Occupational therapists assessing young Hmong children with developmental problems must consider their families’ cultural beliefs as they affect the design of assessment procedures and practices. Choices that families make about health and educational services are influenced by their beliefs. Developmental status can be affected by unresolved medical problems and the child’s general health condition. Assessment components based on cultural awareness may improve the effectiveness of early identification of Hmong children with developmental delay. Appropriate use of interpreters, creation of the most beneficial assessment environment, parental report, and observation of functional skills and play provide needed information when determining the child’s eligibility for early intervention services. The author has found that trained interpreters provide the most reliable communication between family members and the therapist. Assessments in the home environment are encouraged due to the child’s age and the need for family support and interaction. Parents are an excellent source of information about the child’s current and past functional abilities. Observations of the child’s interaction with family members, with objects and toys during play, and during functional daily living activities provides the therapist with valuable information about the child’s need for intervention.