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Developmental screening examines how a child is developing by identifying which milestones they've met and in which areas they may need more support. Parents are encouraged to complete a developmental screening tool - usually a questionnaire or checklist - to see how their child is progressing.

Review the resources below to learn more about developmental screening.

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According to Zero to Three, "The first three years of a child's life are uniquely important, because this is the most sensitive period for brain development."

Review the resources below to learn more about the way babies' brains development, and how to encourage that development.

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What Resources are Available for Early Childhood Educators?

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What Resources are Available for Early Childhood Educators?

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All of the resources on this board have been selected to help parents and early childhood educators gain a better understanding of developmental screening and brain development. The resources below specifically apply to early childhood professionals.

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Visit this website from the CDC for an explanation of developmental monitoring.

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Centers for Disease Control and Prevention

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Developmental Monitoring and Screening | CDC

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Learn about developmental monitoring and screening.

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This campaign provides information and resources about the importance of early intervention.

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Centers for Disease Control and Prevention

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From birth to 5 years, your child should reach milestones in how he plays, learns, speaks, acts and moves. Track your child's development and act early if you have a concern.

Act Early Ambassadors work to integrate LTSAE across the country.

A federal effort to encourage healthy child development.

Here you'll find the agency to contact in your state if you have a concern about your young child's development.

See how others help their communities "Learn the Signs." and "Act Early."

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free materials to track child development

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free materials for early care and education

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"Learn the Signs. Act Early." has FREE child development tools

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Use CDC's "Learn the Signs. Act Early." tools to track and celebrate children's developmental milestones from 2 months to 5 years and learn what to do if you ever have a concern.

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Developmental screening tools are questionnaires or checklists that look at whether children have met certain milestones in different developmental areas, such as language, physical, and social-emotional behavior. A developmental screening tool does not provide a diagnosis, but it does indicate if a child is delayed in certain areas and may need to see a medical professional for an evaluation.

Below are some examples of popular screening tools in New Jersey.

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Early Screening Inventory, 3rd Edition (ESI 3)

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Early Screening Inventory, 3rd Edition (ESI 3)

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Ages and Stages Questionnaires, 3rd Edition (ASQ-3)

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Ages and Stages Questionnaires, 3rd Edition (ASQ-3)

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Introduction to the Ages & Stages Questionnaires (ASQ-3)

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Brigance Early Childhood Screens Demonstration

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What Resources are Available for Families?

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What Resources are Available for Families?

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Parents and caregivers may have questions about how to get an evaluation for their child with an identified delay, or about which resources are available to support children with identified delays.

Below is a list of national and community resources that provide assistance with the early intervention process.

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When Developmental Concerns are Identified

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When Developmental Concerns are Identified

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When Developmental Concerns are Identified

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This chart provides statewide resources parents and families can access when they identify a developmental concern.

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Next Steps When Developmental Concerns are Identified: County-Specific Flow Charts

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Next Steps When Developmental Concerns are Identified: County-Specific Flow Charts

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This list of county resources, assembled by The Boggs Center on Developmental Disabilities, provides flow charts of who to contact when developmental concerns are identified for each county in New Jersey.

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This list, assembled by the New Jersey Department of Human Services, contains community resources related to early intervention and more.

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Important Information and Community Resources

The New Jersey Department of Human Services, Division of Family Development (DHS/DFD) works in partnership with service providers and other state and municipal agencies to help families' access quality programs and services. You can find many of these programs on the DHS website Opens in new window . Links to more support services and resources are below.

If you are deaf or hard of hearing, please call TTY 1-877-294-4356 to access any hotline: (voice callers use 7-1-1 NJ Relay)

NJ 2-1-1
Just dial 2-1-1 or www.nj211.org Opens in new window
2-1-1 is a convenient way to assist individual's access information or self-screen for many of programs supported by DHS/DFD. It will prompt you to answer a few questions about your household, income and other expenses which will then identify other programs for which you may qualify.

Affordable Care Act
1-800-318-2596 or www.healthcare.gov Opens in new window
The Affordable Care Act (ACA) provides affordable health insurance for millions of New Jerseyans. Click here for more information on the Affordable Care Act Opens in new window .

