METRO MANILA DEVELOPMENTAL SCREENING TEST

A CASE STUDY ON A TODDLER

By: Michael Jones G. Balansag BSN 2A

Chapter I
A. Background of the Study
The study of Metro Manila Screening Test is not an IQ test;  it is sought to establish baseline information on the developmental characteristics of Filipino toddlers.

It helps in determining as to what are the developments and progress of child.  This is a tool which is used to detect if there are delays on children age 2 weeks - 6 ½ years of age.

B. Objectives

General
◦ Be able to determine and evaluate child’s development and developmental delays through the use of MMDST.

 Specific ◦ To conduct the test which enhances child’s ability to participate and cooperate. ◦ To let the child do the test items that intersect in her age line and observe if she is able to do the said tasks. ◦ To determine the growth and development of the child using MMDST. ◦ To help parents identify child’s developmental delays and aid them to resolve the delays. ◦ To enhance parents willingness in setting plans to resolve these delays. ◦ To give recommendations for the family and proposals for the community.

Age Line – a vertical line which intersects test items that a child is going to perform. Gross Motor – refers to the movement of a child utilizing large amount of muscles. Glossary of Terms ◦ a. Delay – a test item which is failed and falls completely to the left of the age line. Language – the ability of the child to hear. Failed – refers to the inability of a child to perform a test item. ◦ g. ◦ f. ◦ c. ◦ d.C. speak and follow directions. Fine – Motor Adaptive – the movement of a child utilizing small groups of muscles ◦ e. . Full Term – the fetus that had reach 38 – 42 weeks before delivery. ◦ b.

. k. Test item – an activity to be done by a child. m.Social – the ability of the child to get along with other people. n.       h. Toddler – age period of childhood from 1 year to 3 years old. Metro Manila Developmental Screening Test (MMDST) – a screening instrument used in determining the development of a child. Personal. Passed – used to indicate that a child had successfully done a test item. l. Normal Spontaneous Vaginal Delivery (NSVD) – refers to the normal delivery of a child through the vagina. Refused – indicates that a child did not perform a test item. j. i.

will help them understand the child’s growth whether the child can perform the developmental tasks at her age. Significance of the Study  To the client  This study will bring enjoyment to the child and it enhances child’s abilities and capabilities to discover new things to her environment.  To the parents  This .D.

 To the students will help students to understand the importance of growth and development through actual evaluation of qualitative and quantitative changes seen in growth and development of children.  study .

2009  Birth Place: Mercy Maternity Center #10 First Opal Street Near Corner Veloso/Dacudao Agdao/Obrero.E. Guerra Age: 1 year and 11 month  Sex: Female  Birth Date: October 21. Client’s Profile   Name of the client: Cristal Khate B. Davao City .

Present Medical Condition  During the time of the assessment the child has no signs or symptoms of health problem.A. . The child appeared to be healthy and was very much energetic during the conduction of the test.

B. The mentioned health problems were resolved through management obtained in the clinic and medications were given. high fever that reached 40 degree centegrade and Thrombocytopenia (reduced platelet count). Past Medical History  According to the client's mother the child had experienced some illness in the past such as diarrhea. .

C. Family History Birth order of the client: 1st child  Total number of siblings: 1  Number of living siblings: 1   Heredo.familial Disease:   Father side: Mother side: Hypertension Arthritis .

38 weeks Place of delivery . Maternal and Prenatal History        Illness during pregnancy 1st trimester .D.NSVD Attendant .Full term.Fever .none X-ray during 1st trimester .Midwife Infants Problem during 1st month .Mercy Maternity Center Type of delivery .none Term .

E. Developmental History         TYPES OF DEVELOPMENT Rolled Over Sat alone Stood alone Walk alone Talked Toilet Trained Coordination AGE ACHIEVED 6 months old 8 months old 11 months old 1 year 1 year and 4 months 1 year and 8 months 1 year and 8 months .

to present 4 hrs .F. Nutritional History TYPES OF FEEDING AGE STARTED DURATION FEEDING INTERVAL Breast feeding At birth 1 yr & 2 mo. 1yr and 6 mo. 3 hrs Artificial feeding 1 yr & 2 mo.

.G. Immunization  Is a process by which vaccines are introduced into the body before infections sets in. Immunization are also called vaccination’s a method of stimulating resistance in the human body to specific disease using microorganism that have been modified and being injected to the body.

