What is the recommended framework for development screening intervals in preschoolers?

• A. Screen only at birth
• B. Formal screening only at 9 and 18 months
• C. Ongoing developmental surveillance at every visit plus formal screening at 9, 18, 30 months and again around age 3–5
• D. Formal screening only at age 5

Answer: (C)

Developmental screening combines two components: ongoing developmental surveillance at every visit and formal screening at specific ages. Surveillance means routinely asking about a child’s development, watching how they play, learn, speak, move, and interact, and noting any parental concerns at every well-child visit. This keeps track of progress over time and helps catch concerns that might emerge between formal checks.

Formal screening uses validated tools at designated ages to systematically assess development and identify children who may need further evaluation. The recommended intervals—around 9, 18, and 30 months, with another formal screen around preschool age (3–5 years)—align with key stages of development and the typical cadence of pediatric visits. Doing both parts together—surveillance at every visit and formal screening at these intervals—improves the chances of early detection and timely intervention, which leads to better outcomes.

Choosing to screen only at birth, only at two early time points, or only at age five misses opportunities to identify and address delays earlier. Formal screening should complement, not replace, ongoing surveillance.