The term developmental milestone is generally understood as a marker for how an infant or young child is growing and developing. Parents and other caregivers of very young children, and the professionals who commonly have relationships with them—such as pediatricians, early childhood educators, and home visitors—may identify emerging concerns when developmental milestones are not observed at the expected age. However, there is a wide range of individual variation in each child’s development. Exploring the child and family’s social and cultural context is essential to understanding a child’s behavior and functioning, parenting practices, and systems of belief and values—all of which have an impact on child development and early relationships. Partnering with families to identify emerging concerns, along with recognizing family strengths and resources, provides the best opportunity for successful early intervention.
Pediatricians play a significant role in monitoring early childhood development because they are one of the professionals most likely to have regular contact with families during infancy. To that end, the American Academy of Pediatrics (AAP) recommends a developmental surveillance and screening process and timetable that monitor development to determine whether a child is at risk for a delay. The use of developmental checklists is one of the tools that help guide surveillance. However, developmental checklists are not the same as screening and evaluation tools, and should not be used to diagnose a developmental delay. Rather, a checklist is used, along with other information-gathering techniques and clinical judgement, to determine whether further screening and evaluation is warranted.
The Centers for Disease Control and Prevention recently revised their developmental surveillance checklists in collaboration with the AAP by convening an expert work group to identify evidence-informed milestones. This issue of the Journal takes a deep dive into these recent modifications, some of the questions and misconceptions around developmental surveillance and screening, and recommended practices. We also explore how disparities exist for some children who face multiple risk factors, and promising approaches for more equitable approaches to surveillance and screening.
Let us know what you think of the articles in this issue, and share the questions you have and the topics you want to know more about by writing us at Letters to the Editor http://s.alchemer.com/s3/ZERO-TO-THREE-Journal-Letters-to-the-Editor.
Stefanie Powers, Editor-in-Chief
spowers@zerotothree.org
