“I think our program’s screening process is essential to our work with young children. In case after case, it has caught the first signs of difficulty—the things that are barriers to a child’s learning, whether it’s vision, hearing, speech, or behavior issues.” – Head Start Preschool teacher

This chapter explains how your program screens new children for disabilities or delays. Depending on your role, you might lead the process or work with others like the education or health manager.

You may help with tasks such as:

• Choosing the right screening tools
• Training staff to use them
• Making sure screenings happen on time
• Reviewing the results
• Talking with families about what you find

You don’t have to do it alone. Other staff will help, but you’ll likely play a big part.

Key Ideas 

• Screening gives a quick look at a child’s development to see if there are any concerns.
• All children must be screened within a set time after they enroll.
• Tools must be high-quality, based on research, and proven to work for your group of children.
• Trained staff must do screenings. Screening tools must fit the child’s age, development, culture, language, and any disabilities.
• Take special steps when screening children who speak more than one language.
• Screenings help find children who may need more testing or support.
• Families are partners in the screening process. Keep them involved and informed.
• Agreements with local agencies (like IDEA Part C and Part B) explain how screening and referrals should work.
• Health staff usually handle medical and dental screenings.
• Everyone must work together to make sure no child with a delay or disability is missed.

Why and How to Screen Children

Screening is one of the first steps in understanding a child’s development. It gives teachers and staff a quick look at how a child is doing in areas like behavior, movement, language, thinking, and emotions. This early check helps identify any concerns that might need more attention or follow-up.

However, screening is different from ongoing child assessment. It’s important for both staff and families to understand the difference.

Key Differences

• Screening is a one-time snapshot. It happens early in the program year and is used to spot possible developmental concerns.
• Ongoing assessment is continuous. It tracks a child’s growth over time and helps staff plan learning experiences that match the child’s needs.

According to the Head Start Program Performance Standards, programs must use observation-based or structured assessments to monitor each child’s progress. You can build these into daily routines and activities.

How Ongoing Assessment Works

In center-based or family child care settings:

• Staff observe children during regular activities.
• They use this data to plan personalized learning and improve teaching practices.

In home-based programs:

• Staff and families use assessment data to plan home visits.
• They tailor learning experiences and group socializations based on the child’s progress.

Programs must analyze and summarize assessment data at least three times a year—or twice a year if the program runs for fewer than 90 days. While education staff lead this work, your role on the disabilities team is still important for supporting children with special needs.

With that distinction in mind, let’s now turn our attention to the screening process itself. Screening is a critical first step in identifying children who may need additional support. Understanding how it works is essential for ensuring every child gets the best possible start.

Screening in Head Start Programs

Federal rules (Child screenings and assessments, 45 CFR §1302.33 and Child health status and care, 45 CFR §1302.42) require programs to screen all enrolled children. This includes developmental, vision, and hearing screenings. These screenings help staff support each child’s growth and learning from the very beginning.

In addition to using formal screening tools, programs must gather input from people who know the child well.

This includes:

• The child’s family
• Teachers or home visitors
• Other staff who regularly interact with the child

These different sources help staff understand the child’s typical behavior across settings. This well-rounded view is important for making informed decisions about next steps.

All information collected during the screening process is confidential. Programs are not allowed to use screening results to deny a child enrollment or limit their participation in any way.

Using the Right Tools

Programs must use at least one research-based screening tool. The tool must be reliable, valid, and appropriate for the child’s age, culture, language, and developmental level. It must also work well for children with disabilities. Only trained and qualified staff should conduct the screenings.

Validity means the tool measures what it’s supposed to. For example, a tool that checks thinking skills won’t tell you how well a child can run or jump.

Reliability means the tool gives consistent results, no matter who uses it or when. If many children score low and later evaluations confirm delays, the tool is considered reliable.

What Areas to Screen

Screen in all five domains of the Head Start Early Learning Outcomes Framework (ELOF):

• Approaches to Learning
• Social and Emotional Development
• Language and Literacy
• Cognition
• Perceptual, Motor, and Physical Development

When Screenings Happen

Most screenings take place at the start of the program year. If a child joins later, the program must complete the screenings within a certain number of days. 

• 45 calendar days of the child's first day at the program or home visit (most programs)
• 30 calendar days if a program operates for 90 days or less

What Screening Does—and Doesn’t Do

Screening is a quick check, not a full evaluation. 

• It helps staff decide if a child might need more testing or support.
• It does not diagnose a disability or track a child’s learning over time. Only a professional evaluation can provide a diagnosis.

If a screening shows concerns, the program must talk with a mental health or child development expert. With the family’s consent, you can refer the child to a local agency that provides services under the  IDEA. The referral is based on the screening results and other important information.

Next Steps After a Referral

While a child is waiting for a full evaluation, the program must provide temporary, individualized support whenever possible. These interim services may be funded through:

• The child’s health insurance
• Section 504 of the Rehabilitation Act
• The program’s own budget

Importantly, programs are not allowed to expel or unenroll children because of behavior issues. These rules show how important it is to screen children early and follow up quickly when screenings find concerns.

