Developmental and Behavioral Screening Tests
Developmental and behavioral screening tests use checklists and questionnaires to monitor a child's growth and identify potential developmental delays early.
What are developmental and behavioral screening tests?
Developmental and behavioral screening tests look at how your child is developing. The screenings are made up of checklists and questionnaires for parents. They include questions about your child's language, movement, thinking, behavior, and emotions.
Many of the questions are based on developmental milestones. These are skills and behaviors that babies and children reach at certain ages as they grow, such as smiling for the first time, rolling over, and walking. The screenings compare your child's milestones to those of other children of the same age. If a screening shows your child is developing at a slower rate, it may be a sign of a developmental disability.
Developmental disabilities are conditions that begin during a child's developmental period and can cause physical, learning, language, or behavior issues. These conditions may cause challenges in completing daily tasks and last through the person’s lifetime. They include:
- Intellectual disabilities (IDs): Conditions that cause limitations in mental abilities; people with IDs often need help with learning and daily living skills.
- Autism spectrum disorder (ASD): A disorder that affects behavior, communication, and social skills.
- Cerebral palsy (CP): A condition that affects movement, coordination, and balance.
- Deafness or other hearing problems.
These screening tests do not diagnose conditions, but they can show if your child is not developing on schedule. If the screening tool finds an area of concern, a trained specialist may perform a formal developmental evaluation, which could involve observation, tests, or further questionnaires. Early treatment, known as early intervention, helps children learn important skills and make the most of their strengths.
What are they used for?
Screenings are used to see if a child is meeting their developmental milestones. While children grow at different rates, looking at milestones helps identify potential problems early. Examples of milestones include:
- By 4 months: Smiling, cooing, and bringing hands to the mouth.
- By 6 months: Playing with others, looking at themselves in the mirror, sitting without support, and rolling over.
- By 9 months: Making sounds like "mama" and "dada," understanding the word "no," crawling, and pulling up to standing.
- By 1 year: Playing peekaboo, following simple directions, and walking while holding on to furniture.
- By 18 months: Speaking and understanding several words, eating with a spoon, walking, and going up and down stairs.
- By 2 years: Noticing when others are upset, saying at least two words together, using gestures like nodding yes, and kicking a ball.
- By 3 years: Recognizing labels and colors, naming common objects, getting dressed and undressed, and walking and running easily.
Why does my child need a screening test?
The American Academy of Pediatrics (AAP) recommends developmental and behavioral screenings during regular well-child checkups at 9, 18, and 30 months. Screenings for autism spectrum disorder are recommended at 18 and 24 months.
Additional screening may be required if your child is at higher risk due to:
- Premature birth
- Low birth weight
- Multiple birth
- Exposure to lead or other environmental risks
- Infection during pregnancy
What happens during a screening test?
Screenings may be performed by your child's provider or by you with the provider's guidance. Tests often assess social interactions, language skills, and motor skills. Gross motor skills involve moving large muscles (e.g., walking, jumping), while fine motor skills involve moving small muscles with precision (e.g., picking up a toy).
Common screening tests include:
- Ages and Stages Questionnaire: For children 1 month to 5 1/2 years; uses "yes," "sometimes," and "not yet" answers.
- Parents' Evaluation of Developmental Status (PEDS): A brief test for children from birth to age 8.
- Child Development Inventories (CDI): Three tests for infancy to preschool, each with 60 yes/no questions.
- Modified Checklist for Autism in Toddlers (M-CHAT): For toddlers 16 to 30 months; includes 23 yes/no questions.
What do the results mean?
If results show your child is not developing at the same rate as others, it does not necessarily mean there is a problem, but your child may be referred to a specialist. If a problem is identified, your provider may recommend developmental monitoring, where parents use brief checklists to track growth and changes over time.