Although intervening early can improve child and family outcomes when a child has a developmental disability, most children with developmental delays are not identified prior to school entry. Childcare professionals can play a key role in identifying delays early. The developmental monitoring attitudes, knowledge, and practice of childcare providers in the United States are described based on survey data. Findings indicate that childcare providers commonly monitor development but may do so in ways that are better suited to providing care than to identifying risk for developmental disability. Most providers identify early intervention/early childhood special education programmes as a place to refer for developmental concerns, while not identifying referral to the doctor unless prompted to consider the doctor's role. Overall, these findings suggest childcare providers may be well poised to identify delays and make referrals early through developmental monitoring but need additional knowledge and tools to do so effectively.