What Is the Role of Parents/Caregivers in Developmental Screening?

Early development occurs first within an infant's earliest interactions and relationships with parents. It then expands to include other people, objects, and the rest of the world. Parents and grandparents are often the first to notice or suspect developmental problems, so it is important for parents to become good observers of their own infants, toddlers, and preschoolers, and to follow recommended schedules for well-child exams. Parents know their children best, so accurate screening depends on the active participation of the child’s parents or other caregivers.

As part of most screenings, parents are asked to provide a developmental history and a description of the child’s daily environment(s) and activities. For infants and toddlers, this account usually includes schedules of eating, sleeping, and playing, as well as portrayal of the child’s personality and patterns of interaction with adults. The same information is gathered for preschoolers, along with information about friends, child care, preschool, and play groups. Parents’ familiarity with their child's moods, activity levels, and typical responses to new situations and people provides a critical context for conducting and interpreting screening tests. Parents may also be asked to answer questions about movement, communication, and problem solving skills of their child. Some screening instruments are designed as questionnaires that are completed by parents and scored by professionals.

Another important role for parents is to provide an alternative perspective on the results of screening. Sometimes parents still feel there may be a problem, even when screening test results are reassuring. In other cases, parents may know that their young child did not perform typically, and suspect that a referral for further testing is unnecessary. In either case, parents should share their points of view on the interpretation of screening test results and to make plans together with professionals. The results of screening, like all assessments, can be especially misleading for children from social and cultural groups who were not represented in the original construction of the test. If parents feel, for example, that a child’s delay in communication is being mistaken for a problem learning English as a second language, they should say so and pursue other assessments with the professionals conducting screening. The best contributions of both caregivers and professionals will result in the most accurate results from developmental screening.

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