Early Years Developmental Concerns: Identification & Signposting

UK guide for childminders: recognising developmental concerns, understanding referral pathways, communicating with parents, and meeting Ofsted requirements.

⚠️ Important Disclaimer: This guide is for informational purposes only and does not constitute medical, developmental, or professional advice. Always consult with appropriate specialists (health visitors, speech therapists, educational psychologists, GPs) for assessment and diagnosis of developmental concerns. Use your professional judgment and refer early — it's always better to check with a health professional if you're uncertain.

Seven Areas of Learning & Development

The EYFS framework organises child development into these seven areas. Most developmental concerns fall into one or more of these categories.

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Communication & Language
Understanding and using language, listening, attention, and verbal expression.
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PSED (Personal, Social & Emotional)
Self-esteem, relationships, emotional regulation, confidence, and cooperation.
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Physical Development
Gross motor (running, climbing), fine motor (grasp, coordination), and body awareness.
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Literacy
Phonological awareness, letter recognition, reading, and writing skills.
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Mathematics
Number, pattern, shape, space, and mathematical thinking.
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Understanding the World
Curiosity, exploration, nature, communities, and cultural awareness.
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Expressive Arts & Design
Creativity, imagination, music, art, and self-expression.

Red Flags & Developmental Concerns

These are areas where development may be significantly below age expectations. Document specific observations if you notice these.

🗣️ Speech & Language Delays
  • Not babbling or vocalising by 12 months
  • Not responding to name by 12 months
  • Not saying single words by 16 months
  • Not using two-word phrases by 24 months
  • Speech unclear to unfamiliar listeners beyond age 3
  • Not following simple commands by 18 months
  • Not using gestures (pointing) by 12 months
  • Very limited vocabulary compared to peers
  • Difficulty understanding or processing language
🚴 Gross Motor (Large Movement) Delays
  • Not sitting without support by 9 months
  • Not crawling or moving forward by 12 months
  • Not walking by 18 months (or significant difficulty walking)
  • Difficulty with balance, coordination, or climbing
  • Significant asymmetry (using one side of body much more than the other)
  • Unusual muscle tone (very stiff or very floppy)
✏️ Fine Motor (Hand Skills) Delays
  • Cannot grasp or hold objects appropriately
  • Cannot use utensils or eating independently
  • Cannot stack blocks by 18 months
  • Cannot use pincer grasp (thumb and fingers) by 12 months
  • Difficulty with puzzles, threading, or manipulation tasks
  • Cannot scribble or draw by 2 years
👥 Social & Communication Concerns
  • Limited eye contact or difficulty engaging socially
  • Not smiling or showing enjoyment by 6 months
  • Difficulty understanding others' emotions or perspectives
  • Difficulty initiating or sustaining friendships
  • Significant difficulty with emotional regulation or frequent meltdowns
  • Limited back-and-forth interaction or turn-taking
  • Difficulty responding to verbal or non-verbal communication
  • Concerns about attachment or relationship with caregivers
✓ Important Note: If a child shows delays in multiple areas (e.g., speech + gross motor + social), this is more likely to indicate a significant concern requiring specialist assessment. Even single-area delays warrant early discussion with health professionals.

Official UK Referral Pathways

Here's how developmental concerns are assessed and referred in the UK health system.

Primary Route: Health Visitor Pathway

1
You raise concern
Childminder observes delays and discusses with parents, suggests health visitor visit.
2
Health Visitor assessment
Parent or Health Visitor contacts HV. They conduct targeted developmental review, may use ASQ-3 (Ages & Stages Questionnaire) tool.
3
Specialist referral if needed
HV refers to Speech & Language Therapy, Community Paediatrics, or Educational Psychology if concerns persist.
4
Specialist assessment
Specialist service conducts full assessment and provides support plan or diagnosis.

Alternative: GP Route

If parents prefer, they can contact their GP directly. GP will usually refer to Health Visitor first, or directly to Community Paediatrics if appropriate.