Child Care Help Line
1-800-332-9227
Connects families to the local Child Care Resource & Referral (CCR&R) agencies to help families determine if they are eligible for New Jersey's Subsidy Program, find and locate quality child care services and other child care options.

Child Support Hotline
1-877-NJ KIDS1 (1-877-655-4371) or www.nj.gov/education/ Opens in new window
The focus of the Division of Early Childhood Education (DECE) is to enhance social, emotional, physical, and academic development of New Jersey's children -- preschool through third grade -- by providing leadership, resources, and professional development in support of high-quality early childhood programs within a comprehensive, collaborative program.

Early Intervention Services (Birth to Age Three)
1-888-653-4463 or www.nj.gov/health/fhs/eis/for-families/ Opens in new window
The New Jersey Early Intervention System (NJEIS), under the Division of Family Health Services, for infants and toddlers, birth to age three, with developmental delays or disabilities, and their families.

Early Intervention Services (Over Age Three)
1-800-322-8174 or www.nj.gov/health/fhs/eis/for-families/ Opens in new window
New Jersey Early Intervention System Project Child Find Opens in new window - Assists families of preschoolers ages 3 through 5 concerned about their child's development.

Earned Income Tax Credit (EITC)
Federal: 1-800-929-1040 / State: 1-888-895-8179 or www.NJEITC.org Opens in new window
EITC - is a federal and state tax credit benefit for individuals and families who earn low-to moderate incomes in NJ.

Families First Discovery Pass
www.FamiliesFirstDiscoveryPass.com Opens in new window
State Council on the Arts and the New Jersey Historical Commission have partnered with the NJ Departments of Human Services (DHS) and Health (DOH) to launch New Jersey's Families First Discovery Pass program. This program provides families and individuals enrolled in state assistance programs with free or highly discounted admission to arts and history organizations, venues, and programs - both in-person and virtual. The Families First Discovery Pass Program offers broad access to cultural experiences for New Jersey residents and helps cultural organizations engage new audiences with the goal of building long-lasting relationships. Residents who receive benefits through SNAP, WFNJ, Child Care Subsidy and/or WIC are eligible for free or steeply discounted cultural programs throughout the state.

Family Help Line
1-800-THE KIDS (1-800-843-5437)
24 hours a day - 7 days a week
If you're feeling stressed out, call the Family Help Line and work through your frustrations before a crisis occurs. You'll speak to sensitive, trained volunteers of Parents Anonymous who provide empathic listening about parenting and refer you to resources in your community.

Head Start
https://eclkc.ohs.acf.hhs.gov/hslc/HeadStartOffices Opens in new window
The Office of Head Start (OHS) promotes the school readiness of young children from low-income families through local programs. Head Start and Early Head Start programs support the mental, social, and emotional development of children from birth to age 5. Use the link above to locate Head Start near you.

Home Visitation Services
609-888-7400 or http://www.state.nj.us/dcf/families/early/visitation/ Opens in new window
Home Visitation provides helpful information and support to pregnant woman, new mothers or fathers, or other caregivers in the comfort and privacy of their home to ensure that babies and young children grow up healthy, happy and safe.

Individuals with Disabilities Education Act (IDEA)
http://idea.ed.gov Opens in new window
Infants and toddlers with disabilities (birth-2) and their families can receive early intervention services under IDEA Part C. Children and youth (ages 3-21) can receive special education and related services under IDEA Part B.

Low Income Home Energy Assistance (LIHEAP)
1-800-510-3102 or http://www.nj.gov/dca/divisions/dhcr/offices/hea.html Opens in new window
The Home Energy Assistance Program helps very low-income residents with their heating and cooling bills, and makes provisions for emergency heating system services and emergency fuel assistance within the Home Energy Assistance Program.

NJ FamilyCare
1-800-701-0710 ( TTY: 1-800-701-0720) or www.njfamilycare.org Opens in new window
New Jersey's publicly funded health insurance program - includes CHIP, Medicaid and Medicaid expansion populations. That means qualified NJ residents of any age may be eligible for free or low cost health insurance that covers doctor visits, prescriptions, vision, dental care, mental health and substance use services and even hospitalization.

