Early Identification:
Screening, Evaluation and Assessment

Benchmarks in Early Screening and Testing (Project BEST) has developed benchmark indicators and recommended practices for states to support the timely identification, referral and provision of services to infants and toddlers eligible for Part C Early Intervention services. Project BEST is funded through a cooperative agreement between the Centers for Disease Control (CDC) and the Association for University Centers on Disability (AUCD). (posted 05/17/2013)

The Children's Health Fund in New York has published a guide to developmental and social-emotional screening instruments for infants and young children (posted 09/08/2011) . The guide includes sections on Developmental Screening Tools for Infants, Toddlers, & Young Children, Infant Neuromotor Development Screening Tools, Infant Mental Health Screening Tools, Early Childhood Speech-Language Screening Tools, Autism Spectrum Disorder (ASD) Screening Tools, Screening Tools for Preschool Age Children, Mental Health Screening Tools, Developmental Screening Logic Models, and Billing Codes for Developmental Screening and Testing.

The Administration for Children and Families has released a report Understanding and Choosing Assessments and Developmental Screeners for Young Children Ages 3-5: Profiles of Selected Measures (June 2011). The report provides a general overview of screening and assessments, as well as reviews of specific assessments and developmental screeners appropriate for this age group.

In May 2011, the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA) published a study on developmental disabilities in children aged 3-17. The study found that approximately one in six American children have a developmental disability, an increase of 17% during the past 10 years. The increase is thought to have been caused in large part by shifts in the prevalence of autism and attention deficit hyperactivity disorder (ADHD) and may also be related better diagnostic tools, improved screening for disabilities, increased public awareness, more preterm births and higher parental age.

Full citation: Boyle, C. A, Boulet, S., Schieve, L. A., Cohen, R. A., Blumberg, S. J., Yeargin-Allsopp, M., Visser, S., Kogan, M. D. (2011). Trends in the prevalence of developmental disabilities in US children, 1997-2008. Pediatrics. Originally published online May 23, 2011. doi 10.1542/peds.2010-2989

The Center for Disease Control's National Center on Birth Defects and Developmental Disabilities has a web page on child development that includes sections on developmental milestones and developmental screening.

The Assuring Better Child Health and Development (ABCD) initiative, funded by the Commonwealth Fund and administered by the National Academy for State Health Policy (NASHP), is designed to enhance healthy child development for low-income children, ages 0-3, and their families, by strengthening primary health care services. The ABCD Screening Academy began in April 2007 and focused on the adoption of structured developmental screening of young children. See Identifying Children and Families at Risk for a list of ABCD states involved in this initiative, the screening tools they have recommended/required, and related resources.

The Commonwealth Fund has published a guide to Pediatric Developmental Screening (2008) that includes an interactive web feature to guide selection of an appropriate screening instrument.

Materials from the National Conversation on Developmental Screening: Promising Practices for Coordination of Services conference call (June 21, 2007) are available online. This call was sponsored by the National Medical Home Autism Initiative (NMHAI), the American Academy of Pediatrics (AAP) and the National Early Childhood Technical Assistance Center (NECTAC).

The American Academy of Pediatrics (AAP) has developed a number of policy statements on screening, including Identifying Infants and Young Children with Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening (2006). The AAP's Medical Home Screening and Surveillance Program (posted 10/26/10) describes the rationale for improving developmental screening using primary care physicians. See the Developmental Surveillance and Screening Algorithm for guiding providers through the delivery of developmental surveillance and screening. See also, the related parent resources and training/education.

The Save Babies Through Screening Foundation supports, assists and advocates for disorders that are detectable through filter paper newborn screening, are unlikely to be clinically diagnosed without screening and cause mental retardation, physical disability and/or death in early childhood when left untreated. Their website lists states and their newborn screenings, frequently asked questions and a guide about newborn screening for parents (in both English and Spanish).

The General Accounting Office (GAO) released the following report: Newborn Screening: Characteristics of State Programs (2003). The GAO was asked to prepare a report on the variations among state newborn screening programs, including information on criteria considered in selecting disorders to include in state programs, education for parents and providers about newborn screening programs, and programs' expenditures and funding sources. Highlights of the report are also available.

