Screening: The First Step in Getting to Know a Child
Health screening is a key part of children’s overall health care. It can help identify concerns early. Explore basic information about screening, as well as resources about screening infants and toddlers. Also, learn about culturally and linguistically responsive screening, lead screening, sensory screening, and social, emotional, and behavioral screening. You’ll also find helpful, practical tools.
Screening is the first step in getting to know a child at the beginning of each enrollment year. This "baseline data" helps staff plan and individualize services. It also helps them identify "red flags" for further examination or evaluation.
When concerns go unidentified, they can lead to bigger problems. Resources from Learn the Signs. Act Early. help staff and families become familiar with developmental milestones. Knowing what to expect helps adults support children's progress.
When staff and families know the basics of screening, they have a good foundation to implement it well. The recorded webinars, Health Screening and Determining Child Health Status, also help staff understand the "what, why, when, who, and how" of screening. To learn tips to support staff and engage families, read Screening in Head Start.
Focusing on the potential benefits of screening helps everyone understand its importance. Birth to 5: Watch Me Thrive! focuses on four specific goals. Screening helps staff and families:
- Celebrate milestones
- Promote universal screening
- Identify possible delays and concerns early
- Enhance developmental supports
Find a compendium [PDF, 1.1MB] that provides descriptions of screening measures for young children. Also, share the guides with partners in screening.
Screening is part of a larger process professionals use to learn about children's health and development. In partnership with families, developmental monitoring (or surveillance), screening, and assessment keep children on track developmentally. For definitions of each, read Developmental Monitoring and Screening that offers descriptions of each and their importance. The webinar, Don't Just Wait and See, and presentation slides from Developmental Screening in Early Childhood Settings [PDF, 317KB] provide an overview of these processes.
Everyone has a part to play in screening. Birth to 5: Watch Me Thrive! An Early Care and Education Provider's Guide to Developmental Monitoring and Screening [PDF, 532KB] gives directors, managers, and staff an overview of and helps them think through the details. Screening, Assessment, Evaluation & Observation helps staff identify concerns and promote child development. Finally, staff can use Tips for Talking with Parents [PDF, 57KB] to make sure parents are engaged in the process.
Another rich resource, How Screening and Assessment Practices Support Quality Disability Services in Head Start [PDF, 1KB page 20 - 24], offers a clear explanation of the teacher or caregiver's role. It also offers the next steps after screening which may involve special educators. To learn about their role, review resources listed on Early Identification: Screening, Evaluation, and Assessment. This webpage also describes federal requirements for diagnostic evaluation and offers state guidance.
In Head Start programs, managers build relationships with partners and define each professional's responsibilities. To learn more, read the Head Start Health Manager Orientation Guide, Chapter 3: Health Topic Self-Reflection Checklists [PDF, 329KB] and Chapter 4: Health Topics: Delving Deeper [PDF, 2.6MB].
The medical home also has a critical role in screening. Screening and Diagnosis for Healthcare Providers describes how the primary health care provider can offer support. The American Academy of Pediatrics (AAP) offers recommendations for developmental monitoring (or surveillance) and screening during preventive health care visits. Children who stay current on a schedule of well-child care have access to regular screening to identify concerns.
Together, professionals collaborate to observe child health and development over time. The information helps everyone identify and address concerns.
Infants and Toddlers
Children develop rapidly during the first three years of life, so keeping a watchful eye on health and development is critical. The webinar, Developmental Screening, Assessments, and Evaluations for Infants and Toddlers, offers a thorough overview of the screening process for infants and toddlers. It also describes the relationship between screening and assessment for infants and toddlers. Mentioned in the webinar, "What is Screening?" offers an easy-to-read description of screening infants and toddlers.
Specific questions arise when planning screening activities for infants and toddlers. The following resources offer answers:
- How Do We Screen Premature Infants When There Is No Developmental Screening Tool That Allows for Negative Age? Early Head Start Tip Sheet No. 1
- What Are "Behavioral Skills" in Infants and Toddlers? How Do We Screen Them?" Early Head Start Tip Sheet No.27
- Do Infant and Toddler Screenings Need to Be Standardized?" Early Head Start Tip Sheet No. 30 [PDF, 29KB]
Child care health consultants help infant/toddler programs create effective screening processes. Infant/Toddler Development, Screening, and Assessment is a training module for consultants new to screening. It covers the entire process of screening, evaluation, and assessment.