NJHelps
www.njhelps.org Opens in new window
This site will help to see if you are eligible for food assistance (SNAP), cash assistance (WFNJ/TANF or WFNJ/GA), and health insurance (NJ FamilyCare/Medicaid). From there you can apply for services or learn about additional resources.

NJ Parent Link
www.njparentlink.nj.gov Opens in new window
The focus of NJ Parent Link is to meet the information and resource needs of expectant parents, families with young children (newborns to children entering kindergarten) and professional stakeholders vested in the health and well-being of New Jersey's children and families. Parenting and support resources for families with older children, school aged to young adulthood, are also available.

NJ Supplemental Nutrition Assistance Program (NJ SNAP)
1-800-687-9512 or www.NJSNAP.gov Opens in new window
NJ SNAP is New Jersey's supplemental nutritional assistance program that can help low-income families buy the groceries they need to eat healthy. To apply online visit https://oneapp.dhs.state.nj.us

NJ SNAP-Ed
www.NJSNAP-Ed.gov Opens in new window
NJ SNAP-Ed, a part of the Supplemental Nutrition Assistance Program (SNAP), is a nutrition and fitness education program aimed at teaching NJ residents how to make healthy, budget-friendly food choices and lead more active lives.

Ready.gov
https://www.ready.gov/kids Opens in new window
Disasters happen everywhere, and every member of the family can prepare. Preparedness for the future starts today. Whether you're a kid or teen yourself, a parent or loved one, or work with youth, Ready Kids has tools and information to help before, during and after disasters.

Right from the Start NJ
https://rightfromthestartnj.org Opens in new window
Right From the Start NJ is a public awareness campaign created to educate the public at large and New Jersey policy makers about the critical importance of the early years of child development, from birth to three.

Statewide Parent Advocacy Network (SPAN)
1-800-654-SPAN or www.spanadvocacy.org Opens in new window
SPAN is an independent organization committed to empowering families as advocates and partners in improving education, health, and mental health outcomes for infants, toddlers, children and youth.

Social Service for the Homeless (SSH)
www.nj.gov/humanservices/dfd/programs/ssh Opens in new window
Provides assistance to New Jersey residents who are at risk of homelessness, but are ineligible for Temporary Assistance for Needy Families welfare, General Assistance welfare or Supplemental Security Income.

Work First New Jersey (WFNJ)
1-800-792-9773 or www.nj.gov/humanservices/dfd/programs/workfirstnj Opens in new window
The state's welfare reform program provides temporary cash assistance and many other support services to families through the Temporary Assistance for Needy Families (TANF) program and to individuals and couples with no dependent children, through the General Assistance (GA) program.

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The New Jersey Department of Human Services, Division of Family Development (DHS/DFD) works in partnership with service providers and other state and municipal agencies to help families' access quality programs and services. You can find many of these programs on the DHS website Opens in new window .

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National Association for the Education of Young Children (NAEYC) Early Intervention Resources

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National Association for the Education of Young Children (NAEYC) Early Intervention Resources

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NAEYC promotes and supports high-quality early learning for infants through age 8.

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Discover the benefits of early childhood accreditation, learn about the four step process, find support and resources for your program or login to the accreditation portal.

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Zero to Three provides resources and support for early childhood educators and parents with children from infancy through age 3.

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Ages zero to three are the most important for lifelong mental health and well-being.

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When Does a Child Need Early Intervention?

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When Does a Child Need Early Intervention?

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This website from the New Jersey Department of Health explains how Early Intervention Services can help address delays in a child's development.

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The first three years of life are important, formative years in maximizing a child's future potential. If you suspect that an infant or toddler may be experiencing developmental delays, contact Early Intervention System at 888-653-4463. The call is toll-free for New Jersey residents.

Babies develop at their own pace, so it's impossible to tell exactly when a child will learn a given skill. The developmental
milestones listed in our official pamphlet, "Your Child's Development," provide a general idea of the changes to expect, but don't be alarmed if a child's development takes a slightly different course.
View or Download "A Child's Development" El Desarrollo de su Niño
More detailed information is available in the guide, New Jersey Birth to Three: Early Learning Standards, published by the New Jersey Council for Young Children.

