Child Development Screening 18 months to 4 years old

Abstract

In Singapore, there is a rising prevalence of children with developmental and behavioural disorders referred to the KKH's Department of Child Development and NUH's Child Development Unit with a 76 percent increase in children presenting with developmental issues from 2010 to 2014. 2 e mean age of referral for children with developmental delays to government-funded early childhood intervention programs in Singapore is 35.8 months, suggesting that early detection could be improved. 6 Even though parents are usually the rst to raise concerns about the child's development, a local study evaluating the parental perceptions of the child development screening in the health booklet found that only half the parents completed the developmental checklist and only one in four parents took their child to the two to three-year developmental monitoring visit. 7 General Practitioners (GPs), through the Child Development Surveillance Programmes, are well placed to bridge this service gap by identifying those who are not meeting their developmental milestones. However, variability in knowledge and skills of family physicians in screening for early developmental delays, combined with limited time in the clinic may impact prompt identi cation. 8 is may delay early detection and referral of those with developmental delay or atypical development resulting in less satisfactory developmental trajectories as children are more responsive to early intervention if started before three years of age. 9 is topic review aims to provide an overview on the child development screening between 18 months to four years and includes normal development, international recommendations on Child Developmental Surveillance including screening for Autism Spectrum Disorder and the current situation in Singapore. It accompanies the guidelines on Child Development Screening developed by the Ministry of Health. Normal Child Development Child development is a continuous interactional process that is a ected by biological and psychosocial risk factors. It relates to a child's ability to move, use of his or her hands, communicate, learn, interact with others and self-care. Changes in these areas occur throughout childhood. e pattern of development is predictable, and milestones are acquired in a sequential manner with minor individual variation. If a child is late in achieving milestones which 90 percent of the children have met, then it is cause for concern. Assessing a child's development involves observing a child's step-wise acquisition of skills in di erent developmental domains and detecting delays or deviations in normal development.