If your child has been referred for a developmental assessment, you may wonder what to expect. A developmental assessment usually combines discussion, observation and age-appropriate activities, and may also include structured developmental tools where appropriate. The clinician looks at how your child communicates, moves, learns, plays and manages everyday activities.
You may be asked about your child’s history and milestones, while the clinician observes them through play or age-appropriate activities and may carry out a physical examination. Information from nursery, school or other professionals may also be considered, helping the clinician build a fuller picture and decide whether your child may need additional support or further assessment, or whether reassurance and monitoring are appropriate.
What Is a Child Developmental Assessment?
A child developmental assessment looks at how your child is progressing across areas such as communication, movement, learning, play, behaviour and social skills. Rather than focusing on a single milestone, the assessment considers how different areas of your child’s development are progressing together.
It is not a test your child needs to prepare for, and there is no simple pass or fail result. The assessment can help you understand your child’s strengths, identify any difficulties and decide whether they may need additional support or further assessment.
Why Might Your Child Be Referred for an Assessment?
Your child may be referred for a developmental assessment if you, your GP, health visitor, nursery or school have concerns about their development. You might notice delayed speech, difficulties with movement or hand skills, or differences in social interaction, play, attention, behaviour or sensory responses.
A referral does not mean that your child has a developmental diagnosis. It gives professionals an opportunity to understand your child’s development in more detail and decide whether monitoring, further assessment or targeted support may be helpful.
What Happens Before the Appointment?
Before the appointment, you may be asked to complete questionnaires or provide reports from nursery, school or other professionals who know your child. This information helps the clinician understand how your child manages in different settings, as they may behave differently at home, school or in the clinic.
You can prepare by thinking about when you first noticed your concerns and what situations make things easier or harder for your child. Bring their Red Book and any relevant reports or letters if you have them, and write down your questions so you can discuss everything you want to know.
UK Guidance Note
In England, health visitors have an important role in monitoring health and development during the early years as part of the Healthy Child Programme. Developmental concerns may therefore already have been discussed during routine health reviews before a child is referred for more detailed assessment. The exact route to specialist assessment varies according to your child’s age, needs and local services.
If you are worried about your child’s development, you do not need to wait until a routine review or until nursery or school raises the same concern. Your GP, health visitor or other professional involved in your child’s care can advise whether monitoring, support or referral is appropriate.
In England, the Healthy Child Programme includes a 12-month health and development review between 9 and 15 months and a 2-to-2-and-a-half-year review between 24 and 30 months.
What Medical and Family History Will Be Discussed?
You may be asked about your child’s health and development, including illnesses, hospital stays, medicines, allergies, hearing, vision, feeding, sleep and any previous investigations. You may also be asked about your family history, including developmental difficulties, autism, ADHD, epilepsy or genetic conditions.
Share as much relevant information as you can, as these details can help the clinician understand your child’s development alongside their health, family background and everyday experiences.
Why Will the Clinician Ask About Pregnancy and Birth?
Your child’s developmental history may include questions about your pregnancy with your child and their birth, such as how many weeks pregnant you were, whether there were complications and whether your baby needed extra medical care. You may also be asked about birth weight, feeding and any time spent on a neonatal unit.
Prematurity can be important when interpreting early developmental milestones because clinicians may use your child’s corrected age rather than their chronological age during the first two years. These questions help build a fuller picture, so do not worry if you cannot remember every detail. Tell the clinician what you know and bring any relevant medical letters or records you have.
How Will Developmental Milestones Be Reviewed?
You may be asked when your child reached important milestones, such as sitting, moving around, walking, using words or combining words. You do not need to remember exact dates, as approximate timings and your child’s overall progress can still give the clinician useful information.
The clinician may also ask whether your child has lost any skills they previously used consistently and compare progress across different areas. This can help show whether a difficulty is more specific or affects development more broadly, and whether further support or assessment may be helpful.
Clinical Note
Reaching a milestone later than another child is different from losing a skill that your child previously used consistently. If your child stops using words they previously used, loses social or self-care skills, or can no longer perform a physical ability they had already developed, contact your GP or healthcare team rather than simply waiting for the next routine review.
Loss of previously acquired skills needs prompt assessment. NICE recommends referral to an autism team for children younger than 3 years who have regression in language or social skills. Children older than 3 years with regression in language, and children of any age with regression in motor skills, should be referred first to a paediatrician or paediatric neurologist. Other regression concerns should also be discussed promptly with your child’s healthcare team.
What If More Than One Area of Development Is Affected?
In children under 5 years, professionals may use the term global developmental delay (GDD) when significant delay affects two or more areas of development. GDD describes a developmental pattern rather than a specific underlying cause, so the next steps depend on your child’s history, examination and individual needs.
The assessment may also consider whether there are medical, sensory or other factors that could be contributing to the developmental difficulties. Depending on your child’s history and examination, the clinician may recommend hearing or vision checks, further medical assessment or selected investigations. Not every child with developmental delay needs the same tests, and any investigations should be chosen according to your child’s individual clinical picture.
