As a healthcare professional, you are a trusted source of information and guidance for parents and caregivers regarding their children’s physical, social, emotional, and behavioral development.
- Start the conversation. Healthcare providers should discuss developmental milestones and childhood monitoring and screenings with parents and caregivers—explaining what they are and why they are important.
- Normalize childhood screenings. By making screening a routine part of well-baby care, parents will no longer be frightened that you are saying something is wrong with their baby.
- Use the available tools. Ask parents and caregivers to complete an evidence-based screening tool (such as the ASQ-3) and use the results as part of regular developmental screenings.
The American Academy of Pediatrics (AAP) recommends that healthcare providers do the following:
- Monitor the child’s development during regular well-child visits.
- Periodically screen children with validated tools at recommended ages to identify any areas of concern that may require further examination or evaluation.
- Ensure that more comprehensive developmental evaluations are completed if risks are identified.
Developmental monitoring—also referred to as developmental surveillance—is the process of recognizing children who might be at risk for developmental delays. Developmental monitoring should be a part of every well-child preventive care visit and includes:
- Asking about parents’ concerns
- Obtaining a developmental history
- Observing the child
- Identifying risk and protective factors
- Documenting the findings
- Share information with early childhood professionals, as indicated
Engage parents and caregivers in the process of observing and monitoring their child’s developmental progress by:
- Educating them about developmental milestones.
- Sharing resources with families such as Developmental Milestone Checklist and the free Milestone Tracker App
- Encouraging them to share observations and any concerns.
The American Academy of Pediatrics (AAP) recommends developmental and behavioral screening for all children during regular well-child visits at these ages:
- 9 months
- 18 month,
- 30 months
- Annually thereafter until age five
In addition, AAP recommends that all children be screened specifically for autism spectrum disorder (ASD) during regular well-child visits at:
- 18 months
- 24 months
If concerns are identified through developmental monitoring, they should be addressed promptly with an evidence-based screening tool to identify and refine any risk or concern that has been noticed.
Parents and caregivers naturally will be anxious if they believe you have identified a developmental delay or behavioral issue. You can provide support by:
- Explaining what developmental and behavioral monitoring and screening are and note that it is a normal process to make sure children are on track in their development.
- Letting the parent or caregiver know that the American Academy of Pediatrics recommends that children be screened for general development at 9, 18, and 24 or 30 months of age or whenever a parent or provider has a concern.
- Starting off by pointing out something positive. Name a skill or behavior the child is doing well and note their progress.
- Using and sharing the Learn the Signs. Act Early. developmental factsheets to support your observations on the child’s strengths and challenges.
- Identifying any specific areas of concern and asking the parents and caregivers if they have observed the same behavior(s) at home.
- Stress that a developmental screening does not provide a diagnosis.
- Ask the family if they know whether their child has been screened in the past. If so, discuss the results of that screening.
Comprehensive Developmental Evaluation
Based on the outcome of the screening, if you or the family has a reason for concern, you should facilitate a referral for a more advanced developmental evaluation by an appropriate specialist, including a developmental pediatrician, neurologist, psychologist, or early intervention service.
At this stage in the process, it is okay to say to the parent or caregiver, “I may be overly concerned, but I just want to make sure.”
- If you have completed a screening with a child under age 3 and you believe that further developmental assessment is indicated, you can connect the family to a local early intervention service program. Early intervention service programs under Part C of the Individuals with Disabilities Education Act (IDEA) are available in every state and territory of the United States and offer child evaluations free of charge if the program determines the child is suspected of having a disability to determine if a child is eligible for services under IDEA.
- If the child is 3 years of age or older, you can help connect the family to their neighborhood public school, which can provide information on evaluation under Part B of IDEA, even if the child is not yet in kindergarten.
It is important to track any referral to specialists, to ensure that the child receives follow-up service and that the results of any diagnosis and/or treatment are received and notated in the child’s health record.
- Child Developmental Screening Guidelines
- Birth To Five: Watch Me Thrive | A Primary Care Provider’s Guide for Developmental and Behavioral Screening
- Part C of the Individuals with Disabilities Education Act (IDEA) | Virginia
- Part B of the Individuals with Disabilities Education Act (IDEA) | Virginia