects in new ways as well.

Sitting up makes it easier for a baby to reach out and grasp or play with an object. They can pick it up and drop it, turn it around, or put it in their mouth.

All of these new observations, interactions, and experiences with their environment have a huge impact on your baby’s cognitive development, teaching them cause and effect, sensory exploration, focus, and many other abilities.

So as this example demonstrates, sitting, a movement milestone, creates an opportunity for observation and experience, which leads to cognitive development.

Example 2: Crossing the midline

The first year of a baby’s life features numerous milestones involving their hands–banging objects together, passing objects from one hand to the other, clapping–that may appear at first to be fine motor milestones.

You can help your baby develop these skills by playing games together, such as Pat-a-cake. Playing with your baby also strengthens your relationship, which is essential for their social, emotional, and language development.

You might not be that excited when your baby bangs objects together or passes a toy from their right to their left hand–these actions don’t seem as important as a baby’s first smile or first steps. But in fact, they are just as clinically significant as learning to walk.

These abilities are critical cognitive milestones involving coordination, focus, and problem-solving. They are especially important in developing your child’s ability to “cross the midline.”

Crossing the midline (an imaginary line dividing your body into right and left halves) involves reaching across the middle of the body and is essential to developing a variety of skills and abilities later in your child’s growth.

First, repeatedly crossing the midline allows one hand to become dominant and develops fine motor skills that will become important later for writing.

A child with difficulty crossing the midline will also have trouble visually tracking from one side to the other, which can impact their ability to observe and later to read.

Just think, playing Pat-a-cake now may help your child learn about whales, baseball, or castles years in the future!

How to incorporate PROE into daily life

Once you begin thinking about child development through the lens of PROE, you’ll see that the connections are endless.

Physical play encourages your child’s motor development by building coordination, balance, and strength. These skills allow your child to explore their environment with greater ease and experience new things, which will lead to cognitive growth.

A close relationship with you will give your child the security and emotional skills that they need later on to play with and relate to peers, which will in turn encourage their language, social-emotional, and cognitive abilities.

If this makes child development seem like a self-perpetuating cycle, that’s because it is, with your input and encouragement! In fact, a recent study showed that the more a parent believes that their contributions can impact their child’s development, the better the developmental outcome for that child.

But just because these developmental concepts are important doesn't mean they have to be difficult or complicated.

Play can be as simple as saying a silly nursery rhyme with hand gestures or rolling a ball back and forth.

Relationships are all based on your bond with your child, which you naturally nurture through daily attention and affection.

Observation occurs countless times a day–any time your child goes outside, sees you at work, or watches you interact with another family member.

To provide your child with new experiences, include them in your daily routine—involve them in household chores, even at the simplest level, and bring them with you to run errands.

Your child is a little sponge, and they will absorb information from all of these activities and interactions.

If anything, keeping the PROE concepts in mind makes it easier to teach your child and encourage their development. PROE is not a task list. You don't need special educational toys or enrichment programs—PROE means finding the enrichment everywhere in the world and integrating it as a natural part of daily life.

Sample PROE Day 1

  1. At breakfast, talk to your child about what they are eating and what they will do that day. (Relationship, Observation)

  2. Go for a walk and point out different flowers, birds, cars, etc. (Observation) Stop at a playground and let your child run or crawl around with other children. (Play, Relationship, Observation, Experience)

  3. At the grocery store, name and count the foods that you are buying. (Observation, Experience)

  4. Give your child cups or strainers in the bath and encourage them to play in the water. (Play, Experience)

  5. Sit with your child on your lap and read a book together at bedtime, discussing the pictures. (Relationship, Observation)

Sample PROE Day 2

  1. Take turns playing Peek-a-boo while getting your child dressed in the morning. (Play, Relationship)

  2. During the drive or walk to school, take turns talking with your child about the things you see on the way. (Relationship, Observation)

  3. While doing laundry, give your child different pieces of clothing so they can feel the textures and see the colors (Observation). Ask them to help you put clothes in the basket. (Experience)

  4. Give your child pans and a wooden spoon to bang while you make dinner. (Play, Experience)

  5. Cuddle with your child and sing a song before bedtime. (Relationship)

These sample “PROE days” above are not intended to be a precise formula for how to use PROE. We provide them merely for inspiration and to demonstrate that PROE does not need to be a chore or burden.

