Research shows that developmental delays, learning disorders, and behavioral and social-emotional problems affect roughly 1 in every 6 children. But busy pediatricians typically do not identify these issues in infants and toddlers, especially if they rely on clinical judgment alone. In fact, less than 30 percent of children with developmental delays are identified as needing help before school begins.
Because early intervention is key, home visitors in the Family Strengthening Network’s free home visiting programs are trained to screen babies before their first birthday and to help families find additional screening and specialists when necessary. These home visitors also help parents become familiar with developmental milestones so they know what to expect as their babies grow.
As part of Early Childhood Screening Week (#ScreeningWeek, August 15-19), the Office of Head Start put together a comprehensive list of useful materials and tools, drawing largely on the two major federal initiatives: HHS’s Birth to 5: Watch Me Thrive! and the CDC’s Learn the Signs. Act Early. We’ve reproduced the list below; it begins with the “Infants and Toddlers” section and goes on to cover culturally and linguistically responsive screening, lead screening, sensory screening, and social, emotional, and behavioral screening.
Be sure to read A Home Visitor’s Guide for Developmental and Behavioral Screening (also available in Spanish) and the Compendium of Screening Measures for Young Children, a collection of research-based screening tools for children under the age of 5. Home visitors and other practitioners in early care and education can use this reference to learn cost, administration time, quality level, training required, and age range covered for each screening tool.
Watch the videos of webinars embedded below — one to guide home visitors and help families make the most of these assessments, and another on using the ASQ with diverse families. For the what, why, when, who, and how of screening, watch these webinars: Health Screening and Determining Child Health Status. The webinar Don’t Just Wait and See and presentation slides from Developmental Screening in Early Childhood Settings also provide good overviews.
For an explanation of screening and developmental monitoring, read the CDC’s Developmental Monitoring and Screening. Screening, Assessment, Evaluation & Observation helps staff identify concerns and promote child development. Finally, staff can use Tips for Talking with Parents to make sure parents are engaged in the process.
The webinar in this first video — Developmental Screening, Assessments and Evaluations for Infants and Toddlers, presented by Early Head Start — helps home visitors identify behavioral and developmental issues while working with infants and toddlers. It also discusses how to integrate data from screening assessments into daily experiences.
The webinar in the next video discusses best practices and strategies for using the ASQ with families from diverse backgrounds. Topics include:
- Meeting with parents and introducing screening (including tips for working with translators)
- Administering screening tools (ASQ-3 & ASQ:SE)
- Communicating results with families
- Determining appropriate follow-up
- Making community referrals
Below is the list compiled by the Office of Head Start.
Infants and Toddlers
Children develop rapidly during the first three years of life, so keeping a watchful eye on health and development is critical. The webinar, Developmental Screening, Assessments, and Evaluations for Infants and Toddlers, offers a thorough overview of the screening process for infants and toddlers. It also describes the relationship between screening and assessment for infants and toddlers. Mentioned in the webinar, “What is Screening?” offers an easy-to-read description of screening infants and toddlers.
Specific questions arise when planning screening activities for infants and toddlers. The following resources offer answers:
- How Do We Screen Premature Infants When There Is No Developmental Screening Tool That Allows for Negative Age? Early Head Start Tip Sheet No. 1
- What Are “Behavioral Skills” in Infants and Toddlers? How Do We Screen Them?” Early Head Start Tip Sheet No.27
- Do Infant and Toddler Screenings Need to Be Standardized?” Early Head Start Tip Sheet No. 30
Child care health consultants help infant/toddler programs create effective screening processes. Infant/Toddler Development, Screening, and Assessment is a training module for consultants new to screening. It covers the entire process of screening, evaluation, and assessment.
Culturally and Linguistically Responsive Screening
Most early childhood programs serve diverse families. Therefore, the best screening tools gather information in ways that respond to culture and language. To better understand how this works, several resources offer guidance and tips:
- Developmental Screening Tip Sheet 10: Culturally and Linguistically Responsive Screening Practices[PDF, 449KB]
- Gathering and Using Language Information that Families Share [PDF, 1KB]
- Screening and Assessment of Young English Language Learners, Where We Stand (NAEYC)[PDF, 78KB] Also available in Spanish (español) [PDF, 122KB]
- Screening Dual Language Learners in Early Head Start and Head Start: A Guide for Program Leaders[PDF, 1.5MB]
Lead is poison. Exposure to lead interferes with children’s growth. Screening children on an ongoing basis can identify children at risk. Most states require lead screening or lead assessment during well-child visits.
