For many health and education professionals, developmental screening of infants and toddlers is a common responsibility. As you carefully observe a child’s behavior, language, movement, and social–emotional development, you may notice an area of concern—or perhaps a parent or caregiver presents a concern to you during a visit. That’s when it’s time for a closer look.

These guidelines can help you plan a thorough evaluation to clarify what’s going on with the baby or toddler in your care:

1. Check the recommendations, eligibility criteria, laws, and timelines for early intervention in the Individuals with Disabilities Education Act (IDEA) and in your state. Keeping up to date with these requirements is important because they can change from year to year. Meeting deadlines and eligibility criteria will have a direct impact on services for the children in your care.   

2. Consider the child’s risk and protective factors. Some delays run in families; later walking and talking is one example. Other delays may be linked to infections that occurred before birth, exposure to certain medications and environmental toxins, or malnutrition (Khan & Leventhal, 2023).     

3. Choose assessments in a language most likely to show you what a child knows and can do. IDEA requires professionals to screen and assess in a child’s “native language,” or the language spoken at home. Assessments involving pictures may still require a child to understand instructions or know the names of pictured objects. 

4. Select assessments that closely match a child’s characteristics. As you review your assessment options, consider a child’s age, developmental history, sensory needs, physical abilities, language skills, social–emotional development, and cultural background. A good match between assessment strategies and the child’s personal characteristics makes it more likely that assessment data will reflect what the child can actually do. 

5. Assess comprehensively. To deepen your understanding of the infant’s strengths and needs, you’ll want to assess different developmental domains in all settings where the child typically spends time. You’ll want to review medical records, if possible, and to find out as much as you can about family health and educational history. It’s a good idea to use different assessment methods, too—including observation, interviews, and standardized assessments where needed. 

6. Add authentic assessment to your tool kit. Observing children as they play and interact in natural settings can help you learn more about a child’s daily functioning in environments where they feel comfortable. While many states link eligibility for services to outcomes on standardized assessments, best practice is to consider the child in a natural context rather than solely in a clinical setting (Stein et al., 2023). 

7. Center the family’s concerns and address their priorities. A family-centered approach builds engagement and leads to better outcomes, researchers say. Family-centered early intervention:

• treats family members as equals;  
• respects cultural and social differences;  
• embeds goals in everyday life;  
• ensures families can access information;  
• considers family resources; 
• builds family competence; 
• incorporates family feedback at every stage of the process; 
• improves family decision-making capacity; and
• may lead to better developmental outcomes and greater family empowerment (Frugone-Jaramillo & Gracia, 2023). 

It’s especially important to make sure your reports are written in plain language the family can access, and that they address a family’s priorities and concerns in a useful way. 

8. Build a collaborative evaluation team. In some practice settings, a service coordinator acts as a liaison between the family and a multidisciplinary evaluation team. Pediatricians, developmental specialists, audiologists, occupational therapists, speech–language pathologists, physical therapists, psychologists, social workers, mental health professionals, teachers, daycare professionals, registered dieticians, caregivers, and other health professionals work together with the family to identify delays and plan interventions in all areas of development.  

9. Broaden your reach with telehealth service delivery. In a 2022 study, early intervention specialists described the behaviors that seemed to keep families engaged when they were receiving care via telehealth. Families stayed engaged when early interventionists:  

• showed empathy; 
• considered the child’s and parent’s expectations; 
• communicated with warmth and respect;   
• responded when children tried to interact; and   
• took action on parents’ feedback (Retamal-Walter et al., 2022). 

10. Use your own clinical judgment, as well as test results, in the assessment and planning process. An assessment may have strong psychometric properties, but your own clinical reasoning, along with that of your team members, is equally important. Clinical reasoning allows you to:

• synthesize the information you’ve received from all sources; 
• consider personal and contextual information about the child;  
• balance contradictory findings; 
• think deeply about different hypotheses; and 
• look for possible biases (Wilcox et al., 2023). 

11. Use tools that allow you to monitor progress effectively. Verifying eligibility is a big part of the early intervention process, but it certainly isn’t the last stop. Evaluating a child’s progress, updating your plan—and measuring the effectiveness of your program—are also important. The right assessment will be sensitive enough to help you find out whether interventions are working, whether a child is growing, and where your program might be improved moving forward.  

Learn more about enhancing your clinical reasoning through professional development with WPS ProLearn™. 

Key Message

Developmental screenings can take place in the course of regular care or to address the possibility of a delay. When a parent, educator, or health professional expresses concerns about development, using best practices ensures that the infant or toddler receives a thorough, timely, and sensitive evaluation.

To learn more about best practices in developmental screening and assessment, you may want to explore the recommendations provided by the Council for Exceptional Children, Division of Early Childhood.