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Developmental Screening,
 

Assessment, and Evaluation:
 

Key Elements for Individualizing
 

Curricula in Early Head Start Programs
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Technical Assistance Paper No. 4 

Developmental assessment is a process designed to deepen 

understanding of a child’s competencies and resources, and 

of the caregiving and learning environments most likely to 

help a child make fullest use of his or her developmental 

potential. Greenspan & Meisels, 1996, p.11. 

The developmental assessment of infants and 

toddlers in Early Head Start (EHS) programs is 

a continuous process throughout the entire 

length of the child’s enrollment in the program. This 

technical assistance paper will define the concepts of 

screening, ongoing assessment, and in-depth evaluation; 

discuss “best practices” related to developmental 

assessment and reflected in the Head Start Program 

Performance Standards (Head Start Bureau, 1996); and 

illustrate the connection between developmental 

assessment and curriculum development. 

Understanding Screening, 

Assessment, and Evaluation 

The terms screening, assessment, and evaluation have 

distinct meanings and purposes and are defined in the 

Head Start Program Performance Standards1 

. 

Screening 

In collaboration with each child’s parent, and within 45 

calendar days of the child’s entry into the program, grantee 

and delegate agencies must perform or obtain linguistically 

and age appropriate screening procedures to identify 

concerns regarding a child’s developmental, sensory (visual 

and auditory), behavioral, motor, language, social cognitive, 

perceptual, and emotional skills. To the greatest extent 

possible, these screening procedures must be sensitive to the 

child’s cultural background. 

Grantee and delegate agencies must obtain direct guidance 

from a mental health or child development professional on 

how to use the findings to address identified needs. 

Grantee and delegate agencies must utilize multiple sources 

of information on all aspects of each child’s development and 

behavior, including input from family members, teachers, 

and other relevant staff who are familiar with the child’s 

typical behavior. 45 CFR 1304.20(b)(1-3) 

Hamilton Center, Inc. EHS, Terre Haute, IN 

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1 Please note that numerous disciplines (i.e. psychology, psychiatry, medicine, special education and early intervention) are concerned with developmental functioning and there 

may be slight variations in the precise definition of terms related to assessment and evaluation. The term “assessment” can refer to both an ongoing process of information gathering 

as well as a structured testing procedure. This paper will define these words as they are used in the Head Start Program Performance Standards. 
2 Early Head Start National Resource Center 

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The screening process is used to determine if 

developmental skills are progressing as expected, or if there 

is cause for concern and further evaluation is necessary. 

All children enrolled in EHS must receive a developmental 

screening within 45 days of entry into the program. The 

screening process is only the initial step of ongoing 

observations about the needs and resources of the child 

and family. Yet it is so important that this process is done 

well so that children with special needs are identified as 

early as possible. Furthermore, the screening process itself 

begins during the enrollment period as EHS staff build 

partnerships with families and initiate EHS services. 

Screening for sensory, behavioral, or developmental 

concerns determines if further evaluation is necessary. It 

does not lead to a decision about whether a child has a 

developmental problem. Therefore, children who are 

referred for further, in-depth evaluation may or may not 

be diagnosed with a developmental delay. Based on the 

results of the screening, it is always in the child’s best 

interests to obtain a more in-depth evaluation if parents 

or staff have a concern. Further, this initial screening is not 

the only time that a child can be referred for an evaluation. 

Since developmental assessment is an ongoing process, any 

time a concern arises about a child’s developmental 

functioning it is appropriate to refer that child for an 

in-depth evaluation. 

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Federal regulations require that programs obtain 

direct guidance from a mental health or child 

development professional on how to use the findings from 

the screening to address identified needs [45 CFR 

1304.20(b)(2)]. This individual can help staff create 

appropriate screening procedures, identify methods for 

prompt follow-up on the results of the screening, 

and develop strategies for engaging families in the 

screening process. 

Sumter School District #17 Early Head Start, 

Sumter, SC 

Assessment 

Assessment means the ongoing procedures used by 

appropriate qualified personnel throughout the period of a 

child’s eligibility 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 child. 

45 CFR 1304.3 

All children enrolled in EHS participate in ongoing 

assessment of their development. Ongoing assessment is 

both a formal and an informal process. Formal procedures 

for ongoing assessment may include the use of published 

developmental profiles or checklists; health and medical 

tests and procedures; and/or structured observations. 

Informal procedures include conversations with parents 

and caregivers or informal observations of the children 

in their daily routines. 

Developmental assessment, as defined in the 

Performance Standards, encompasses all of the activities 

that provide information about a child’s developmental 

strengths, needs, resources, and family priorities. Thus, both 

the screening process and the formal evaluation to 

determine eligibility for early intervention services 

(discussed below) are part of the ongoing developmental 

assessment of children participating in EHS programs. 

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3 

Children’s Home Society of Washington, 

Auburn, WA 

Evaluation 

Enrolled families with infants and toddlers suspected of having 

a disability are promptly referred to the local early 

intervention agency designated by the State Part C plan to 

coordinate any needed evaluations, determine eligibility for 

Part C services, and coordinate the development of an IFSP 

(Individualized Family Service Plan) for children 

determined to be eligible under the guidelines of that State’s 

program. Grantee and delegate agencies must support 

parent participation in the evaluation and IFSP 

development process for infants and toddlers enrolled in their 

program. 45 CFR 1304.20(f)(2)(ii) 

An evaluation is conducted to determine or diagnose 

a developmental delay and to develop strategies for 

intervention. Only children suspected of having a 

developmental delay are referred for an in-depth 

evaluation. The early intervention partners in the 

community are key resources for ensuring an effective 

approach to evaluation and early intervention. In 

addition, the Disability Services Quality Improvement 

Center (DSQIC)2 in the region is an excellent resource for 

designing high-quality services for infants and toddlers 

with disabilities. 

Commercially available tools for screening, ongoing 

assessment, and evaluation are available. However, 

screening, assessment, and evaluation of infants and 

toddlers is particularly challenging and there is 

tremendous variability in the quality of the tools that 

are available. Some of the challenges with conducting 

screening, assessment, and evaluation with this age 

group include: 

• Young children have no or limited expressive 

language skills and can’t “tell” you what they know 

or think. 

• Each area of development is influenced by every other 

area of development and it is difficult to tease apart 

where a problem may occur. 

• Young children are changing at an incredible rate. 

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Technical Assistance Paper No. 4 

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• Children’s behavior reflects the values and culture in 

which they are raised and any judgment about child 

development must be done with sensitivity to 

cultural influences. 

• Developmental problems in young children can be 

subtle and it takes much experience and knowledge 

of infant development to build acute observation and 

interpretation skills. 

2 A regionally based system consisting of seventeen (16) Head Start Quality 

Improvement Centers (HSQICS) and twelve (12) Disabilities Services Quality 

Improvement Centers (DSQICS) provides training and technical assistance to 

meet the needs of all head start grantees and delegate agencies. These centers 

are staffed with specialists in early childhood education and development, health, 

family and community development, program design and management, 

transportation and facilities. The Infant/Toddler Specialists serve as professional 

resources to Early Head Start programs beginning with initial funding 

through ongoing delivery of services designed to enhance quality programming 

for pregnant women, infants, toddlers and their families. These services are 

specifically targeted to meet the individual needs of each Early Head Start 

program. Contact information for the HSQICs and DSQICs is available on the 

Web site of the Head Start Bureau at http://www. acf.dhhs.gov/programs/hsb/. 
 

 

4 Early Head Start National Resource Center 

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Developing an Approach to 

Screening, Assessment, and 

Evaluation 

The developmental screening and ongoing assessment 

of infants and toddlers requires thoughtful planning and 

specific attention to the elements that create an effective 

process. The Performance Standards do not require that 

a specific screening instrument or strategy be used. 

Rather, the Guidance3 (see sidebar) encourages a 

developmental screening approach that may or may not 

involve a formal, standardized screening instrument. 