How Do You Screen Children Who Are Dual Language Learners (DLLs)?

Children who are Dual Language Learners (DLLs) are learning two or more languages at the same time, or they are learning a second language while still developing their first. These children must be screened just like their peers—on time and using tools that are appropriate for their language and culture.

Key Screening Requirements for DLLs

According to the Head Start Program Performance Standards (Child screenings and assessments, 45 CFR §1302.33(c)), programs must follow specific rules when screening DLLs:

• Use qualified bilingual staff to conduct the screening whenever possible.
  • If bilingual staff are not available, programs must use an interpreter along with a qualified staff member.
  • If no interpreter is available, staff may conduct the screening in English, using detailed input from the family.
• Collect data on the child’s skills in both their home language and in English.
• Screen in all five domains of the ELOF:
  • Approaches to Learning
  • Social and Emotional Development
  • Language and Literacy
  • Cognition
  • Perceptual, Motor, and Physical Development
• Use screening tools that are:
  • Research-based
  • Valid and reliable for DLL populations
  • Culturally and linguistically appropriate
  • Suitable for children with disabilities

Support for Program Leaders

Head Start offers an online guide called Screening Dual Language Learners in Head Start Programs: A Guide for Program Leaders. This resource helps program leaders:

• Choose the right screening tools for DLLs
• Plan and carry out high-quality developmental screenings
• Evaluate and improve their screening process for DLLs

What is your role in the screening process?

If you're new to the role, start by talking with experienced colleagues. Ask what has worked well in the past and what they would like to improve. You might even form a team with staff from different parts of the program to review screening tools together. As a group, consider whether a new tool is affordable, valid, and reliable. Also think about how much time it will take to train staff and complete screenings.

Screening should happen in natural settings whenever possible—like the classroom, a family child care setting, or the child’s home. Work closely with the education manager, teachers, and home visitors to make this happen.

As the DSC, your responsibilities include:

• Making sure staff understand how and when to conduct screenings
• Clarifying each person’s role in the process
• Helping staff use screening data to support children
• Explaining the purpose and benefits of screening to families
• Working with the HMHSAC to plan screening and assessment events for families and the community

You’ll also need to stay organized and manage deadlines. Use your data tracking skills to monitor where each child is in the screening process. During the first 30 days of the program year, consider reviewing screening data weekly. After that, you might switch to biweekly reviews—or even daily if you're in a large program.

When concerns arise, meet with the team—including family members, mental health consultants, and child development professionals—to review the child’s data and decide on next steps. If a child has special health care needs, work with the health manager to make a referral.

It’s important to understand what screening results mean and when they suggest a child needs a referral for further evaluation. You don’t have to figure this out alone—mental health consultants, specialists, and other staff can support you.

Most children will not need a referral. But staff should stay alert for any signs of developmental delays. Use ongoing assessments to track progress and listen to families; they may notice concerns before staff do.

Planning for Partnerships

When your program conducts developmental screenings, local Part C and Part B agencies are responsible for follow-up evaluations. To make this process smooth and effective, you and your partners should work together closely.

Here are key ways to collaborate:

• Provide support services, such as interpreters or translators, to ensure screenings are fair and accurate.
• Share updates about the screening tools your program uses.
• Plan joint training sessions to help everyone understand how to use the tools correctly.
• Create clear communication plans so families receive timely and consistent updates throughout the process.
• Define what information is needed to make a referral, such as developmental history or results from ongoing assessments.
• Identify possible challenges and agree on how each partner will support the family if issues arise.

This kind of teamwork helps ensure children get the services they need without delay.

Coordinating with Program Staff

As the DSC, you play a central role in the screening, referral, and evaluation process—but you don’t have to do it alone. Many of your colleagues can help you build a complete picture of each child’s development and identify any concerns early.

Here’s how different staff members can support the process:

• Family Service Staff
  These team members can share valuable insights from families about the child’s history, strengths, challenges, and development. Their close relationship with families helps you understand the child in context.
• Health Manager or Health Staff
  With the family’s permission, they can request developmental screening results or medical history from the child’s doctor or specialists. This information can help confirm or clarify concerns.
• Education Staff
  Teachers and home visitors gather ongoing assessment data during daily activities or home visits. Their observations are key to understanding how the child is learning and growing over time.
• Human Resources or Program Management
  These staff can help you find qualified bilingual screeners or interpreters to support children who are Dual Language Learners (DLLs). This helps ensure screenings are fair and accurate.

By working together, you can make the screening process more effective and supportive for every child and family. Collaboration helps ensure no child falls through the cracks—and that every child gets the support they need to thrive.

Family Considerations

Some families may not fully understand the purpose of developmental screening. They might think it’s a test of their child’s skills or intelligence. Others may not be familiar with developmental milestones or the idea that children grow and learn at different rates. As a result, they may feel nervous or unsure when staff ask questions about their child—and may try to give what they think are the “right” answers.

To ease these concerns, it’s important to explain the purpose of screening clearly before it begins. Let families know that screening is not a test, but a tool to help support their child’s development.

