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Developmental Screening

Know your child’s milestones.

Developmental milestones are clues that your child is growing as expected. The way kids listen, talk, act, and learn at specific ages are big milestones. These are key to a healthy start in life.

A mom reading a book with her child

What is developmental screening?

Developmental screening allows a parent to complete a questionnaire about their child’s growth and emotional well-being. The questionnaire will provide insights as to whether the child’s growth and emotional health are on track. The American Academy of Pediatrics recommends a system of developmental monitoring and screening in order to identify conditions or delays impacting children’s development over the long and short term. The Academy recommends the promotion of early detection and intervention for developmental disorders to improve the well-being of children and families.

Developmental delays and disabilities such as autism, behavioral disorders, speech, and language challenges are frequently missed until the child reaches school age — which is too late. Research shows the earlier the detection, the better the chances for a child with developmental delays to improve. Developmental screening is therefore critical to ensuring a child’s school readiness and social emotional health.

Know your child’s milestones

Developmental milestones are clues that your child is growing as expected. The way kids listen, talk, move, act, and learn at specific ages are big milestones. These are key to a healthy start in life.

Milestones by age

There are ways that children speak, act, and learn by certain ages. For example, most babies make a lot of sounds and say “mama” by nine months. A doctor or childcare provider can check to make sure a child is on track. When they are not, it’s time to get help.

CDC Milestone Checklist
Children playing with an abacus

Delaware milestones

Over 170,000 evidence-based screens (ASQ and PEDS) were completed between January 2014 and December 2020.

Source: MCH/ECCS: 2020 PEDS and ASQ Online Data

Early intervention

The screening result is just a snapshot of a child’s development. It is not an assessment. After the screening, there are three possible result levels: High Risk, Medium Risk, or No Risk. High Risk means there’s a greater chance of delays and the need to refer to an early intervention program for further assessment. Medium Risk means the child could show a level of developmental delay in one or more areas of development. If a child needs an evaluation, depending on their age, one of two organizations will reach out.

Staff from Birth to Three (commonly known as Child Development Watch) or Child Find will then contact the family, assess the child, then coordinate services to help the family. If families also have other issues such as housing insecurity, food insecurity, etc., providers make a referral to Delaware’s Help Me Grow 2-1-1 call center.

A childhood milestone, a child learning to walk

Delaware milestones

About 17,000 unduplicated kids, or 20% of children in Delaware from birth to 8 years old, have been screened.

Source: MCH/ECCS: 2020 PEDS and ASQ Online Data

Why screen kids?

Developmental delays and disabilities like autism, behavioral disorders, speech, and language challenges can be missed until the child reaches school age. That’s too late. Research shows the earlier developmental delays are detected, the higher the chance for improvement. That’s how developmental screens help.

These are the screeners the state prefers:

  1. Ages and Stages (ASQ)

  2. Parents’ Evaluation of Developmental Status (PEDS) online screen
    • Used in pediatric and family medicine practices.
  3. Modified Checklist for Autism in Toddlers (M-CHAT) screen
    • Used by doctors’ offices only.
    • Parent completes the questionnaire and a follow-up interview is conducted for more details.

In Delaware, health care providers use the Parents’ Evaluation of Developmental Status (PEDS) online tool. Home Visiting programs, childcare, and education settings use the Ages and Stages Questionnaire (ASQ).

According to the American Academy of Pediatrics, Bright Futures recommends Developmental Screenings at 9, 18, 24, and 30 months, and every year after. The new Delaware legislation requires licensed childcare centers to do annual developmental and social emotional screening. If you’re worried about a child’s developmental progress, talk to friends, family, or reach out to your child’s doctor for more information and help.

According to House Bill 202 childcare providers will administer developmental and social emotional screening to identify children who may be eligible for Early Intervention or special education services.

Need help? Call 2-1-1 for the Help Me Grow program. It can help you find screening services. Or you can come to one of our Books Balls & Blocks events where screenings are available.

Schedule developmental screening: 9, 18, 24, 30 months and every year after until age 8

Talking to Those Around You

Talking to your health care provider

Each time you take your child to a well visit, you can get them a developmental screening. Even if you don’t have any concerns, you can ask to have your child screened. If you do have concerns about your child’s development, share them with the doctor. Visit the CDC for more information.

Family and Caregiver Guide for Developmental Concerns offers information to help understand the steps to take if a child is referred due to developmental delays.

Here are tips on how to share concerns about your child’s development:

  • Be Prepared. Make notes about what milestones you think your child is missing. Be specific and give examples. This can help your doctor understand your concerns.
  • Be Persistent. Your child’s healthy development is essential. Your concerns can be emotional. It is crucial to be clear and concise. Do not accept unclear answers from the doctor like “don’t worry” or “let’s wait and see.” If you still do not get clear answers, ask for a referral to see a pediatrician specializing in development or behavior.
  • Ask Questions. Ask for clarity if you don’t fully understand the terms your doctor uses. Make sure you ask for results after a screening or tests and what those results mean. If you are unsure, also ask about the next steps.
  • Follow Up. Ask for screenings at 9, 18, 24, and 30 months, and every year after. Suppose a screening suggests your child is at risk for developmental delays. In that case, you can get a follow-up from an early intervention program. Your doctor can refer you to an early intervention program, or you can call 2-1-1 for the Help Me Grow call center.
A childhood milestone, a child learning to ride a bike

Delaware milestones

36 practices + 78 physicians trained to implement PEDS online across the state.

Source: MCH/ECCS: 2020 PEDS and ASQ Online Data

DELAWARE MILESTONES: A father coloring with his children

Delaware milestones

Most Delaware kids have met the developmental milestones by the time they go to kindergarten.

Source: MCH/ECCS: 2020 PEDS and ASQ Online Data

Additional Resources

Below are resources and outside services that can help.

Developmental Screening QR Code Tabletop Handout

Information for parents and guardians about developmental screening for children from birth to 36 months of age. Two-sided — English and Spanish — with a QR code to the Ages & Stages Questionnaire.

Delaware Division of Behavioral Health

The Division of Prevention and Behavioral Health Services, also known as DPBHS, provides an array of prevention, early intervention, and behavioral health treatment services statewide.

Division of Social Services for SNAP Benefits

Supplemental Nutrition Assistance Program (SNAP) is a food supplemental program that enables low-income families to buy a variety of food that is the basis for better nutrition.

Examples of Delaware Thrives developmental milestones resources: posters, brochures, facts sheets

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© 2023. Delaware Division of Public Health.