What do Early Intervention Services Do?

Early intervention services are designed to address a problem or delay in development as early as possible. The services are available for infants and toddlers up to age three. Contracted agencies serve as the Early Intervention Program providers (EIPs) and arrange for early intervention practitioners to address the needs of eligible children and their families. Following the evaluation and assessment, an Individualized Family Service Plan (IFSP) is developed to describe the services that are needed by the child and family and how they will be implemented. Services are provided by qualified practitioners in natural environments, settings in which children without special needs ordinarily participate and that are most comfortable and convenient for the family, such as the home, a community agency, or a child care facility.
Early Intervention System in New Jersey: Frequently Asked Questions (PDF)

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The first three years of life are important, formative years in maximizing a child's future potential. If you suspect that an infant or toddler may be experiencing developmental delays, contact Early Intervention System at 888-653-4463. The call is toll-free for New Jersey residents.

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This handout accompanies the "How Baby Brains Develop" video in the "Videos" column.

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Communicating Developmental Screening Results 

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Communicating Developmental Screening Results 

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Communicating Developmental Screening Results 

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This infographic provides tips and strategies for communicating with families following a developmental screening.

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Communicating Dev. Screening Results with Families

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This handout offers suggestions for early childcare professionals to communicate effectively and empathetically with families.

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NAEYC Code of Ethical Conduct and Commitment

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NAEYC Code of Ethical Conduct and Commitment

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The NAEYC Code of Ethical Conduct specifically mentions that early childhood professionals are responsible for cooperating and communicating with parents for the well-being of their child(ren).

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NAEYC Código de Conducta Éticay Declaración de Compromiso

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NAEYC Código de Conducta Éticay Declaración de Compromiso

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The Spanish translation of the NAEYC Code of Ethical Conduct. This document specifically mentions that early childhood professionals are responsible for cooperating and communicating with parents for the well-being of their child(ren).

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Why is Developmental Screening Important?

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Why is Developmental Screening Important?

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This article explains why developmental screening is important and provides a glossary of terms that are commonly used when talking about developmental screening.

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What is developmental screening and why is it important?

Not every delay is visible to the eye. Developmental delays and disabilities, such as autism, emotional disturbances, and speech and language disorders, often go undetected until a child enters elementary school.

Study after study has shown that the earlier a delay is recognized and intervention is begun, the better the child's chance of substantial improvement. Developmental screening is one of the best things you can do to ensure a child's success in school and life. (And that's why so many organizations have made it a top priority.)

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Developmental Screening - Ages and Stages

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What is developmental screening and why is it important? Screening can help ensure a child's success in school and life as they reach developmental milestones.

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Aimed specifically at early childhood educators, this resource provides guidance for speaking with families about their child's development.

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This guide walks early childhood professionals through both developmental and behavioral screening.

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How Culture Influences Children's Development

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How Culture Influences Children's Development

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This article gives a brief overview of how a child's culture can impact their development. Those impacts must be considered when conducting a developmental screening.

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How culture influences children's development

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Child development is a dynamic, interactive process. Every child is unique in interacting with the world around them, and what they invoke and receive from others and the environment also shapes how they think and behave. Children growing up in different cultures receive specific inputs from their environment.

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Achieving the Promise of a Bright Future: Developmental Screening of Infants and Toddlers

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Achieving the Promise of a Bright Future: Developmental Screening of Infants and Toddlers

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This article outlines how policies can ensure all infants and children have access to developmental screening. Although this article is geared toward policymakers, the information and statistics included can help early childhood professionals emphasize the importance of screening to parents and families.

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When an infant is born and we look into his or her eyes, we can see the promise of a bright future for that child and for all of us. For some infants and toddlers, healthy development may not be a clear path, and intervention is needed to achieve that promise of a bright future. Occasionally, there are obstacles that compromise an infant's growth-a medical condition, prenatal or birth trauma, or factors in the child's environment. Many months may elapse between the time a problem or concern first emerges and when a child is enrolled in appropriate services, which can make a difference in the child's developmental outcome.

