What developmental milestones should I assess in a child at their 2-year check-up?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

A 2-year health check-up should include a comprehensive developmental assessment, particularly for children undergoing enhanced developmental surveillance . This assessment should involve discussing any parental or carer concerns about the child's development . Key areas to check for signs and symptoms of developmental problems and disorders as appropriate include:

  • Global developmental delay and learning disability .
  • Speech, language, and communication problems .
  • Motor problems, such as delayed sitting, crawling, or walking, or unusual movements ,.
  • Autism spectrum disorder .
  • Visual impairment .
  • Hearing impairment .
  • Feeding problems .
  • Sleep problems, including sleep apnoea .
  • Problems with inattention, impulsivity, or hyperactivity .
  • Emotional and behavioural problems .
  • Executive function problems .
  • Potential special educational needs .

During the assessment, physical measurements should be taken, including length or height, weight, and head circumference ,. These measurements should be recorded in the parent or carer-held Personal Child Health Record ,. For children born preterm, development should be corrected for gestational age up to 2 years .

Tools that may be used include the Parent Report of Children's Abilities – Revised (PARCA-R) to identify risks of global developmental delay, learning disability, or language problems . If PARCA-R is unsuitable, a suitable alternative parent questionnaire should be used . If cerebral palsy has been diagnosed, the Gross Motor Function Classification System (GMFCS) score should be included . Ensuring that checks of vision and hearing have been carried out in line with national recommendations is also important .

Any developmental concerns reported by parents or carers, or noted during the visit, should be carefully evaluated and reviewed . If a developmental problem or disorder is suspected, further investigation or referral to the appropriate local pathway should be considered .

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