Mental health assessment of young children provides valuable information to shape a formulation and guide treatment. Early childhood mental health assessment can occur in an increasing number of settings beyond traditional mental health practices, including childcare settings, primary care settings, and other settings where children and family are regularly seen. Although many of the components of an early childhood mental health assessment are included in the assessment of older children, assessment of very young children requires some specific developmental adjustments and additional considerations including attention to the parent-child relationship and caregiving context and rapid development.