By EdCaptain editorial desk · Published
General educational guidance. No qualified clinical review is recorded for this article. Health and safety information.
The milestone checklist asks whether your child can fasten a button. You think through their wardrobe and realise every coat has a zip. You’ve watched them get dressed a hundred times, but you’ve never seen them try a button. Which box do you tick?
If the checklist offers “not sure”, use it and jot down why. “We mostly wear clothes with zips, so I haven’t seen her try a button” gives a caregiver or health professional something concrete to work with. If the form came from a clinic or preschool as part of a formal screening, read its instructions or ask the person who sent it how they want you to handle an uncertain item.
Read the question for the part it’s asking about
Two items that sound alike can ask for different observations. When a question includes “without help,” think about what happens when you leave your hands free. If you hold the fabric still while your child pushes a button through, that’s useful information. So is the fact that they started the button themselves. You can write both down even if the form has room for only one answer.
Distinguish between things you haven’t seen, things you’ve seen with support and things you’ve seen independently. If you remember a skill happening once, write down what you remember and check how the form defines each response. Some forms ask about frequency. Others ask whether you’ve observed the skill at all.
- Little chance to observe: “We live on one level. I don’t know what he does on stairs at childcare.”
- Observed with help: “She puts her arm through the sleeve after I hold it open and point to it.”
- Observed in another way: “He chooses the answer on his communication device during a story. Does the item include that?”
Make room for the skill in a routine you already have
If there’s a safe, comfortable way to offer a chance, pick a time when neither of you is in a hurry. For the button example, sit with your preschooler and set a familiar cardigan with securely attached buttons in their lap. You might say, “Want a go at this one?” Pause before stepping in. If they hand it back, you can finish getting dressed together and note that you didn’t get a clear observation. There’s no need to repeat the invitation until you get an answer.
For a baby or toddler, use a routine that’s already working. If you’re unsure how your toddler asks for help, notice what they do the next time they bring you a toy they can’t operate. They might hand it over, point, make a sound, sign or use a word. You don’t need to create frustration by withholding something they want. Write down what they did and whether you prompted it. If the wording on the form names a specific kind of response, keep your observation and ask how to record it.
Use your child’s usual glasses, mobility aid, supportive seat or communication equipment. If the item is unfamiliar, uncomfortable or unsafe for your child, describe the barrier and ask about an appropriate way to observe the skill. You can also check with someone who regularly cares for your child. Try asking, “Have you seen him try the steps, and what kind of help did he use?” That’s easier to answer than “Can he do stairs?”
Return the form with the uncertainty still visible
The CDC’s online milestone checklists are for developmental monitoring. For example, the five-year checklist offers “not sure” and suggests looking for the uncertain skill during ordinary activities over the next week or two. It also advises talking to a provider if you select “not yet” or have a concern.
A formal screening questionnaire has its own instructions. The developers of the Ages & Stages Questionnaires explain that families can leave some items unanswered and talk through the reason with their provider. Other tools may handle missing answers differently. If a digital form forces an answer, contact the person who sent it. You can say, “I’m ready to return this, but I’m unsure how to answer two items we haven’t tried. Can I send you my notes or go through those questions with you?” Ask about language support if the wording is unclear or you’d prefer to discuss it in another language.
If you’re concerned about your child’s development, a milestone you expected to see is missing, or your child has lost a skill they previously used, contact a qualified child-health professional promptly. You can bring an unfinished checklist. If your child was born preterm, ask which age or form to use. This guide to corrected age after premature birth explains why the answer can differ from calendar age. For what happens after you hand in the form, see how monitoring, screening and assessment differ.
Sources and further reading
- CDC’s five-year checklist and guidance on uncertain answers
- Ages & Stages guidance on unanswered screening questions
- CDC guidance on developmental monitoring and screening
- CDC’s milestone resources and when to raise a concern
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