Limitations of regulatory in vivo developmental neurotoxicity (DNT) testing and assessment are well known, such as the 3Rs conflict, low throughput, high costs, high specific expertise needed and the lack of deeper mechanistic information. Moreover, the standard in vivo DNT data variability and in the experimental animal to human real life extrapolation is uncertain. Here, knowledge about these limitations and uncertainties is systematically summarized using a tabular OECD format. We also outline a hypothesis how alternative, fit-for-purpose Integrated Approaches to Testing and Assessment (IATAs) for DNT could improve current standard animal testing: Relative gains in 3Rs compliance, reduced costs, higher throughput, improved basic study design, higher standardization of testing and assessment and validation without 3Rs conflict, increasing the availability and reliability of DNT data. This could allow a more reliable comparative toxicity assessment over a larger proportion of chemicals within our global environment. The use of early, mechanistic, sensitive indicators for potential DNT could better support human safety assessment and mixture extrapolation. Using kinetic modelling ideally these could provide - eventually context dependent - at least the same level of human health protection. Such new approaches could also lead to a new mechanistic understanding for chemical safety, permitting determination of a dose that is likely not to trigger defined toxicity traits or pathways, rather than a dose not causing the current apical organism endpoints. The manuscript shall motivate and guide the development of new alternative methods for IATAs with diverse applications and support decision-making for their regulatory acceptance.