It is natural to wonder whether your child is developing as expected, especially if they use fewer words, find play difficult, struggle with everyday tasks or need more help than other children of a similar age. Children develop at different rates, so a difference in one area does not necessarily mean that your child has a developmental problem.
However, a developmental assessment can help you understand your child’s strengths and identify areas where they may need extra support. If you have concerns, you can speak to your health visitor or GP without waiting for them to become more serious.
What Is a Developmental Assessment?
A developmental assessment looks at how your child is progressing in areas such as communication, movement, learning, play, social interaction, behaviour and independence. You may be asked about their development at home, nursery or school, while a clinician may also observe how they play, communicate and respond to others.
You may also discuss the pregnancy and birth, your child’s early health and your family history to provide a clearer picture of their development. It is not a test your child can pass or fail, but a way to understand their strengths, difficulties and whether they may benefit from additional support.
How Do You Know Whether Your Child Is Developing as Expected?
Developmental milestones give you a general idea of when children may learn skills such as sitting, walking, communicating, playing and becoming more independent. They are not strict deadlines, so children of the same age can reach the same milestone at different times and still develop appropriately.
Rather than focusing on one skill, it is more helpful to look at your child’s overall progress and whether they are continuing to gain new skills. If your child was born prematurely, clinicians may use their corrected age when assessing early development. Corrected age is calculated from your child’s expected due date rather than their actual date of birth and is particularly relevant during the first two years of development.
UK Guidance Note
In England, babies and young children are offered routine health and development reviews, including a 12-month review between 9 and 15 months and a 2-to-2-and-a-half-year review between 24 and 30 months. Developmental tools such as the Ages and Stages Questionnaire (ASQ-3) may be used to support discussion about communication, gross motor skills, fine motor skills, problem-solving and personal-social development. These tools form only one part of the wider professional assessment. You do not need to wait for a routine review if you are concerned about your child’s progress; you can contact your health visitor or GP earlier.
Key Areas a Developmental Assessment May Consider
| Area | Examples of skills considered |
| Communication and language | Understanding words and instructions, gestures, speech, expressing needs and communicating with others |
| Gross motor development | Sitting, standing, walking, running, climbing and balance |
| Fine motor and self-care skills | Using the hands, drawing, feeding, dressing and handling everyday objects |
| Social interaction and play | Sharing enjoyment, interacting with other people, imaginative play and responding socially |
| Learning and attention | Problem-solving, learning new skills, concentrating and participating in age-appropriate activities |
| Independence | Eating, dressing, toileting and managing everyday routines appropriate for the child’s age |
A difficulty in one of these areas does not by itself confirm a developmental condition.
Can Speech and Language Difficulties Be a Reason for Assessment?
Speech and language difficulties are a common reason to discuss your child’s development, particularly if they use fewer words than expected, are difficult to understand or struggle to understand others. Some children develop language skills later than others, but persistent difficulties with understanding or using language may benefit from further assessment.
Professionals may look at how your child uses gestures, responds to their name, follows instructions and communicates their needs, as well as whether their progress is continuing. Hearing can also affect communication, so a hearing assessment may be considered alongside looking at your child’s speech and understanding.
What Physical or Movement Signs May Need a Closer Look?
Your child’s development includes gross motor skills, such as sitting, standing, walking and climbing, as well as fine motor skills involving their hands and fingers. Some variation is normal, but it is worth seeking advice if movement seems significantly delayed, unusually difficult or noticeably different on one side of the body.
You may notice unusual stiffness or floppiness, persistent or unusually frequent falls for your child’s age, or difficulty with activities such as stairs, dressing, drawing or using cutlery. If motor development is significantly delayed, a developmental assessment can help identify whether your child may benefit from physiotherapy, occupational therapy or further investigation.
Clinical Note
Certain motor-development patterns deserve closer assessment rather than simply waiting to see whether your child catches up. NICE recommends referral to a child development service if a child is not sitting unsupported by 8 months, is not walking independently by 15 months for girls or 18 months for boys, or shows a clear preference for using one hand before 12 months, with age corrected for prematurity where appropriate. These signs do not by themselves confirm cerebral palsy or another neurological condition.
What About Play and Social Interaction?
Play gives you and professionals useful insight into your child’s communication, imagination, problem-solving and social skills. You may want to seek advice if your child regularly finds it difficult to engage with others, share interests, take part in back-and-forth interaction or play flexibly, although every child has their own style of play.