Developmental screening programs identify children whose development may deserve closer observation or assessment and children who may be at risk of later developmental problems. Early identification of developmental issues, partnered with a system of supports to intervene, can prevent early challenges from compromising the child's development. Building ongoing developmental screening into services that routinely have contact with infants, toddlers, and their families allows professionals to monitor and support children's development. If screening raises concerns, children can be referred for in-depth evaluation and appropriate intervention to improve developmental outcomes. Policymakers can offer a bright future for infants and toddlers by ensuring that all children have access to developmental screening and that follow-up services are available for those children who need more detailed evaluation and treatment.

Approximately one of every seven children in the United States faces a developmental disability or a disabling behavioral problem before age 18. Yet fewer than 50% of these children are identified before they start school.

Policy Recommendations

1. Ensure that all infants and toddlers who are eligible for Medicaid and the Medicaid-expansion Children's Health Insurance Program (CHIP) are enrolled and receive periodic developmental screening under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program, which includes physical, mental, and dental health.

Low-income infants and toddlers are more likely to have poor birth outcomes or experience physical and social-emotional challenges that can lead to developmental delays and disabilities. More than 25% of U.S. infants and toddlers live in poverty and are eligible for health services under public health programs such as Medicaid or CHIP. Medicaid mandates health and developmental screening through the EPSDT requirements. However, not every eligible child is enrolled, and even many enrolled children do not receive the full services to which they are entitled. In 2008, 40 states met the federal benchmark that at least 80% of the infants enrolled in Medicaid receive at least one developmental screening during their first year of life, and 44 states met the benchmark of two screenings for toddlers. Only five states have implemented the American Academy of Pediatrics (AAP) recommendation that infants receive seven well-child visits, during which ongoing screening and monitoring can take place. Ongoing monitoring is important because one in five children with a disability will not be identified through a single developmental screening. Disabilities are more likely to be detected if monitoring and screening are continued in all well-child medical care visits. State Medicaid managed care agreements and publicly funded children's health plans should clearly outline required EPSDT services, screening frequency, and other screening mandates, and ensure that these important services are delivered to all eligible children. Children eligible for CHIP services should also receive EPSDT-like screening, diagnosis, and treatment services regardless of whether the state uses CHIP funds for Medicaid expansion or for a separate children's health insurance program.

2. Require the use of standardized developmental screening tools through regulation, including tools that screen for issues in social-emotional development.

Some developmental issues may pass unnoticed during the early years, and some issues, especially relating to social-emotional development and behavioral health, are not identified early or easily without the help of standardized screening tools. The AAP recommends that surveillance be conducted at all well-child checkups (at 3-5 days of age, at 2, 4, 6, 9, 12, 15, 18, 24, and 30 months, and at the 3rd birthday). Developmental screening using a standardized screening tool should be conducted at 9, 18, and 30 months. Surveillance should consider parents' concerns as well as risk and protective factors. These include family conditions, such as parental depression or alcohol or substance abuse, that impact the child's development and security. Policymakers should make funding available to provide training and technical assistance to support professionals (pediatricians, home visitors, early care and education professionals, and others) to incorporate standardized screening tools into their contacts with infants, toddlers, and families. In addition, state Medicaid and CHIP regulations and private health care plans should spell out covered screening, diagnosis, and treatment services and identify appropriate screening tools.

3. Ensure that physicians and mental health professionals are reimbursed adequately for conducting screenings.

Physician reimbursements under private insurance or Medicaid/CHIP for well-child visits may be low, and pediatric care providers may have limited time to devote to surveillance and screening activities during well-child visits. Policymakers should ensure that reimbursement for well-child visits covers the time required to complete surveillance and screening along with other visit activities. Payment should also reimburse for screening as a separate activity whenever a concern is suspected between checkups. More favorable reimbursement rates for preventive care activities have been provided through 2014 under the Affordable Care Act (ACA), but funds will be needed to maintain this increase in the long term and to support state cost-sharing under ACA.

Poverty is a strong predictor of poor developmental outcomes in children. Low-income children are more likely than children from other income groups to have poor health and special health care needs that place them at risk of developmental delays. Yet these children are less likely to receive developmental screening.

