Health Visitor Developmental Reviews: What New Parents Need to Know

A short guide to the 9–12 month and 2–2½ year checks, the Ages and Stages Questionnaire, and how to walk in prepared rather than panicked.

At intervals through your baby’s early life, a specially trained nurse or midwife will check in on how you and your baby are doing. These health visits and developmental reviews can feel exciting, daunting and confusing all at once.

In the latest episode of the Science Baby Podcast, we take a deep dive into why they happen, what they involve, and how you can best prepare for them.

What is the health visiting service?

Health visitors are qualified nurses or midwives with additional specialist training to support families in the community. Unlike much of the NHS, the service is proactive: it comes to you. It traces back to 1862 in Manchester and Salford, where “sanitary visitors” were sent into homes to support families and reduce the era’s high infant mortality. There’s an unbroken line to today’s NHS Healthy Child Programme, which supports families from pregnancy until a child starts school.

The handover works like this: a midwife cares for you through pregnancy and the early days, until your baby regains their birth weight; you then move to the health visiting service. Crucially, this is not a social services check: it’s a “you’re a new parent with a new child, is everything okay?” check-in.

One thing to expect: provision varies a lot by area. Some families get an antenatal visit, others don’t; some are seen at home, others at a clinic or hub. If your experience differs from a friend’s, that’s normal.

The two developmental reviews

After the early weeks of weighing and measuring, there are typically two longer, in-depth reviews focused on how your child is developing:

9 to 12 months
2 to 2½ years

Each involves a questionnaire you complete in advance, then a home or clinic visit lasting around 45 minutes to an hour. The key principle: development happens across a wide range. The review checks whether a child is moving towards expected milestones, not whether they’ve ticked every box on a precise schedule.

The Ages and Stages Questionnaire (ASQ-3)

The core tool is the Ages and Stages Questionnaire, third edition (ASQ-3) — one of the most widely validated developmental screeners in use. It’s designed to be parent-friendly: rather than an exam, it describes things you observe your child doing naturally, plus simple activities to try at home beforehand.

It screens five developmental areas:

Communication — at 9–12 months, making sounds and word-sounds (“ba-ba,” “da-da”) and responding to simple commands; by 2 years, understanding words, body parts, pronouns and relationship words like “under” and “behind.” Comprehension matters more than perfect pronunciation.
Gross motor — at 9–12 months, sitting unaided and bearing weight on the legs while holding on; by 2 years, walking, kicking a ball, climbing stairs and jumping.
Fine motor — at 9–12 months, picking up small objects with finger and thumb; by 2 years, stacking blocks, threading, and copying lines, as control travels up the arm.
Problem solving — at 9–12 months, handling and combining objects and showing object permanence (looking for a hidden toy); by 2 years, continuing patterns, completing a drawing, and the mirror test (recognising themselves), plus the start of pretend play.
Personal-social — at 9–12 months, sharing toys and interacting during play; by 2 years, growing independence such as using “I” and “me” and starting to dress themselves.

How it’s scored: each item is marked 0 (not yet), 5 (sometimes) or 10 (yes). Totals for each area are compared against a cut-off: above it means development appears on track; the “monitoring zone” means keep an eye and try some activities; below it means a closer look may help. It’s a screening tool, not a diagnosis.

The questionnaire also has free-text space to note anything you want to raise, worries or wins. Treat it as a memory aid for the conversation, not a grade.

*Being able to kick a ball is just one of many skills assesed in the 2.5 year questionnaire*

What to expect from the visit

The questionnaire is only half of it; the other half is about you. The health visitor will ask how you’re feeling and coping, and what support you have. In many areas this is formalised through validated screening for postnatal depression and perinatal anxiety (using tools such as the Whooley questions, GAD-2 or the Edinburgh Postnatal Depression Scale). Postnatal depression affects roughly one in ten new mothers, and partners can be affected too — so this is a genuine, supportive opportunity to talk, not a box-tick.

When it doesn’t go to plan

The same review can feel completely different depending on the health visitor and the words they use. The same worry: “my baby isn’t crawling yet”, can land as a verdict (“that’s a concern; what do you want to do about it?”) or as reassurance (“there’s a big leap between 9 and 12 months; shall I call you in eight weeks?”). A few things help to remember:

Going in with no idea what to expect does much of the damage. Knowing the format helps.
There’s real subjectivity in the form, and the printed scoring grid can sting more than it should.
If a review leaves you shaken, go back to the team. It is not social services; you will not lose your child for raising a concern. They are there to support you.

How to prepare (without treating it like an exam)

Look at the questionnaire in advance and try the activities — your child may be able to do things you’ve never thought to ask.
Find alternative routes: if they won’t do exactly what an item describes, note how they show the same skill another way, so a potential “fail” becomes a useful conversation.
Use the free-text boxes as your notes.
Spend time genuinely noticing your child — useful for the review, and quietly enriching.

The bottom line

A developmental review is not a test, and there’s no pass or fail for your child or for you. It’s a structured check-in at a stage when new skills appear almost weekly, designed to celebrate progress and gently flag anything that might benefit from a closer look or a referral to services you may not know exist. The experience varies hugely by area and by person, so a wobbly one says nothing about you as a parent.

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Sources are for general information and reflect guidance current at the time of writing; provision varies by area, so check your local NHS service for specifics.

The Science Baby