Paeds · clinical-assessment-and-reasoning
Developmental surveillance and milestone assessment
Also known as Developmental screening · Milestone assessment · Developmental surveillance · ASQ developmental screen · M-CHAT autism screen
Fellowship approach to developmental surveillance, evidence-informed milestones, standardised screening including autism tools, early referral, equity and exam performance from infancy through early childhood.
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Study tools
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Target exams
Red flags
- Developmental regression after previously acquired skills
- No babbling, pointing or social response in the age window where these are expected
- Strong caregiver concern for autism or global delay even if a screen is pending
- Acute encephalopathy or rapid loss of skills — emergency pathway, not routine surveillance
- Suspected severe neglect with stalled development
Life stages
Care settings
Clinical exam formats
Board mappings
- General and Community Paediatrics
- Current 2026 PREP curriculum — Learning Objective 1.2.1: Communicate with a child or young person in a way which is appropriate to the position of that child within their own culture
- Renewed curriculum for first-year trainees from 2027 — Learning goal 5: Clinical assessment – essential general paediatrics
- Renewed curriculum for first-year trainees from 2027 — Learning goal 10: Clinical assessment and management – developmental and behavioural paediatrics
- Renewed curriculum for first-year trainees from 2027 — Learning goal 12: Communication with patients, families, and health professionals
- Clinical Applications
- Long Cases
- Short Cases
- 2. Professional skills and knowledge: Communication
- 4. Professional skills and knowledge: Patient management
- Neurodevelopment and Neurodisability
- Foundation of Practice (FOP)
- Applied Knowledge in Practice (AKP)
- Development
- History
- Communication
- General Pediatrics Content Outline — Domain 1: Preventive Pediatrics/Well-Child Care
- General Pediatrics Content Outline — Domain 5: Mental and Behavioral Health
- General Pediatrics EPA 10: Leading Interprofessional Teams to Provide Collaborative, Family-Centered Care
- Patient Care 4: Clinical Reasoning
- Interpersonal and Communication Skills 1: Patient- and Family-Centered Communication
- Systems-Based Practice 3: System Navigation for Patient Centered Care – Coordination of Care
- Medical Expert
- Pediatrics: Transition to Discipline EPA #1 — Performing and presenting a basic history and physical examination
- Pediatrics: Foundations EPA #8 — Communicating assessment findings and management plans to patients and/or families
Three nested jobs
Surveillance
Screening and evaluation
These distinctions are central to AAP guidance on identifying developmental disorders early. [1]
Overview & Definition
Parents often notice first. Your job is to turn that notice into a structured process that does not lose the child in a “wait and see” fog. Developmental surveillance is the continuous process of asking, watching and documenting. Developmental screening is the periodic use of a standardised tool with known performance characteristics. Developmental evaluation is the deeper assessment that can establish diagnoses and intervention plans. [1]
A milestone is an observable skill that most children of a given age have achieved. Tools and lists must be evidence-informed. CDC and AAP collaborative work revised surveillance milestones so that listed skills are achieved by most children at that age, reducing false reassurance from outdated “average age” lists. [2]
This page owns surveillance and screening logic. Cross-link growth charting, physical examination, autism management, genetics and school-age learning topics rather than hiding full specialty chapters here. [1]
References10ShowHide
- [1]Lipkin PH Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics, 2020.PMID 31843861
- [2]Zubler JM Evidence-Informed Milestones for Developmental Surveillance Tools. Pediatrics, 2022.PMID 35132439
- [3]Robins DL Validation of the modified checklist for Autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics, 2014.PMID 24366990
- [4]Kuo DZ Recognition and Management of Medical Complexity. Pediatrics, 2016.PMID 27940731
- [5]Mills E Association between caregiver concern for clinical deterioration and critical illness in children presenting to hospital: a prospective cohort study. The Lancet. Child & adolescent health, 2025.PMID 40451224
- [6]Boylen S Impact of professional interpreters on outcomes for hospitalized children from migrant and refugee families with limited English proficiency: a systematic review. JBI evidence synthesis, 2020.PMID 32813387
- [7]Starmer AJ Changes in medical errors after implementation of a handoff program. The New England journal of medicine, 2014.PMID 25372088
- [8]Katz AL Informed Consent in Decision-Making in Pediatric Practice. Pediatrics, 2016.PMID 27456510
- [9]Forkey H Trauma-Informed Care. Pediatrics, 2021.PMID 34312292
- [10]Burvenich R Effectiveness of safety-netting approaches for acutely ill children: a network meta-analysis. The British journal of general practice : the journal of the Royal College of General Practitioners, 2025.PMID 39117428