Can Behaviour, Attention or Sensory Differences Be Part of Developmental Concerns?
You may start to wonder about your child’s development if you notice frequent distress, difficulty with changes, intense reactions or problems taking part in activities at nursery or school. Tantrums and frustration are common in young children, so professionals will consider how often these difficulties happen, how intense they are and how much they affect everyday life.
You may also notice differences in attention or sensitivity to sounds, textures, clothing, food, lights or touch. These experiences can have many causes, so it is helpful to describe exactly what you see rather than trying to identify the reason yourself.
Why Is Losing Previously Acquired Skills Important?
If your child loses a skill they had previously mastered, it is important to tell a healthcare professional. For example, you may notice that your child stops using words they previously used regularly, loses social skills or can no longer manage a physical ability they had already developed.
Regression is different from reaching a milestone later than expected. If your child clearly loses a skill they previously used consistently, contact your GP or healthcare team rather than waiting for the next routine developmental review. Loss of previously acquired skills needs prompt assessment. NICE recommends specialist referral for motor regression. Regression in language or social skills should also be discussed promptly so that the appropriate developmental, paediatric, neurological or autism pathway can be considered.
When to Seek Prompt or Emergency Medical Help
| What you notice | What to do |
| Your child clearly loses previously acquired language, social or physical skills | Contact your GP or healthcare team promptly rather than waiting for a routine developmental review. |
| Your child develops progressive loss of motor abilities | Seek prompt medical assessment. Children with motor developmental regression should be referred to paediatric neurodevelopmental or paediatric neurology services according to local pathways. |
| Your child has a seizure for the first time | Call 999. |
| A seizure lasts longer than is usual for your child, or lasts more than 5 minutes if you do not know their usual seizure duration; your child has repeated seizures without recovering; does not regain full consciousness; has difficulty breathing after the seizure; or is seriously injured during the seizure. | Call 999. |
If your child has diagnosed epilepsy and an agreed seizure care plan, follow the instructions in that plan unless emergency help is required.
Does Needing a Developmental Assessment Mean My Child Is Autistic?
No. A developmental assessment does not automatically mean your child is autistic, as developmental differences can have many possible causes. It looks at a broad range of skills, while an autism assessment focuses specifically on social communication and interaction, together with restricted or repetitive patterns of behaviour, interests or activities.
A single difference, such as delayed speech, preferring to play alone or finding noisy places difficult, does not by itself mean that your child is autistic. If wider concerns arise, you can speak to your GP, health visitor or school about whether an autism assessment may be helpful.
| Myth | Fact |
| A developmental assessment means something is definitely wrong with my child. | A developmental assessment is designed to understand your child’s strengths and difficulties. Some children are reassured that their development is progressing within the expected range, while others may benefit from monitoring or additional support. |
| Needing a developmental assessment means my child is autistic. | Developmental assessments consider many areas, including communication, movement, learning, play, behaviour and independence. Autism is only one possible reason why a child may show developmental differences. |
| If my child is late reaching one milestone, they definitely have a developmental delay. | Children develop at different rates. Clinicians consider the overall pattern of development, whether your child continues to gain new skills and how any differences affect everyday life. |
| I should wait until nursery or school raises concerns before asking for help. | You can speak to your health visitor or GP whenever you have concerns. You do not need to wait for someone else to identify a problem or for difficulties to become more noticeable. |
| A developmental assessment always involves blood tests or scans. | Many assessments are based on developmental history, observation and clinical examination. Further investigations are considered only when there is a specific clinical reason. |
| My child needs a diagnosis before they can receive any support. | Depending on your child’s needs and local services, some support may begin before a final diagnosis is reached, including therapy or adjustments at nursery or school. |
What Happens During a Developmental Assessment?
During a developmental assessment, you will usually be asked about how your child has developed, including their milestones, communication, movement, play, behaviour, health and early history. Depending on your child’s age, the clinician may also watch them play, interact with you or take part in simple age-appropriate activities.
Your child may also have a physical examination to check things such as movement, coordination or muscle tone, depending on your concerns. If your child is shy, tired or behaves differently during the appointment, tell the clinician what they are usually like at home or nursery so they can consider the full picture.
How Does the Developmental Referral Pathway Work?
