Early Screening for Intellectual Disability: A First Step for Parents and Teachers

When a child is slow to speak their first words, takes longer to walk than other children the same age, or seems to struggle with tasks their peers handle easily, it can leave parents and teachers with many questions. These signs don’t always mean something is wrong – but they shouldn’t be dismissed either. The first practical step in making sense of these concerns is screening: a simple, structured process of observation that helps identify whether a child needs a closer look. Screening for intellectual disability isn’t about labelling a child. It is about making sure no child misses the support they deserve, as early as possible.

What screening is – and what it isn’t 🔗

Screening is the preliminary step in identifying whether a child may have a developmental disability, including an intellectual disability. It is not a diagnosis. According to the Early Childhood Technical Assistance Center, a developmental screening tool asks questions about a child’s development across language, motor, cognitive, social, and emotional areas – and then indicates whether a closer specialist assessment is needed. The results do not confirm a condition; they flag a possibility.

This distinction is important for parents and teachers to understand. A screening result saying a child “needs further evaluation” does not mean the child has an intellectual disability. It simply means a more thorough assessment should follow. On the other hand, skipping screening entirely – or taking a passive “wait and see” approach – is one of the most common barriers to early identification. Research from the CDC’s National Center on Birth Defects and Developmental Disabilities shows that families and professionals who delay acting on concerns often deprive children of timely support that could meaningfully improve their outcomes.

Why early identification matters 🔗

The goal of screening is to catch potential delays as early as possible, so that intervention can begin before a child falls too far behind. Studies consistently show that early identification of developmental disabilities can improve a child’s developmental skills and intellectual functioning, and can empower families to seek the services their child needs. When children receive targeted support early – whether it is speech therapy, special education, or occupational therapy – their ability to learn, communicate, and participate in daily life improves significantly.

In a school setting, early identification also means teachers can adapt their classroom strategies before a child experiences repeated failure. As noted in research on inclusive education, early screening helps avoid unnecessary and unscientific labelling of children, while allowing teachers to focus their attention more effectively on students who need it.

Using developmental milestones to spot delays 🔗

At the heart of any screening process is an understanding of developmental milestones – the skills and behaviours that children typically achieve at certain ages. These include physical abilities like sitting, crawling, and walking; communication skills like babbling and forming words; cognitive skills like following instructions or solving simple puzzles; and social behaviours like smiling, making eye contact, and playing with others.

According to MedlinePlus, developmental screening tools compare a child’s milestones against those of other children the same age. If a child is developing at a noticeably slower rate, this may indicate a developmental disability. For example, by 9 months, most children babble, understand the word “no,” and pull themselves to standing. By 18 months, most children are walking, using several words, and beginning to eat with a spoon. A child who is significantly behind in several of these areas at these ages warrants further attention.

It is important to note that milestones are ranges, not fixed deadlines. Children develop at varying paces, and a slight delay in one area alone is rarely cause for alarm. However, delays across multiple domains – motor, language, social, and cognitive – are a stronger signal. Clinical research on global developmental delay confirms that delays across two or more developmental domains, particularly before age five, warrant evaluation for intellectual disability.

A peer-reviewed study on the predictive validity of developmental milestones found that certain specific milestones – such as balancing the head while sitting at 9 months and babbling while playing – are highly predictive of later intellectual functioning when not achieved at the expected age. This reinforces that structured milestone-based screening, rather than casual observation, is a reliable first filter.

Tools for screening: schedules and PRASHAST 🔗

For structured, practical screening, specific tools have been developed to guide parents, teachers, and community workers through the process systematically.

Screening schedules 🔗

Screening schedules are standardised questionnaires or checklists organised by age and developmental domain. They list expected behaviours and skills at specific ages, and the screener simply records whether the child has achieved each one. These schedules draw from established population norms – meaning the milestones included have been validated through large-scale studies to reflect what most children achieve at a given age.

The American Academy of Pediatrics recommends standardised screening at regular intervals during early childhood, specifically noting that a single screening is less reliable than repeated, scheduled screenings over time – particularly for skills like language that develop later. The same principle applies in school and community settings: periodic, structured observation using a checklist gives a far more accurate picture than a one-time impression.

PRASHAST: India’s school-based screening tool 🔗

In the Indian context, one of the most significant tools available to teachers is PRASHAST – which stands for Pre-Assessment Holistic Screening Tool. Developed by the Central Institute of Educational Technology (CIET) under NCERT, PRASHAST is a disability screening checklist designed for use in schools across India. It is structured around the 21 disability conditions recognised under the Rights of Persons with Disabilities (RPwD) Act, 2016, which includes intellectual disability, autism spectrum disorder, specific learning disabilities, and others.

PRASHAST is divided into two parts. Part 1 is meant for regular classroom teachers. It contains straightforward, observable indicators – such as whether a student speaks clearly, responds when called, or walks typically – that any teacher can assess through daily interaction. Part 2 is for special educators, counsellors, or school heads, and is used to validate and further examine the findings from Part 1. Students who are flagged through both parts are then referred to assessment camps for formal identification and certification.

