The child’s neuromuscular development should be tracked with a standard assessment tool such as the Denver Developmental Screening Test. If these tools are used conscientiously, they can illustrate subtle developmental problems that might otherwise go unnoticed. They also allow the early detection of medical problems, such as hearing impairment, that must be treated promptly to prevent disruption of the child’s development.

The standards of care for pediatric preventive medicine are stringent. The federal maternal and child health programs set explicit standards for developmental screening. A physician in private practice cannot justify a lower standard of care for health assessment than the child would receive in a community health center or from the local health department.