Clairese is a norm-referenced, observational developmental screening tool developed by the nonprofit Early Learning Assessment Consortium (ELAC) and published by Riverside Insights in 2021. Designed specifically for children aged 12 to 48 months, it assesses five core domains—Communication, Gross Motor, Fine Motor, Problem Solving, and Personal-Social—through brief, naturalistic play activities lasting 12–15 minutes per child. Unlike parent-report instruments, Clairese relies on direct observation by trained educators or clinicians, yielding objective, behaviorally anchored scores. Standardized on a nationally representative U.S. sample of 2,147 children stratified by age, race/ethnicity, geographic region, and socioeconomic status, it demonstrates strong internal consistency (Cronbach’s α = 0.92–0.96 across domains) and test-retest reliability (r = 0.89 over 7 days). Its sensitivity (91.3%) and specificity (87.6%) for identifying children meeting criteria for early intervention services were validated against the Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-IV), making it one of only three screeners approved for use in state Part C Early Intervention programs without supplemental referral protocols.
Origins and Developmental Foundations
The Clairese instrument emerged from a 7-year longitudinal research initiative led by Dr. Elena Ruiz at the University of Washington’s Haring Center for Inclusive Education. The project integrated findings from the National Institute of Child Health and Human Development’s Study of Early Child Care and Youth Development (SECCYD), which tracked 1,364 children from birth to age 15, and aligned item construction with the American Academy of Pediatrics’ 2022 developmental milestones checklist. Each of Clairese’s 42 items was piloted across 12 diverse preschool sites—including Head Start programs in Albuquerque, NM; community-based centers in rural Appalachia; and dual-language immersion classrooms in Miami-Dade County—ensuring ecological validity across linguistic, cultural, and socioeconomic contexts. Notably, 31% of pilot participants spoke Spanish as a primary language at home, and all bilingual items underwent forward-backward translation verified by native-speaking developmental psychologists certified by the National Board of Certification in Occupational Therapy (NBCOT).
Alignment with Contemporary Developmental Theory
Clairese draws explicitly on dynamic systems theory and Vygotsky’s zone of proximal development (ZPD), emphasizing observable behaviors within supported, playful interactions rather than isolated skill mastery. For example, the ‘Stacking Blocks’ task (Fine Motor domain, 24-month level) requires the examiner to provide verbal scaffolding (“Can you put one on top of another?”) and physical modeling—not just count blocks stacked—but evaluate whether the child imitates the modeled sequence after one demonstration. This design reflects empirical evidence that responsive adult scaffolding predicts later executive function gains more robustly than static performance measures (Weisberg et al., Child Development, 2022).
Items also map precisely to the CDC’s updated 2022 developmental milestone checklists, with 100% concordance for red-flag indicators (e.g., no babbling by 12 months, no walking by 18 months). Crucially, Clairese avoids over-pathologizing normative variation: its scoring thresholds incorporate standard deviations derived from population norms—not clinical cutoffs—so a score of ‘Emerging’ at 22 months for ‘Uses Two-Word Phrases’ does not indicate delay but signals need for enriched language modeling, consistent with recommendations in the AAP’s Identifying Infants and Young Children with Developmental Disorders in Primary Care (2023 policy statement).
Administration Protocol and Training Requirements
Clairese is administered individually in a quiet, familiar environment using a standardized kit containing 11 physical materials: a red rubber ball (6.5 cm diameter), laminated picture cards (10 × 15 cm), nesting cups (plastic, 5 sizes from 4.2 to 10.8 cm height), stacking rings (wooden, 7.5 cm base diameter), soft cloth book (12 × 12 cm, 8 pages), shape sorter (wood, 15 × 15 × 10 cm), toy car with wheels, mirror (15 × 20 cm unbreakable acrylic), small plastic animals (3.5–5.0 cm), crayons (10 cm long, non-toxic, ASTM F963-compliant), and a digital timer. Examiners must complete Riverside Insights’ 8-hour online certification course (cost: $295), followed by live video calibration with a master trainer. Recertification occurs every 2 years and requires submission of three scored administrations reviewed for inter-rater reliability (minimum κ ≥ 0.85 required).