4. Promote linkages between early identification services and a network of treatment services so that children's developmental concerns are addressed.

Identifying a possible developmental concern is the first step to successful prevention or intervention. If health providers and others are linked in a network providing early identification, preventive and treatment services, and family supports, they can recognize developmental concerns early and respond to children's needs. Some valuable linkages include coordinating care through a medical home; building relationships between pediatricians and local IDEA Child Find and intake services; strengthening information and referral networks; providing health and mental health consultation to child care providers and home visitors; and building collaboration between public health, child welfare, and early intervention services to ensure that children in the child welfare system are screened and referred. Funding should be provided to support increased service coordination, to increase community screening and referral networks through collaborative efforts such as Early Head Start, and to develop data systems that support tracking of children across service sectors.

Uninsured children are less likely to receive developmental screenings and preventive health care than children enrolled in public insurance programs such as Medicaid or the Children's Health Insurance Program (CHIP).

5. Support outreach to inform parents about developmental screening and follow-up services.

Many parents seek assurance that their children are developing on a typical path, yet they may not understand the purpose of developmental screening. If they have a concern, they often do not know where to go for help. Community helpers who enter the lives of infants and toddlers (for example, child care providers, parent educators, home visitors, and health clinic staff) should understand that services are available for developmental screening, assessment, and treatment and should be able to provide information about these services. Funds should be provided to raise awareness and conduct outreach campaigns to educate community providers and increase family participation in screening activities.

Key Definitions

Surveillance or monitoring refers to the ongoing process of observing a child's development and tracking parents' concerns.

Developmental screening is the process of identifying children who may have a developmental problem or a delay in one or more domains of development, or who are at risk of developmental problems in the future. Comprehensive developmental screening should include consideration of the child's physical, cognitive, language, and social-emotional development and risk factors in the child's background.

Standardized screening tools are measures that gather evidence indicating the probability of or potential for a developmental problem, delay, or risk. Assessment is a more intensive process that evaluates the child's development in depth in order to identify a specific developmental problem and to determine whether the child could benefit from intervention.

Early and Periodic Screening, Diagnosis, and Treatment (EPSDT): Under Medicaid, every eligible child is entitled to periodic developmental screening and treatment for diagnosed conditions to ensure that physical and mental conditions that could affect development are identified and corrected. The screening component includes keeping a health history and conducting a physical exam; laboratory tests; developmental and mental health screening; and dental, vision, and hearing screening.

Policymakers should ensure that reimbursement for well-child visits covers the time required to complete screening and other visit activities.

Child Find: The Individuals With Disabilities Education Act (IDEA) requires that states create a system to "find" children from birth to 3 years of age who may be eligible for services provided under Part C of IDEA, and children ages 3-18 years for Part B services. Child Find systems must coordinate with other state agencies and systems in efforts to identify children in need of services.

Research

Early investments have significant benefit to children and to society at large. An example of this long-term benefit is found in the test to detect congenital hearing problems in newborns. This simple test allows children to be identified beginning in the first months of life. Early treatment may prevent severe disabilities in communication and language development. Although the incidence of congenital hearing problems is low, its personal and economic cost is great. The Centers for Disease Control and Prevention estimates that the cost of providing special education services to a child with significant hearing loss is $11,006 per year. Early detection and treatment could greatly reduce this expense. Children whose hearing loss is detected in infancy and who receive treatment services have better language outcomes at 8 years of age. This in turn is linked to better educational outcomes and enhanced lifelong productivity. The newborn hearing screening test has been mandated in 43 states, and it is one of the 30 newborn screening tests recommended by the March of Dimes.

Low-income children are at greater risk of developmental delays and problems. Low-income children are more likely to face a number of risks that make them more vulnerable to health and development problems. These risks include parental depression, poor housing conditions (contributing to problems like lead poisoning or asthma), and nutrition deficiencies. In addition, the greater risk of exposure to substance abuse in the family, child abuse or neglect, or family disruption among low-income families puts children at greater risk of long-term problems in health and behavior. These risks could be detected and addressed through comprehensive screening and follow-up programs. While the number of low-income children covered by Medicaid or CHIP grew steadily in the early 2000s through CHIP expansion programs, low-income children still continue to face barriers to care such as frequent eligibility redetermination; lowered eligibility ceilings; shortages of participating pediatricians, dentists, and specialists; language barriers; and challenges due to immigration status. Their mothers are less likely to receive adequate prenatal care and screening for perinatal depression. In the current fiscal climate, states are shrinking eligibility for health services and early intervention programs or increasing families' out-of-pocket expenses, making preventive care, screening, and treatment programs even less available for vulnerable families.

