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

Journal article

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.

Authors: Lysons, J; Mendez Pineda, R; Alarcon, G; Aquino, MRJ; Cann, H

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: BMJ Publishing Group
• Journal: BMJ Open
• Volume: 16
• Issue: 2
• Pages: e102853
• Article number: bmjopen-2025-102853
• Publication date: 2026-02-04
• Acceptance date: 2026-01-06
• DOI: 10.1136/bmjopen-2025-102853
• EISSN: 2044-6055
• ISSN: 2044-6055
• Language: English
• Keywords: PUBLIC HEALTH; Health policy; Community child health; Child; Health