The clinician will look at which areas are affected and whether your child is continuing to gain new skills. Next steps may include monitoring, further assessment or support such as speech and language therapy, physiotherapy, occupational therapy or educational support.
What Communication Skills Will Be Assessed?
Your child’s communication assessment looks at more than the number of words they can say. You may be asked about how they understand language, express their needs and use words, sounds, gestures, pointing or facial expressions to communicate.
The clinician may also observe how your child communicates during play and everyday interaction, as they may respond more naturally this way. If difficulties are identified, your child may be referred for speech and language therapy, and their hearing may also be checked if needed.
How Are Movement and Physical Skills Checked?
Your child’s assessment may look at both gross motor skills, such as sitting, standing and walking, and fine motor skills, such as picking up and handling objects. Depending on their age, you may see the clinician observe how your child moves around, reaches for objects, draws, builds with blocks or completes simple puzzles.
The clinician will consider not only what your child can do, but also how they move and whether there are noticeable differences in coordination or symmetry. If significant difficulties are identified, the clinician may consider whether physiotherapy, occupational therapy or further medical assessment would be appropriate.
Why Will the Clinician Watch Your Child Play?
Your clinician may watch your child play because it gives them a natural way to see how they communicate, move, solve problems, pay attention and interact with others. You may notice your child exploring toys, asking for help, copying actions or sharing enjoyment, while these behaviours provide useful information for the assessment.
You do not need to practise activities with your child beforehand, as the clinician wants to see how they naturally respond. If your child becomes distracted, does not want to take part or moves away from an activity, tell the clinician if this is typical or unusual for them. How your child responds during the appointment can form one part of the overall assessment.
Myth vs Fact
| Myth | Fact |
| A developmental assessment means my child definitely has a developmental condition. | An assessment is used to understand your child’s strengths and difficulties. Some children need additional support or monitoring, while others may not need further specialist assessment. |
| My child needs to perform well during the appointment. | There is no simple pass or fail result. Clinicians consider history, observation, everyday functioning and information from different settings rather than judging your child on one activity. |
| A developmental assessment automatically means autism is suspected. | A developmental assessment considers many areas, including communication, movement, learning, play, behaviour and independence. An autism assessment is a more specific process when relevant concerns are present. |
| If my child behaves differently in the clinic, the assessment will be inaccurate. | Children may be shy, tired, anxious or more active than usual during an appointment. Your observations and information from nursery or school can help the clinician understand how your child usually behaves. |
| Every developmental assessment involves blood tests or brain scans. | Many children do not require these investigations. Tests are considered when the history, examination or developmental pattern gives a clinical reason to investigate further. |
| One appointment will always provide a diagnosis. | Some children receive a clear explanation after one assessment, while others need monitoring, information from other professionals or more specialised assessment before the picture becomes clearer. |
Will Social Interaction and Behaviour Be Observed?
You may be asked about how your child interacts with you and other people, while the clinician may observe their communication, use of gestures and facial expressions, sharing of attention and how they respond during interaction. Attention, emotional regulation, reactions to change, repetitive behaviours or sensory differences may also be discussed when relevant to your concerns.
No single behaviour usually provides an answer, so professionals consider the wider pattern across your child’s development and different everyday settings. If there are specific concerns about autism, your child may be referred for a more focused autism assessment.
Will There Be a Physical Examination?
Your child may have a physical examination as part of the assessment, depending on why they have been referred. The clinician may measure your child’s height and weight and, when relevant, assess their growth, movement, posture, coordination, muscle tone or other physical features.
The examination is guided by your child’s history, so it will not be exactly the same for every child. If your child finds touch or examinations difficult, let the clinician know so they can adjust the pace and approach to help them feel more comfortable.
Why Might Nursery or School Information Be Needed?
The appointment gives the clinician information about how your child manages in the clinic, while nursery or school can provide a wider view of their everyday development. For a school-aged child, information from the special educational needs co-ordinator (SENCO), where relevant, may also be useful.
You may notice that your child behaves differently at home and in school, and this does not mean that either observation is wrong. Information from different settings helps professionals understand your child’s strengths and difficulties more fully and decide what support may be helpful.
Which Professionals Might Be Involved?
The professionals involved will depend on your child’s needs and the services available locally. A developmental or community paediatrician may review your child’s medical and developmental history, examine them and decide whether further assessment or investigations are needed. The combination of professionals involved will depend on which areas of your child’s development need further assessment or support.
Your child may also see a speech and language therapist, physiotherapist, occupational therapist, educational psychologist, audiologist or other education professional, depending on their needs and local services. Not every child needs all these specialists, but their findings can be brought together to give you a clearer picture of your child’s strengths and support needs.
Will My Child Need Blood Tests, Genetic Tests or Scans?
Not every child needs blood tests, genetic tests or scans during a developmental assessment. In many cases, your child’s history, development and clinical examination provide enough information to decide what support or further assessment may be needed.
If further investigations are suggested, they should be based on your child’s history, examination findings and developmental pattern. Depending on the clinical question, this could include hearing or vision assessment and, in selected children, blood tests, genetic investigations or imaging. Ask what each investigation is looking for and how the result could affect your child’s care.
