When children at risk for developmental variation are identified at a young age, their chances of success in school and in the future can be greatly enhanced through early intervention programs. Pediatric nurses in community and acute care settings are in key positions to identify children "at risk" and to make appropriate referrals. Nurses are encouraged to engage in "developmental surveillance," that is, a continuous awareness of all activities relating to the detection of developmental problems and the promotion of development during primary child care. A parental interview of six questions can assist the nurse in developmental surveillance and the identification of developmental variations. Once a child is identified as "at risk" the nurse should initiate referrals for more thorough evaluation, diagnosis, and, if warranted, intervention.