Background: The BSID – III (Bayley Scale of Infant & toddler Development) was developed in 2006 to assess the developmental functioning of infants and young children 1–42 months of age. It is normed for children of the US population, however used worldwide. The present study was undertaken to determine difficulties encountered in developmental assessment of Indian children using BSID III.

Methods: This cross–sectional study was conducted in outpatient department of Lata Mangeshkar Hospital, Nagpur from September 2016 through February 2017. Children from nearby urban slum belonging to low socioeconomic strata were assessed using BSID–III.

Results: Twenty five normal children of age group ≤ 24 months  were assessed. There were 14 children (56% ) who required time more than 90 minutes for assessment. Maximum duration was 180 min and minimum was 60 min and 9 out of 25 children (36%) required frequent breaks (>3 breaks /session). Difficulty in transitioning was seen in 12 out of 25 (46%) children. Difficulty in understanding certain tasks related to picture book, puzzles, stimulus book and connecting block was seen in 11 children (44%).

Conclusion: Problems were encountered while using BSID–III. Majority of difficulties were attributed to unfamiliarity with test items due to lack of exposure in children belonging to low SES. There should be an Indian standardization of BSID–III for valid interpretation of scores.