However, a standardized instrument, as one piece of the 

screening process, can be a valuable device to organize and 

record observations and information related to the 

screening. A comprehensive screening approach should: 

• Be systematic	 – The approach should include a 

method for documenting observations; a process for 

planning when, where, and how screenings will be 

accomplished; a system for communicating the results 

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of the screening to parents and other professionals; and 

a process for tracking change over time and the outcomes of any referrals. 

• Include observations of	 children’s behavior and 

actions – This process should include the observations 

of parents, EHS staff, child care providers, and others 

who regularly interact with the child. 

• Incorporate health and developmental history	 – 

Through this process, information should be gathered 

about prenatal care and childbirth, timelines of when 

the child reached developmental milestones, and past and 

current health issues. 

• Consider family characteristics – The approach should 

provide a description of the nature of the relationships 

between child and parents, the social and emotional 

support systems of the child and family, and other 

environmental or situational factors such as safe 

housing, employment, and quality child care. 

Screening for Developmental, 

Sensory, and Behavioral 

Concerns: 

The Head Start Program Performance Standards do 

not require that any particular strategy, instrument 

or technique be used. Appropriate procedures, 

however, should conform to sound early childhood 

practice and be valid, measuring what they are 

supposed to measure, and reliable, yielding consistent 

results over time and across users. Agencies consult 

with the program’s content area experts in health, 

child development, and mental health, with parents, 

and with the Health Services Advisory Committee as 

they design and implement a developmental 

screening approach. Guidance related to 45 CFR 

1304.20(b)(1-3) 

3 The Guidance materials, published alongside the mandatory regulations found in the Head Start Program Performance Standards, provide examples of how agencies might operationalize 

the standards. The Guidance also provides a rationale for the related standard, and is designed to stimulate ideas about how the standards could be implemented. The Performance 

Standards and the Guidance are available through the Head Start Publications Management Center on the Internet at http://www.hskids-tmsc.org or by calling 202-737-1030. 

Guidelines for Developmentally 

Appropriate Screening, 

Assessment and Evaluation of 

Young Children and their Families 

The following guidelines were adapted from a 

publication of the Task Force on Screening and 

Assessment of the National Early Childhood Technical 

Assistance System (NECTAS) in collaboration with 

ZERO TO THREE (Meisels & Provence, 1989). The 

purpose of the Task Force was to provide assistance to 

States regarding policies and programs for children, ages 

birth through 5, with developmental delays or 

vulnerabilities. These “best practices” also are reflected in 

the Head Start Program Performance Standards and 

supporting Guidance materials. 

1. Screening, assessment, and evaluation should be 

viewed as services — as part of the intervention — and 

not only as means of identification and measurement. 

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Screening, assessment, and evaluation are dynamic 

processes. These activities have an impact on the family 

and should be an integral part of family goal setting, parent 

education, and curriculum development. These processes 

are not just scores on paper that determine eligibility for 

services; they are tools to organize observations about a 

child’s and family’s needs and resources. 

2. Processes, procedures, and instruments intended for 

screening, assessment, and evaluation should only be 

used for their specified purposes. Test developers design 

screening, assessment, and evaluation tools for specific 

purposes and any adaptation of that tool can seriously 

impair the results of the instrument. Anyone who uses a 

tool should be familiar with the purpose of the tool, how 

it was developed, and what it is intended to measure, as 

well as the limitations of the tool. Knowledge of test 

measurement principles, such as reliability and validity, 

is essential to selecting the most appropriate instrument 

and interpreting the results. (See Guideline 6 below, and 

Appendix A for more information about the concepts of 

reliability and validity and other terms related to 

developmental assessment). 

3. Multiple sources of information should be included 

in screening, assessment, and evaluation. Children 

behave differently in different settings and with different 

people. They may be better able to demonstrate their 

competencies under certain conditions than others. In 

addition, developmental disorders are generally due to 

multiple factors. Thus, it is important, and required in the 

Performance Standards, that EHS programs utilize 

multiple sources of information on all aspects of a child’s 

development and behavior. Some methods for gathering 

information include observations, verbal or written 

reports, work samples, rating scales, checklists, audiotape, 

videotape, or photography. 

4. Developmental screening, assessment, and evaluation 

should take place on a recurrent or periodic basis. As 

noted earlier, change in the early years occurs at a swift 

rate. It is important to monitor developmental changes 

to identify challenges as early as possible and to meet the 

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Technical Assistance Paper No. 4 

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evolving needs of families. Furthermore, children’s 

behavior during a screening, assessment, or evaluation is 

often affected by situational factors – the child’s familiarity 

with the setting and participating adults, energy level, 

hunger, mood, etc. Ongoing reassessment should occur 

in the context of the child’s daily activities, in multiple 

settings, and be conducted by those who are working with 

the family and child. If a child is receiving early 

intervention services, the team of professionals (including 

the parents) working with the child and family should 

regularly meet to compare observations and make any 

necessary modifications in the services. 

5. Screening should be viewed as only one path to 

further assessment or evaluation. Screening tools 

provide only a “snap shot” of a child’s functioning. They 

also require the user to make inferences about a child’s skills 

based on limited information. There is no single screening 

instrument that can capture the range of developmental 

skills and challenges that can occur in young children. 

Thus, even children who perform well on a screening tool 

should be considered in light of all the other factors that 

may have an impact on developmental functioning but 

are not revealed through a screening instrument. 

Examples of these other factors include health or social 

support vulnerabilities, family functioning, unstable 

housing, or exposure to violence. A more in-depth 

evaluation may be desirable when these additional factors 

are present. 

6. Screening, assessment, and evaluation procedures 

should be reliable and valid. Reliability and validity are 

terms used to evaluate the quality of an instrument. The 

tools must measure what they are supposed to measure, give 

consistent information, be sensitive enough to adequately 

detect developmental deviations, and be appropriate for the 

cultural or ethnic group they are used with. 

The standardization process is related to the reliability 

and validity of a test. Standardization refers to the 

uniformity of procedure in administering and scoring the 

test. This is the process the test developer uses to choose 

the test items or questions and the conditions under which 

the test should be administered (i.e., verbal instructions 

to the test taker, if and how the test administrator can 
6 Early Head Start National Resource Center 

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demonstrate a task, how many times the test taker can 

attempt the task, etc.). An important step in this process 

is the development of norms. The norms refer to the 

normal or average performance on the test and determine 

how much variation from the average performance is 

considered above or below average. The test must be 

normed on a large, representative sample of the 

population it is to be used with. Those who use 

standardized tests should investigate the standardization 

process to ensure that it is representative of the people who 

will be tested. For example, if the standardization sample 

for an infant screening tool consisted of Caucasian, 

middle-class children in a suburban neighborhood it would 

not be appropriate to use that tool with low-income, 

African American children from the inner city. 

Standardization, reliability, and validity are critical to 

the use and interpretation of the results of the screening, 

assessment, or evaluation instrument. If these factors are 

in question, there can be little confidence in the results of 

the test. 

How does the test user know if an instrument is reliable 

and valid? It is critically important that EHS staff 

investigate the materials they are considering for use with 

the families they serve. One method is to consult with a 

local university to locate individuals who have expertise 

in test measurement and can provide guidance to the EHS 

program. Other resources include staff or consultants from 

the DSQICs, Part C community partners, and the EHS 

program’s Health Services Advisory Committee. 

EHS staff can also use published reference materials 

to learn more about specific screening and assessment tools 

that are being considered for use with the children and 

families enrolled in their program. An important resource 

is The Buros Institute of Mental Measurements at the 

University of Nebraska. The Buros Institute publishes a 

series called Mental Measurements Yearbook that critically 

evaluates commercially available testing instruments. 

These reference books are available through academic 

libraries or can be ordered on the Internet. The Buros 

Institute Web site (http://www.unl.edu/buros) offers a faxrequest service for specific test reviews, a classified subject 

index of all the tests that have been reviewed, and other 

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valuable resources to make informed decisions about the
 

use of measurement instruments.
 

