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IF UNSURE, REFER. Avoid the “Don’t worry, (s)he’ll grow out of it” trap!


Parents want and expect information on child development, as demonstrated by the Commonwealth Fund, the Healthy Steps Program, the North Carolina Access Project, and CHILD Profile surveys in Washington State.  Parents are often the first to notice difficulties in their child’s development. About 16-18% of all children have disabilities such as speech and language disorders, motor disorders, and mental retardation.  Only half of children with developmental disabilities are identified prior to school entry. Well-child exams in the first years of life are ideal for the detection of problems with a child’s development.

Click on the links below for more information on STEPS for Developmental Surveillance and Screening:

  1. Listen to concerns
    What you should know about concerns from the parent, child-care providers or others in contact with the child.
  2. Assess risk factors
    Summary of biologic and environmental factors that may place a child at higher risk for poorer developmental outcome.
  3. Monitor development with surveillance and screening
    • Definition of surveillance and screening.
    • Review of screening techniques and tools.

    Links to Developmental Screening with the Ages and Stages Questionnaire

  4. Talk with parents about results
    • Normal
    • Minor Concerns – No pathology/ ‘Immaturity’
    • More than Minor Concerns
  5. Parents as Partners – Monitoring and Referral
    Give parents activities to enhance development, tools to continue to monitor developmental progress, and resources for child development information and programs.
  6. If unsure, REFER! Further evaluation to confirm or refute presence of delays. Includes:
    • Special Education in local school districts (3-21 years old)

    If developmental delay is confirmed
    Information on:

    • Connecting with interventions
    • Establishing etiology – includes references on evaluation of developmental delay and mental retardation
    • Assisting parents with information and support
    • Care coordination
    • Medical specialists
  7. Early Intervention Works!
    Information on results of early intervention programs.

Further Information

For Families

Information on assessing developmental delays, commonly used screening tools, and next steps.
From the American Academy of Pediatrics

Developmental Monitoring section:

Edited by Katherine TeKolste, MD, FAAP / Last revised 7/21/15

Developmental Pediatrician; MHLN Medical Consultant