In plain words
Developmental surveillance is the everyday watching of a child's growth in skills. At each well-child visit, a provider asks about and observes what the child can do. Skills include movement, speech, understanding, play, and social response. The provider compares these with typical milestones for the child's age. Surveillance is a continuous process, not a single test. Formal screening tools are used at set ages, such as nine, eighteen, and thirty months. Parents are often asked questions about what they see at home. A mother may notice a skill that seems late or a skill that has stopped. Raising it early is useful, because support can begin sooner. Most children who are behind in one area catch up, and a check does not mean a diagnosis.
The deeper version
The American Academy of Pediatrics recommends developmental surveillance at every well-child visit, supplemented by standardized screening at 9, 18, and 30 months (Lipkin and Macias, Pediatrics, 2020, from the Council on Children with Disabilities). The CDC's 2022 milestone checklist (Zubler and colleagues, Pediatrics, 2022) provides age-based expectations used in many practices. Surveillance is sensitive to parent concern and clinician observation, while standardized tools improve specificity. Evidence that routine screening improves outcomes is mixed, and the gap between surveillance-based and screening-based referral rates is a live question. The threshold for referral to early intervention varies by state and by clinician.
Where it comes up
What mothers here say about developmental surveillance
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Sources
- Lipkin PH, Macias MM, Council on Children with Disabilities — Promoting optimal development: identifying infants and young children with developmental disorders through developmental surveillance and screening. Pediatrics, 2020
- Centers for Disease Control and Prevention — Learn the Signs. Act Early. developmental milestones checklists, 2022 update