Measuring child development at the 2–2½-year health and development review in England: a rapid scoping review of available tools

Objective All children in England should receive a health review at 2–2½ years, with the Ages and Stages Questionnaire third edition (ASQ-3) used to collect public health surveillance data on child development. However, practitioners also value tools that assess individual children’s development—consistent with ASQ-3’s original purpose. Concerns about licensing costs and barriers to digitalisation have prompted interest in alternative tools to the ASQ-3 in England.

Design To inform policy, we conducted a rapid scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines to identify tools that can measure or assess early child development.

Data sources Searched PubMed, PsycINFO and Web of Science from January 2012 to November 2022, with targeted search update November 2024.

Eligibility criteria: We included English-language studies published after January 2012 that described or evaluated tools in English which could measure or assess early child development in children <5 years across five domains: motor, cognitive, communicative, social and emotional.

Data extraction We extracted key features and reliability, validity, sensitivity and specificity of tools which could feasibly be implemented at the 2–2½-year review (eg, including multiple age versions and <30 min to use). We used Quality Assessment of Diagnostic Accuracy Studies-I to assess risk of bias.

Results We identified 112 unique publications describing 34 tools; six met our feasibility criteria for the 2–2½-year review (reported in 53 studies). Only ASQ-3 and CREDI offer domain-specific scoring—a government priority. ASQ-3 moderately detects mild delays and performs better for severe delays in at-risk groups. Caregiver Reported Early Development Instruments (CREDI) was designed for public health surveillance, and we do not yet know how it performs for individual assessment.

Conclusions ASQ-3 and CREDI are most promising for use at the 2–2½-year review. However, we lack UK-based validation and norming studies, even for ASQ-3. Ultimately, careful implementation and integration into existing systems will determine a tool’s value for identifying developmental needs, supporting families and producing high quality data for public health surveillance.