Screening, evaluation and assessment are distinct processes with different purposes under the provisions of Part C and Part B. Screening includes activities to identify children who may need further evaluation in order to determine the existence of a delay in development or a particular disability. Evaluation is used to determine the existence of a delay or disability, to identify the child's strengths and needs in all areas of development. Assessment is used to determine the individual child's present level of performance and early intervention or educational needs.
Under Part C, screening is at a state's discretion and is part of Post-Referral Procedures. Screening is conducted using appropriate instruments, administered by trained personnel, by the lead agency or an early intervention program. The purpose of screening is to determine whether an infant or toddler is suspected of having a disability and is, therefore, in need of early intervention services. Screening requires parental notice and consent, must be performed within the 45 day timeline, and, at a parent's request and with consent, the EI program must conduct an initial evaluation of the infant or toddler even if the results of the screening do not identify the child as suspected of having a disability. Under Part B, screening may be conducted as part of child find activities in order to ascertain whether the child should be referred for an evaluation to determine if the child has a disability and is in need of special education and related services.
Translating Evidence-based Developmental Screening (TEDS), the largest study to date to confirm the feasibility and effectiveness of standardized developmental screening in urban primary care settings (2012), PolicyLab at The Children's Hospital of Philadelphia. See Effectiveness of Developmental Screening in an Urban Setting, Pediatrics, published online December 17, 2012, doi: 10.1542/peds.2012-0765. Some key findings include:
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 and timely transition to early childhood special education programs under Section 619. 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).
The American Academy of Pediatrics' (AAP) 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).
Part C requires a timely, comprehensive, multidisciplinary evaluation of each child, birth through age two. If the child is determined eligible, a child assessment is conducted. Evaluation and assessment ( 34 CFR 303.321) 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. " Assessment is defined as "the ongoing procedures used by qualified personnel to identify the child's unique strengths and needs and the services appropriate to meet those needs and includes the assessment of the child and the assessment of the child's family." A family-directed assessment is conducted to identify the resources, priorities, concerns and the supports, and services necessary to enhance the family's capacity to meet the needs of their child. Qualified personnel must use informed clinical opinion and multiple procedures when conducting evaluations and assessments. While a "child's medical or other records may be used to establish eligibility (if those records indicate that the child's level of functioning in one or more of the developmental areas constitutes a developmental delay or that the child otherwise meets the criteria for an infant or toddler with a disability)", an assessment still must be conducted.
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:
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:
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 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. A 2012 presentation, An Assessment Primer: Effective Assessment in the Early Childhood Classroom is also available.
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.
New Mexico's Family Infant and Toddler Program developed a technical assistance document on Evaluation and Assessment (April 2013).
New Mexico's Public Education Department (PED) developed a Technical Evaluation and Assessment Manual (July 2011) and training modules (videos and scripts) on disability categories, initial evaluations, and eligibility determinations. Disability categories include developmental delay.