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Strategies for Developmental Screening During Challenging Times

Dec 8, 2021

Patricia Gellasch, The College of New Jersey; Marisa Macy, University of Nebraska at Kearney; and AnnMarie Alvarado, Children’s Home Society of Florida Early Head Start, Orlando, Florida


All children need access to equitable opportunities for developmental screening. The COVID-19 pandemic has resulted in gaps in well-child visits, and greater inequities in overall health. Young children who show signs of a delay or disability need effective screening practices so that prevention and/or early intervention can begin as soon as possible. This article shares professional strategies on conducting developmental screening. The authors describe the importance of re-imagining developmental screening and provide a vignette to illustrate common challenges. They share their top 10 screening strategies in conducting effective developmental screening and coordinating services during challenging times.

The first 3 years of a child’s life include rapid progression in cognitive development, language, motor skills, and social and emotional skills (Lipkin et al., 2020; Marks et al., 2011). All children need access to equitable opportunities for developmental screening of early identification of risk, delay, or disability (UNICEF, 2020; United Nations Children’s Fund, 2020). The process of conducting a developmental–behavioral screening involves gathering information to make decisions about whether further assessment is warranted.

The American Academy of Pediatrics (2006, 2010) recommends developmental screening for all children in the early years of life. Screening practices are multidisciplinary and can be done by professionals who are pediatricians (Guerrero et al., 2011; Marks et al., 2013), nurses (Gellasch, 2016), social workers (Macy, 2013), early childhood educators, and more (Bricker et al., 2013; Dreu et al., 2012). Developmental screening is a recommended practice across all these professional sectors during specific and critical periods of child development (e.g., newborn, early months of life, every 2 or 3 months for infants and toddlers, and every 3–6 months for preschoolers until formal schooling). In addition to professionals, parents can provide input into developmental–behavioral screening assessments (Bruder & Dunst, 2015; Squires et al., 2013). Although it is a recommended practice to conduct developmental screening of young children, professionals and families may find the process challenging.

Children may be more vulnerable during challenging times due to short- and long-term risks resulting from a crisis like the global pandemic (Yoshikawa et al., 2020). Since the start of the COVID-19 pandemic there has been a significant drop in well-child encounters, which has resulted in delays in appropriate developmental screening (American Academy of Pediatrics, 2021). Data show that during the COVID-19 pandemic there have been 44% fewer child screening services, which are the foundation to providing early detection of developmental delays (Center for Health Care Strategies, 2020a; Centers for Medicare & Medicaid Services, 2020).

Professionals, for example home visitors, serve in an essential role addressing the needs of young children to support families and connect them to programs, supports, and needed services. The COVID-19 pandemic has pushed many professionals working with young children (e.g., service coordinators, home visitors) to adjust their in-person services by accommodating virtual home encounters and tackling various barriers as families grapple with new or expanding challenges (Johns Hopkins, 2020).

This article will introduce screening practices and highlight effective methods to screen, observe, interpret findings, and coordinate services during challenging times. We will also discuss what can happen when equitable access to screening supports young children and their families despite the obstacles encountered by highlighting how programs may be adapted to continue providing families with essential services.

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