For Early Care and Education Providers:
- Educational Interventions for Children Affected by Lead [PDF, 1.4MB]
- Environmental Protection Agency and National Head Start Association Lead Poisoning Prevention Resources
- Home Advisory: Talking Points for Head Start Staff [PDF, 45KB]
- Impact of Lead Exposure in Very Young Children
- Lead and Our Children: The Role of Early Care and Education Programs (webinar)
- Lead Poisoning Prevention for Head Start Children
- Learn about Lead
A child’s hearing and vision affects their development. To identify concerns early, sensory screening is recommended for all children. Professionals use several approaches. These resources describe sensory screening and offer strategies for use in programs.
- Early Childhood Hearing Outreach (ECHO) Initiative
- Early Childhood Hearing Screening and Follow-Up: Screening in Health Care Settings
- May Is Better Hearing and Speech Month: Promoting Early Developmental and Hearing Screening for Young Children
- Beyond Vision Screening: Building a Comprehensive Vision Program (webinar)
- Implementing an Evidence-Based Vision Screening Program – Tools and Tips for All Ages! (webinar)
- Prevent Blindness America
- Vision Fact Sheet
Social and Emotional, and Behavioral Screening
Young children are learning to get along with others and manage their own emotions. When a child enters a program, staff get to know what social and emotional skills children are working on. They use social and emotional or behavioral screening tools to gather that information. The following resources offer information and tips to enhance social emotional screening.
- What Are “Behavioral Skills” in Infants and Toddlers? How Do We Screen Them? Early Head Start Tip Sheet No. 27
- The National Early Childhood Technical Assistance Center: Developmental Screening and Assessment Instruments with an Emphasis on Social and Emotional Development for Young Children Ages Birth through Five [PDF, 1MB]
- Screening for Social and Emotional Concerns: Considerations in the Selection of Instruments
Practical Tools for Early Care and Education Providers
There are several best practice tools to use for screening. Staff can access these resources to select the best tools for their programs. Resources are organized by type of screening. In addition, you will find tools for managing all screening information or data.
- Center for Disease Control and Prevention (CDC) Immunization Schedules
- Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) by State
- Lead Screening: Well-Child Health Care Fact Sheet
- The Well-Visit Planner for Families
- American Academy of Pediatrics: Best Practice Tools: Freely Available Developmental and Behavioral Screening and Assessment Tools
- Birth to 5: Watch Me Thrive! A Compendium of Screening Measures for Young Children [PDF, 1.1MB]
- Birth to 5: Watch Me Thrive! An Early Care and Education Provider’s Guide to Developmental Monitoring and Screening [PDF, 532KB]
- CLAS Review Guidelines for Material Selection: Child Assessment [PDF, 538KB]
- Tips for Early Care and Education Providers [PDF, 670KB]
Speech and Language Screening:
Managing Screening Data:
- Screening Systems Review Tool [PDF, 233KB]
- Sensory Screening Protocol
- When Health Affects Assessment
- The Head Start Health Manager Orientation Guide
- Chapter 3: Health Topic Self-Reflection Checklists [PDF, 328KB]
- Chapter 4: Health Topics: Delving Deeper [PDF, 2.7MB]
- Use the Developmental Screening Passport to keep track of and share your child’s screening history and results. Download a printable version.
- Find Help Near You
- Explore resources for Behavioral Health, Child Welfare, Communities, Early Care and Education, Early Intervention, Home Visitation, and Primary Care.
- Talk With Your Doctor About Newborn Screening
- Prevention Guidelines for Infants and Toddlers: This helpful table clearly lists screening tests and immunizations, who needs them, and how often they should be administered. The guidelines are from the American Academy of Pediatrics and the U.S. Preventive Services Task Force. The immunization schedule is from the CDC.