Crucially, PRASHAST has been made available in 23 languages, including all 22 languages in the Eighth Schedule of the Indian Constitution, making it accessible to teachers across all regions of the country. A mobile app version is also available, which enables teachers and school heads to conduct screenings digitally and generate school-level reports for authorities to plan disability assessment camps.

For conditions like intellectual disability, which are less visibly apparent than physical disabilities, PRASHAST’s structured behavioural indicators play a key role. As the NCERT documentation on PRASHAST notes, disability conditions such as intellectual disability and autism often remain unidentified because they are not readily visible, making a structured checklist particularly valuable for early school-level identification.

Who can screen and how it should be done 🔗

One of the strengths of screening – as distinct from formal assessment – is that it does not require clinical expertise. Screening can be done by anyone who is in a position to carefully observe a child or speak with their family: a classroom teacher, a parent, an anganwadi worker, or a community health volunteer. What matters is the quality and consistency of observation, not professional credentials.

That said, there are clear best practices that make screening more reliable.

Observe on multiple occasions 🔗

A child’s behaviour on any single day can be influenced by factors that have nothing to do with their developmental status – they may be unwell, anxious, distracted, or simply having a difficult day. The American Academy of Pediatrics emphasises that repeated and regular screening is more likely than a single screen to identify genuine developmental problems, especially for skills that emerge later. A screener should observe the child across different activities and different days before drawing conclusions.

Cross-check with family members 🔗

Parents and caregivers are the most consistent observers of a child’s behaviour. They see the child across many contexts – at home, during meals, while playing, during routines – over months and years. Best practice in assessment and screening consistently recommends gathering information from multiple informants, particularly parents, to build a complete picture. If a teacher notices a concern, cross-checking with parents can confirm whether the pattern holds at home as well – or reveal that the difficulty is context-specific.

Avoid relying on a single indicator 🔗

No single behaviour or missed milestone should be treated as conclusive. Screening tools work because they look at patterns across multiple developmental domains simultaneously. A child who is behind in language but developing well in motor and social domains presents a very different profile from one who shows delays across all three. The overall pattern matters more than any individual item on a checklist.

The right time and setting for observation 🔗

Where and when a child is observed during screening has a direct impact on the accuracy of the results. Children do not perform their best in unfamiliar or high-pressure situations. A child who is shy, nervous, or in an unfamiliar room may appear far less capable than they actually are – or, conversely, the stress of the setting may mask a real difficulty.

The most accurate screening happens when the child is observed during their natural daily routine – eating, playing, interacting with familiar people, or participating in classroom activities they are used to. A familiar environment brings out a child’s typical behaviour, which is precisely what screeners need to see. The Early Childhood Technical Assistance Center confirms that children’s development can be observed on an ongoing basis in programme settings at home or wherever children spend their time – not just in clinical or formal settings.

For teachers, this means that the classroom, the playground, and transition times between activities are all valid and valuable screening contexts. For parents, it means that a child’s behaviour during mealtimes, bath time, or play at home is just as informative as any formal test. The key is to observe the child doing what they naturally do, with the people they are comfortable with, in a setting they know.

Screening is a beginning, not an end 🔗

It bears repeating: screening is the starting point, not the finish line. A child who is flagged through a screening tool has not been diagnosed with intellectual disability – they have been identified as someone who would benefit from a more thorough assessment by a specialist. Research published in a 2025 ScienceDirect review on intellectual disability assessment underlines that early screening and diagnosis can reduce duplication of assessment processes, shorten waiting times, and is an essential component of intervention planning. When screening is done well and followed up promptly, it sets in motion a chain of support that can genuinely change the trajectory of a child’s life.

For parents who have been quietly worried, and for teachers who have noticed something they couldn’t quite name, a structured screening tool offers a clear, practical first step – one that replaces uncertainty with action.

What do you think? If a child in your classroom or family shows delays in some developmental milestones but not others, how would you decide when it’s time to move beyond observation and seek a formal screening? And considering that screening can be done by teachers, parents, or community workers – what kind of training or support do you think these individuals need to use tools like PRASHAST effectively?

References

1. https://ectacenter.org/topics/earlyid/screeneval.asp
2. https://pmc.ncbi.nlm.nih.gov/articles/PMC10193264/
3. https://www.dailyexcelsior.com/prashast-a-disability-screening-tool-for-schools/
4. https://medlineplus.gov/lab-tests/developmental-and-behavioral-screening-tests/
5. https://www.e-cep.org/journal/view.php?number=20125555698
6. https://pmc.ncbi.nlm.nih.gov/articles/PMC6438572/
7. https://publications.aap.org/pediatrics/article/145/1/e20193449/36971/
8. https://ciet.ncert.gov.in/prashast
9. https://dsel.education.gov.in/en/node/2151
10. https://cdnbbsr.s3waas.gov.in/s32d2ca7eedf739ef4c3800713ec482e1a/uploads/2023/09/2023091562.pdf
11. https://idmhconnect.health/i-am-professional/mental-health-care-pathway/mental-health-professionals-and-gps/care-pathways/assessment
12. https://www.sciencedirect.com/science/article/abs/pii/S1751722225000897