Part C requires a timely, comprehensive, multidisciplinary evaluation of each child, birth through age two, referred for evaluation, and a family-directed identification of the needs of each child's family to appropriately assist in the development of the child. Evaluation and assessment (34 CFR 303.322) are considered processes that have different purposes under Part C. Evaluation is defined as the procedures used by "appropriate qualified personnel to determine a child's initial and continuing eligibility", consistent with the state definition of infants and toddlers with disabilities' and includes determining the status of the child in each of the developmental areas (cognitive development, physical development, including vision and hearing, communication development, social or emotional development and adaptive development). "Assessment means the ongoing procedures used by appropriate qualified personnel throughout the period of a child's eligibility under this part to identify - (i) the child's unique strengths and needs and the services appropriate to meet those needs; and (ii) the resources, priorities, and concerns of the family and the supports and services necessary to enhance the family's capacity to meet the developmental needs of their infant or toddler with a disability."

Part B (34 CFR 300.15) defines evaluation as the procedures used in accordance with Sec. 300.304 through 300.311 to determine whether a child has a disability and the nature and extent of the special education and related services that the child needs. Under 34 CFR 300.304 a full and individual initial evaluation is conducted for each child being considered for special education and related services under Part B of the Act to determine if the child is a "child with a disability" and to "determine the educational needs of the child." Evaluation and assessment are not defined as separate processes. For further information, see:

• CFR 300.300 Parental Consent,
• CFR 300.301 Initial Evaluations,
• CFR 300.302 Screening for instructional purposes is not evaluation,
• CFR 300.303 Reevaluations,
• CFR 300.304 Determination of Eligibility,
• CFR 300.310 Observation,
• CFR 300.311 Specific Documentation for Eligibility Determination.

NECTAC convened a web-enhanced conference call on April 11, 2001, entitled Recommended Practices for Assessing Young Children in Early Childhood Settings (birth to eight years). Drs. John T. Neisworth and Stephen J. Bagnato presented information during this teleconference that addressed the following content and objectives: 1) To justify fundamental changes in the process and practices of assessment in early childhood and early intervention settings. 2) To present an overview of the DEC and NAEYC recommended practice standards for early childhood assessment. 3) To define 8 overarching benchmarks that characterize a more developmentally appropriate assessment approach and which enable professional sand parents to critique and select assessment materials and methods. 4) To identify several specific assessment instruments and methods that best match the 8 benchmarks. For more information on DEC's Recommended Practices and a literature review, visit http://www.dec-sped.org/About_DEC/Recommended_Practices.

Assessing All Children (2008). This chapter in a book by the National Research Council of the National Academies, entitled Early Childhood Assessment: Why, What, and How, discusses the challenges to assessment posed by the following groups of children:

1. young children who are members of ethnic and racial minority groups in the United States;
2. young children whose home language is not English; and (3) young children with disabilities.

The National Association for the Education of Young Children (NAEYC) has developed a position statement related to the Screening and Assessment of Young English-Language Learners (2005). It is available in both English and Spanish.

See also, Assessment Considerations for Young English Language Learners (2007), by Espinosa, L., & Lopez, M. This paper was prepared for the National Early Childhood Accountability Task Force and First 5 LA, with support from the Pew Charitable Trusts.

The National Association of School Psychologists has developed a Position Statement on Early Childhood Assessment (2005).

The National Institute for Early Education Research (NIEER) has developed a policy fact sheet on Preschool Assessment: A Guide to Developing a Balanced Approach (2004). The complete policy brief (2004) includes an overview of effective assessment and all references.

The U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation (ASPE) provides ongoing support for federal collaboration on early childhood research through the Science and Ecology of Early Development (SEED) initiative, ASPE and the Administration for Children, Youth, and Families (ACYF) contracted with Child Trends to develop profiles of early childhood measures. This project produced a compendium of early childhood assessments, Early Childhood Measures Profiles (n.d.), commonly used to measure domains of development, including language and literacy, cognition, mathematics, social-emotional competency, and approaches to learning. Various types of ongoing observational assessments were also included. A profile of each assessment includes the purpose of the measure, key constructs, administration, and reliability information.

Nevada's Part C program has developed a guidance document, Intake, Evaluation/Assessment & Eligibility Effective Practice Guidelines (2006).

The Washington Infant-Toddler Program's ITIEP Early Intervention Practice Guide (2009) provides guidance from evaluation, through assessment, to the initial IFSP meeting.