This cross sectional study of a stratified sample of children from 0-3 years has two objectives; to evaluate screening tools for early detection of physical abnormalities and to standardize a culturally sensitive developmental tool to screen children and to look at the influence of socio-demographic variables on child development. The sample included three residential areas of village, city and refugee camp and drawn from 66 Mother and Child Health clinics in the West Bank and the Gaza Strip. Children were screened for physical abnormalities through family and child history, parental concern and physical examination; those with abnormalities were referred to specialists for further assessment.The developmental tool was compiled from international tools, translated to Arabic then piloted and modified. It was administered through interview with the main caregiver with the child present. Of 2053 children surveyed,11.3% were referred to specialists. Physical examination and parental concern had the highest yield and positive predictive values. Multiple regression models explained more than 70% of the variance in child development.