14 weeks) 11/11/09 ------------ ----------- ---------- ----------- ---------- Measles (9 months) 01/12/10 03/17/10 07/28/10 ---------- ---------- ---------- Vit. 10 weeks. 14 weeks old) 01/02/10 02/10/10 03/17/10 ---------- ---------- ---------- OPV (6 weeks. A (start at 6 months) Deworming 04/28/10 ---------- ---------- ---------- ---------- ---------- 05/21/10 .NEWBORN SCREENING BCG (at birth) 1ST DOSE 2ND DOSE 3RD DOSE 4TH DOSE 5TH DOSE 6TH DOSE 11/11/09 ----------- ----------- ---------- ---------- ----------- DPT (6 weeks. 10 weeks. 10 01/12/10 02/10/10 03/17/10 --------- ---------- ---------- weeks. 14 weeks old) Hepatitis B (6 weeks.

5 cm Vital Sign Temperature Respiratory Rate Pulse Rate Results 36.5 cm 44.H.2 °C 23 bpm 87 bpm Weight 8.5cm 45.62 kg . Physical Assessment Anthropometric measurements Length Head Circumference Chest Circumference Abdominal Circumference Results 84 cm 44.

with range of motion No masses and tenderness noted. Spine vertically aligned and she has straight spinal column.Parts Skin Eyes Assessment No presence edema. The pupil is color black. No murmurs heard during auscultation. Ears Nose No presence of cerumen. . Neck Lung Heart No mass noted. the skin color is brown. No lesion. Nails are properly cut and clean. Normal heart sounds characterized by “lub dubb”. the skin color is brown Pinkish conjunctiva. . Abdomen Extremities No lesion. Sinuses are not tender to palpation and no crepitus is evident. Thorax No deformities of the Thorax. the abdomen is not distended. Eyelashes are equally distributed. Normal Breathing expansion. No loss of extremities. Symmetric.

They only have one bedroom which is located at the right side of their house. it is made up of blocks and wood. 10 Emerald St.. Doña Salud Subd. Settings ◦ The study was conducted last September 22.Chapter III Methodology A. ◦ The family does not owned the house they share only a renters there for two years now. Sasa Davao City. 2011 at the residence of Guerra family located at Km. The house does have adequate lighting facilities. The living space is also adequate and . ◦ The house is semi concrete.

Methods Used ◦ INTERVIEW. ◦ This method was done by asking the parent the facts and information about the child’s abilities and skills. ◦ This method also helped the group to gather data on the profile of the client and family background. .B.this is an approach in gathering information from the person involved in the growth and development of the child.

OBSERVATION . .the bars that intersect her age are the items give by the administrators and being performed by the client.  MMDST tool . This method was also used to study the surroundings of the child’s environment.this method was used when the group allowed this child to perform the different task to be able to determine what she can do at her age. This s considered as the most important tool since most of the item requires careful observation of the client’s behaviour.

this method was to record and document all gathered information.I used different methods in conducting physical assessment to identify our client’s development. if the client is growing according to his age development.  . Our client was able to do the entire test without any difficulties.  PHYSICAL EXAMINATION .RECORDING AND DOCUMENTAION .

C.5 inches in diameter ◦ Pencil and Bond Paper ◦ 8pcs of 1 inch blocks . Test Materials ◦ Clear small glass with 5/8 inch opening ◦ Cheese curls ◦ Small Rubber Ball with 12.

P.D. Generally the test starts with personal sector: this gives the toddler a chance to get used to the tester. the toddler is allowed three trials to perform each item before a failure is scored Items may be scored either of 4 ways of scoring. Every effort is made to see what a toddler can actually do rather than asking the parent. Test Procedures          The toddler may sit on the lap of her mother/ caretaker. Put mother or caregiver at ease and establish rapport stating that the tester is interested in knowing what toddler can do in a certain age.PASS F. Set test materials on the table.REFUSED NO -No opportunity (not considered in the total score) . The gross motor comes. The language sector comes next: toddler will be more comfortable with the task and much more likely imitates speech sound and noises that the tester asks to imitate.FAIL R. The fine motor adaptive follows: toddler can perform the task at hand without having the talk to the tester directly at yet.

