Universal Developmental Screening — A Strong Start for Children

Strong Start logo: Washington State's Universal Developmental Screening System
Photo of three diverse children playing together


We can give every child a strong start by making sure their development is on track. Regular screenings help determine whether a child is meeting developmental milestones. Screenings create opportunities to celebrate each child’s strengths and address any concerns.

Parents, guardians, and health care providers can use Strong Start: Washington State’s Universal Developmental Screening System to track screenings.

    Strong Start

    • Is FREE to use statewide
    • Tracks screenings of children birth through age 5
    • Is safe, secure, and confidential
    • Creates a lifetime record that parents can share with early learning partners and health care providers
    three children smiling and looking toward the camera

    Information for parents and guardians

    adult male reading to child

    Regular screenings can help your child get the best possible health care. Screenings happen in a variety of places—from doctors’ offices to preschools to child-care programs. When your child’s doctor, teachers, and child-care providers give you screening results, you can enter them into Strong Start. It’s an easy, centralized way to keep track of screening records.

    Use Strong Start to record information from a screening that has already been completed. You won’t have to keep track of paper records once you enter screening results into Strong Start!

    With Strong Start:

    • You control the information that is being entered.
    • Your child’s health care provider can access records and enter screening results, too. You control who else can see the information.
    • You will make decisions about next steps and any interventions.
    • You won’t miss screenings, and you’ll avoid duplicate screenings.
    • You’ll have a record that you can use to document your child’s eligibility for programs.

    Getting started

    Ready to use Strong Start? Check out our Strong Start Access Guide (PDF).


    Want to learn more? Read our Frequently Asked Questions for Parents and Guardians.

    Community Resources

    Looking for early childhood supports? Connect with these community resources:

    Help Me Grow Washington

    • Free child developmental screening for all kids under 5 (no waiting lists or income requirements)
    • Connections to services and supports that are close to home like parenting classes, diaper banks, medical clinics, and food banks
    • Activities and games that support healthy growth and learning; or, if your child needs extra support, connections to resources and specialists who can help
    • Additional family supports such as food assistance resources and free or low-cost health insurance

    Not finding what you’re looking for in the Help Me Grow online directory? Call the Help Me Grow hotline to speak with a Family Resource Navigator: 1-800-322-2588. Services are available in multiple languages.

    Washington Communities for Children

    • Who we are: A network of coalitions, organizations, and individuals who come together to improve child and family well-being. Ten regions across Washington state, with hundreds of partners, make up the network. Many members have experience with developmental screening and support. We work collaboratively to strengthen how families access resources and support their child's development.
    • What we offer: Need help getting connected? WCFC is organized around six Learning Networks — Family Voice, Health Provider Voice, Equity, Data, Policy & Advocacy, and Resource Navigation & Access. We meet regularly to build relationships, learn together, identify challenges, and test ideas.
    • Connect with us! To learn more about the Learning Networks, or get connected to a Regional Coalition, visit the Washington Communities for Children website.

    Child Care Aware Washington

    • Child-care referrals, early learning resources, and connections with community resources for families across Washington.
    • Mental Health consultation to child-care providers and the families they serve. Learn more about Holding Hope consultation.
    • Supports for the ASQ screening implementation for child-care providers and caregivers.
    • Training and coaching supports for on-going child assessment practices for child-care providers.
    • Help for families experiencing homelessness, needing help paying for child-care, and seeking care options to meet a child’s or family’s specific needs.
    • Resources for child care providers, including professional development, quality improvement, business supports, and advocacy.

    Not finding what you’re looking for in your Child Care Aware online search? Call the Family Center to speak with a child care expert: 1-800-446-1114. Services are available in multiple languages.

    Curious about the screening tools included in Strong Start? Find information about:

    Information for health care providers

    male doctor making faces with child held by parents

    Strong Start is an easy-to-use system that will help you provide better care and coordination for children.

    With Strong Start:

    • You can enter and track developmental screening results. Parents and guardians can also enter records.
    • You can see the history of screenings no matter where they were done.
    • You can avoid unnecessary duplicate screenings.

    Getting Started

    Ready to use Strong Start? Check out our Strong Start Access Guide (PDF).


    Want to learn more? Read our Frequently Asked Questions for Health Care Providers.

    "We all lead busy lives as parents, educators and health care providers. But we can do better by our children and join forces to give them the strong start they each deserve from the very beginning.

    Let us come together with this tool and celebrate all the developmental milestones a child is meeting. If they happen to not meet all of them, let us all get on the same page, partner together and act early.

    Reach out and speak up for them. Early support is available for children under 3 years and in school districts for ages 3 and up. These resources build on what families are already doing at home. We need to empower families and each other to highlight a child's strengths and celebrate their successes in areas where they need a bit more support."

    Christina L. Pease, MD
    Sea Mar Community Health Centers

    headshot of Christina L Pease

    Tools included in the Strong Start UDS System:

    Find a quick reference guide to these tools on the Frequently Asked Questions for Health Care Providers.

    Billing for developmental screening:  Developmental screenings are billable to Apple Health (Washington’s Medicaid). Private insurance varies; we recommend checking with your clinic administrator. More information: “How to bill” in the Frequently Asked Questions for Health Care Providers.

    Information for early childhood partners

    female teacher playing with toy telephone held by child

    Strong Start is an easy, centralized way to keep track of developmental screening records. Parents, guardians, and healthcare providers can use it to enter the results of screenings that have already been completed, wherever they happen. Families will have an ongoing record they can share with early learning partners like you. This will help ensure children get screenings when they need them. It will also help prevent duplicate screenings.

    Are you an early care or early learning provider who conducts developmental screenings in your center?

    • If you complete the screening with the family, encourage parents to enter the results in Strong Start. That way they will have a lifetime record of their child’s screenings that they can access any time.
    • If the child has been screened somewhere else and their information has been entered into Strong Start, parents will be able to share the results with you, avoiding a duplicate screening.

    As the system becomes more widely used, we will be able to generate reports that can be useful to early care and early learning providers. Note: no individual records will be identified in any reports. The summary data will help us know where screenings are taking place, and if families are getting connected to needed support.


    Want to learn more? Read our Frequently Asked Questions for Early Learning Partners.

    A word about our partners

    Strong Start: Washington State’s Universal Developmental Screening System was developed in collaboration with state partners, including:

    And with invaluable input from local health jurisdictions (LHJs), tribal partners, and parents and families from across the state. We are grateful to all and look forward to continuing collaboration!

    Contact us

    Have more questions? Reach us at UnivDevScrn@doh.wa.gov or call 833-887-0195 (toll-free).