The referral pathway depends on your child’s age, the type of concern and local services. You may start by speaking with your health visitor or GP, while nursery staff, teachers or the SENCO can also share useful observations. Depending on the concern and local pathway, your child may then be referred to community paediatrics or a relevant specialist service such as speech and language therapy, physiotherapy, occupational therapy or audiology.
Referral processes and waiting times vary between areas, so the pathway will not be identical for every family. While waiting, ask whether nursery, school or therapy services can offer practical support, as some developmental or educational help may be available without a formal diagnosis.
Will My Child Need Tests?
Your child will not automatically need blood tests or scans during a developmental assessment. In many cases, professionals can understand your child’s development through their history, observation and clinical examination, with further tests considered only when needed.
Depending on your child’s history, examination and developmental pattern, further investigations may include hearing or vision assessment and, when there is a specific clinical reason, blood tests, genetic testing or imaging. Not every child needs medical investigations, and the clinician should explain why any test is being recommended.
What Could the Assessment Find?
In children under 5 years, clinicians may use the term global developmental delay (GDD) when there is significant delay affecting two or more areas of development. GDD describes a pattern of developmental difficulty rather than explaining its underlying cause. Further assessment may be recommended to understand why your child’s development is delayed and what support may be helpful.
A developmental assessment may reassure you that your child’s development is within the expected range, or it may identify a specific difficulty with areas such as speech, language or movement. Your child may then be offered targeted support without needing a wider developmental diagnosis.
If several areas are affected, further assessment may be needed to understand the reason, and sometimes the picture becomes clearer as your child grows. Whatever the outcome, you should be given a clear understanding of your child’s strengths, difficulties and the support that may help.
What Happens After the Assessment?
What happens next depends on the assessment findings. Your child may need no further specialist assessment, or the clinician may recommend monitoring development over time, targeted therapy, support at nursery or school, additional medical investigations or assessment by another specialist. Sometimes there is enough information to identify a particular developmental condition, while in other children the developmental pattern needs to be reviewed as they grow.
Before the appointment ends, ask what the findings mean, whether any referrals are being made and when your child’s progress should be reviewed. It can also help to ask who you should contact if new concerns arise while you are waiting for follow-up. If no diagnosis is made but your child continues to experience difficulties, you can still discuss what practical support is appropriate for their current needs.
Why Can Early Support Be Helpful?
Depending on your child’s needs and local service pathways, some support can begin before a final diagnosis is reached. This may include speech and language therapy, physiotherapy, occupational therapy or adjustments at nursery or school.
Early support can provide additional opportunities for your child to practise skills and may help make everyday activities easier to manage. Your child’s abilities and support needs may change as they grow, so their progress can be reviewed and the support they receive adjusted when necessary.
How Can You Prepare for a Developmental Assessment?
You do not need to train your child for the appointment, as the clinician needs to see how they naturally communicate, play, move and respond. Before the assessment, think about when you first noticed your concerns, how they have changed and whether nursery or school has noticed similar difficulties.
Bring your child’s Red Book, relevant letters or previous reports, and write down examples of their strengths and areas they find difficult. You can also ask nursery or school for observations and prepare questions about the assessment, possible support and when your child’s progress should be reviewed.
Key Takeaways
- A developmental assessment looks at your child’s communication, movement, learning, play, social interaction, behaviour and independence.
- Children develop at different rates, so one late milestone does not necessarily mean that your child has a developmental condition.
- Ongoing concerns, loss of previously acquired skills or difficulties affecting everyday life should be discussed with your health visitor, GP or another appropriate healthcare professional.
- A developmental assessment does not automatically mean that your child is autistic, and it does not always involve blood tests, scans or genetic testing.
- Depending on your child’s needs and local services, support such as speech and language therapy, physiotherapy, occupational therapy or educational adjustments may sometimes begin before a final diagnosis is reached.
- Seek prompt medical advice if your child loses previously acquired skills. Call 999 for a first seizure, a seizure that lasts longer than usual or more than 5 minutes when the usual duration is not known, repeated seizures without recovery, failure to regain full consciousness, difficulty breathing after the seizure or serious injury during the seizure.
FAQs
1. What are the signs that my child may need a developmental assessment?
Ongoing concerns about communication, movement, learning, play, social interaction or everyday independence may be worth discussing with a health visitor or GP, particularly if your child is not continuing to gain skills.