Only 5 states meet the standard for frequency of well-child checkups in the first year of life as recommended by the American Academy of Pediatrics for monitoring the infant's health and development.

Training and support for pediatricians can improve screening rates and practices. The Assuring Better Child Health and Development (ABCD) project, designed to incorporate developmental monitoring and screening into pediatric practices and link pediatricians to referral networks, has significantly increased the occurrence of developmental screening and adoption of validated screening tools across the participating states. The project has also demonstrated strategies for taking these best practices to scale and made policy recommendations to improve practice statewide, such as revising Medicaid payment policies and training health providers on billing procedures so that reimbursement for screening activities was adequately covered. New voluntary benchmarks for use by Medicaid and CHIP programs to track health care quality will support states' efforts to improve screening practices.
For a list of citations, download the full PDF.

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Achieving the Promise of a Bright Future: Developmental Screening of Infants and Toddlers

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When an infant is born and we look into his or her eyes, we can see the promise of a bright future for that child and for all of us. For some infants and toddlers, healthy development may not be a clear path, and intervention is needed to achieve that promise of a bright future.

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Watch Me! Celebrating Milestones and Sharing Concerns

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Watch Me! Celebrating Milestones and Sharing Concerns

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This is a free 1-hour online course for early care providers on developmental milestones and best practices for helping children reach those milestones.

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Watch Me! Celebrating Milestones and Sharing Concerns

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Watch Me! Celebrating Milestones and Sharing Concerns

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Early care and education providers play a critical role in the health and wellbeing of children.

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Tips for Child Care Providers to Communicate with Parents Their Concerns about a Child's Development

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Tips for Child Care Providers to Communicate with Parents Their Concerns about a Child's Development

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This resources provides strategies that early childhood professionals can use when they have a concern about developmental delays.

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Child care providers are in a unique position to notice if a child is not developing through typical stages or milestones. If there is a possibility that a child has a developmental delay, child care providers have the responsibility to discuss their concerns with the child's family right away.

Children develop very quickly. If a child has a special need that affects her development, it is best not to take a "wait and see" approach. Getting professional help early for children can make a tremendous difference in their quality of life, their learning, and their later development. Sharing a concern about a child's development with a parent is never easy, but it can be an important way for child care providers to ensure that children receive the early intervention they need.

Parents sometimes rely on child care providers for professional advice. If a parent comes to you with a concern about a child's development, listen respectfully. Take a few days to watch the child, and see if you observe the same issues. Share what you observe with the parent, and discuss what to do next.

If you are the one who has concerns about a child's development and need to bring up a concern with a parent, show them the same respect. Explain your concerns gently. Encourage them to observe the child, and allow them some time to see if they notice the things you are sharing with them.

Specific Tips for Communicating Concerns with Parents

Here are some suggestions for talking to parents about your concerns for a child's development:

Choose a time and place where you can talk alone. Share your thoughts in person; this is not a conversation to have on the phone. If you are still responsible for children during this time, ask another adult to supervise them.

Make sure both you and the parents have enough time to talk. This should not be done in a hurry as a parent is rushing out the door to work. You may want to schedule this conversation ahead of time. You might say, "Mary, I often have regular chats throughout the year with parents to get to know them better, talk about how their children are adjusting to child care, or just general things we need to touch base on. It's time to schedule a chat with you. I wonder if you would have time this week to drop by in the afternoon?"

Be prepared for strong emotions. Parents often sense there may be a problem but have been afraid to talk about it. Often they may not know how to put their concerns into words. Sometimes they are not familiar with typical ages and stages and do not realize that some of their child's behavior is not typical. This is especially true for young parents who may not have other children. Parents also may be worried that if their child does have a special need, you will no longer want to provide child care for their child.

