Toddler development assessments: What you need to know

What is a development assessment?

Children develop at different paces — some talk early, some walk before their peers are even crawling. But if your child seems behind the curve in an area of development, you may need to get a development assessment.

This is a structured evaluation of your child's physical, language, intellectual, social, and emotional development. A developmental assessment specialist may conduct the evaluation, or a team of professionals that can include a pediatrician, language specialist, audiologist, occupational therapist, child psychologist, and child psychiatrist, among others.

The specialist or team will tailor your child's assessment to his age and suspected problem or delay. In general, you can expect that you'll spend time answering a host of detailed questions about your child's growth, physical movements, behavior, play, and interactions with family members and the rest of the world. And your child will undergo a series of tests that may include a physical exam, hearing and vision screenings, play observation, and standardized tests that present your child with certain tasks to determine areas of strength and weakness.

If your child's teacher or doctor has recommended that your child be assessed, you may be feeling anxious, scared, or even guilty. No parent likes to hear that his child may have a problem. It's normal to be concerned, but remember that an assessment is simply an evaluation of your child. It's not a diagnosis in and of itself (though it may lead to one), nor a sign that something is seriously wrong.

In many cases, an assessment will reveal that your child is absolutely normal and needs no further treatment. Even if the doctor or teacher suspects a problem, he or she may give you suggestions on how to work with your child at home. Try to keep an open mind, and remember that the ultimate goal of an assessment is to help your toddler stay healthy as he grows.

How do I know whether my child needs one?

Your child's doctor will informally monitor his development at each well-child visit. If he notices an area in which your child seems to be lagging significantly behind his peers, he may refer you to a developmental specialist for an assessment.

As a parent, you too can be the driving force behind an assessment. You know your child best, and may be the first to notice a developmental delay. A doctor spends only a few minutes with your child at each visit, so it's easy for him to miss subtle problems. If you're worried about a particular issue, your child's speech or ability to grab objects, for instance, and the doctor doesn't mention anything, bring it up and ask for a referral to a specialist.

If your child is in preschool or a daycare center with staff trained in early childhood development, a teacher or caregiver may suggest that you take your child for an assessment.

What are the signs of a good assessment?

Every assessment is different because every child and family is different. The best share the following characteristics, according to Zero to Three, a nonprofit organization devoted to the physical and mental health of young children, and a leader in establishing professional standards for child assessments.

> Parents and professionals should work together. You are an expert on your child's behavior; you should play a key role in the evaluation process. Your information and opinions are crucial in determining how your child is really doing.

> The assessment should be conducted by a team that can include a pediatrician, audiologist, child psychologist, and child psychiatrist, among others, to get a complete picture of your child's skills. The members of the team should all have a solid understanding of child development.

> Your child should be observed in a number of settings with different people. Behavior is complicated. To get a complete picture of how your child plays, learns, reasons, moves, interacts, etc., he needs to be evaluated in different surroundings. How he acts with you, for instance, may differ from how he is at daycare or with his siblings. A good assessment team will take all these things into consideration.

> The process should identify your child's strengths and weaknesses. Child development is complex, and a good assessment should take into consideration how your child is functioning in a number of areas, not just the one or two that he seems to be having trouble with.

> Your child shouldn't be forced to separate from you during testing. A toddler can't be expected to function at his best if he's anxious or scared.

> An assessment should feel like help. A formal evaluation of your child's development is often the first step in determining whether he needs early intervention or treatment. But when the testing is done well, many parents say that's helpful in itself. During the process you should feel like your knowledge of your child is growing, and you're getting answers to many of your development questions and new ideas for how to interact with your child. You may even feel some sense of relief. Being faced with a potential development problem can be upsetting, but knowing that help is available can feel like a big step forward.

How can I ensure the best results for my child?

Preparing for an assessment and being an advocate for your child are the two most important things you can do to ensure optimal test results. Here are a few specific pointers:

• Both parents should attend any meetings or screening exams, if possible. You may have different information or ideas to contribute, and you can compare notes later to make sure you understand everything that took place.
• Make sure your child is healthy and comfortable during testing. A child who is scared, or has a cold or ear infection, for example, won't perform at his best.
• Ask for a written report at the conclusion of the assessment. And ask questions about anything you don't understand, whether it's part of the test itself or jargon on the report.
• If the assessment points to a developmental delay, consider getting a second opinion before starting an intervention program. Treatment can be costly, time consuming, and emotionally draining for you and your child. Before you commit to it, make sure you have a rock-solid diagnosis.
• Have your child reassessed periodically. Children grow and develop so rapidly and at such different rates, it's important to reevaluate them regularly. Your child may outgrow a delay or develop new ones. Continued monitoring will catch any changes.

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