Paeds · preventive-and-community-paediatrics
Developmental and behavioural screening
Also known as Developmental screening programme · Behavioural screening in children · ASQ developmental screen · M-CHAT autism screening · Early childhood mental health screening
Fellowship guide to developmental and behavioural screening in preventive paediatrics: key-age general screens, autism-specific two-stage pathways, early emotional-behavioural screening, interpretation, closed-loop referral, equity and exam defence — cross-linked to surveillance technique without cloning it.
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Target exams
Red flags
- Developmental regression after previously acquired skills
- Positive autism screen after structured follow-up with no referral plan
- Strong caregiver concern dismissed because a tool was reported as pass
- Acute encephalopathy, seizures or collapse during a screening visit
- Suspected severe neglect or family violence uncovered while screening
- Failed communication screen with no hearing pathway
- Open-loop positive screen lost on a waitlist with no interim support
Life stages
Care settings
Clinical exam formats
Board mappings
- General and Community Paediatrics
- Growth and development
- Health promotion and disease prevention
- Learning goal 10 developmental and behavioural paediatrics
- Learning goal 15 essential general paediatrics
- Community and preventive paediatrics
- Clinical Applications
- Long Cases
- Short Cases
- Communication
- Health promotion and illness prevention
- Neurodevelopment and Neurodisability
- Patient management
- Foundation of Practice (FOP)
- Applied Knowledge in Practice (AKP)
- History
- Development
- Clinical
- General Pediatrics Content Outline — Domain 1: Preventive Pediatrics/Well-Child Care
- General Pediatrics Content Outline — Domain 2: Growth and Development
- General Pediatrics EPA: Provide well-child and preventive care
- Patient Care 1: History
- Patient Care 4: Clinical Reasoning
- Patient Care 5: Patient Management
- Systems-Based Practice 3: System Navigation for Patient Centered Care – Coordination of Care
- Interpersonal and Communication Skills 1: Patient- and Family-Centered Communication
- Medical Expert
- Health Advocate
- Communicator
- Collaborator
- Pediatrics: Foundations EPA — Assessing and providing routine care for a well child
Overview & Definition
A parent hands you a completed questionnaire at the 18-month visit. The nurse has scored the autism screen. The toddler is climbing the examination table. Your job is not to file the paper. Your job is to run a developmental and behavioural screening programme inside preventive care: the right tool, at the right age, with the right interpretation, referral and follow-up. [1] [8]
Developmental screening is the periodic use of a standardised instrument with known performance characteristics to identify children who need further evaluation. It sits between continuous surveillance (asking, watching, documenting every visit) and evaluation (the diagnostic assessment that can name a condition and open services). Lipkin’s AAP report is the modern programme anchor for this nested model. [1] [7]
This page owns screening systems in preventive and community paediatrics. Bedside milestone technique, evidence-informed milestone content and observation craft live on the linked page Developmental surveillance and milestone assessment. Cross-link it. Do not hide a second surveillance chapter here. [1] [3]
Behavioural screening in early childhood means structured attention to emotional, relational and behavioural risk — not only motor and language scores. More than 10% of young children experience clinically significant mental health problems. The medical home is often the first and only reliable contact. [5]
Programme spine in one visit
- 1
Is the child well and safe?
If no, convert. Screening paperwork can wait.
- 2
Surveillance always
Elicit concern and observe — see the D01 surveillance page for technique.
- 3
Right tool class
General developmental, autism-specific, and/or behavioural as age and concern dictate.
- 4
Score and interpret
Pass, borderline/monitor, or refer — with clinical judgement over a lonely number.
- 5
Act and close the loop
Refer, interim supports, owner, date, safety-net.
References16ShowHide
- [1]Lipkin PH Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics, 2020.PMID 31843861
- [2]Robins DL Validation of the modified checklist for Autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics, 2014.PMID 24366990
- [3]Zubler JM Evidence-Informed Milestones for Developmental Surveillance Tools. Pediatrics, 2022.PMID 35132439
- [4]Schonhaut L Validity of the ages and stages questionnaires in term and preterm infants. Pediatrics, 2013.PMID 23629619
- [5]Gleason MM Addressing Early Childhood Emotional and Behavioral Problems. Pediatrics, 2016.PMID 27940734
- [6]Barger B Medical Home, Developmental Monitoring/Screening, and Early Autism Identification. Journal of autism and developmental disorders, 2024.PMID 37477840
- [7]Council on Children With Disabilities Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening. Pediatrics, 2006.PMID 16818591
- [8]Committee on Practice and Ambulatory Medicine 2023 Recommendations for Preventive Pediatric Health Care. Pediatrics, 2023.PMID 36938620
- [9]Committee on Practice and Ambulatory Medicine 2021 Recommendations for Preventive Pediatric Health Care. Pediatrics, 2021.PMID 33593848
- [10]Garner AS Early childhood adversity, toxic stress, and the role of the pediatrician: translating developmental science into lifelong health. Pediatrics, 2012.PMID 22201148
- [11]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
- [12]Kuo DZ Recognition and Management of Medical Complexity. Pediatrics, 2016.PMID 27940731
- [13]Szilagyi MA Health Care Issues for Children and Adolescents in Foster Care and Kinship Care. Pediatrics, 2015.PMID 26416941
- [14]Turchi RM Patient- and family-centered care coordination: a framework for integrating care for children and youth across multiple systems. Pediatrics, 2014.PMID 24777209
- [15]Coker TR Well-child care clinical practice redesign for serving low-income children. Pediatrics, 2014.PMID 24936004
- [16]Medical Home Initiatives for Children With Special Needs Project Advisory Committee The medical home. Pediatrics, 2002.PMID 12093969