What are the key developmental milestones for children aged 0-5 years that I should assess during routine check-ups?

During routine check-ups for children aged 0 to 5 years, key developmental milestones to assess include:

• Physical growth and measurements: length/height, weight, and head circumference should be measured and plotted on growth charts to monitor growth patterns ¹,².
• Motor development: assessment of gross motor milestones such as sitting, crawling, walking, and fine motor skills; watch for delayed motor milestones or abnormal movements which may indicate cerebral palsy or other motor problems ¹.
• Vision and hearing: checks for visual and hearing impairments should be performed in line with national screening recommendations ¹,².
• Speech, language, and communication: evaluate the child's ability to communicate and understand language, identifying any delays or difficulties ¹.
• Social and emotional development: assess social smiling, visual fixing and following in infants, and later social, attentional, emotional, and behavioural development using tools such as the Strengths and Difficulties Questionnaire (SDQ) ¹,².
• Cognitive development: monitor for global developmental delay, learning disabilities, and intellectual disabilities using parent questionnaires like the Parent Report of Children's Abilities – Revised (PARCA-R) and standardised tests such as the Wechsler Preschool and Primary Scales of Intelligence (WPPSI) at around 4 years ¹.
• Feeding and sleep: check for feeding difficulties and sleep problems including sleep apnoea ¹.
• Neurological signs: assess tone, reflexes, posture, and behaviour to identify abnormalities such as hypotonia or spasticity ¹,².
• Screening for autism spectrum disorder: be alert to early signs and refer as appropriate following NICE autism guidelines ¹.
• Physical examination: includes inspection of head, face, eyes, ears, neck, limbs, heart, lungs, abdomen, genitalia, spine, skin, hips, and cry quality ².

These assessments should be tailored to the child's corrected age if born preterm and include discussions with parents about any concerns. Enhanced surveillance is recommended for children born preterm or at risk of developmental problems ¹,².