Culturally and Linguistically Responsive Screening
Most early childhood programs serve diverse families. Therefore, the best screening tools gather information in ways that respond to culture and language. To better understand how this works, several resources offer guidance and tips:
- Developmental Screening Tip Sheet 10: Culturally and Linguistically Responsive Screening Practices [PDF, 449KB]
- Gathering and Using Language Information that Families Share [PDF, 1KB]
- Screening and Assessment of Young English Language Learners, Where We Stand (NAEYC) [PDF, 78KB] Also available in Spanish (español) [PDF, 122KB]
- Screening Dual Language Learners in Early Head Start and Head Start: A Guide for Program Leaders [PDF, 1.5MB]
Lead is poison. Exposure to lead interferes with children's growth. Screening children on an ongoing basis can identify children at risk. Most states require lead screening or lead assessment during well-child visits.
For Early Care and Education Providers:
- Educational Interventions for Children Affected by Lead [PDF, 1.4MB]
- Environmental Protection Agency and National Head Start Association Lead Poisoning Prevention Resources
- Home Advisory: Talking Points for Head Start Staff [PDF, 45KB]
- Impact of Lead Exposure in Very Young Children
- Lead and Our Children: The Role of Early Care and Education Programs (webinar)
- Lead Poisoning Prevention for Head Start Children
- Learn about Lead
A child's hearing and vision affects their development. To identify concerns early, sensory screening is recommended for all children. Professionals use several approaches. These resources describe sensory screening and offer strategies for use in programs.
- Early Childhood Hearing Outreach (ECHO) Initiative
- Early Childhood Hearing Screening and Follow-Up: Screening in Health Care Settings
- May Is Better Hearing and Speech Month: Promoting Early Developmental and Hearing Screening for Young Children
- Beyond Vision Screening: Building a Comprehensive Vision Program (webinar)
- Implementing an Evidence-Based Vision Screening Program – Tools and Tips for All Ages! (webinar)
- Prevent Blindness America
- Vision Fact Sheet
Social and Emotional, and Behavioral Screening
Young children are learning to get along with others and manage their own emotions. When a child enters a program, staff get to know what social and emotional skills children are working on. They use social and emotional or behavioral screening tools to gather that information. The following resources offer information and tips to enhance social emotional screening.
- What Are "Behavioral Skills" in Infants and Toddlers? How Do We Screen Them? Early Head Start Tip Sheet No. 27
- The National Early Childhood Technical Assistance Center: Developmental Screening and Assessment Instruments with an Emphasis on Social and Emotional Development for Young Children Ages Birth through Five [PDF, 1MB]
- Screening for Social and Emotional Concerns: Considerations in the Selection of Instruments
Practical Tools for Early Care and Education Providers
There are several best practice tools to use for screening. Staff can access these resources to select the best tools for their programs. Resources are organized by type of screening. In addition, you will find tools for managing all screening information or data.
- Center for Disease Control and Prevention (CDC) Immunization Schedules
- Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) by State
- Lead Screening: Well-Child Health Care Fact Sheet
- The Well-Visit Planner for Families
- American Academy of Pediatrics: Best Practice Tools: Freely Available Developmental and Behavioral Screening and Assessment Tools
- Birth to 5: Watch Me Thrive! A Compendium of Screening Measures for Young Children [PDF, 1.1MB]
- Birth to 5: Watch Me Thrive! An Early Care and Education Provider's Guide to Developmental Monitoring and Screening [PDF, 532KB]
- CLAS Review Guidelines for Material Selection: Child Assessment [PDF, 538KB]
- Tips for Early Care and Education Providers [PDF, 670KB]
Speech and Language Screening:
- Speech and Language Screening: Well-Child Health Care Fact Sheet
Managing Screening Data:
- Screening Systems Review Tool
- Sensory Screening Protocol
- When Health Affects Assessment
- The Head Start Health Manager Orientation Guide
Screening: The First Step in Getting to Know a Child. HHS/ACF/OHS/NCECHW. 2016. English.
Last Reviewed: August 2016
Last Updated: August 17, 2016