The purpose of this study was to apply the GoCheckKids, iScreen, PlusoptiX and SPOT to young patients and developmentally challenged patients in a paediatric eye practice. One hundred and eight children were assessed with a mean age of 47 months (9-146). Eleven had developmental delay and / or autism, 11 had constant strabismus and one had nystagmus. Spherical equivalent refractive error ranged from -22 to +6DS. Ten patients had anisometropia of >2D. Twenty-seven children passed all four assessments: nine had intermittent strabismus of 10-30PD. All four instruments were found to yield good screening accuracy and are valuable in identifying treatable vision impairment early enough for amblyopia treatment to be effective. Sensitivity, specificity and inclusive results were: PlusoptiX (83, 86 and 23%), SPOT (80, 85, 4%), iScreen (75, 88 and 13%), iScreen with Delta Center Crescent (92, 88, 0%) and GoCheckKids with Delta Center Crescent (81, 91, 3%).