Respecting Differences

Screening results may reflect differences in how families raise children. For example:

• Some families do not encourage children to speak with adults. This may appear as a language delay.
• Some families don’t expect children to do things independently at a young age. This could raise concerns about motor skills.

You and family advocates should work together to ensure that the screening process respects each family’s cultural values and expectations.

Building Trust and Understanding

When working with families from a variety of backgrounds:

• Learn about their norms and preferences.
• Understand who in the family must give permission for referrals or evaluations—this may be a male guardian or elder.
• Be aware of who should be present during discussions about screening results.
• Always use the family’s preferred language. Bring a translator or interpreter, if needed.

Partner with family service staff or local community organizations that know the families’ cultures well. This helps build trust and ensures families feel respected and supported.

Meeting Screening Deadlines in Migrant and Seasonal Programs

Migrant and Seasonal Head Start (MSHS) programs that operate fewer than 90 days must complete screenings within 30 days. This can be challenging during summer months when local education agencies are closed.

One MSHS program found a creative solution:

• They recruited bilingual, state-licensed speech–language pathology students who were close to graduating.
• Many of these students had been migrant children themselves and understood the families’ needs.
• Under supervision, they completed their practicum in the MSHS program, helping with screenings and evaluations.
• They explained the importance of early intervention and preserving the home language.
• They helped families understand how to advocate for their children and prepare for transitions to new programs or schools in other states.

This approach allowed the program to provide high-quality services with minimal disruption, even for families on the move.

Tips to Ensure a Smooth Screening Process

As the DSC, you lead the screening process for children with disabilities or suspected delays. Your role involves coordinating people, managing timelines, and removing barriers to make sure every child is screened fairly and on time.

• Keep accurate records.
  Track where each child is in the screening process. Ask yourself:
  • Who have we screened?
  • Have we reviewed the results?
    (See Appendix C for tracking sheets and Appendix D for screening tasks.)
• Monitor deadlines.
  Make sure all staff know and meet the 45-day deadline—or 30 days for programs operating fewer than 90 days.
• Gather family input.
  Families know their children best. Respect their insights and be sensitive to cultural and language differences.
• Use classroom observations.
  Education staff can provide valuable information based on what they see during daily routines and activities.
• Stay informed about screening tools.
  Know which tools are valid and reliable for your program’s population, including children who are DLLs.
• Communicate clearly.
  Keep staff, families, and partners informed about screening procedures and any updates. If problems come up, explain how they were resolved.
• Understand relevant laws.
  Stay up to date on federal and state legislation that may affect screening and share this information with your early intervention and special education partners.
• Review and improve your process.
  Work with your management team and partners to review screening procedures at least once a year. Discuss what’s working and what needs to change.
• Plan for DLL screenings.
  Regularly review your policies for screening children who speak languages other than English. If no valid tools exist for a child’s home language, identify qualified translators or interpreters in your community.

People Who Can Help You

• Family service manager and advocates
• Teaching staff and home visitors
• Data manager
• Health manager and staff
• Human relations manager
• Program management
• Representatives from Part B and Part C local agencies

Questions to Ask Your Team

• How are we including parent input in the screening process?
• What screening tools are we using, and how are we using them?
• Are our tools valid and reliable for DLLs?
• What’s our plan if no standardized tool exists for a child’s home language?
• How do we decide whether to refer a child? Do we use other data too?
• How do we involve parents in referral decisions? Who makes the referral?
• Is our tracking system working well? Does it need improvement?

Scenario: Supporting Eva Through the Screening Process

Three-year-old Eva recently joined a Head Start family child care program. Her family speaks only their home language, and Eva has not been exposed to English at home. Her parents are concerned because she speaks very little—even in her home language—and often responds with just “yes” or “no.” She also doesn’t participate in family events like singing or dancing.

Building Trust with the Family

Maria, a bilingual family advocate, supports the intake process. She explains that all Head Start children receive developmental and health screenings and shares the benefits of early screening. Eva’s parents are unfamiliar with the process, as their older children were never screened. Although they feel nervous, they agree to participate.

Planning a Culturally Appropriate Screening

Maria and George, the DSC, review the Head Start Program Performance Standards for screening DLLs. They know that a qualified bilingual professional should conduct screenings—but no one is currently available.

Their program has a plan:

• Maria interprets while an English-speaking teacher conducts the developmental screening.
• Maria also helps with Eva’s hearing and vision screenings, which she has never had before.

Meanwhile, the family child care provider:

• Learns basic words in Eva’s home language to help her feel comfortable.
• Observes Eva’s communication and behavior during daily routines.
• Shares observations with George and the education supervisor.

Reviewing Results and Taking Action

George reviews Eva’s screening results alongside reports from her parents and provider. Together, they suspect a speech delay in her home language. The hearing screening also shows signs of hearing loss.

George and Maria meet with Eva’s parents to:

• Explain the screening results in a supportive way
• Describe the referral process for a formal evaluation
• Emphasize that only a full evaluation can confirm the hearing loss and determine the right support

Eva’s parents agree to move forward. The program submits a referral to the local school district, which is the Part B agency responsible for evaluations.

Last Updated: October 3, 2025