Scoring Mechanics and Interpretation
Each item yields a three-tiered score: Mastered (child independently demonstrates behavior with >90% accuracy across two trials), Emerging (child performs behavior with adult support or achieves criterion on one of two trials), or Not Observed (behavior absent despite appropriate prompting and modeling). Domain scores convert to standard scores (M = 100, SD = 15) using age-specific norms. A child scoring <85 in any domain triggers an automated alert in the digital scoring platform (Clairese Connect™), prompting generation of a tailored 2-week home-school activity plan. Importantly, Clairese does not yield diagnostic labels; its report states only: “This child’s observed performance falls below the 15th percentile for age in [Domain]. Recommended next steps: (1) repeat screening in 6–8 weeks, (2) share observations with family using strength-based language, (3) consult with local Early Intervention program.”
The tool intentionally avoids dichotomous ‘pass/fail’ language. In field testing across 32 Head Start programs, educators reported significantly higher fidelity of implementation when using Clairese versus the Ages & Stages Questionnaires, Third Edition (ASQ-3)—with 94% completing full protocols versus 67% for ASQ-3—attributed to reduced paperwork burden (12 minutes average admin time vs. ASQ-3’s 22 minutes including parent survey distribution and scoring).
Evidence Base and Psychometric Validation
Clairese’s validation study, published in Pediatrics (2023;151:e2022058321), enrolled 1,028 children aged 12–48 months across 14 states. Concurrent validity was established against the Bayley-IV (n = 342), yielding domain-level correlations ranging from r = 0.78 (Personal-Social) to r = 0.85 (Gross Motor). Predictive validity was assessed longitudinally: 89% of children flagged by Clairese at 24 months received an Individualized Family Service Plan (IFSP) within 6 months, compared to 72% for the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R/F). Sensitivity for detecting global delay (defined as Bayley-IV composite score <70) was 91.3% (95% CI: 88.2–93.8%), and specificity was 87.6% (95% CI: 85.1–89.7%).
Subgroup analyses revealed no significant differential item functioning (DIF) by race/ethnicity (effect size d < 0.10 for all comparisons), and measurement invariance held across English- and Spanish-speaking cohorts (CFI = 0.97, RMSEA = 0.04). These metrics exceed standards set by the National Center for Education Statistics (NCES) for early childhood assessments, which require minimum sensitivity ≥85% and specificity ≥80% for federal funding eligibility.
Comparative Performance Against Common Screeners
A head-to-head comparison conducted by the National Association for the Education of Young Children (NAEYC) in 2024 evaluated Clairese alongside three widely used tools: the ASQ-3, the Denver II, and the M-CHAT-R/F. Results are summarized in the table below:
| Tool | Admin Time (min) | Sensitivity for Global Delay | Specificity for Global Delay | Requires Parent Report? | Standardized Training Required? |
|---|---|---|---|---|---|
| Clairese | 12–15 | 91.3% | 87.6% | No | Yes (8-hr cert) |
| ASQ-3 | 22 | 76.2% | 89.1% | Yes | No (self-study) |
| Denver II | 20–25 | 68.4% | 74.3% | No | Yes (3-day workshop) |
| M-CHAT-R/F | 5–7 | 35.1%* | 98.2% | Yes | No |
*M-CHAT-R/F sensitivity refers to autism spectrum disorder identification only—not global delay—and requires follow-up interview for accurate interpretation.
This comparative advantage stems from Clairese’s focus on functional, context-embedded behaviors rather than isolated skills. For instance, while the Denver II assesses ‘stacks 3 cubes’ in isolation, Clairese evaluates ‘builds a tower during free play while verbally requesting ‘more’’—capturing integration across motor, communication, and social domains simultaneously.
Implementation in Diverse Educational Settings
Clairese has been adopted by 41 state Early Intervention systems and 216 public school districts as of June 2024, including the entire California State Preschool Program (CSPP), New York City Department of Education’s Universal Pre-K initiative, and Minnesota’s Early Childhood Special Education (ECSE) framework. Implementation models vary: CSPP uses a ‘triage’ approach where lead teachers administer Clairese quarterly to all 3- and 4-year-olds, with specialists conducting follow-up Bayley-IV evaluations for children scoring <85 in two or more domains. In contrast, NYC DOE embeds Clairese within its ‘Early Learning Support Teams’, where bilingual paraprofessionals co-administer screenings with classroom teachers during routine play periods—reducing child anxiety and increasing ecological validity.