2. Does delayed speech mean my child needs a developmental assessment?
Not necessarily. Some children develop speech and language later than others, but persistent difficulties with understanding language, using words, following instructions or communicating needs may warrant further assessment. Hearing problems can also affect communication, so a hearing assessment may be considered.
3. Can movement difficulties be a reason for a developmental assessment?
Yes. Significant delays with sitting, standing, walking, climbing or using the hands may be worth discussing with a healthcare professional. Stiffness, floppiness, frequent falls, poor coordination or noticeable differences between the two sides of the body may also need closer assessment.
4. Does needing a developmental assessment mean my child is autistic?
No. A developmental assessment looks broadly at your child’s development and does not automatically mean autism is suspected. If specific social communication or behavioural differences are present, a separate autism assessment may be considered.
5. What happens during a developmental assessment?
The clinician will usually discuss your child’s developmental history and may observe their communication, movement, play and interaction. A physical examination or further investigations may be recommended when clinically appropriate.
6. Will my child need blood tests or scans?
Not necessarily. Many developmental concerns can be assessed through your child’s history, observation and clinical examination without blood tests or scans. Hearing or vision checks, blood tests, genetic testing or imaging may be considered when there is a specific reason to investigate further.
7. Can nursery or school concerns help with a developmental assessment?
Yes. Feedback from nursery or school can provide useful information about how your child communicates, plays, interacts with other children and manages structured activities. Specific examples of difficulties and strengths can help professionals understand your child’s development more fully.
8. What should you do if your child loses a skill they previously had?
Losing a previously acquired skill should be discussed with a healthcare professional rather than simply waiting for the next routine review. This may include losing words, social skills or physical abilities that your child had already developed, particularly if the change happens suddenly or occurs alongside other concerning symptoms.
9. Can a child receive support before receiving a diagnosis?
Yes. Depending on your child’s needs, support such as speech and language therapy, physiotherapy, occupational therapy or adjustments at nursery or school may be helpful before a final diagnosis is made. Early support can help your child develop skills and manage everyday difficulties more effectively.
10. How can you prepare for a developmental assessment?
Bring your child’s Red Book and any relevant reports, and write down your main concerns, examples of difficulties and questions. Information from nursery or school can also be helpful.
Final Thoughts: Supporting Your Child’s Development
If you have concerns about your child’s development, seeking advice can help you understand their strengths and whether additional support may be useful. If you’re considering autism assessment for children, you can get in touch with us at London Paediatric Clinic.
References:
- Department of Health and Social Care (2026) Part 2: health visiting (ages 0 to 5). Delivery of the Healthy Child Programme. Updated 12 March 2026. Available at: https://www.gov.uk/government/publications/delivery-of-the-healthy-child-programme/part-2-health-visiting-ages-0-to-5
- National Institute for Health and Care Excellence (NICE) (2017) Cerebral palsy in under 25s: assessment and management. NICE guideline NG62. Published 25 January 2017. Available at: https://www.nice.org.uk/guidance/ng62
- National Institute for Health and Care Excellence (NICE) (2023) Suspected neurological conditions: recognition and referral. NICE guideline NG127. Published 1 May 2019; updated 2 October 2023. Available at: https://www.nice.org.uk/guidance/ng127
- National Institute for Health and Care Excellence (NICE) (2017) Developmental follow-up of children and young people born preterm. NICE guideline NG72. Published 9 August 2017. Available at: https://www.nice.org.uk/guidance/ng72
- National Institute for Health and Care Excellence (NICE) (2017) Autism spectrum disorder in under 19s: recognition, referral and diagnosis. Clinical guideline CG128. Published 28 September 2011; updated 20 December 2017. Available at: https://www.nice.org.uk/guidance/cg128
- NHS (2023) What to do if someone has a seizure (fit). Page last reviewed 19 December 2023. Available at: https://www.nhs.uk/symptoms/what-to-do-if-someone-has-a-seizure-fit/
- Department for Education and Department of Health (2015) Special educational needs and disability code of practice: 0 to 25 years. Statutory guidance. January 2015. Available at: https://www.gov.uk/government/publications/send-code-of-practice-0-to-25
- Alder Hey Children’s NHS Foundation Trust (2025) Global Developmental Delay (GDD). Page last reviewed 19 May 2025. Available at: https://www.alderhey.nhs.uk/conditions/patient-information-leaflets/global-developmental-delay-gdd/