Developmental Screening in Children

Developmental screening is the systematic use of standardized tools to identify children at risk for developmental delays. The AAP recommends developmental screening at 9, 18, and 30 months of age during well-child visits, with autism-specific screening at 18 and 24 months. The Ages and Stages Questionnaire (ASQ-3) is the most widely used parent-completed developmental screening tool, assessing five domains: communication, gross motor, fine motor, problem-solving, and personal-social. The Modified Checklist for Autism in Toddlers (M-CHAT-R/F) screens for autism spectrum disorder in children aged 16-30 months. A positive screening result is NOT a diagnosis — it indicates the need for referral to a developmental specialist for comprehensive evaluation. Early Intervention (EI) services under the Individuals with Disabilities Education Act (IDEA) Part C serve children birth to age 3 with developmental delays. These services are family-centered and provided in the child's natural environment (home, childcare setting). The community health nurse's role includes administering screening tools at well-child visits and community health events, educating parents on developmental milestones, making appropriate referrals to early intervention programs, and following up to ensure families access services. Cultural considerations are critical — developmental milestones may be interpreted differently across cultures (age of independent eating, sleeping arrangements, communication expectations), and screening tools may have cultural bias.