AbstractThe early years are a critical period that can impact development across the life course in both negative and pos-itive ways. Identification of children who have or may be at risk for delay is an area fraught with challenges related to how and when to do surveillance and screening, what tools to use, as well as the necessary conditions for assessments. We pro-pose that efforts to identify childrenwith developmental prob-lems use a system of developmental surveillance that focuses onmeasuring parental concerns as developmental temperature taking along with contextual risk factors. Furthermore, we propose to move to a process of developmental surveillance that incorporates the 4M’s: many eyes, many times, many measures, and many situations, concepts that address the in-herent limitations of traditional screening. KeywordsSurveillance.Screening. Parental concerns. Early years. Developmental disorders