These test reviews are written for an audience that 


is skilled at analyzing test measurement. EHS staff may
 

consider consulting with professionals who have expertise
 

in this area and can interpret the technical information
 

contained in the reviews. Appendix B provides a brief
 

summary of the type of information that is found in the
 

published test reviews of several popular screening,
 

assessment, and evalutation instruments for infants 


and toddlers.
 

7. Family members should be an integral part of the
 

screening, assessment, and evaluation process. The
 

child’s relationship and interactions with his or her
 

caregiver should form the cornerstone of the assessment.
 

Children will generally reveal their highest level of skills
 

in the context of spontaneous, motivated interactions with
 

caregivers. The evaluator can build on these interactions
 

by coaching the parent to elicit certain behaviors or skills
 

or by joining in the interaction.
 

As in all EHS services, parents are intimately involved
 

in the screening, goal-setting, and decision-making
 

activities. Parents’ needs, priorities, and perceptions play
 

a central role in all aspects of this process. EHS grantees
 

are required to familiarize parents with the developmental
 

procedures administered through the program, and
 

ensure that the results of these procedures are understood
 

by parents [45 CFR 1304.20(e)(2)]. Parents are involved
 

in an ongoing process of sharing observations, setting
 

priorities, and determining progress.
 

8. Screening, assessment, and evaluation should be
 

conducted in natural, non-threatening settings and
 

involve tasks that are relevant to the child and family.
 

Children will demonstrate their true capacities when they
 

are in a place that is secure and familiar, and with people
 

whom they know and trust. Infants and young children
 

may be particularly sensitive to unfamiliar caregivers and
 

separation from trusted adults. In addition, the activities
 

and materials should reflect the kinds of experiences and
 

objects that are relevant to their daily life.
 

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7 

9. All tools, procedures, and processes intended for 

screening, assessment, and evaluation must be 

culturally sensitive. Most developmental instruments are 

developed to reflect the popular culture and its values and 

norms. EHS programs should take great care in selecting 

instruments and developing procedures that take into 

consideration the variety of backgrounds, languages, 

customs, and values of participating families. 

10. Those who screen, assess, and evaluate young 

children should be well trained.It is a great responsibility 

to adequately assess children’s strengths, needs, and 

challenges due to the decisions that are based on those 

assessments. To do this well, EHS staff need: 

• excellent observational skills; 

• a thorough knowledge of
 

early development;
 

• an understanding of the proper
 

use and interpretation of
 

screening and assessment tools;
 

• relationship-building skills with
 

both children and adults;
 

• knowledge of how to best use the
 

results of a screening, ongoing
 

assessment or evaluation; and 


• the ability to effectively
 

communicate those results to
 

families and other professionals.
 

Given the considerable variation in 

the normal range of development 

during the early years, professionals 

must have sound knowledge of the 

typical sequence and timetable for 

different areas of development. This 

knowledge will allow the assessor to 

recognize what should emerge next in the 

Technical Assistance Paper No. 4 

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child’s development, if the child is making adequate
 

progress in obtaining new skills, and the quality of the
 

child’s skills in a given area. It will also allow the
 

professional(s) to determine the appropriate strategy for
 

making gains and meeting developmental challenges. This
 

approach is far more desirable then using a score on a test
 

to make a decision about developmental functioning.
 

Staff development experiences to strengthen these 


skills, as well as reflective supervision and consultation 


with experts, is essential for the delivery of high 


quality services.
 

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Astor Early Head Start, Poughkeepsie, NY 

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8 Early Head Start National Resource Center 

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Principles of Appropriate 

Screening, Assessment, and 

Evaluation 

In addition to the above guidelines, EHS programs 

should consider the following principles of appropriate 

screening, assessment, and evaluation and some 

practices to avoid that were recommended by Greenspan, 

Meisels, and the ZERO TO THREE Work Group on 

Developmental Assessment (1996): 

• 	Developmental evaluation should follow a 

certain sequence. 

The steps in the process are: 

1. Build an alliance with the parent/caregiver 

and discuss issues and concerns of the family; 

2. Obtain developmental history and current 


family experience;
 

3. Observe the child in the context of spontaneous 

play with parents and/or familiar caregivers; 

4. If appropriate, observe the interaction between 

the child and the evaluator/clinician; 

5. Conduct specific assessments of individual
 

functions, as needed; and
 

6. Use a developmental model as a framework to 

integrate all of the data to create picture of the 

whole child. Convey evaluation findings in the 

context of an alliance with families. 

• Screening, assessment, and evaluation must be based 

on an integrated model of child development. 

Developmental screening, assessment, and evaluation 

must take into account the full range of variables that 

influence a child’s functioning. This integrated model 

includes the range of developmental domains (i.e., motor, 

cognitive, sensory, social and emotional capacitates) as well 

as how the child organizes and uses his or her skills. An 

effort must be made to understand the child in relation 

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to his or her family, community, and culture and to 

examine how the child relates to the world around his or 

her. This approach requires that those responsible for 

screening, assessment, and evaluation find approaches that 

reveal the child optimal level of functioning. This 

necessitates observing the child over time and in different 

contexts. 

• Screening,	 assessment, and evaluation should 

emphasize attention to the child’s level and pattern of 

organizing experience and to functional capacities, 

which represent an integration of emotional and 

cognitive functioning. 

The basic functional capacities of relating, interacting, 

and thinking will directly impact on the specific 

developmental skills under consideration. It is not just a 

question of whether or not particular skills exist, but how 

the environment supports the child’s developmental 

functioning. These capacities include such skills as paying 

attention, relating and engaging, reciprocal or back-andforth communication, and symbolic thinking. These 

capacities must also be understood in the child’s particular 

culture and family context. 

Young Families Early Head Start, Billings, MT 

• The screening, assessment, and evaluation process 

should identify current competencies and strengths, as 

well as identify the next step in the developmental 

sequence in order to facilitate growth. 

It is more useful to think about how to build on the 

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9 

child’s current capacities, than to merely describe deficits 

or lags in development. Too often an assessment focuses 

on the delay in development. Knowledge of typical child 

development and the progression of developmental skills 

help inform how to best support emerging capacities and 

build on what the child can do. 

Practices to Avoid 

• Young children should never be challenged during a 

screening, assessment, or evaluation by separation from 

their parents or familiar caregivers. 

Separation from trusted and familiar caregivers places 

enormous stress on a young child and has no place in the 

assessment process. Children will rarely demonstrate 

their highest level of functioning under such stressful 

circumstances. As described earlier, parents have a critical 

role in the assessment. 

• Young children should never be tested by someone with 

whom they are unfamiliar. 

It is unlikely that children will demonstrate their highest 

abilities when faced with a strange examiner. This is an 

unnecessary challenge to the child and usually leads to less 

meaningful results. 

• Screenings, assessments, or evaluations that are 

limited to developmental areas that are easily 

measured should not be considered complete. 

Assessments that focus only on certain areas, such as 

cognitive or motor skills, are inadequate. The child’s 

interactions with caregivers and functional capacities are 

critical elements of an evaluation. Assessments should not 

be conducted using a tool simply because it is available 

or because somebody is trained to use it. These types of 

assessments do not provide an integrated understanding 

of the child’s capacities. 

• Formal tests or tools should not be the cornerstone of 

a screening, assessment, or evaluation. 

Formal tests are only approximations of a child’s 

capacities in the real world. The limitations of formal tests 

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Technical Assistance Paper No. 4 

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must be understood and taken into account. Formal tests 

for infants and young children have often been developed 

using methodology created for older children and it is 

debatable how much meaningful information can be 

derived from such test scores. 

