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 2020 and March 2021.

Main points

  • In 2020/21, 10% of children who received a 13-15 month review, 15% of those at 27-30 month review, and 13% of those at 4-5 year review had a concern noted about at least one area of their development.
  • There was a small increase in the proportion of children who had a developmental concern recorded at the 27-30 month review, from 14% in 2019/20 to 15% in 2020/21. Speech, language and communication remains the most frequent developmental domain in which concerns are noted at this stage.
Image caption Percentage of developmental concerns recorded by domain, 2020/21
  • At the 13-15 month review most concerns were noted about gross motor (5%) and speech, language and communication development (5%); at the 4-5 year review most concerns were noted about speech, language and communication (6%), and emotional/behavioural development (6%).
  • There are persistent inequalities in the proportion of children who are found to have a developmental concern. At 27-30 months, this proportion is 2.6 times higher among children living in the most deprived areas (23%) than those in the least deprived (9%).


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, Ready Steady Toddler, and Parent Club.

Further information

The next release of this publication will be April 2023. 

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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