It’s simply a shift in mindset to help you make the most of the many learning opportunities that are already part of your own day.

I like the PROE framework because it is easy to comprehend and easy to adapt into everyday life with your child as these things currently are already happening! It is flexible to use and change as your child grows so I will definitely be sticking with it.

— C. Pellegrini, Parent

Furthermore, we at Pathfinder Health understand that parenthood can be busy and overwhelming and you may not be able to engage in every PROE category every day.

Don’t let this be a source of stress–it’s more important to strive for an equal balance overall and make sure that you are regularly helping your child learn through all four PROE categories.

For example, a sick child might spend a day or two inside wanting to be cuddled.

Their relationship bucket will be full for that time, but they might not have done much from the other PROE categories.

When they feel better, take them outside and run around together. They’ll have fun playing, observing, and experiencing the wider world again and will still have the full benefit of all aspects of PROE.

I like that it helps reinforce that the everyday activities I do with my child are furthering development. It also helps me ensure that I give my child every part of PROE everyday.

— Lauren P., Parent

The PROE Wheel

Now that you know how simple things like Play, Relationships, Observation, and Experiences affect your child's development, you are much better equipped to create a positive environment that will encourage your child to flourish. Just keep the PROE framework in mind!

But if you’re interested in a more advanced approach, the PROE Wheel exercise allows you to see where you put most of your efforts when it comes to your child's development.

This will help you find the gaps and areas where your child might need more support so that you can focus your efforts and optimize their development and learning.

Keep track note of the types of activities you are doing with your child regularly and try to ensure you’re balancing activities across all four areas of the framework.

Looking for a printable copy? Download it here, and hang it on your refrigerator to serve as a daily reminder when planning your activities!

PROE WHEEL - Pathfinder Health
Download PDF • 115KB

I liked that this model gave me a framework to think about different aspects of my child's development and how I can focus on certain areas. I also appreciated that the information gives me tools so I can take action in areas of concern.

— Kelly J., Parent

If you need further examples, ideas, or inspiration, check out the 1,000+ activities in the Pathfinder Health app that parents and caregivers can do to promote a child's development.

Download the app: iOS, Android

These activities will strengthen your relationship with your child, encourage them to develop new physical/motor, cognitive, language, and social/emotional abilities, and make learning fun!

How to know if your child’s development is on track?

At Pathfinder Health, we know that parents want to see their children grow and flourish. However, it can be challenging to determine whether your child is developmentally on track.

Parents are not developmental experts and may not understand when children ought to achieve certain milestones or even how to assess whether a milestone has been reached.

Added to that, there are many potential causes of developmental delay–in fact, anything that interferes with a child's ability to develop normally. These causes include, but are not limited to:

  • Premature birth

  • Exposure to toxins or infections during pregnancy

  • Genetic abnormalities

  • Problems with the nervous system

  • Intellectual disability

  • Environmental factors

Furthermore, developmental delays can manifest themselves in a multitude of ways. Parents should be aware of the many different indicators of potential developmental delay so they can recognize them in their child.

If you notice any of the following signs in your child, it's important to talk to your pediatrician or healthcare professional:

  • Not meeting developmental milestones when expected

  • Delays in speech and language development

  • Poor eye contact or social skills

  • Lack of interest in toys or playing with others

  • Hyperactivity or impulsivity

  • Aggressive behavior

Developmental screening by a healthcare professional is an even more reliable way to determine if your child is on track with their developmental milestones or if they may have a developmental delay.

Unfortunately, only 17-30% of US pediatricians take the time or have the training to accurately conduct developmental screenings during well-child visits.