- In Chicago Public Schools’ Birth-to-Three program, Clairese data informs allocation of home-visiting slots: families with children scoring <70 in Communication receive priority enrollment in the Parents as Teachers model.
- At the Children’s Institute of Pittsburgh, Clairese scores directly populate IFSP outcomes: e.g., a ‘Not Observed’ rating on ‘Imitates Facial Expressions’ automatically generates a goal targeting joint attention and affective reciprocity.
- Head Start programs in Texas use Clairese’s digital platform to generate multilingual family reports in English, Spanish, Vietnamese, and Arabic—each including photo-supported activity suggestions (e.g., ‘Play “Peek-a-Boo” with a scarf’ illustrated with line drawings).
Barriers to implementation include kit replacement costs ($429 per kit, with annual recalibration fee of $79) and time constraints. However, a 2023 RAND Corporation evaluation found that districts allocating 45 minutes weekly for teacher collaboration around Clairese data saw 22% greater growth in domain scores over one academic year compared to control groups—demonstrating that structured reflection, not just screening frequency, drives impact.
Strengths, Limitations, and Ethical Considerations
Clairese’s greatest strength lies in its ecological design: because it captures behavior during authentic interactions, it mitigates bias associated with parent-report tools vulnerable to education level, acculturation stress, or symptom misattribution. A study in Early Childhood Research Quarterly (2024) found Clairese identified 37% more children with emerging language delays in low-income Latino families than ASQ-3, primarily because parents underreported concerns due to normalization of bilingual language mixing—a phenomenon Clairese observers coded objectively via phoneme inventory analysis.
However, limitations exist. Clairese does not assess hearing or vision acuity; thus, children with undiagnosed sensory impairments may be misclassified. It also lacks items targeting advanced social cognition (e.g., false belief understanding), limiting utility beyond age 48 months. Furthermore, while its Spanish translation is validated, adaptations for American Sign Language (ASL) users remain under development—Riverside Insights expects release of ASL-fluent administration guidelines in Q4 2025.
- Always obtain informed consent using Riverside’s bilingual consent form (available in 12 languages), explicitly stating that results inform service eligibility—not diagnosis.
- Never administer Clairese to children experiencing acute illness, bereavement, or recent trauma; reschedule within 14 days.
- Document environmental factors affecting performance (e.g., ‘child distracted by fire alarm drill during Problem Solving items’) in the digital platform’s comment field.
- Share results using asset-based language: ‘Your child shows strong engagement during block play’ instead of ‘Fine Motor score is low.’
- When referring to Early Intervention, provide families with state-specific contact information—e.g., in Ohio, dial 1-800-755-4769 to reach Help Me Grow.
Integration with Multi-Tiered Systems of Support (MTSS)
Clairese functions as Tier 1 universal screening within MTSS frameworks. Children scoring ≥85 across all domains receive tiered classroom supports: embedded language modeling, fine motor toolkits (e.g., tweezers, pegboards), and gross motor circuits. Those scoring 70–84 enter Tier 2, receiving small-group interventions like Hanen’s It Takes Two to Talk or Handwriting Without Tears’ Wet-Dry-Try curriculum. Scores <70 trigger Tier 3: individualized assessment and IFSP development. Data aggregation at the classroom level enables school-wide action planning—for example, if 40% of 3-year-olds score <85 in Personal-Social, staff might implement Second Step’s preschool curriculum with fidelity checks.
Importantly, Clairese data cannot substitute for comprehensive evaluation. As stated in the AAP’s 2023 clinical report, ‘No screener replaces clinical judgment, medical evaluation, or multidisciplinary assessment.’ Districts violating this principle—such as one in Georgia that denied speech therapy eligibility solely based on Clairese scores—faced corrective action from the Office of Special Education Programs (OSEP) in 2023.
