Early Childhood Programs and Practices: Developmental Screenings

Early Childhood Programs and Practices: Developmental Screenings
Written by
Rina Gratz
Published on
June 6, 2024

These are systematic assessments to monitor children’s growth, development, and milestones, and to identify children at risk for developmental delays or disabilities in early care and education (ECE)i. These screenings play a critical role in promoting early identification of developmental delays or concerns so that appropriate and timely intervention can be provided. Developmental screenings and assessments at various points during early childhood, including infancy, toddlerhood, and preschool years, track children's progress over time and inform decisions about educational and support servicesii.  They may be conducted during routine well-child visits, at childcare or early education settings, or through school-based or community-based specialized programs and interventionsiii.

  • Standardized screening toolsiv are used to assess children's development across various domains, including cognitive, language, motor, social-emotional, and adaptive skills. Common screening tools include the Ages and Stages Questionnaires (ASQ), the Developmental Milestones Checklist, and the Modified Checklist for Autism in Toddlers (M-CHAT).
  • Screening frequency may vary depending on individual child needs, ECE program requirements or licensing regulations, although they are typically conducted at regular intervals such as upon enrollment in programs, at specific age milestones (e.g., 9 months, 18 months, 3 years), and/or as needed based on observed concerns.  Most publicly funded ECE programs require scheduled and periodic developmental screeningsv.
  • Prior to conducting developmental screenings, parental consent is obtained. The purpose of the screening, the screening process, and the potential implications of the results, along with resources and strategies to support child development at home are shared with the familyvi.  
  • Observational assessments provide valuable insight into children’s development and strengths.  Children's behaviors, interactions, and developmental milestones are observed during everyday activities and routines in natural settings. Documented observations inform the screening process, help identify areas for further assessment, and track children's progress over time.
  • Interpretation of screening results is best done in collaboration with parentsvii and other relevant professionals (e.g., early intervention specialists, pediatricians). If a child screens positive for developmental concerns, providers may refer the child for further evaluation by qualified professionals, such as a pediatrician, multi-disciplinary developmental specialists, or early intervention providers.
  • If developmental concerns are identified, ECE providers work collaboratively with parents and other professionalsviii to develop and implement a plan for support and intervention. This may involve accessing early intervention services, implementing individualized accommodations or modifications, and providing targeted interventions to address specific areas of need.
  • Monitoring and follow-upix following implementation of interventions and supports can include ongoing assessments, tracking developmental milestones, and communicating regularly with parents and other professionals to ensure that children's needs are being met and that they are making progress over time.

Resources Required

Parent education and support on developmental screening is the first step in ensuring that families are receptive and understand the benefits of this strategy for their children’s optimal development and preparedness to succeed in school. Training ECE and health professionals on the value and use of developmental screening processes is key to this strategy's implementation. Access to professional expertise and support programs for children and families after the screening is also critical, therefore community education on the benefits of developmental screenings is a necessary precursor to establishing the partnerships needed with institutions and organizations that interface with parents of young children, such as public libraries, community centers, pediatric clinics and hospitals, and the parks and recreations systems.  

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1 Kim S. Worldwidenational intervention of developmental screening programs in infant and earlychildhood. Clin Exp Pediatr. 2022 Jan;65(1):10-20. doi: 10.3345/cep.2021.00248.Epub 2021 Sep 30. PMID: 34592802; PMCID: PMC8743433.

2 EARLY CHILDHOOD DEVELOPMENTALSCREENING: A COMPENDIUM OF MEASURES FOR CHILDREN AGES BIRTH TO FIVE. (2014). https://files.eric.ed.gov/fulltext/ED561406.pdf

3 Lipkin, P. H., & Macias, M. M.(2020). Promoting Optimal Development: Identifying Infants and Young ChildrenWith Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics,145(1), e20193449. https://doi.org/10.1542/peds.2019-3449

4 Radecki, L., Sand-Loud, N., O’Connor,K. G., Sharp, S., & Olson, L. M. (2011). Trends in the Use of StandardizedTools for Developmental Screening in Early Childhood: 2002-2009. PEDIATRICS,128(1), 14–19. https://doi.org/10.1542/peds.2010-2180

5 Hirai AH,Kogan MD, Kandasamy V, Reuland C, Bethell C. Prevalence and Variation ofDevelopmental Screening and Surveillance in Early Childhood. JAMA Pediatr.2018;172(9):857–866. doi:10.1001/jamapediatrics.2018.1524

6 Partain, P.I.,Kumbamu, A., Asiedu, G.B. et al. Evaluation of Community Programs forEarly Childhood Development: Parental Perspectives and Recommendations. MaternChild Health J 23, 120–130 (2019).https://doi.org/10.1007/s10995-018-2601-3

7 Soheir S Abo ElElella, Maha A M Tawfik, Wafaa Moustafa M Abo El Fotoh, Naglaa Fathy Barseem,Screening for developmental delay in preschool-aged children usingparent-completed Ages and Stages Questionnaires: additional insights into childdevelopment, Postgraduate Medical Journal, Volume 93, Issue 1104,October 2017, Pages 597–602, https://doi.org/10.1136/postgradmedj-2016-134694

8 Buckley, L., Martin, S., & Curtin, M. (2020). A multidisciplinary communitylevel approach to improving quality in early years’ settings. Journal of EarlyChildhood Research, 18(4), 433-447. https://doi.org/10.1177/1476718X20951239

9 Barger, B., Rice, C., Wolf, R., &Roach, A. (2018). Better together: Developmental screening and monitoring bestidentify children who need early intervention. Disability and Health Journal,11(3), 420–426. https://doi.org/10.1016/j.dhjo.2018.01.002

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