Integrated two and a half year old review

Integrated two and a half year old review

Information about the two and a half year old review and what is involved.

The integrated review at age two has retained all key aspects of the existing two-year progress check and Healthy Child Programme (HCP) health and development review, as set out in key governmental guidance.

Through developing communication links between health visitors, early years practitioners and parents or carers, a more complete, holistic picture of a child’s progress can be gathered, identifying developmental needs and offering timely support or interventions.

The integrated two and a half year old review should:

  • improve multiagency working and sharing of information to support families
  • reduce duplication
  • provide clearer and more consistent information for parents or carers
  • provide a more holistic understanding of a child’s needs
  • provide earlier identification of needs and earlier access to support
  • contribute to improved outcomes for children, including improved school readiness

The process

Education settings

Childcare settings ensure admissions and registration includes ‘consent to share information with other professionals’, (and is signed by parent or carers.)


Education settings

Childcare setting to publicise the integrated review to parents by:

letter to parents or carers when child reaches 2 years of age, providing information about the process of the progress check and how this links to the Health and Development Review (HDR) provided by Public Health Nursing Team (PHNT)
newsletters, notice boards, posters, starter pack information or key person


Education settings

Ask parents to notify key person date of their child’s HDR is known (Letters are sent by post or electronically by PHNT usually two weeks before appointment).


Health settings

Letter to parents or carers regarding date of their child’s HDR and providing information about the link with the nursery setting progress check at age two.


Education settings

practitioner to discuss the child’s development with parents or carers and complete the progress check between two years and two years three months, where possible. (See top tips for more information)
practitioner places parent or carers copy of progress check into the child’s red book, for sharing with PHNT and other professionals as relevant
If permission to share is not given, record when and by whom the progress check was completed. (Use the red book notes pages).


Education settings

if any concerns about the child’s development: early years practitioner to contact the PHNT prior to the HDR (with parents or carers consent)
contact the early years area SENDCO or other professionals, if required
Health settings

HDR completed by the PHNT between two years three months and two years six months, EYFS progress check is accessed from the red book and any identified concerns note  and discussed with parent or carer
a member of the PHNT completes an ASQ information summary for parent to place in the red book and advises parent or carer to share any concerns or recommendations with Early Years setting


Ask parents or carers for feedback from the HDR with the PHNT

if any concerns arise from the progress check or HDR the person identifying these should complete an Early Help Assessment, followed by either referral to appropriate specialist support or a multidisciplinary meeting with parents or carers, health professionals, Early Years setting and other professionals, as required.
implement support for the child


Also note:

If the progress check at age two is completed after the HDR:

  • practitioner should discuss the HDR with the parents or carers and look at the information in the red book from the PHNT
  • if any concerns from the progress check or HDR complete an Early Help Assessment, followed by either referral to specialist support or a multidisciplinary meeting with the parents or carers, health and any other professionals, as required

If you are concerned about a child and feel that they may be in need of protection or safeguarding raise a Cause for Concern

What are the statutory requirements?

Early years progress check at age 2

When a child is aged between two and three, practitioners must review their progress, and provide parents or carers with a short written summary of their child’s development in the prime areas. This is outlined in the Statutory framework for the early years foundation stage, 2014, p.13, 2.3.

Health and development review at age 2 to 2 and a half

Healthy Child Programme (universal offer): Ages and Stages Questionnaire (ASQ) developmental review. This is a parent or carer completed questionnaire, designed to screen the developmental performance of children in the areas of communication, gross motor skills, fine motor skills, problem solving and personal-social skills.

During assessment; dental health, accident prevention, sleep management, toilet training and providing sources of parenting advice and family information are discussed.

Top tips for integrated two and a half year old review process

Communication is imperative for the success of the integrated two year review

An equal partnership needs to be developed to ensure early intervention. Key to this is picking up the phone or sending an email when you have concerns about a child. (Permission must be sought from parents or carers before contacting other professionals).

When should a practitioner complete the check?

Practitioners should only complete the check when they are confident they know their key child well enough to write a short summary of the child’s development in the prime areas. Where possible, complete this prior to the health and development review by the health visitors.

Parents should have a voice prior to finalising the progress check at age two

Practitioners should share and discuss the child’s development with parents.

Encourage parents to share the child’s Personal Child Health Record (PCHR) red book on entry to the setting

This should be used on an ongoing basis for communicating between professionals about health and development. Encourage parents or carers to always have the red book available. The PCHR contains useful information, such as the child’s expected date of delivery, immunisations, and health and development that you can use to inform your on entry information. Practitioners should be familiar with the PCHR, the health and development review

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