This document provides an overview of early childcare provider training on developmental screening and regulations. It discusses Nevada regulations requiring developmental assessments for children in childcare facilities. It also reviews several developmental screening tools including the Ages and Stages Questionnaire, CDC Milestone Booklets, and Modified Checklist for Autism in Toddlers. The document defines key concepts like developmental milestones, screening, and provides resources for children needing further evaluation.

1. Early Childcare Provider Training
Module 2: Developmental Screening and Regulations
NvLEND
Presenter- Dr Mario Gaspar de Alba
Developmental Behavioral Pediatrician, UNLV School of Medicine
Nevada Act Early
Nevada Act Early

2. • Review Child Care Regulations that address child
screenings/assessments
• Learn about the Ages and Stages Questionnaire, 3rd
Ed.
• Become familiar with the Centers for Disease
Control (CDC) Milestone Booklets
• Learn about the Modified Checklist for Autism in
Toddlers (M-CHAT)
• Review Ages and Stages Questionnaire - Social and
Emotional (SE)
Learning Objectives

3. State of Nevada
Child Care Regulations
• All child care facilities are required to assess children
within three months of enrollment and twice per
year.
• Assessments include the use of: Portfolios,
observations, checklists, rating scales, and screening
tools.
• The purpose is to monitor and support the learning
and development of each child enrolled in the
facility.
• Many facilities use Ages and Stages Questionnaire,
Centers for Disease Control developmental
checklists, and/or portfolios.

4. Regulations….cont.
• Once the information is obtained from the
assessment the child care providers use the
information to individualize curriculum.
• If there are concerns about a delay, the child
care provider needs to discuss this with the
parent and refer the parent to a professional for
diagnostic assessment.
• If a child is already receiving services due to a
developmental delay, the facility can request a
copy of the assessment from the parent to
incorporate the developmental goals into their
curriculum.

5. Child Development
• Child development addresses how a child is
able to do more complex things as they get
older.
• It is more than just physical growth, which refers
only to a child getting bigger in size.
• Children grow, change and acquire a broad
range of skills starting at birth and continuing
throughout their lives.

6. Child Development…cont.
• Development is a continuous process.
• Each new aspect of development includes and
builds on the skills a child has already learned.
• Each skill is the necessary foundation to the next
set of skills a child learns.

7. Developmental Milestones
• Developmental milestones are the things most
children can do by a certain age.
• The skills children learn fall into several major
areas: Social/Emotional,
Language/Communication, Cognitive (learning,
thinking, problem-solving), and
Movement/Physical Development.

8. Developmental Milestones…cont.
• Children develop in predictable steps within an
age-range in months or years.
• Although each milestone has an age level
associated with it, the actual age when most
children reach that milestone can vary quite a
bit.

9. Developmental Screening
• Developmental screening helps doctors, nurses,
and child care providers tell if a child is learning
basic skills when they should, or if they might
have problems.
• It is important that parents talk with their child’s
doctor at every visit about their child’s
development.

10. Developmental Screening…cont.
• Parents can discuss the milestones their child
has reached and ask the doctor what to expect
next.
• Parents and child care providers can learn how
a child is developing by watching how they play,
learn, speak and behave.

11. Ages & Stages Questionnaire:
Edition 3 & Social-Emotional
• You may want to review the general
Questionnaire & the Social Emotional
Questionnaire on your own
• Please pause Dr. Gaspar’s video now and watch
the video below entitled Developmental
Screening Works.

12. Ages & Stages Questionnaire
• Screens for developmental delays: 1 month to 5½
years.
• Recommended by the American Academy of
Neurology, First Signs, The Child Neurology
Society, and CDC.
• Takes 10-15 minutes and comes in English and
Spanish.
• 21 age appropriate questionnaires
2 month intervals from 2 months-24 months
3 month intervals from 24 months to 36 months
6 month intervals from 36 months to 60 months

13. Ages & Stages
Questionnaire..cont
• Looks at communication, gross motor, fine
motor, problem solving, and personal social
skills.
• Can be administered by a parent,
paraprofessional, or professional.
• For example: Observe the child during snack or
lunch is associated with the following 24 month
ASQ Personal-Social Question
– Does your child drink from a cup, putting it
down with little spilling?

14. Ages & Stages:
Social and Emotional Screening
• Please pause Dr. Gaspar’s video now and watch
the video below entitled Early Childhood Social
& Emotional Screening.

15. Ages & Stages:
Social and Emotional Questionnaire
• A screening tool that is designed to identify children
who may be at risk for social and emotional
difficulties.
• It is a series of 8 questionnaires that correspond to
age intervals from 3 months to 6 years.
• It contains questions about self regulation,
compliance, communication, adaptive behaviors,
autonomy, affect, interactions with people.
• The screening takes about 10-15 minutes to
complete and it can be completed by parents,
professionals, or paraprofessionals.

16. Ages & Stages:
Social and Emotional Questionnaire
• This is not a diagnostic screening but instead a tool to
help identify children who would benefit from further
evaluation or intervention.
• The questions are open ended and the answers are
based on feelings and opinions about the child’s
behaviors.
• For example for children 33 – 41 months:
– Does your child like to be hugged or cuddled?
– Does your child seem happy?
– When upset does your child calm down within 15
minutes?
– What are things you enjoy most about your child?

17. CDC Milestone
Moments Booklet
• The Milestone Moments booklet is a wonderful
resource that can help you check the milestones
a child has reached by a certain age.
• The booklet has lists of the important milestones
to look for ages 2 months to 5 years.
• NvLEND has adapted the Milestones Moments
booklet that was developed by the CDC and
added resources specific to our state of Nevada.

18. Milestone Moments Booklet…cont.
• Each age is divided into checklists in the
following areas of development:
 Social/Emotional
 Language/Communication
 Cognitive (learning, thinking, problem-solving)
 Movement/Physical Development
CDC Milestones Website:
www.cdc.gov/ncbddd/actearly/milestones/

19. Milestone Moments Booklet…cont.
• Next to the checklists are
things that parents can
do to help each baby’s
and child’s development
and a list of things to be
aware of.

20. Milestone Moments Booklet…cont.
• If you are a child care provider it is important to
let a parent know if their child is not doing one or
more of these things.
• The last section of the Milestones Moment
booklet has a list of resources and agencies to
refer to for children in Nevada ages birth through
three years old and children ages three plus
years.

21. Modified Checklist for Autism in
Toddlers (M-CHAT)
• The M-CHAT is an autism screening tool and is to be
administered by a trained health care professional.
• The M-CHAT is designed to identify children 16 to 30
months of age who should receive a more thorough
assessment for possible early signs of autism spectrum
disorder (ASD) or developmental delay.
• The American Academy of Pediatrics (AAP)
recommends that all children receive autism-specific
screening at 18 and 24 months of age in addition to
regular developmental screening.

22. M-CHAT…cont.
• The M-CHAT is one of the AAP recommended
tools and can be administered at well-child visits.
• Parents can ask their pediatrician to provide an
M-CHAT at a well-child visit.
• If the parent and their child’s physician agree
that further screening is needed, he/she can
request a free developmental assessment for
their child through Nevada State Early
Intervention Services.

23. Referral for Birth to 3
• The contact information for the three State Early
Intervention offices in Nevada are:
 Nevada Early Intervention South
702-486-9200
 Nevada Early Intervention Northwest
775-688-1341
 Nevada Early Intervention Northeast
775-753-1214

24. Referral Birth to 3…cont.
• Early Intervention sites offer further evaluations
of a child free-of-charge.
• These developmental assessments may involve
a physical exam, a cognitive exam, a hearing
assessment, and a speech and language
assessment.

25. Other Autism Screening Tools
• Childhood Autism Rating Scale, 2nd Ed.
• Social Communication Questionnaire
• Gillian Autism Rating Scale, 2nd Ed
• Please note: These can be provided by other
healthcare professionals for you and or the
parent to complete.

26. Professionals for Evaluation
Purposes
• Speech-Language Pathologist
• Occupational Therapist
• Physical Therapist
• Child Developmental Specialist
• Psychologist
• Developmental Behavioral Pediatrician
• Psychiatrist
• Neurologist

27. Acknowledgements

28. Sources
Robins, D., Fein, D., & Barton, M. (1999).
m-chat. Retrieved from https://www.m-chat.org/index.php
Allen, K. E., & Marotz, L. R. (2003).
Developmental profiles pre-birth through twelve. (Fourth Edition ed.).
Clifton Park: Delmar Learning.
NvLEND.
US Department of Health and Human Services,
Centers for Disease Control and Prevention. (n.d.). Milestone moments
(220788)

29. Additional Training Opportunities
• Module 1- What is Autism?
• Module 2 - Developmental Screening (ASQ, CDC Milestones
Booklet, MCHAT); Regulations
• Module 3 - Additional Information Regarding Conducting
Developmental Screenings
• Module 4 - Referral and Diagnostic Process; Working with
Parents
• Module 5 - Individual Family Service Plans; Individual
Educational Plans
• Module 6 - Strategies for Inclusion
• Module 7 - Other Neurodevelopmental Disabilities
• Module 8 - Dealing with Challenging Behaviors