A study of the methods used by 20 general practitioners to perform developmental screening examinations of preschool children showed that routine physical examination was adequately performed but at the expense of additional tests of child development. A total of 348 children were examined by either a doctor (144 cases) or a health visitor (90), or both (114). The degree of participation by health visitors suggests that developmental screening need not necessarily be the sole responsibility of doctors, and health visitors should have training opportunities as they have an important contribution to make in this area of child care. Some omissions in testing hearing, vision, and language were clearly due to conflicting demands on the general practitioners' time, but some tests were not performed because the doctors doubted their value. Nevertheless, too many children still enter school with hearing, visual, and speech handicaps that could have been easily identified. If preventive medicine is to become an increasing component of general practice, the methods used by doctors and health visitors must be scrutinised before attempting to evaluate the outcome of large-scale screening programmes.
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