Screening, Assessment, and 

Evaluation in Relation to 

Curriculum Planning 

Grantee and delegate agencies must use the information from 

the screenings for developmental, sensory, and behavioral 

concerns, the ongoing observations, medical and dental 

evaluations and treatments, and insights from the child’s 

parents to help staff and parents determine how the program 

can best respond to each child’s individual characteristics, 

strengths, and needs. 45 CFR 1304.20(f)(1) 

Developmental Screening and 

Curriculum Planning 

As defined earlier, the screening process is used to 

determine if a child’s developmental skills are progressing 

at the expected level, or if there is concern about 

developmental functioning and a more in-depth 

assessment is warranted. By its very nature, a 

developmental screening is brief and global. Based on the 

results of the screening, the decision will be made that the 

child is functioning within normal limits, or that a 

potential problem requires a more in-depth evaluation. 

Regardless of the decision, the screening process itself 

provides a preliminary profile of the child’s abilities, 

challenges, resources, and needs. All this information is 

a rich resource for individualizing the curriculum to 

support each child’s particular learning style. 

A word of caution: The results of a screening tool are 

not designed to be used for the purpose of developing 

intervention strategies. Rather, it is the observations about 
10 Early Head Start National Resource Center 

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developmental functioning gleaned from the screening 

process that enrich the curriculum experiences. For 

example, it would be inappropriate to take a task from a 

screening test and make that task a goal of the child’s 

curriculum. To illustrate, a common item on a screening 

test for infants is “child can put one block in a cup.” The 

action of placing objects in a container is not in itself 

meaningful. Staff must understand the underlying 

developmental functions of that behavior. In this example, 

the underlying developmental capacity is the ability to 

begin to combine objects in relational play. This occurs 

when a child begins to see the effects of his or her actions 

on the environment and understand that objects can relate 

to each other in some kind of meaningful way. Generally, 

this will lead to the child exploring and combining 

objects into more interesting effects and eventually into 

more complex actions and relationships between objects 

(e.g., putting on lids, opening doors, etc.). Thus, the goals 

of the curriculum would relate to the underlying 

developmental capacities, not to the content of the 

screening tool, and should provide a variety of experiences 

to support the emerging capacities. 

Murray Early Head Start, Murray, KY 

The Head Start Program Performance Standards define 

curriculum as a written plan that includes: the goals for 

children’s development and learning; the experiences 

through which they will achieve these goals; what staff and 

parents do to help children achieve these goals; and the 

materials needed to support the implementation of the 

curriculum [45 CFR 1304.3(a)(5)]. The information 

from the screening process can help to refine and 

individualize the goals for children’s development and 

learning. These goals will reflect the skills, interests, and 

areas of needed support that emerged during the 

screening process. 

In addition to providing the content, or goals and 

objectives, to individualize the curriculum, the 

information gathered during the screening process can 

inform the context, or how the curriculum 

is implemented. Consider, for example, the 

characteristics of the environment that 

would support emerging developmental 

skills. If a newly mobile infant is 

continually motivated to pull up to stand, 

the environment should support this 

emerging skill by providing plenty of 

low surfaces to pull up on, and soft 

flooring for the inevitable falls. Another 

example is the case of a very young infant 

who, during the screening process, 

demonstrated increased distress and 

disorganization when handled by several 

people. Yet when the lights were dimmed 

and other sources of stimulation were 

eliminated, he became increasingly alert 

and responsive. This observation revealed 

how changes to the environment had an 

impact on this child’s demonstration of 

his true capacities. 

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11 

Ongoing Assessment and 

Curriculum Planning 

Ongoing observations about a child’s unique skills, 

progress, interests, resources, and needs is at the heart of 

individualizing the curriculum. Staff must use a variety of 

strategies to promote and support children’s learning and 

developmental progress based on the observations and 

ongoing assessment of each child [45 CFR 1304.21(c)(2)]. 

Some of the these strategies include: 

• recording children’s behavior to identify current 

functioning and emerging skills; 

• communicating with parents and other caregivers 

about behavior in the home or other settings; 

• identifying different ways children learn and 

expanding the experiences to incorporate different 

learning styles; and 

• modifying the materials, experiences, or
 

environment to encourage new skills.
 

Tennesse Cares EHS, Paris, TN 

Developmental Evaluation and 

Curriculum Planning 

Formal evaluations, as defined earlier, are conducted 

to diagnose a developmental delay and to identify 

strategies for intervention. EHS programs may have 

qualified staff to conduct assessments, or may collaborate 

with community partners, such as Part C agencies, to 

provide these assessments. The evaluation process 

provides an even more in-depth view into the child’s skills, 

resources, and needs and is thus an even richer source of 

information for individualizing EHS services. Families of 

children who are diagnosed with a developmental delay 

will receive an Individualized Family Service Plan (IFSP), 

a written plan, that details the specific outcomes and 

intervention strategies the family and service providers have 

............................................


...........................................................................................................


.

Technical Assistance Paper No. 4 

..............................................
 

identified. The evaluation process and the IFSP provide 

critical information that can be used to modify the 

curriculum to best support the individual child and tailor 

EHS services to ensure that every child’s individual 

learning style is best supported. 

EHS program managers should pay particular 

attention to the systems that are in place to ensure that the 

information from the assessment is communicated to the 

EHS staff working directly with the child and family. 

Record-keeping, reporting mechanisms, confidentiality 

guidelines, and comprehensive planning all support the 

EHS program’s ability to work effectively with families and 

community partners. This is particularly valuable for 

transition planning from EHS into Head Start or other 

community-based preschool programs [see 45 CFR 

1304.20(f)(iii) and 45 CFR 1304.41 (c)(2)]. The 

assessment information that has been collected and used 

during the child’s enrollment in EHS will help to 

determine the appropriate placement of the child and 

ensure that the child and family continue to receive the 

services and supports they need. 
12 Early Head Start National Resource Center 

...............................................
 

In Summary 

• The formal processes of screening and evaluation serve 

unique purposes and are only one part of ongoing 

observations of the child’s and family’s needs, resources, 

and strengths. 

• EHS staff have a responsibility to educate themselves 

about the appropriate use of formal and informal 

methods of evaluating children’s developmental 

functioning and progress. Important decisions are made 

based on the outcome of the screening, assessment, and 

evaluation activities and each process requires particular 

skills and training. 

• All levels of developmental assessment (screening, 

ongoing assessment, and in-depth evaluation) provide 

rich sources of information to meet the Head Start 

Program Performance Standards for individualizing 

the program. High-quality services demand attention 

to individual growth, changing circumstances, and 

evolving needs. 

...........................................................................................................


• The observations and information gathered for
 

screening, assessment, and evaluation purposes are only
 

one part of the process. Staff and families must then
 

determine how to use the information. Using the
 

information to best support young children and their
 

families requires systems and procedures that support a
 

careful analysis of the information, is responsive to ethical
 

considerations, and helps staff and parents develop
 

meaningful goals. EHS staff should consider precisely
 

what information is necessary, how the information will
 

be gathered, and what will be done with the information
 

once it is collected.
 

• Management systems, such as record-keeping, play a
 

critical role in the assessment process. It is crucial to have
 

formal procedures for documenting observations,
 

interpreting the results, and developing goals and
 

activities to support the results of ongoing assessment.
 

Effective systems for documenting and communicating
 

about developmental progress provide a bridge from
 

developmental assessment to individualizing the
 

curriculum for every child.
 

Laconia EHS, Laconia, NH 

References 

Greenspan, S. I., & Meisels, S. J. (1996). Toward a new vision
 

of developmental assessment of infants and young
 

children. In S. J. Meisels & E. Fenichel (Eds.), New visions
 

for the developmental assessment of infants and young
 

children (pp. 11-26). Washington, DC: ZERO TO THREE.
 

Meisels, S. J., & Provence, S. (1989). Screening and
 

assessment: Guidelines for identifying young disabled and
 

developmentally vulnerable children and their families.
 

Washington, DC: ZERO TO THREE.
 

