What is the difference between developmental surveillance and developmental screening in pediatrics, and which tools are commonly used in primary care?

• A. Surveillance is ongoing observation by clinicians and parents; screening uses standardized tools like ASQ, PEDS, M-CHAT
• B. Surveillance uses standardized tools; screening is informal observation by parents
• C. Screening is ongoing observation; surveillance uses checklists like ASQ, PEDS
• D. Surveillance and screening are the same; there are no standard tools

Answer: (C)

Developmental surveillance is the ongoing, informal process of watching and talking about a child’s development during every visit, asking parents about concerns, and observing interactions and milestones over time. Developmental screening, in contrast, is a brief, formal check using validated instruments to identify children who may have a delay and need further evaluation. In primary care, the screening tools are designed to be quick and parent-friendly, and they help standardize the process across visits. Commonly used tools include the Ages and Stages Questionnaires (ASQ, including ASQ-3 and ASQ-SE), the Parents’ Evaluation of Developmental Status (PEDS), and autism-specific screening such as the Modified Checklist for Autism in Toddlers (M-CHAT-R/F). These tools are not diagnostic, but they raise flags that prompt a more thorough developmental assessment. The combination of ongoing surveillance and periodic screening maximizes early detection and referral for intervention.