In the past decade, American and Canadian pediatric societies have recommended that pediatric care clinicians follow a schedule of routine surveillance and screening for young children to detect conditions such as developmental delay, speech and language delays and disorders, and autism spectrum disorder. The goal of these recommendations is to ensure that children with these developmental issues receive appropriate referrals for evaluation and intervention. However, in 2015 and 2016, the US Preventive Services Task Force (USPSTF) and the Canadian Task Force on Preventive Health Care issued recommendations that did not support universal screening for these conditions. This occasional paper is designed to help make sense of the discrepancy between Task Force recommendations and those of the pediatric community in light of research and practice. To clarify the issues, in this paper I review the distinction between screening and surveillance; the benefits of screening and early identification; how the USPSTF makes its recommendations; and what the implications of not supporting screening are for research, clinical practice, and families.