Developmental examination is part of the process of identifying children at risk of poor developmental outcomes. Development is a rapidly changing process with large variations within the population and for the same child, which limits the sensitivity and specificity of any examination method. There is now a good body of scientific knowledge and an evidence base for improving the examination method and clinical decision-making. The four main components of this examination are eliciting concerns, gathering information on social and biological risk factors, making structured observations of spontaneous and elicited behaviour, and interpreting findings with knowledge both of the features which raise significant concerns and of common behavioural phenotypes of developmental disorders. The focus of developmental examination needs to shift from simply 'measuring' development to informing the developmental profile of a child's needs and identifying children at risk of adverse outcomes. The objective of helping the child is best achieved when the interpretation of findings, management guidance and management plan are shared through good communication with parents, carers and other agencies.