This is where Pathfinder Health provides such critical help. We are the only parenting app that goes beyond tracking developmental milestones to also identify concerns, provide parents and caregivers with resources, and facilitate treatment.

Download the app: iOS, Android

And we provide all of this data in an easily digested report. You can share your child’s Pathfinder Health screening results with your child’s doctor to maximize your brief well-child visits and leave more time to discuss specific concerns.

The importance of early intervention

While developmental delays can be scary, it's important to remember that early intervention and proper support provide many benefits for infants and toddlers with developmental delays or disabilities and can even change your child's developmental path.

Early intervention services can help your young child learn the skills they need to be successful in school and life, reducing the need for more costly special education and related services later on.

Some of the benefits of early intervention services include:

  • Improved communication and social skills

  • Increased ability to participate in daily activities

  • Greater self-confidence and self-esteem

  • Improved academic performance

  • Increased independence and self-reliance

Early intervention can also play a vital role in supporting parents and caregivers. By building their competence and confidence, early intervention can help parents and caregivers provide the best possible care and support for their children.

If your child is diagnosed with a developmental delay, don’t despair–there are many possible treatments that can help them catch up. Timely and appropriate access to these services can make a big difference in your child's life and in some cases even help them catch up with their peers.

Frequently Asked Questions

1. What are the 5 stages of child development?

  • The five stages of child development are:

  • Newborn: birth to three months

  • Infant: three months to one year

  • Toddler: one to three years

  • Preschool: three to five years

  • School age: five to 17 years

2. What activities help a child develop?

A few of the many types of activities that help with child development include:

  • Having conversations with your child about what you see and do

  • Reading to your child and discussing what you read

  • Involving your child in household chores, such as laundry or cleaning

  • Exploring outside using different senses

  • Building with different materials, such as blocks or playdough

  • Playing movement, word, or board games

3. Is daycare good for child development?

As long as you choose high-quality care, daycare can be very good for child development. Children learn many social and communication skills by playing with others. Moreover, quality daycares also teach pre-academic skills that are important for school readiness.

4. How do building blocks help a child's development?

Building blocks help develop many abilities. Children use fine motor skills, coordination, problem-solving, and focus to stack. Rebuilding after blocks fall also helps them practice their patience and emotional regulation.

5. What is nature vs nurture in child development?

Nature and nurture are different factors that can impact a child’s development and behavior. Nature refers to innate characteristics, usually from genetics, present from birth. Nurture refers to traits that develop as a result of their environment, primarily their family.

6. What is scaffolding in child development?

Scaffolding is a way that adults support children as they learn new skills by providing just enough assistance to help the child accomplish a task, but not so much that they become dependent on adult help. The adult gradually withdraws support as the child gains confidence and competence.

7. What is an example of scaffolding in child development?

An adult can help a child learn to tie their shoes by first guiding their hands through each step and then transitioning to verbal reminders and encouragement.

The Takeaway

Remember that child development is an individual process and every child will grow and develop at their own pace and reach milestones in their own time.

However, you can support and encourage your child’s development in a variety of ways. Make time for play every day. Sustain close family relationships as your child’s foundation. Give them the opportunity to observe the world and plenty of new and varied experiences. These are the best ways to set your child up for success in achieving milestones and developing to their fullest potential over the course of their life.

Pathfinder Health’s PROE framework can help you balance your efforts to support your child easily and meaningfully. And if you need more help, support, or ideas to encourage your child’s development through PROE, we have a wealth of activities and resources to inspire you!

But if you are worried about your child's development, don't hesitate to take advantage of our screenings and developmental milestones tracking tools–they will reassure you that everything is going well or flag any concerns and highlight the next steps.

Our clinical team’s broad expertise in child development means that Pathfinder Health can detect delays at an early age–often before symptoms even become noticeable.

Early detection and intervention are crucial for ensuring that children with developmental delays get the treatment they need to maximize their potential.

If you have any questions or would like to share your experiences, please leave a comment below.


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