One sector with two or more delay or more sectors with one delay and in that same sectors no passes intersecting age line.Criteria in Interpreting the Scores Criteria 1. Two or more sector with two or more delays. One sectors with two or more delays 4. Questionable Questionable 5. Interpretation Abnormal Abnormal 3. 2. One or more sector with one delay and in that same sector no passes intersecting age line. Untestable . When refusal occurs in number large enough to cause test result to be questionable or abnormal these were scored as failures.

Calculation of Toddler’s Age  To get the chronological age of a toddler. Date of Test: Date of birth: Year September 22. 2009 Month 09 10 11 1 year and 11 month and 1 day Day 22 21 01   Total Age: 2011 2009 01 Child’s Age: . 2011 October 21.G. subtract the birth date of the client from the date of administration.

Chapter IV  The result. . analysis and justification of the four sectors of MMDST.

enjoys holding spoon (often upside while eating and a little spilling of down) and drinking from glass or cup.Hathaway. he or she will be able to pull on simple clothing.E. Murkoff. According to what to expect the toddler years. Eisenberg.&.) Removes Garment Pass The Child was able to remove her clothes without any help from her Toddler may e able to remove one or two loose items of clothing. S.(2005). Justification Uses Spoon spilling Pass little The client was able to use spoon Helps feed self. Maternal and Child Health Nursing care of the childbearing and childrearing family (4th Edition. not always accurate in getting utensils into mouth.E. frequent spills should be expected. & Wilkins (2005) mother. Maternal and Child Health Nursing care of the Childbearing and childrearing Family. Item used Personal-Social Result Analysis Skills food was noticed. Puts on Clothing Pass The client was able to wear her Toddler gradually will become more cooperative dress without asking supervision during dressing and learn to extend legs and arms from her mother. A. Pillitteri.. A. to help put on coats and pants. . At the age of two. Lippincott W. H.

A (2007). Maternal and child health 3rd attempt she does it well. Fine Motor Adoptive Skills The child failed on the 1st The 22 months old can make tower of four attempt of making the tower blocks. One year later. Pass The child spontaneously The child is ale to perform the given task y just dumps the cheese curl out of telling her to transfer the cheese curl to the other the small glass according to bottle. Tower of 4 cubes Pass Dumps Cheese Curls from bottle – spontaneously. of 4 cubes but on the 2nd and Pilliteri. coordination is developed resulting manipulation of objects. The eye-hand coordination is developed what had been told to her resulting manipulation of objects. Pillitteri. The eye-hand do the task. (2005). Nursing. Maternal and child Health Nursing Care of the childbearing and childrearing family (4th edition). A. he can stack eight blocks. Maternal and child health to do it. . Pass The child dumps the cheese The child was able to do it after the examiner curl out of the bottle with a demonstration given how to showed how the task done. without a demonstration how Pilliteri. A (2007). nursing. Dumps cheese curls form the bottle demonstration.

E. (13) Follows Direction 2 or 3 Passed The client was able to follow Once the children becomes toddlers. they are ready to learn how to follow directions. Murkoff. ears. “bye bye”. S. Pilliteri. directions given like getting the Pillitteri. if a toddler cannot do so by 24 months. consult to their health care provider.Hathway.E. & Wilkins (2005) Maternal and Child Health Nursing care of the like “hello”. (14) Names one picture Passed The client was able to name fish Toddler name familiar people and objects. Points to 1 named body part Passed The client was able to point body The easiest things that a child is able to identify at the earliest onset of life would be those parts like nose. 3 words other than mama and dada Language Skills Passed The client was able to spoke 3 Uses 2 – 3 words other than mama and dada at 12 – 15 months. (2005). Their Attention span is short. (2008). lips. Maternal and child health nursing. there is a range of ages at which children are first able two words like “hello mama” to combine words into sentences. and “hawa”. H. A. Combine 2 words Passed The client was able to combine Combines 2 words at 16 – 24 months. parents should and “bye bye mama”. A. colors.&. Maternal and Child Health Nursing. such basics as letters. Recognition of and dog during assessment. Eisenerg. Maternal and child health nursing care of the childbearing and ball on the other side of the chair childrearing family (4th Edition. “hi!” childbearing and childrearing family. body parts. would then progress into the more complicated nuances of language and development of thought expression. . pictures of familiar persons.) and putting it to the table. eyes most commonly taught by elders. words other than mama and papa Lippincott W. According to what is expected to toddler years. and shapes These and arms. A. (2007). A. Pilliteri..

