Health and development two year old reviews

Health and early education reviews for young children at the age of two.

In Oxfordshire, the two assessments at age two are complementary and equally important. They provide parents with a more complete picture of their child’s development while conveying the importance of early identification of needs and provision of support to ensure children’s health and good level of development:

Health and development review

This is completed by a health visitor when the child is aged 2 to 2 ½. This is a universal entitlement which is carried out in the context of the child’s family and home

This review uses Ages and Stages Questionnaires (ASQ-3 and ASQ:SE) to assess the child’s development in six domains: Communication, Gross motor skills, Fine motor skills, Problem solving, Personal-Social and Social-Emotional development.  Additional information is provided relating to public health messages, school readiness and access to early years education

A free ASQ-3 and the two-year review programme e-learning module provides more information.

Link health visitor

Every Early Years Provider has been allocated a link health visiting team to act as a point of contact between that provider and the health visiting service.

The role of the linked Health Visitor

The role of the Linked Health Visitor is:

  • to work in partnership with the provider
  • to liaise between the provider and Health Visiting service
  • to signpost to named HV team for the child should any concerns arise
  • to act as a public health contact for providers should they need advice on any current public health issues affecting that provision. This may then require signposting to other services or provision of health promotion.

Postcard and communication pathway

Communication tools for HVs and EY providers include:

  • HV postcard (electronic or a paper version) sent when there is a concern
  • the child’s red book
  • the communication pathway (pdf format, 295Kb) for sharing outcomes of the reviews and ‘what to do’ plan if concerns arise.


When the health review has been carried out, the Health Visitor will complete and send an electronic postcard securely via NHS mail to an identified setting and the parent has given consent. This will happen if the health visitor has concerns about developmental, emotional, or social skills.

On receipt of the first secure email, providers will be prompted to set up a password for access. Accessing+Encrypted+Emails+Guide

If the health visitor has no concerns about a child, practitioners will not be notified of the health review, however information from the review will continue to be recorded in the child’s red book; which you can request from parents.

If you have concerns about a child and would like to liaise with the Health Visitor, please get in touch

Childminders should receive postcards in the same way that settings do, as long as the parent provides the health visitor with the childminder’s contact details and this is where the child attends for the majority of sessions.

If the child is not currently in a setting then the postcard will be given to the parent/carer to pass on when they begin attending so please ask for this or the Red Book

If a child has not had a 2-year health review, encourage the parent to contact their Health Visitor or you could highlight this to the Health Visiting team and they will contact the parent (providing you obtain consent from the parent to contact the HV).

The postcard will identify the contact details of the Health Visitor that has seen the child and provide a brief outline of any concerns. This information can be used to help guide your support for the child, and to help you prepare for the EYFS progress check at 2 ½ -3 years of age.

If when a postcard is received and you also have questions and would like to liaise with the Health Visitor, please use the contact details on the card to get in touch.

If any more significant concerns are identified, then the Health Visitor will contact the setting directly to discuss a joint approach of support to the child and family.

This communication pathway following a child’s health review at 2 - 2 ½ sets out a process of communication and partnership working between Oxford Health NHS and Early Years sector to support concerns about a child’s development.

The EYFS progress check at age 2

The Early Years Foundation Stage Statutory Framework (EYFS) requires that practitioners must review children’s progress and provide parents and/or carers with a short-written summary of their child’s development in the prime areas: Personal, Social and Emotional Development, Physical Development and Communication and Language. In Oxfordshire, practitioners are advised to carry out the progress check when a child is aged between 2 ½ - 3.

Progress check

The summary must:

  • highlight areas in which the child is progressing well
  • highlight areas in which some additional support might be needed
  • focus particularly on any areas where there is a significant concern that may indicate a special educational need or disability
  • describe the activities and strategies the provider intends to adopt to address any issues or concerns

Where any needs in areas of development are identified, providers should discuss how they will support the child, in partnership with parents and other professionals (for example, health visitor) as appropriate.

There is no prescribed or standard format for the progress check summary – below are some provider examples.

Information for parents

Resources to display in your setting or give to parents to raise awareness of the 2 year old checks: