Developmental and Behavioral Screening Tests

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. Developmental milestones are skills and behaviors that show up in babies and children reach at certain ages as they grow. They can include 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). These conditions cause limitations in mental abilities. People with IDs often need help with learning and daily living skills.
• Autism spectrum disorder (ASD). This is a disorder that affects behavior, communication, and social skills.
• Cerebral palsy (CP). This is a condition that affects movement, coordination, and balance.
• Deafness or other hearing problems

Developmental and behavioral screening tests don't diagnose these 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 do a formal developmental evaluation. This could involve observation of your child, tests, and/or having you complete a questionnaire.

The results of a formal developmental evaluation help determine if your child needs treatment. When developmental disabilities are found and treated early, it can help to improve your child's life. Early treatment, known as early intervention, helps children learn important skills and make the most of their strengths.

Other names: Ages and Stages Questionnaire, Parents' Evaluation of Developmental Status (PEDS), Modified Checklist for Autism in Toddlers (M-CHAT), Child Development Inventories (CDI)

What are they used for?

Developmental and behavioral screening tests are used to see if a child is meeting their developmental milestones. Children grow at different rates, and there is a range in what is considered normal development. But looking at milestones can help identify potential problems early. Below are some examples of milestones for infants and toddlers:

• By 4 months Includes smiling, cooing, and bringing their hands to their mouth.
• By 6 months. Includes playing with others, looking at themselves in the mirror, sitting without support, and rolling over.
• By 9 months. Includes making sounds like "mama" and "dada," understanding the word "no," crawling, and pulling themselves up to standing.
• By 1 year. Includes playing peekaboo, following simple directions, and walking while holding on to furniture.
• By 18 months. Includes speaking and understanding several words, eating with a spoon, walking, and walking, and going up and down stairs.
• By 2 years. Includes noticing when others are upset, saying at least two words together, using more gestures such as nodding yes, and kicking a ball.
• By 3 years. Includes recognizing labels and colors, naming pictures of common objects, getting dressed and undressed, and walking and running easily.

Developmental milestones are general guidelines. If your child reaches one of the developmental milestones later than other children of the same age, they may have a developmental delay.

If developmental delays don't go away on their own, early treatment may help your child catch up with other children their age. But if a provider identifies that your child has a developmental disability, early treatment may help, but these are usually lifelong conditions.

Why does my child need a developmental and behavioral screening test?

The American Academy of Pediatrics (AAP) recommends developmental and behavioral screenings for all children during regular well-child checkups at the following ages:

• 9 months
• 18 months
• 30 months

The AAP also recommends that all children should be screened for autism spectrum disorder during regular checkups at:

• 18 months
• 24 months

Your child's provider may want to do additional screening if your child is at a higher risk for developmental concerns, for example because of:

• A premature birth
• A low birth weight
• Being one of a multiple birth
• Exposure to lead or other environmental risks
• An infection during pregnancy

As a parent, you will probably be the first to notice any problems with how your child interacts, learns, speaks, or moves. Talk with your provider about a screening if you think there is a problem with your child's development.

What happens during a development and behavioral screening test?

Screenings may be done by your child's provider and/or by you with guidance from your child's provider.

There are many different types of developmental and behavioral screening tests. Each asks questions about a child's development. You may be asked about your child's social interactions, language skills, and/or gross and fine motor skills. Motor skills are the ability to move muscles.

• Gross motor skills involve moving large muscles, for example when walking and jumping. 
• Fine motor skills involve the ability to move small muscles with precision, such as when picking up a toy or using a fork.

There are many screening tests. Some of the common ones include:

• Ages and Stages Questionnaire. This test is designed for children between the ages of 1 month and 5 1/2 years. It contains a series of questions with answer choices of "yes," "sometimes," and "not yet."
• Parents' Evaluation of Developmental Status (PEDS). This test is designed for children from birth to age 8. It is a brief test that can be completed in about five minutes.
• Child Development Inventories (CDI). These are three different tests geared to age groups from infancy to preschool. Each contains 60 yes or no questions.
• Modified Checklist for Autism in Toddlers (M-CHAT). This test is for toddlers between the ages of 16 and 30 months. It includes a series of 23 yes or no questions.

Are there any special preparations needed for this screening?

There are no special preparations needed for this screening.

Are there any risks to the screening?

There is no risk in taking a questionnaire.

What do the results mean?

If the results show that your child is not developing at the same rate as other children of the same age, it doesn't necessarily mean there is a problem. But your child may be referred to a specialist for further testing and treatment.

If you have questions about the results, talk to your child's provider. When deciding on the next steps, your provider may consider the results of the screening tests in combination with your child's health and family history.

Is there anything else I need to know about developmental and behavioral screening tests?

If screening tests show a problem with your child's development, your child's provider may recommend at-home developmental monitoring. Developmental monitoring is a way to look at how your child grows and changes over time. To do it, parents and other caregivers use brief checklists to track the child's development.