Be caring, supportive, and respectful. Some parents may be relieved to visit with you, but others may be defensive or scared. Showing warmth and respect will help parents trust and listen to what you have to share.

Begin by saying something positive about the child. You might point out several things you really like about the child - his smile, curiosity, love of puzzles. Or you might mention something positive the child did recently such as helping a friend or learning a song. Say something positive about the child's relationship with the parent. When things go wrong, parents sometimes tend to blame themselves. Pointing out the positives helps reassure them that they are good parents. You might say, "Mary, Sara seems to have a real interest in puzzles. She is so skilled at them. Tell me, have you worked with her on this? I can tell that you seem to have a real interest in helping Sara grow and develop."

Ask if parents have concerns or questions about how the child seems to be developing. Quietly and respectfully ask the parents to share what they have noticed. Who, what, when, where, how questions will help you gather more information and help parents focus on the issue. You might say, "I wonder if you have had any concerns about Jason being able to understand what you say?" Or "Have you noticed if Sara seems to be having a hard time hearing loud noises or people talking? Tell me what you have noticed." You might also say, "How long has this been happening? When does this seem to happen? What happens next? Has anyone else noticed this? Where does this seem to happen most?"

Share your own observations and concerns. Do this only after the parents have had a chance to talk. Share information on typical developmental milestones or other developmental checklists so parents will have something to look at. If it makes you feel more comfortable, practice what you will say beforehand.

Choose your words carefully. Rather than say, "I think Sara might be deaf," give specific examples and describe what you have seen. You might say, "I noticed the other day a gust of wind blew the door shut. It made a loud bang and scared all of us, but Sara didn't even flinch. And last week, I kept calling her to come to the lunch table and she didn't seem to hear me."

Avoid using labels or technical terms. Remember you are not trying to present yourself as an expert. It is not your job to identify the specific disability. It is a very scary thing for parents to hear that someone may think their child has a disability. Keep it simple. Use words that describe only what you have seen. You might say, "I've noticed that Sara doesn't seem to hear loud sounds", or, "Jason seems to bump into things a lot as if he has trouble seeing." Or, "I miss hearing Megan babble and smile like she did when she was a baby."

Keep your eye on the goal. Your goal is to encourage the parents to get a professional evaluation for their child so that any concerns can be checked out. You might say, "It never hurts to check things out. Think about how relieved you will be to find out for sure. And if it does turn out that there is a problem, getting help now will make a big difference."

Stress the importance of checking things out right away. It is very common for parents to need a few days to think about and understand what you have shared. They often feel doubtful, confused, and scared. If they seem unable to take action, reassure them of your support. Remind parents that if there is a problem, getting help early can keep things from getting worse. Early help can make a big difference for a child's later development.

Be ready to offer information and resources. Be prepared to guide the parents through the next steps to get an evaluation or help for the child. The first step usually is to have the child's doctor assess the situation. Your local school system should also be able to direct you to local services available to evaluate young children for developmental delays. Have contact information and website information on hand. If parents do not have access to the Internet, print off information and have it ready to share.

Continue your support. When parents find out that their child has a disability, they may be in shock. Many parents go through a period of grieving. They may become depressed or angry. The range of emotions they experience may make it hard for them to complete everyday tasks. It is possible they may even consider removing the child from your care because they don't want to face the issue. Sometimes this happens. Continue to be understanding and to listen and offer help.

Trust yourself. As someone who cares for children every day, you are in a unique position to notice when a child may be experiencing problems. Sharing your concerns respectfully with parents shows that you really care about their child. Even if a parent seems to resist your efforts at first, they will most likely be grateful later for your concern.

For More Information

To learn more about supporting children with special needs in child care, check out the eXtension Alliance for Better Child Care section on Child Care for Children with Special Needs, or take a look at the following articles:

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Tips for Child Care Providers to Communicate with Parents Their Concerns about a Child's Development

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Child care providers are in a unique position to notice if a child is not developing through typical stages or milestones. If there is a possibility that a child has a developmental delay, child care providers have the responsibility to discuss their concerns with the child's family right away.

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