U.S. Department of Health and Human Services, Head
 

Start Bureau. (1996). Revised Head Start Program
 

Performance Standards. Washington, DC: Author.
 

............................................
 
Technical Assistance Paper No. 4 13 ...............................................
 

Selected Resources for 


Screening and Assessment
 ................. ....................................................................................... ...


Each resource in this section is followed by a brief description 

of its content. Some of the resources are designed for an 

audience with advanced understanding of the technical 

aspects of developmental assessment and the use of tests to 

measure developmental functioning; these are indicated 

with an asterisk(*). They are offered here for those who wish 

to deepen their understanding, or as resources to use with 

consultants who can support EHS programs in their efforts 

to make the most informed decisions about appropriate 

assessment instruments and procedures. 

*Buros Institute, University of Nebraska. (1959-1995).

Mental Measurements Yearbook. Lincoln, NE: Author. 

This is a reference manual that is currently in the 13th 

edition. Experts in the field provide critical reviews of 

a wide variety of tests and measurements. The reviews 

in this reference manual are written for an audience 

with advanced knowledge of the technical aspects of 

assessment procedures. 

Fenichel, E. (Ed.). (1997). Assessing and treating infants 

and young children with severe difficulties in relating and 

communicating. Zero To Three, 17(5). 

This special issue of the Zero to Three bulletin is

designed to help professionals treat and understand 

children diagnosed with Multisystem Developmental 

Disorder, Pervasive Developmental Disorder, and

Autistic Disorder. The issue contains an especially

moving essay by a father who chronicles the families’ 

journey through initial concern, diagnoses, and

treatment. 

Fenichel, E. (Ed.). (2000). Responding to infants and 

parents: Inclusive interaction in assessment, consultation, 

and treatment in infant/family practices. Zero to Three,20(4). 

This special issue of the Zero to Three bulletin focuses 

on the interpersonal work of meeting the needs of 

families with infants and toddlers. The work of the 

Infant Parent Program at the University of California, 

San Francisco, is highlighted. 

Gibbs, E., & Teti, D. (1990). Interdisciplinary assessment of 

infants: A guide for early intervention professionals. 

Baltimore, MD: Paul H. Brooks Publishing Co. 

A textbook in infant assessment, this book has a 

particularly helpful chapter on understanding 

questions of measurement. Psychometric properties 

of tests are discussed in a simple, easy-to-read manner. 

*Keyser, D. & Sweetland, R. (1985). Test critiques. 

Minneapolis, MN: Behavior Science Systems. 

This reference manual provides critical reviews of tests 

in the areas of psychology, education, and human 

resources. A companion book, Tests, offers an 

annotated list of published instruments. Tests provides 

a detailed description with price and ordering 

information but does not evaluate the instruments. 

............................................
 
14 Early Head Start National Resource Center 

............................................... 
 ...........................................................................................................
 . .

Linder, T. W. (1993). Transdisciplinary play-based 

assessment: A functional approach to working with young 

children. Baltimore, MD: Paul H. Brooks Publishing Co. 

This book offers a model for a team-oriented 

approach to assessing a child in a natural context. The 

manual provides helpful charts of developmental 

milestones, and charts to guide observations of a child’s 

cognitive, language, motor, and social-emotional 

functioning in the context of play. A companion 

book, Transdiciplinary Play-Based Intervention: 

Guidelines for Developing a Meaningful Curriculum for 

Young Children (1997), goes beyond assessment to 

developing intervention strategies. 

Meisels, S. J., & Fenichel, E. (1996). New visions for the 

developmental assessment of infants and young children. 

Washington, DC: ZERO TO THREE: National Center for 

Infants, Toddlers, and Families. 

This book reflects the most current developments in 

the field of assessment and intervention. Clinicians, 

researchers, parents, and policymakers contributed their 

expertise and insight to describe assessment 

approaches at the cutting-edge of best practice. 

Rosetti, L. M. (1990). Infant-toddler assessment: An 

interdisciplinary approach. Austin, TX: Pro-Ed. 

The purpose of this text is to address the underlying 

issues and challenges inherent in the developmental 

assessment of infants and toddlers, and to provide some 

direction in tackling these concerns. The author 

provides background and rationale for the need for 

infant screening and assessment, and provides 

concrete suggestions for issues such as correcting for 

prematurity, models for service delivery, selecting an 

appropriate instrument, and personnel training issues. 

ZERO TO THREE: National Center for Infants, Toddlers, 

and Families. (1999). New visions for parents: A guide to 

understanding developmental assessment. [On-line]. 

Available: http://www.zerotothree.org/. 

This is a family information packet based on the 

publication New Visions for the Developmental 

Assessment of Infants and Young Children. The packet 

includes a letter to parents preparing for an 

assessment; a guide to understanding assessment; 

tips for preparing for an assessment; and definitions 

for frequently used terms. (These materials are only 

available on the ZERO TO THREE Web site.) 

..........................................
 
Technical Assistance Paper No. 4 15 ...............................................
 

Appendix A 

Definition of Common Terms1 ...........................................................................................................


Assessment 

The Head Start Program Performance Standards state: 

Assessment means the ongoing procedures used by 

appropriate qualified personnel throughout the period of 

a child’s eligibility 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 child. 

(45 CFR 1304.3)
 

Assessment is commonly referred to as an ongoing 

process by which qualified professionals, together with 

families, through standardized tests and observation, look 

at all areas of a child’s development: motor, language, 

intellectual, social/emotional, and self-help skills. The 

assessment should identify both strengths and areas 

needing support. This term is often used interchangeably 

with “evaluation.” 

Developmentally Delayed/Disabled 

A term used to describe infants and toddlers who need 

early intervention services because they: 

a. are experiencing developmental delays, a term used 

when a child has not achieved the skills and abilities 

expected to be mastered by children of the same age. 

Delays can be in any of the following areas: physical, 

social, emotional, intellectual, speech and language 

and/or adaptive development, sometimes called 

self-help skills, which include dressing, toileting, 

feeding, etc.; or 

....
 ........................................

b. have a diagnosed physical or mental condition which 

has a high probability of resulting in a developmental 

delay. Some examples include: chromosomal 

abnormalities; genetic or congenital disorders; severe 

sensory impairments, including hearing and vision; 

inborn errors of metabolism; disorders reflecting 

disturbance of the development of the nervous 

system; congenital infections; disorders secondary to 

exposure to toxic substances, including fetal alcohol 

syndrome; and severe attachment disorders. 

Developmental Domains

Term used by professionals to describe areas of a child’s 

development, for example: gross motor development (large 

muscle movement and control); fine motor development 

(hand and finger skills, and hand-eye coordination); speech 

and language/communication; the child’s relationship to 

toys and other objects, to people and to the larger world 

around them; and the child’s emotions and feeling states, 

coping behavior, and self-help skills. 

Diagnosis 

Term used to describe the critical analysis of a child’s 

development in all the developmental domains, after 

reviewing all the assessment results, and the conclusion 

reached by such analysis. From this diagnosis, 

professionals should offer parents a precise and detailed 

description of the characteristics of a child’s development, 

including strengths and the ways in which a child learns. 

Early Intervention 

Refers to the range of services designed to enhance the 

development of infants and toddlers with disabilities or 

at risk of developmental delay. These services should be 

offered, to the maximum extent possible, in a natural 

environment, such as the home or in community settings, 

1 These definitions were adapted from New Visions for Parents: Terms Frequently Used 

in Developmental Assessment (1999). The full list is on the ZERO TO THREE Web 

site at http://www.zerotothree.org/. 
16 Early Head Start National Resource Center 

...............................................
 

in which children without disabilities participate. Early 

intervention services that are under public supervision, 

must be given by qualified personnel and require the 

development of an Individualized Family Service Plan (see 

Individual Family Service Plan below), developed in 

conjunction with the family, to guide the early 

intervention or therapeutic services given to a child. 

