About this release

This release by Public Health Scotland provides an update on children’s development as assessed during the 13-15 month, 27-30 month, and 4-5 year child health reviews. The latest information presented comes from reviews provided to children becoming eligible for review between April 2019 and March 2020.

Main points

  • In 2019/20, 10% of children undergoing a 13-15 month review, 14% of children at 27-30 month review, and 13% of children at 4-5 year review, had a concern recorded about at least one area of their development.
  • At 13-15 months most concerns were recorded about gross motor (5%), and speech, language and communication development (4%). At 27-30 months and 4-5 years most concerns were recorded about speech, language and communication (10% and 6% respectively), and emotional and behavioural development (5% for both).



Image caption Percentage of children with a new/previous concern recorded at 13-15 month, 27-30 month, and 4-5 year reviews by developmental domain, Scotland, 2019/20
Chart showing the percentage of children with a new or previous concern recorded at 13-15 month, 27-30 month and 4-5 year reviews by developmental domain.
  • Some groups of children were more likely than others to have a concern recorded about their development. For example, at the 27-30 month review at least one concern was recorded for a higher percentage of boys than girls (19% compared with 10%), for children living in the most deprived areas of Scotland than those in the least deprived areas (22% compared with 8%), and for children who were looked after by their Local Authority than those who were not (34% compared with 14%).


Early child development is influenced by both biological factors (such as being born premature) and environmental factors (such as the parenting and opportunities for play and exploration children receive). Problems with early child development are important as they are strongly associated with long-term health, educational, and wider social difficulties.

Detecting developmental problems early provides the best opportunity to support children and families to improve outcomes. There is good evidence that parenting support and enriched early learning opportunities can improve outcomes for children with, or at risk of, developmental delay. There is also increasing evidence that intensive early interventions for children with serious developmental problems can also improve outcomes.

All children in Scotland are offered the child health programme which includes a series of child health reviews, including an assessment of children’s development at 13-15 months, 27-30 months and 4-5 years. These reviews involve asking parents about their child’s progress, carefully observing the child, and supporting parents to complete a structured questionnaire about the child’s development. At the end of the review Health Visitors record whether they have any concerns about each area of the child’s development.

Information for parents on early child development, and promoting good development, is available through Ready Steady Baby (external website), Ready Steady Toddler (external website), and Parent Club (external website).

Further information

Data from this publication are available from the data files in the interactive data visualisation.

PHS publishes a wide range of information on Child Health including infant feeding, immunisations, and Primary 1 Body mass Index (BMI). Further information is available on the Data and Intelligence website (external website).

The next release of this publication will be in April 2022.

General enquiries

If you have an enquiry relating to this publication, please email phs.childhealthstats@phs.scot.

Media enquiries

If you have a media enquiry relating to this publication, please contact the Communications and Engagement team.

Requesting other formats and reporting issues

If you require publications or documents in other formats, please email phs.otherformats@phs.scot.

To report any issues with a publication, please email phs.generalpublications@phs.scot.

Older versions of this publication

Versions of this publication released before 16 March 2020 may be found on the Data and Intelligence, Health Protection Scotland or Improving Health websites.

Last updated: 21 March 2024
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