Future Directions and Research Priorities
Ongoing work focuses on three priorities. First, the ELAC is validating a telehealth administration protocol using tablet-based video streaming, currently piloted with 18 rural Alaska Native communities where travel distances exceed 100 miles. Preliminary data show 92% agreement between in-person and remote scoring (κ = 0.83), with latency under 120 ms ensuring real-time responsiveness. Second, researchers at Vanderbilt University are linking Clairese domain scores to third-grade outcomes using Tennessee’s longitudinal education database; early findings suggest a 1-point increase in Clairese Communication standard score at age 3 predicts 0.42 additional words correct per minute on the Group Reading Assessment and Diagnostic Evaluation (GRADE) at grade 3 (p < 0.001).
Third, machine learning models are being trained on Clairese video archives (N = 4,200 sessions) to detect subtle motor patterns predictive of later cerebral palsy—achieving 89.7% accuracy in distinguishing high-risk infants (gestational age <32 weeks) from controls. While not yet clinically deployed, these algorithms highlight how Clairese’s rich observational data can fuel precision early identification beyond current manual scoring.
For educators and clinicians, Clairese represents more than a screening tool—it is a shared observational language that bridges home, classroom, and clinical settings. Its design affirms that developmental surveillance works best when rooted in respect for children’s everyday competence, responsive adult-child interaction, and rigorous, transparent evidence. As pediatric neuropsychologist Dr. Arjun Patel notes in his foreword to the Clairese Clinical Manual (Riverside Insights, 2024): ‘What we observe in play isn’t just what a child can do—it’s how they think, feel, connect, and persist. Clairese honors that complexity without reducing it to numbers.’
Riverside Insights provides free access to the Clairese Implementation Toolkit—including editable family handouts, professional development modules, and district-level data dashboards—to all publicly funded early childhood programs. No licensing fees apply for nonprofit or government entities serving children birth through age five. Private providers pay an annual subscription of $199 per licensed user, which includes automatic updates, technical support, and participation in the national Clairese User Community—a peer network of over 12,000 educators and clinicians sharing adaptation strategies and fidelity resources.
Unlike tools that treat screening as an endpoint, Clairese positions it as a starting point for partnership. Its 12-minute observation becomes the foundation for conversations grounded in concrete examples: ‘I noticed how your daughter watched other children build before joining—they were using the blue blocks first, and she chose the red ones. That shows wonderful social awareness.’ Such specificity transforms abstract concerns into collaborative, strengths-based action—precisely what decades of research tell us children and families need most in the earliest, most malleable years of development.
The tool’s growing adoption reflects a broader shift in early childhood practice: away from deficit-focused labeling and toward responsive, relationship-centered support. When a preschool teacher in Portland, OR used Clairese to identify a child’s emerging difficulty with transitions—and then co-designed a visual schedule with the family—the child’s tantrums decreased from 8–10 daily episodes to zero within six weeks. That outcome wasn’t generated by a score; it emerged from what the score helped illuminate: a child’s capacity to learn, adapt, and thrive when met with attuned, evidence-informed care.
As federal and state investments in early childhood expand—evidenced by the $2.3 billion allocated to state Part C programs in the 2023 Bipartisan Infrastructure Law—tools like Clairese will be increasingly vital not just for identification, but for ensuring that every child’s unique developmental trajectory is seen, understood, and nurtured with precision and compassion.
For practitioners seeking to deepen their practice, Riverside Insights offers quarterly webinars featuring real-world case studies, such as ‘Using Clairese to Support Dual-Language Learners in a Minneapolis Preschool’ or ‘Adapting Clairese for Children with Visual Impairments Using Tactile Cues.’ These sessions emphasize practical application over theory, consistently drawing on data from over 240,000 completed Clairese administrations logged in the national database since 2021.
Ultimately, Clairese succeeds because it asks adults to slow down, watch closely, and respond thoughtfully—to see not just what’s missing, but what’s present, unfolding, and possible. In an era of accelerating expectations for young children, that intentional, observant stance may be its most enduring contribution to the field.
Its name, derived from the French word ‘clair’ (clear) and ‘se’ (self), embodies this philosophy: clarity about development emerges not from tests, but from seeing the child clearly—as they are, in context, with potential already evident.
