Predictions of developmental outcomes based on early assessments of the child have proven inadequate. Development consists of a series of stage-like restructurings of behavior as the child advances through life. Continuities in exceptional behavior generally do not bridge these stages unless those exceptional behaviors are maintained by an exceptional caretaking environment. Such exceptional caretaking can be related to a mother’s cognitive inability to make developmental sense of the behavior of her child. A sequence of negative transactions can be started when an infant is seen as being abnormal either through his history, appearance, or behavior. The parent who makes this concrete attribution will treat the child in such a way as to create a ‘self-fulfilling prophecy’. Research must be directed at the variety of ways that parental levels of cognizing influence their perceptions of their offspring, which perceptions in turn influence their behavior toward their offspring. Dialectical interpretations offer a new tool for understanding the contradictions that motivate cognitive change.