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METRO MANILA DEVELOPMENT

SCREENING TEST

Overview
Screening is a presumptive
identification of unrecognized disease
or defect
Early detection model
Test children with problem
Facilitates early referral and treatment

Overview
Detection of developmental disabilities
Children 6 years and below

What then is MMDST?

MMDST
Simple and clinically useful tool
To determine early serious developmental
delays

MMDST
Dr. William K. Frankenburg
Modified and standardized by Dr.
Phoebe D. Williams DDST to MMDST

MMDST
Developed for health professionals (MDs,
RNs, etc)
It is not an intelligence test

MMDST
It is a screening instrument to
determine if childs development is
within normal

Purposes
Measures developmental delays
Evaluates 4 aspects of development

Aspects of development

Personal-social
Fine-motor adaptive
Language
Gross motor behavior

MMDST Kit

Manual
Sample test form
Test materials
MMDST bag

Test materials
A bright red yarn pom-pom
A rattle with narrow handle
Eight 1-inch colored wooden blocks (red,
yellow, blue green)

Test materials
A small clear glass/bottle with 5/8 inch
opening
A small bell with 2 inch-diameter mouth

Test materials
A rubber ball 12 inches in
circumference
Cheese curls
A pencil
Cheese curls

Important considerations
Childs age is crucial= initial step in test
administration
Test items will be dependent on age of
child

Important considerations
Age = guide the selection of test items and
subsequent interpretation of results

Scoring the Test

Passed
Failed
Refused, or
No opportunity

Scoring the test


Failure of an item that is completely to the
left of the childs age is considered a
developmental delay

The Test Form


Made of 105 items written in the range of
development of children between birth and
six years of age

Four Sectors
Personal-Social tasks which indicate
the childs ability to get along with people
and to take care of himself

Four Sectors
Fine-Motor Adaptive tasks which
indicate the childs ability to see and use
his hands to pick up objects and to draw

Four Sectors
Language tasks which indicate the
childs ability to hear, follow directions and
to speak; and

Four Sectors
Gross-Motor tasks which indicate the
childs ability to sit, walk and jump

Test Directions
1. Try to get the child to smile by smiling,
talking or waving to him. Do not touch
him.
2. When the child is playing with toy, pull it
away from him. Pass if he resists.

Test Directions
3. Child does not have to be able to tie
shoes or button in the back
4. Move yarn slowly in an arch from one
side to the other, about 6 above childs
face. Pass if the eyes follow 90o to
midline. (past midline; 180o)

Test Directions
5. Pass if the child grasps rattle when it is
touched to the backs or tips of fingers
6. Pass if the child continues to look where
yarn disappeared or tries to see where it
went. Yarn should be dropped quickly from
sight from testers hand without arm
movement

Test Directions
7. Pass if the child picks up cheese curl
with any part of the thumb and finger
8. Pass if child picks up cheese curl with
the ends of thumb and index finger using
an over hand approach

Test Directions
9. Pass any enclosed form. Fail continuous
round motion.

Test Directions
10. Which line is longer (not bigger). Turn
the paper upside down an repeat (3/3 or
5/6)

Test Directions
11. Pass any crossing line

Test Directions
12. Have child copy first. If failed,
demonstrate

Test Directions
Note
When giving items 9, 11 and 12, do not name
the forms. Do not demonstrate 9 and 11.

Test Directions
13. When scoring, each pair (2 arms, 2 legs,
etc) counts as one part
14. Point to picture and have the child name
it. (No credit is given for sounds only)

Test Directions
15. Tell the child to: give block to mommy;
put block on table; put block on floor.
Pass 2 of 3. (Do not help child by
pointing, moving head or eyes.)
16. Ask child: What do you do when you are
cold? Hungry? Tired? Pass 2 of 3.

Test Directions
17. Tell child to: Put block on table; under
table; in front of chair, behind chair.
Pass 3 of 4. (Do not help child by
pointing, moving head or eyes.)
18. Ask child: If fire is hot, ice is? Mother is
a woman, Dad is a?, a horse is big, a
mouse is ? Pass 2 of 3.

Test Directions
19. Ask child: What is a ball? River? Desk?
House? Banana?, Curtain? Roof? Fence?
Street? Pass if defined in terms of use,
shape, what is it made of or its general
category (such as banana is a fruit, not
just yellow). Pass 6 of 9.

Test Directions
20. Ask child: What is a spoon made of? A
shoe made of? A door made of? (no
other objects can be substituted.) Pass 3
of 3.
21. When placed on stomach, child lifts
chest off table with support of forearms
and/or hands.

