Bureau of Family Health
Developmental Screening for Providers

Developmental Screening for Providers

Developmental screening is a method for parents and providers to monitor and support a child's development across several areas: fine and gross motor skills, language and communication, problem-solving and adaptive behavior, and personal-social skills. It uses validated tools to collect information about a child from their parent or caregiver, to identify the child's risk for a developmental delay. If results on a screen raise concerns, the child will receive further evaluation and early intervention services to help them thrive as early as possible. Early identification paired with early intervention services give children the greatest opportunity for healthy development and success.

The American Academy of Pediatrics (AAP) recommends using parent-completed tools that have been well-validated in a similar population and using the entire tool with fidelity. These tools assess a child's development, their environment, their risk for developmental delays and other issues. Typically, providers should screen across 5 domains: General Development, Autism, Perinatal Depression, Social/Emotional, and Barriers to Health (i.e., Social Determinants of Health). Screening does not provide a diagnosis but helps providers determine if further evaluation is needed.

There are three main components to developmental screening: Watch, Screen, and Act:

Watch: Partner with caregivers to identify issues early. Caregivers and providers can look for milestones to track a child's development. Caregivers are experts on their children and are likely to notice small changes. Providers need to give caregivers information and tools, so they know what to expect as their children grow. If caregivers express concerns, providers should perform a screening.
Screen: Screen using validated tools to measure development. All children need some level of screening. Screening works to assess a child's development and determine if they need further evaluation. Refer to the Louisiana Developmental Screening Guidelines to see recommendations for screening periodicity and validated screening tools.
Act: Refer patients for further evaluation and early intervention, when needed. Screening does not provide a diagnosis, but it does flag a child's risk for developing delay or other issues. Providers may need to refer the child to a specialist to receive further evaluation. The results of that evaluation will determine if a child needs early intervention services.

Who is Involved in Developmental Screening?

Anyone who works with or cares for young children can play a role in identifying delays and developmental screening.

Parents & Caregivers

When parents and caregivers know what to look for, they are in the best position to notice changes or delays in development and can talk to their providers about their concerns. Parents can use milestone-tracking resources such as phone apps to track their child’s development. Partnering with families and sharing decision-making is the cornerstone of family-centered care.

Pediatric Healthcare Providers

Pediatric healthcare providers (e.g., doctors, nurses, medical assistants) are responsible for administering and scoring parent-reported developmental screenings at well-child visits and when parents or caregivers have concerns. Based on the results of the screening, healthcare providers may need to refer a child to a specialist for further evaluation.

Other Providers and Professionals

Other providers and educators (e.g., early care and education providers, teachers, and home visitors) who regularly work with children and families also perform developmental screenings. For example, Early Head Start performs a general development screening for all enrolled children, and Louisiana Department of Health family support and coaching program (home visitors) staff are trained to perform screenings as well.

Louisiana Developmental Screening Guidelines

What are the Louisiana Developmental Screening Guidelines?

The Louisiana Developmental Screening Guidelines (LDSG) were first drafted in 2015 (updated in 2023) to provide Louisiana pediatric providers with easy-to-interpret recommendations about what domains and tools to utilize in their practices. The LDSGs are voluntary but match the intentions of the AAP periodicity schedule, which Louisiana Medicaid has adopted. The purpose of the LDSGs is to outline the domains and highlight specific tools that are best suited to fulfill the developmental screening needs of Louisiana children and families.

These tools may not be the only tools utilized in practice, but have been found to be very useful tools in Louisiana, as well as meet expectations of reliability and validity as laid out by the AAP. As such, the LDSGs endorse the importance of pediatric providers using a parent-reported tool with fidelity that has been validated in samples similar to those in Louisiana. The LDSGs emphasize that the periodicity presented matches AAP’s periodicity and is intended to be the minimum amount of screening conducted. If risk factors for any given concern are present, or if a parent expresses a concern, we endorse screening beyond what is outlined in the guidelines. Regardless of periodicity, referrals should be made to ensure children and families receive evaluation or intervention services for any concern that arises throughout the developmental screening process.

The LDSGs are summarized in the tables below. They lay out which screenings should be performed, when they should be performed, and which tools should be used. The dark orange boxes in the periodicity table indicate the AAP's recommended periodicity, and the light orange boxes are supplemental screenings that were added to meet the specific needs of Louisiana’s children and families. These include additional screening for social-emotional and barriers to health, which helps provide a well-rounded view of the child and family's current experiences, strengths, and needs.

For more information about how to perform developmental screening, take a look at the Developmental Screening Toolkit.

Recommended Developmental Screening Periodicity

Recommended Developmental Screening Instruments

DS Instrument

About the Louisiana Developmental Screening Initiative

In 2015 the Developmental Screening Initiative was formed within the Bureau of Family Health. The Initiative seeks to ensure that all children in Louisiana are screened using validated tools to measure and assess multiple aspects of their growth and development (e.g., general motor skills, language and communication, autism, social and emotional development). The Initiative worked closely with the Young Child Wellness Collaborative (YCWC) to develop the Louisiana Developmental Screening Guidelines.

The YCWC is made up of members of state-level organizations (e.g., Medicaid, Department of Education, Governor's Office, Bureau of Family Health, and Advocates) that work together to shape policies and programs that impact young children and their families. The guidelines highlight and expand upon screening recommendations from the American Academy of Pediatrics, and establish five domains for developmental screening in Louisiana: general development, autism, social and emotional, caregiver depression, and barriers to health.

We created an online toolkit to help any provider working with families of children, birth to 5 years implement or improve developmental screening in their clinics. The toolkit offers step-by-step guidance and resources such as training videos, worksheets, and local resource and referral guides to help you connect families to the support they need. Beyond the toolkit, our developmental screening expert will work with you to create tailored goals and implementation plans for your practice. Our staff can provide customized support and training based on your practice’s needs and capacity. For more information, check out our Implementation Training and Support page.