Does One Appointment Always Give You a Diagnosis?
No, one developmental appointment does not always lead to a diagnosis. Developmental differences can have several possible explanations, so the clinician may need information from you, nursery or school, or may want to review how your child’s development changes over time.
Your child may be offered support for a specific difficulty without receiving a diagnostic label, or they may need a more specialised assessment. The important thing is that you understand what has been identified and what should happen next.
What Happens After the Assessment?
After the assessment, you may be given an initial view of your child’s development and any difficulties that have been identified. You should also be told whether further assessment, monitoring or support is recommended, such as speech and language therapy, physiotherapy or occupational therapy.
Depending on the service, you may receive a written report or clinic letter explaining the findings and next steps. Before you leave, make sure you understand whether your child needs another appointment, a referral or simply monitoring over time.
How Can You Help the Assessment Give an Accurate Picture?
You know your child best, so your observations can help the clinician understand how they communicate, move and manage everyday situations. Try to give specific examples of what you notice, including what your child finds difficult and what they can do confidently.
Do not worry if your child behaves differently during the appointment, as they may be shy, tired or overwhelmed. You can also ask questions if anything is unclear, so you understand what has been found, what remains uncertain and what happens next.
Key Takeaways
- A developmental assessment considers your child’s overall pattern of communication, movement, learning, play, social interaction, behaviour and everyday skills.
- It is not a pass-or-fail test, and your child does not need to practise activities before the appointment.
- Information about the pregnancy and birth, your child’s medical history and relevant family history can help the clinician interpret their development in context.
- Information from home, nursery or school can be useful because children may behave differently in different settings.
- Blood tests, genetic investigations and scans are not routinely required for every child; they are considered when clinically appropriate.
- One appointment does not always provide a diagnosis, and some children may need monitoring or further specialist assessment.
- Seek prompt medical advice if your child clearly loses a skill they previously used consistently.
FAQs
1. What happens during a child developmental assessment?
The appointment usually includes discussion of your child’s health and developmental history, observation of their skills and interaction, and a physical examination when appropriate. Further tests are arranged only when clinically indicated.
2. What should you bring to a developmental assessment?
Bring your child’s Red Book and any relevant medical, therapy, nursery or school reports. Writing down your main concerns, examples and questions beforehand can also help.
3. Will my child have to complete formal tests?
Not necessarily. The assessment may involve observation, conversation, play and simple age-appropriate activities rather than formal testing, depending on your child’s age and the reason for referral.
4. Will the clinician ask about my pregnancy and my child’s birth?
Usually, yes. Your pregnancy with your child, their gestational age, birth, neonatal care and early health can provide useful context, particularly if your child was born prematurely.
5. What developmental milestones will be checked?
The clinician may ask about milestones involving movement, communication, play and independence. If you cannot remember exact dates, approximate timings and the overall pattern of your child’s development can still provide useful information.
6. Will speech and language be assessed?
Yes. The assessment may consider how your child understands language, expresses themselves and uses words, gestures, facial expressions or other forms of communication. Hearing may also be considered because difficulties with hearing can affect speech and language development.
7. Will my child’s movement and physical development be checked?
Yes, when relevant to the concerns. The clinician may observe walking, running, coordination, balance, hand movements and other gross and fine motor skills, and may examine muscle tone, reflexes or symmetry if appropriate.
8. Why does the clinician watch my child play?
Play gives the clinician an opportunity to observe communication, problem-solving, movement, attention and interaction in an age-appropriate and relatively natural setting.
9. Will nursery or school information be included?
It can be very useful because it shows how your child manages in another setting and complements what you observe at home.
10. What happens after a child developmental assessment?
You should be told what the assessment suggests and whether your child needs monitoring, support, further investigation or another specialist assessment. Depending on your child’s needs, this could include referral to speech and language therapy, physiotherapy, occupational therapy or a more specialised neurodevelopmental assessment.
Final Thoughts: Understanding Your Child’s Developmental Assessment
A developmental assessment gives you a clearer understanding of your child’s strengths, difficulties and the support they may need. If your child needs specialist support or you are considering an autism assessment for children, you can contact us at London Paediatric Clinic for support.
Knowing what to expect can make the assessment feel less daunting and help you feel prepared to share the information your clinician needs.
References:
- Department of Health and Social Care (2026) Part 2: health visiting (ages 0 to 5). Delivery of the Healthy Child Programme. Published 6 February 2026; 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
- Alder Hey Children’s NHS Foundation Trust (2026) Developmental paediatrics. Page last reviewed 12 March 2026. Available at: https://www.alderhey.nhs.uk/services/developmental-paediatrics-2/
- 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/
- 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
- 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
- Bellman, M., Byrne, O. and Sege, R. (2013) ‘Developmental assessment of children’, BMJ, 346, e8687. Available at: https://pubmed.ncbi.nlm.nih.gov/23321410/
- NHS England Genomics Education Programme (2026) Presentation: Patient with developmental delay. Page last reviewed 6 February 2026. Available at: https://www.genomicseducation.hee.nhs.uk/genotes/in-the-clinic/patient-with-developmental-delay/