Paeds · investigations-procedures-and-technology

Developmental, cognitive and behavioural assessment tools

Also known as Developmental screening · Cognitive assessment · Bayley Scales · Ages and Stages Questionnaire · M-CHAT-R/F · Strengths and Difficulties Questionnaire · Developmental surveillance

A fellowship approach to the developmental, cognitive and behavioural assessment tools used across childhood, built on the single principle that surveillance, screening and diagnostic assessment are three different acts answering three different questions. Surveillance is the longitudinal, opinion-based monitoring done at every health visit. Screening is a brief, standardised tool applied to the whole population at scheduled ages to find the child who needs a closer look. Diagnostic assessment is the lengthy, trained-administered evaluation that confirms and quantifies a disorder. Hold the schedule of developmental screen at nine, 18 and 30 months and autism screen at 18 and 24 months, layered on surveillance at every visit. Know the broadband developmental screens (Ages and Stages Questionnaires, Parents' Evaluation of Developmental Status, Denver II), the gold-standard cognitive tools (Bayley, Griffiths, Wechsler), the autism screen (M-CHAT-R/F, CHAT) and the behavioural scales (Strengths and Difficulties Questionnaire, Child Behavior Checklist, Vanderbilt, Conners). Hold the psychometric model: standard score mean 100, standard deviation 15, a score of 70 or below two standard deviations below the mean; developmental quotient equals developmental age divided by chronological age times 100. A positive screen is never a diagnosis; low prevalence lowers positive predictive value, so diagnostic confirmation always follows. Always check hearing and vision, because sensory impairment is the reversible mimic, and escalate regression or loss of any skill to urgent diagnostic referral.