Early intervention services should also enhance the 

capacity of families to meet the needs of their infants and 

toddlers with disabilities. Services may include but are not 

limited to: speech and language therapy, physical and/or 

occupational therapy, special education, and a range of 

family support services. 

Early intervention is sometimes used to refer to any 

systematic effort to improve developmental outcomes for 

young children. 

Eligibility 

Specific criteria of developmental delay that meets the 

eligibility level needed for publicly funded services. This 

criteria is unique to each state’s definition. Children who 

have a diagnosed physical or mental condition or are 

experiencing developmental delays are “eligible” for 

services. In addition, states may choose to serve children who 

are “at risk”of developmental delay by making them eligible 

for publicly funded early intervention services. Children who 

may be “at risk”of a developmental delay, may be provided 

services in some states. Risk factors include: 

• established risk: a diagnosed physical or mental 

condition that has a high probability of resulting in 

developmental delay; 

• biological/medical risk: significant biological or 

medical conditions or event that give a child a 

greater chance of developing a delay or a disability 

than children in the general population; and 

• environmental risk: caregiving circumstances and 

current family situations that may place children at 

a greater risk for delay than the general population. 

Examples include: parental substance abuse, family 

social disorganization, poverty, parental 

developmental disability, parent age, parental 

educational attainment, and child abuse or neglect. 

...........................................................................................................


Evaluation 

Term that is often used interchangeably with
 

“assessment.” However, in the context of services
 

supported by the Individuals with Disabilities Education
 

Act (IDEA) (see below), evaluation refers to a procedure
 

that is used to determine a child’s eligibility for early
 

intervention services.
 

There are three types of formal or structured
 

instruments that may be used in the evaluation process:
 

A norm-referencedinstrument is used to compare the 

performance of an individual child to that of the 

normative group. Group “norms” are developed by 

obtaining the performance of a representative sample. 

This is called the standardization process. The 

standardization is critical to the validity and reliability 

of a test. The normative sample should be comprised 

of a representative cross-section of the population for 

whom the test is designed. 

The results of this type of test are generally presented
 

as developmental ages, IQ’s, or percentile scores.
 

A criterion-referenced instrument is used to 

determine if a child has achieved mastery in a 

particular domain. The child’s behavior is measured 

in relation to a specific behavior, rather than to a 

normative group. The focus is on what the child knows 

or can do, not on how they compare to others. 

Performance-based evaluations allow children to 

demonstrate their competencies by acting on the 

environment, solving problems, and interacting with 

others in a natural context. These evaluations attend 

to the quality of children’s skills and involve multiple 

sources of information. 

IDEA 

An acronym for the Individuals with Disabilities
 

Education Act which provides grants to states and
 

jurisdictions to support the planning of service systems and
 

the delivery of services, including evaluation and
 

assessment,for children, adolescents, and young adults (birth
 

............................................
 
17 

through 21 years) who have or are at risk of developmental 

delays/disabilities. Funds are provided through the Early 

Intervention Program for Infants and Toddlers with 

Disabilities (known as part C of IDEA) for services to 

children birth through 2 years of age, and through the 

Preschool Grants Program (known as Part B-Section 619 

of IDEA) for services to children 3 through 5 years of age. 

Individualized Family Service Plan (IFSP) 

A statement of the family’s strengths and needs related 

to enhancing the development of the family’s child, 

including specific statements about outcomes, criteria, and 

timelines regarding progress, specific services, provisions 

for service coordination, and dates for initiation, duration 

and reevaluation process. 

Informed Clinical Opinion 

A term that describes professionals’use of qualitative and 

quantitative information to assess a child’s development, 

especially if there are not standardized measures, or if the 

standardized procedures are not appropriate for a given age 

or development area. Informed clinical opinion makes use 

of a practitioner’s training, previous experience with 

evaluation and assessment, previous experience with 

children, sensitivity to cultural needs,and the ability to gather 

and include family perceptions as important elements in 

order to make a judgment. 

Multidisciplinary Team 

A group of people with different kinds of training and 

experience working together, usually on an ongoing 

basis. Professionals often use the word “discipline” to mean 

a “field of study,” such as medicine, social work, or 

education; Therefore, a multidisciplinary team might 

include a pediatrician, an occupational therapist, a social 

worker, and an early childhood educator. 

Norms 

A pattern or average regarded as typical for a 

specific group. 

............................................


...........................................................................................................


Technical Assistance Paper No. 4 

...............................................
 

Reliability 

The reliability of a test refers to a statistical measure 

of the consistency or dependability of a test. Reliability is 

determined by statistical analysis. No test is 100% reliable 

due to “measurement error.” There are always chance 

fluctuations in the testing environment. The reliability of 

a test is improved when the testing conditions remain 

uniform — the same environment, testing conditions, how 

instructions are presented, the materials used, etc. 

Reliability is always reported as a correlation coefficient. 

For research purposes, a reliability coefficient of .80 is 

sufficient, but for clinical purposes, a correlation of .90 or 

higher is necessary. 

Screening 

A screening tool is used to make a judgment about 

developmental progress in order to determine if further 

evaluation is necessary. The screening process helps an 

individual judge whether development is progressing 

typically or if there is cause for concern. A screening tool 

is not designed to provide detailed description of 

developmental functioning or to design intervention 

strategies. 

Sensitivity 

The sensitivity of a test is a statistical measure that 

indicates the proportion of children at risk who are 

correctly identified by the screening test. 

Specificity 

The specificity of a test is a statistical measure that refers 

to the proportion of children not at risk who are correctly 

excluded from further assessment. 

Validity 

The validity of a test refers to how well it measures what 

it is designed to measure. It cannot be determined in 

general terms, such as high or low, but only in reference 

to the particular use for which the test was designed. 

Technical Assistance Paper No. 4 19 ...............................................
 

Appendix B 

Screening and Assessment Test Reviews1 ......................................................................................................... ..
 ............................................
 

• Ages & Stages Questionnaire 

• Denver Developmental Screening II 

• Battelle Developmental Inventory Screening Test 

• Birth to Three Assessment & Intervention System 

• Minnesota Child Development Inventory 

• Minnesota Infant Development Inventory 

Each review includes a description of the instrument; 

information on standardization, reliability and validity; 

and the potential use of the instrument. Each review is a 

summary of a published evaluation of the tool and 

references follow each review. 

Ages & Stages Questionnaire (ASQ) 

Age range: 4 months to 60 months 

Purpose: Parent completed child 

monitoring system 

Publication Dates: Original Publication Date 1979, 

Revised 1991,1994, 1999 

Publisher: Paul Brookes Publishing Co. 

P. O. Box 10624 

Baltimore, MD 21285-0624 

Description: The ASQ was designed to screen for 

developmental delays by evaluating an infant’s 

development over time. The system consists of 11 

questionnaires to be completed by the parent at 4, 6, 8,10, 

12, 14, 16, 18, 20, 22, 24, 27, 33, 36, 42, 48, 54, and 60 months 

of age. Each questionnaire contains 30 items and examines 

development in the following five domains: 

communication, gross motor, fine motor, problem solving, 

and personal and social development. There are three choices 

parents can choose from in answering questions (“yes,” 

“sometimes,”“not yet”). Each questionnaire also provides 

a section where parents can identify general concerns that 

may not be captured by questionnaire items. All items are 

written at a sixth grade reading level and a Spanish version 

is available. There is also a video tape available that 

provides guidance on how the system may be used in a home 

visiting context. Estimated administration time is 10-30 

minutes. An Administration Manual provides information 

on using the system and scoring the questionnaires, and 

guidance is offered on how one might evaluate the useful 

of the system in their given program. 