Test Directions
22. While child is on back, grasp his hands
and pull him to sitting. Pass if head does
not hang back
23. Child may use wall or rail only, not
person. May not crawl.

Test Directions
24. Child must throw ball overhead 3 feet to
within arms reach of tester
25. Child must perform standing broad
jumps over width of test sheet (8
inches)

Test Directions
26. Tell child to walk forward, heel within 1
inch of toe. Tester may demonstrate.
Child must walk 4 consecutive steps, 2
out of 3 trials.

Test Directions
27. Bounce ball to child who should stand 3
feet away from tester. Child must catch
ball with hands, not arms, 2 out of 3
trials.

Test Directions
28. Tell child to walk backward toe within 1
inch of heel. Tester may demonstrate.
Child must walk 4 consecutive steps, 2
out of 3 trials.

Important
Date and Behavioral Observations
How child feels at time of test, relations to
tester, attention span, verbal behavior, selfconfidence, etc)

The Test Form


Across the top and bottom of form are age
scales
Age is marked in months 1-24, and age in
years from 2 to 6.

The Test Form


Each item is represented in the test form
by a bar
The bar is placed along the age scale to
show when 25%, 50% (indicated by the
hatch mark) 75% and 90% of the normal
children are able to pass the item.

The Test Form


10 11 12

Percentage of
normal children
passing the item

13 14 16

25%

Hatch Mark
50%
WALKS WELL

18

75%

90%

The Test Form


Some items have a small footnote number
at the left end of the bar
Footnote indicates corresponding
instruction for administering the item found
at the test form
Items which can
be passed by report

R
WALKS UP STEPS

Footnote number

23

The Test Form


Some items may be passed by report of
the parent (R)
Only items with an R on the form can be
passed by report
However, whenever possible tester should
observe what the child can perform

The Test Form


The item, equal movements, has an
asterisk (*) at the right end of its bar
Indicates 100% of normal children pass
this item at birth
It is the only item with an * (fine-motor
adaptive sector

The Test Form


9 items have arrows ( ) at the right end
of these bars
This includes the items, defines words and
composition of __.
Arrows indicate that normal children may
pass these items even beyond 6 y.o.

Calculating Childs Age


Formula
Year
Month Day
Date of test
99
11
15
Birthdate -97
- 3
-10
Age of child
2
8
5

Calculating Childs Age


Formula
Year

Month

Day

Date of test
99
2
8
Birthdate -97
- 3
-10
Age of child
1
10
25

Calculating Childs Age


Formula
Year

Month
98
99

Date of test
Birthdate -97
Age of child
1

Day
13

2
- 3

35
8

-10
10

25

Drawing the Age Line


Use age scale shown at the top and
bottom of the form
Mark the age and draw a line through all
four sectors
Show acetate

Drawing the Age Line


Location of age must be accurate
interpretation depends on correct
placement of the line
Space between age -- 2 weeks until 14
mos, 1 mo from 14 to 24 mos
From 24 mos to 5 yrs spaces between
represent 3 mos and thereafter 6 mos

Adjusting for Prematurity


Prematurity affect ability to perform that
normal child pass at the same age
Adjust for children 2 years or younger
After 2 years, it is no longer necessary to
compensate (Frankenburg, et al)
No adjustment is made on postterm

Adjusting for Prematurity


Ask mother if child was born prematurely
For two or three weeks earlier, subtract
the number of weeks from actual age
Draw age line based on adjusted age

Selecting Items to be
administered
Administer first those through which childs
chronological age line passes
If failure occurs in any items, proceed to
administer items to the left of the age line
until you obtain 3 passes then stop

Selecting Items to be
administered
WHAT TO KEEP
IN MIND!!!!!

Selecting Items to be
administered
All items crossing the age line should be
administered
Child should have a minimum of three
passes to the left of any failure; and
Each sector should have at least 3 passes
and three failures

The Test Procedure


Preliminary Phase
Establish rapport
Make the child as comfortable as possible
If infanton mothers lap
Materials should be accessible

The Test Procedure


If child is one year older, put child at ease
Show toysetc

The Test Procedure


Start with Personal-social sector
Gives child chance to get used to tester
Gives tester chance ask parents which
can be scored based on report and can
also directly observe it

The Test Procedure


Fine motor-adaptive sector follows
Child can perform tasks even without
having to directly talk to tester
Filipino child..warming up

The Test Procedure


Third is, language sector
This time child is more comfortable with
you (tester)
Will talk as much to you

The Test Procedure


Lastly, gross-motor sector
Many children are too shy at the beginning
of the test

The Test Procedure


WHAT MAY NOT BE CHANGED?

The Test Procedure


Manner in which each test is administered
Words or direction may not be changed