foot for about 1 sec. A. in place slowly. your toddler will probably be able to kick a ball forward. 18 months. Maternal and Child health nursing. or a mattress on the floor. A. Maternal and Child Health Nursing. Pilliteri. (4th Edition) Balance on 1 foot Passed 1 second 2 of 3 The client was able to balance her body The capacity of the child in balancing on 1 for about 3 seconds with 1 foot. Pilliteri. Place pillows. tester. (2008). . (2008). Pilliteri. A. (24) Throwing ball Passed overhead The client was able to Throw the ball By the age of 24 months.Gross Motor Kick Ball Forward Passed Skills The client was able to kick the ball Around  forward. (2005) Maternal and child health nursing care of the childbearing and childrearing family. & Wilkins (2005) Maternal and child health Nursing Care of the childbearing and Childrearing Family Jumps in place Passed The client was able to perform jumping Toddlers like to jump. many toddlers can overhead 3 feet within arm’s reach of now throw a ball overhead. Cushion. Is less than 30% out of 90%. Lippincott W.

Sasa Davao City an assessment was done to the client and his family to determine the factors that contributes to the growth and developmental status of the child.Chapter V A. 10 Emerald St. This will help you to determine if the child development is within his normal age. From Km. 1 year. The chosen client was Kristine Hermosa (not her real name). Summary ◦ The study aims to determine the developmental status of a toddler. And taking particular of the child’s ability to do whatever was required for him and evaluated accordingly. Doña Salud Subd. . 11 months and 1 day old..

language and gross motor. in all the four sectors of the test personal-social. During the test. . the client was a little bit shy but still cooperates with the test. The child obtained to pass the item intersecting of his age line. The test results reveals the interpretation that the growth and developmental status of the chills is at the normal level. with the score of passed item of 15 out of 15 items intersecting age line. fine motor adaptive. After a while the shame was replace with a very energetic and noisy child. The child passed the entire task that belongs in his age line.

In finemotor skills the task are to make a tower of 4 cubes. I therefore concluded that my client is developing properly within his age. know how to remove garments and use spoon but with the consideration if it spills a little. dumps cheese curls from bottle spontaneously and demonstrate it. Because she was able to do the entire test properly without any problems. In the personal – social skills the task of the client is to put on clothing. She was able to do all of these without any help from others. .

Knowing words that she talk’s can help the client so that he can properly understand and explain words within his capacity and knowledge. combines two words. Part of the developmental growth of the child is the language skills that may help the client in communicating to others. points to 1 named body parts. name’s one picture and follows direction. throwing the ball overhead. The client passed these tasks and she properly done the task without asking any help from his mother. especially soon when she will be attending in school. In this test the client is using his whole body to perform the task like kicking the ball forward. . The tasks is to spoke 3 words other than mama and papa. The gross motor skills use group of muscles in doing tasks. balancing on 1 foot and jumping in place.

socially and spiritually so that the child will attain the optimum level of functioning.  To the Family  The family should continue in supporting the child mentally emotionally. and not to throw their garbage anywhere to provide clean environment in order to have a healthy lifestyle.  To community:  The parents should teach their children in proper hygiene.  hey should be united for easy promotion of health that could lead to healthy community. physically.  The elders of the community must be aware for any problem that is present to their community.  she should avoid eating junk foods. and replace it with good and nutritious foods that are necessary for health. .C. Recommendation  To The Client  she should stop eating candy.

establishing trust is needed.  Be a role model to the people in the community especially to the client.  They must give appropriate health teaching to the people in the community. .  They should continue to conduct studies regarding the growth and development. To The Student  They should be more knowledgeable in conducting the interview.

about .com http://www.yahoo. Erb.  Health Assessment In Nursing by Janet Weber and Jane Kelley 3rd edition.wikipedia.com http://pediatrics.com http://www.com http://www.alpharubicon. Berman 7th edition. & .Bibliography  Internet:      http://www.google.com  Books:  Fundamental of Nursing by Kozier.  Maternal and Child Health Nursing: Care of the Childbearing and Childrearing Family by Adele Pillitteri 5th edition.  Maternal and Child Health Nursing Care of The Childbearing and Childrearing Family by Lippincott W.

Appendices .

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Marriage Certificate and Birth Certificate .

Vaccination .

Thank you for listening! Have a good day! .

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