Standardization: The sample reported in the 

Administration Manual is comprised of 2,008 children 

from the states of Oregon, Hawaii, and Ohio. The sample 

includes children from a variety of ethnic (Caucasian, 

African American, Hispanic, Native American) and 

socioeconomic backgrounds. However, parents from 

Asian backgrounds appear underrepresented. Among the 

standardization group, data has been gathered on typically 

developing infants, as well as infants at risk for 

developmental delay due to medical and/or

environmental risk factors. In fact, from 1980 to 1988 the 

research sample evaluated largely consisted of infants who 

were deemed medically at risk. 

Reliability/Validity: Both test-retest reliability and 

interrater reliability data on use of ASQ have been found 

to be fairly acceptable. Interrater reliability, in this case, refers 

to the percent of agreement between the parent’s rating and 

those of a professional.Validity studies have also yielded fairly 

positive findings. The underreferral rate (those with a delay 

but not picked up by the ASQ) across the 11 age intervals 

ranged from 1% to 13% while the overreferral rate (those 

identified by ASQ as having a delay where in fact no delay 

was found upon subsequent assessment) ranged from 7% 

to 16%. Sensitivity ranged from 38% to 90% across the 11 

age intervals and specificity ranged from 81% to 90% across 

the age intervals. 

1 These reviews were compiled by the staff of the EHS NRC from published test reviews located in the references noted after each review. They do not represent the opinion of the 

EHS NRC and are offered here to illustrate the nature of the information offered in the resources available to the public to assist in making informed decisions about the use of 

measurement tools 
20 Early Head Start National Resource Center 

Utility: Very few reviews have been published on the utility 

of this instrument. Current data on the reliability and 

validity of the tool suggest that it offers promise as an 

infant/toddler screening tool. See listing of references below 

for additional research data on ASQ. Please note that prior 

to the 1994 revision the instrument was referred to in the 

research literature as the Infant Monitoring System. 

...............................................
 .... .............................. . .........................................................


References: 

Bricker, D., Squires, J., Kaminski, R., & Mounts, L. (1988). 

The validity, reliability, and cost of a parent- completed 

questionnaire system to evaluate at-risk infants. Journal 

of Pediatric Psychology, 13, 55-68. 

Squires, J. K., Nickel, R., & Bricker, D. (1990). Use of parentcompleted developmental questionnaires for child find and 

screen. Infants and Young Children, 3, 46-57. 

.......

Squires, J., & Bricker, D. (1991). Impact of completing 

infant developmental questionnaires on at-risk mothers. 

Journal of Early Intervention, 15, 162-172. 

........

Denver Developmental Screening - II 

Age range: 2 weeks to 6 years 

Purpose: A screening tool to detect 

developmental delays 

Publication dates: 1967-1990 

Publisher: Denver Developmental 

Materials, Inc. 

P. O. Box 371075 

Denver, CO 80237-5075 

Description: This instrument was designed to be a quick 

and simple screening tool to be used in clinical settings 

by people with little training in developmental

assessment. The test is comprised of 125 items, divided 

into four categories: Gross Motor, Fine Motor/Adaptive, 

Personal/Social, and Language. The items are arranged in 

chronological order according to the ages at which most 

children pass them. The test is administered in 10 - 20 

minutes and consists of asking the parent questions and 

having the child perform various tasks. The test kit 

contains a set of inexpensive materials in a soft zippered 

............................................
 

bag, a pad of test forms, and a reference manual. The 

manual includes instructions for calculating the child’s age, 

administering and scoring each item, and interpreting the 

test results. 

The test items are represented on the form by a bar that 

spans the age at which 25%, 50%, 75%, and 90% of the 

standardization sample passed that item. The child’s age 

is drawn as a vertical line on the chart and the examiner 

administers the items bisected by the line. The child’s 

performance is rated “Pass,” “Caution,” or “Delay” 

depending on where the age line is drawn across the bar. 

The number of Delays or Cautions determine the rating 

of Normal, Questionable, or Abnormal. 

Standardization: The original standardization sample 

consisted 1,036 children and approximated the 

occupational and ethnic distribution of Colorado. 

Children with known handicaps, twins, breech or 

premature birth, and adopted children were excluded. The 

re-standardization in 1990 included 2,096 children. The 

demographic characteristics of the sample approximate 

the distribution in Colorado which compared to the 

population of the United States is an overrepresentation 

of Hispanic infants, an underrepresentation of African 

American infants, and a disproportionate number of 

infants from Caucasian mothers with more than 12 

years of education. 

Reliability/Validity: This test has been criticized for a 

number of inadequacies. The fit between the test items and 

what the test is supposed to measure has been questioned. 

The most serious concern has been it’s lack of sensitivity 

in correctly identifying children with developmental 

delays, particularly children under 3 years of age. The 

standardization sample is not representative of the nation 

as a whole, but simply presents the age at which children 

in Colorado are able to do a variety of tasks. 

Utility: This test is widely used due to its ease of 

administration and scoring. The weaknesses of this test 

are due to its psychometric problems and the tendency 

to miss children with developmental delays. Moreover, the 

use of this test on populations other than healthy, white, 

upper middle class children has been questioned due to 
21 

the standardization process. The DDST is intended only 

for screening purposes, and should not be used as an indepth assessment of developmental functioning or to plan 

intervention programs. 

References: 

Keyser, D., & Sweetland, R. (Eds.). (1985). Test Critiques, 

Vol. I, pp. 239-251. Austin, TX: PRO-ED. 

Buros, O. (Ed.). (1995). Mental Measurements Yearbook, 

l2th Edition, pp. 263-266. Lincoln, NE: Buros Institute of 

Mental Measurements. 

Battelle Developmental Inventory 

Screening Test 

Age range:	 Birth to 8 years 

Purpose:	 General screening for 

developmental delays 

Publication date: 1984 

Publisher: 	 DLM Teaching Resources 

One DLM Park 

Allen, TX 75002 

Description: The Battelle Screening Test is a part of a larger 

test called the Battelle Developmental Inventory (BDI). The 

full-scale BDI is designed as a diagnostic assessment. The 

Screening Test is designed to identify children who are atrisk for delay and in need of a more comprehensive 

evaluation with the full-scale BDI. The Screening Test 

consists of 96 items in the areas of motor, communication, 

personal-social, adaptive, and cognitive development. Three 

methods of assessment may be used: administering the items 

to the children, observing the child in a natural context, and 

parent report. The manual provides adaptations that can be 

made for children with handicapping conditions. 

Standardization: The standardization for the Screening Test 

is based on the data collected for the larger BDI. Eight 

hundred children participated and were selected according 

to race, gender, and geographic region according to the US 

Census Bureau. While the total percentage of minority 

children for the total sample was representative of the 

national percentage, the sub-sample at any particular age 

............................................


. . 
. ........................................................................................................

Technical Assistance Paper No. 4 

...............................................
 

range may be quite small (e.g., only one minority male in 

the age range of 12-17 months).Also,the minority children 

included Hispanic and African American, but did not 

include Asian or Native American families. Children in 

poverty may also be underrepresented as the authors did not 

attempt to control for socioeconomic status. There is no 

mention whether children with handicaps were included in 

the sample. 

Reliability/Validity: Only information on the parent BDI 

was available. One reviewer raised considerable questions 

concerning the cut-off scores. In many cases (46% of the 

age levels), the range of raw scores separating a moderate 

delay (-1 standard deviation) from a severe delay (-2.33 

standard deviations) was 0,1, or 2 points. For another 

example, a child who receives a nearly perfect score (39 

passes out of 40 items) on the Motor Domain, receives a 

rating of moderate delay at -1 standard deviation below 

average. Furthermore, children whose birthdays are at the 

borderline of the age intervals can have identical test 

performance but significantly different scores. 

Additional concerns with this test include the fact that the 

examiner must collect their own test materials, and the test 

can be administered differently for each child. Therefore, 

the normative comparisons are flawed. An examiner 

cannot compare the performance of a handicapped child 

to the norms if the administration has been altered. 

