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Related Experiment Video

Updated: Jun 19, 2026

Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses

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Published on: January 23, 2017

Screening for developmental delay at 18 months using the Infant Toddler Checklist: A validation study.

Cornelia M Borkhoff^1,2, Haris Imsirovic³, Imaan Bayoumi^3,4

¹Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.

|June 26, 2025

Summary

The Infant Toddler Checklist (ITC) shows high specificity for detecting developmental concerns in toddlers. While it has low sensitivity, a positive ITC score predicts increased healthcare use, including neurodevelopmental consultations.

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Published on: March 17, 2023

Area of Science:

Pediatric Health
Developmental Pediatrics
Health Services Research

Background:

Early detection of developmental concerns is crucial for timely intervention.
The Infant Toddler Checklist (ITC) is a potential tool for screening at the 18-month well-child visit.
Understanding the predictive validity and healthcare utilization associated with positive ITC screening is important.

Purpose of the Study:

To examine the predictive validity of the Infant Toddler Checklist (ITC).
To assess the association between positive ITC screening and subsequent healthcare utilization (HCU).

Main Methods:

Prospective cohort study of 1460 children at their 18-month primary care visit.
Parents completed the ITC; health administrative databases tracked healthcare utilization.
Neurodevelopmental consultation was the primary outcome measure.

Main Results:

11% of children screened ITC positive; 2.6% received a neurodevelopmental consultation by age 8.
The ITC demonstrated 40% sensitivity and 90% specificity for detecting neurodevelopmental consultation.
A positive ITC was significantly associated with increased rates of 6 of 7 HCU types, including neurodevelopmental consultation (aRR 2.78).

Conclusions:

The ITC exhibits high specificity and a low false positive rate, minimizing unnecessary anxiety and resource use for most children.
The low sensitivity of the ITC underscores the necessity of continued developmental surveillance.
Findings suggest the ITC can be a valuable screening tool when complemented by ongoing developmental monitoring.