Specialist Services You Might Refer To:

💡 Top Tip: Early intervention is key. Don't wait until a child is significantly behind — earlier referral means earlier support. Health professionals would rather assess a child who is developing typically than miss a child who needs support.

Talking to Parents About Concerns

Communication is crucial. Here's how to raise developmental concerns sensitively and professionally.

Best Practice Approach:

  1. Build relationship first — establish trust before raising concerns
  2. Be specific — have concrete observations documented (dates, examples)
  3. Use sandwich method — start with strengths, share concern, close with support message
  4. Use non-judgmental language — focus on milestones, not deficit
  5. Involve parents as partners — ask about home observations, agree on next steps
  6. Have resources ready — development checklists, referral information, reassurance

Example Opening (Speech Concern):

"I've really enjoyed watching [child's name] develop over the past [time period]. They've made lovely progress with [specific strength]. I've noticed that their speech is developing a bit differently than some other children the same age — I've been keeping an eye on it. I'd like to chat with you about it and see if we can work together. Would you have noticed similar things at home? It might be worth a chat with your health visitor just to make sure everything's developing well. I can share some of my observations, and the health visitor can give you their professional opinion."

What NOT to Say:

✓ Remember: Parents may feel surprised, worried, or defensive. Be empathetic. Emphasise that you're raising this because you care about the child's wellbeing and want to ensure they get any support they need.

Your Role & Ofsted Expectations

What Ofsted expects to see when they inspect your childminding.

You Should Be Able to Demonstrate:

Documentation to Keep:

💡 Ofsted Focus: Inspectors want to see that you know each child well, that you're supporting their progress, and that you're aware of how they're developing against age expectations. Early identification and appropriate referral is a strength, not a weakness.

Key Resources & Official Links

Bookmark these for reference — they're all official UK government, NHS, or recognised professional body resources.

📚 Development Guidance
  • Development Matters: GOV.UK Development Matters — age-related development expectations
  • Birth to 5 Matters: Non-statutory guidance on development from early years sector
  • EYFS Statutory Framework: Official requirements for early years settings
🏥 Health & Referral Information
  • SEND Code of Practice: GOV.UK SEND Code of Practice — identifying SEN support
  • Local Authority "Local Offer": Search "[Your Council] Local Offer SEND" — includes local referral pathways
  • Health Visitor Pathway: Contact your local health visiting service or call your GP practice
🎓 Professional Resources
✓ Next Step: Bookmark your local authority's "Local Offer" website — it has contact details for Health Visitor services, Speech & Language Therapy, Community Paediatrics, and SEN support in your area.
⚠️ Final Reminder: This guide is informational only and does not constitute professional, medical, or developmental advice. Always consult qualified professionals (health visitors, GPs, therapists) for assessment and diagnosis. Your role is to observe, document, communicate with parents, and refer appropriately — not to diagnose or assess developmental concerns. If you're ever uncertain, contact your health visitor or GP.

Summary: Your Key Actions

  1. Observe — Know each child's development across the seven EYFS areas
  2. Document — Keep dated observations; note specific examples
  3. Discuss — Talk with parents early if you notice delays
  4. Plan — Agree on strategies to support development
  5. Refer — Contact Health Visitor if concerns persist after targeted support
  6. Record — Keep notes of observations, conversations, and referrals
  7. Support — Implement any strategies recommended by specialists

Companion Resources from PolicyAndPlay

Use these tools alongside this guide to document concerns and communicate with parents professionally.

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Developmental Observation Form

Document concerns across EYFS areas, track red flags, and plan next steps with this interactive form.

Use Form →
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Parent Communication Templates

Professional email templates, conversation guidance, and meeting records for discussing concerns with parents.

View Templates →
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Development Statements Bank

Complete EYFS reference consolidating Development Matters, Birth to 5 Matters and ELG framework for observations.

Explore Bank →