Utility: Given the psychometric inadequacies of this test, 

the reviewers recommend that the BDI Screening Test be 

used only as an additional aide in assessing a child’s 

developmental skills, and not as tool to make a decision 

regarding a child’s placement or referral. The error rates 

when using the cut-off scores is extremely high. They 

recommend that the cut-off scores not be used in making 

referral decisions, and that this test should not be used with 

infants under 6 months of age. 

References: 

Buros, O. (Ed.). ( 1990). Mental Measurements Yearbook, 

10th Edition, pp. 23-31. Lincoln, NE: Buros Institute of 

Mental Measurements. 

Keyser, D., & Sweetland, R. (Eds.). (1985). Test Critiques, 

Vol. II, pp. 72-82. Austin, TX: PRO-ED. 
22 Early Head Start National Resource Center 

...............................................
 

Birth to Three Assessment and 

Intervention System 

Age Range: Birth to 3 years. 

Purpose:	 To identify and assess 

developmental delays in young 

children and to design early 

intervention programs. 

Published:	 1986 

Publisher: 	 DLM Teaching Resources 

One DLM Park 

Allen TX 75002 

Description: This is an expanded and updated version of 

the Birth to Three Developmental Scale. The kit consists 

of three spiral bound notebooks: 1) the manual for the 

Birth to Three Screening Test of Learning and Language 

Development; 2) the Birth to Three Checklist of Learning 

and Language Behavior; and 3) the Intervention Manual: 

A Parent-Teacher Interaction Program. 

The Screening Test consists of a 4-page record form. The 

85 test items are divided into five areas: Language 

Comprehension, Language Expression, Avenues to 

Learning (cognitive and perceptual-motor items), SocialPersonal Development, and Motor Development. 

The Checklist consists of an 11-page record form. The 240 

test items are divided equally between, these same five areas, 

with 48 items in each domain. Each 6 month age range 

has six items per developmental area. 

The items for the Screening Test and Checklist were 

selected from existing infant assessment scales. The test 

materials are not provided, but a list of needed items is 

presented in the manuals. The manuals also describe the 

administration procedures and criteria for scoring the 

performance as “Pass,” “Emerging,” or “Fail.” 

The Intervention Manual provides an introduction and 

basic overview for designing an intervention program. The 

focus is on developing a curriculum for cognitive and 

language skill development, with little attention to social­

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 .

emotional development or engaging parents. The 

reviewer (see reference below) found the manual to be too 

superficial to use as a curriculum package or for 

developing an intervention program and warned that 

paraprofessionals should not be mislead into thinking that 

assessment and intervention is as simple and 

straightforward as the manual leads one to believe. 

Standardization: Consisted of 357 children, ages 4 to 36 

months, from the states of California, Tennessee, and Utah. 

The group was balanced for gender, and rural versus urban 

environment, and the manual states that an attempt was 

made to include children from varying ethnic and 

socioeconomic status but does not give any data on who 

was actually included. The normative tables were 

developed with data from the earlier standardization 

sample rather than the current one, but no reason is given. 

Furthermore, the instructions for using the norm tables 

are confusing and did not make sense to the reviewer. 

Reliability/Validity: For the Screening Test, the manual 

does not provide enough information regarding reliability 

and validity to adequately address these issues. The 

reviewer mentioned the lack of standardized test materials 

as a limit to the ability to compare test results between 

individual children. No data was provided on validity 

studies. Similarly, the manual for the Checklist does not 

provide information on how the checklist was constructed 

or any reliability or validity data. There is no discussion 

of how to interpret scores. 

Utility: This instrument is described as a 3-part set for 

screening, program planning, and monitoring progress of 

at-risk or delayed children. The reviewer raised concern 

regarding the inadequate information regarding 

standardization, reliability, and validity. Thus the Screening 

Test was not recommended as a norm-referenced test. The 

Checklist could have some use as a way to monitor a child’s 

progress in a program, but extreme caution should be taken 

not to interpret the child’s performance in a normative way 

(i.e. as delayed or not) until further validity studies have been 

done. The Intervention Manual is useful as a brief 

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23 

introduction or overview of the issues involved in designing 

an early intervention program, but many additional 

resources are needed to adequately address the complex 

needs of an early intervention program. 

References: 

Buros, O. (Ed.). ( 1992). Mental Measurements Yearbook, 

11th Edition, pp.110-112. Lincoln, NE: Buros Institute of 

Mental Measurements. 

Minnesota Child Development Inventory 

Age Range: 1-6 years 

Purpose:	 Screening tool to determine 

developmental status 

Published: 1968-1974 

Publisher: Behavior Science Systems, Inc. 

P.O. Box 1108 

Minneapolis, MN 55440 

Description: This scale is a 320-item parent-completed 

questionnaire. There are eight domains: general 

development, gross motor, fine motor, expressive 

language, comprehension-conceptual, situation 

comprehension, self help, and personal-social. There are 

separate forms according to age and gender. Caregivers are 

instructed to read each statement and check “yes” or “no” 

if it applies to their child. Respondents must have an eighth 

grade reading level to complete the questionnaire. It takes 

approximately 30-50 minutes to complete. This is test is 

designed to supplement a parent interview when 

questions of developmental delay have been raised. 

Standardization: Items were selected on the basis of how 

representative it was of developmental skills, how easily 

observed by mothers in real life situations, descriptive 

clarity, and age-discriminating power. The 

standardization sample consisted of 796 children from 

Bloomington, Minnesota. The ages ranged from 6 months 

to 6 years. The number of boys and girls were equivalent. 

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Technical Assistance Paper No. 4 

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The authors state that “the normative group should not 

be considered representative of white, preschool children 

in general” and “the norms should not be used for 

children from families of lower socioeconomic status or 

other ethnic backgrounds”. 

Reliability/Validity: Limited information exists 

concerning reliability and validity. This test correlates well 

with other established measures of children’s abilities (e.g., 

Bayley, McCarthy, Cattell). The biggest concern was with 

the interpretation of the scores “percent below age level.” 

Utility: One reviewer notes “The demographics suggest, 

and the authors concur, that this instrument is suited for 

use with white, middle-class, non-handicapped children 

from intact families of successfully employed fathers and 

unemployed mothers.” This instrument is meant to 

supplement a parental interview and should not be the only 

source of information about a child. 

References: 

Buros, O. (Ed.). (1985). Mental Measurements Yearbook, 

9th Edition, pp. 991-992. Lincoln, NE: Buros Institute of 

Mental Measurements. 
24 Early Head Start National Resource Center 

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Minnesota Infant Development 

Inventory 

Age range: 1-15 months 

Purpose: 	 Mother’s observations of her 

infant’s development 

Published: 1977-1980 

Publisher: Behavior Science Systems, Inc. 

P.O. Box 1108 

Minneapolis, MN 55440 

Description: This instrument evolved out of the authors 

earlier work with the Minnesota Child Development 

Inventory (MCDI). Similar to the MCDI, the MIDI was 

designed to obtain a mother’s observations of her 

baby’s developmental functioning. It measures five 

domains: gross motor, fine motor, language, 

comprehension, and personal-social. The booklet 

contains 75 questions; there is one item for each month 

of age in each of five areas. There is no manual, and no 

scores are derived. ‘The examiner determines 

developmental delay if the child’s performance falls 

below the behavior of infants 30% younger. 

Standardization: The standardization for this instrument 

is based on the standardization of the parent MCDI. Since 

there were no infants younger than 6 months in the sample, 

the placement of items in the early months is unclear. 

Reliability/Validity: No information is given for this age 

range for either the MCDI or the MIDI. 

Utility: This scale is presented as a method for involving 

parents in examining the development of their infant. 

Reviewers note that no information is provided on the 

psychometric properties, the standardization is 

inadequate, and there is no guidance on the interpretation 

of delay. 

References: 

Buros, O. (Ed.). (1985). Mental Measurements Yearbook, 

9th Edition, Vol. II, pp. 995-996. Lincoln, NE: Buros 

Institute of Mental Measurements. 

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