Paeds · growth-development-and-behaviour
Developmental assessment: history, examination and standardised tools
Also known as Developmental assessment · Developmental examination · Standardised developmental tools · Bayley developmental testing · ASQ developmental screen
Fellowship approach to structured developmental history and examination, correct age use, selection and limits of standardised screening and diagnostic tools, first-line hearing and vision, synthesis, referral and exam performance.
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Red flags
- Developmental regression after previously acquired skills
- Acute encephalopathy, new seizures or rapid loss of skills — emergency pathway
- Strong caregiver concern with multi-domain lag despite a pending or borderline screen
- Suspected severe neglect or unsafe caregiving during assessment
- Hearing or vision concern with delayed communication and no sensory check yet
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- Developmental assessment: history, examination and standardised tools
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Overview & Definition
A developmental assessment answers one practical question: what can this child do across domains, how does that compare with expected skills for age, and what do we do next? It is not a single questionnaire. It is a structured clinical process that combines caregiver report, observation, physical examination and, when appropriate, a standardised instrument. [1]
Surveillance is continuous watching and asking at every visit. Screening uses a validated tool with known performance characteristics. Diagnostic evaluation uses deeper instruments and multidisciplinary judgement that can support a diagnosis and service plan. This page teaches how to run the assessment itself and how to place tools in the right tier. [1] [3]
Use evidence-informed milestones rather than personal folklore. Tools and lists should reflect skills most children of that age achieve, not outdated “average age” lists that falsely reassure. [2]
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]Moeschler JB Comprehensive evaluation of the child with intellectual disability or global developmental delays Pediatrics, 2014.PMID 25157020
- [5]Pavlova P A psychometric study of the Russian-language version of the Bayley Scales of Infant and Toddler Development-third edition: An assessment of reliability and validity Front Psychol, 2022.PMID 36118487
- [6]Maleka BK Developmental Screening-Evaluation of an m-Health Version of the Parents Evaluation Developmental Status Tools Telemed J E Health, 2016.PMID 27286191
- [7]Kuo DZ Recognition and Management of Medical Complexity Pediatrics, 2016.PMID 27940731
- [8]Boylen S Impact of professional interpreters on outcomes for hospitalized children from migrant and refugee families with limited English proficiency: a systematic review JBI Evid Synth, 2020.PMID 32813387
- [9]Starmer AJ Changes in medical errors after implementation of a handoff program N Engl J Med, 2014.PMID 25372088
- [10]Forkey H Trauma-Informed Care Pediatrics, 2021.PMID 34312292