MMDST- Metro Manila Developmental Screening Test

SAMPLE CASE STUDY

I. INTRODUCTION
A. Background of the Study

 MMDST (Metro Manila Developmental Test) is an early detection model that applies to the
detection of developmental disabilities in children aged 6 ½ years and younger. It was
developed by Dr. William K. Frankenburg and was modified and adapted by Dr. Phoebe D.
Williams on Metro Manila children. This screening test was designed so that developmental
delays may be detected and referrals can be made. It is intended as a screening instrument to
determine whether a child’s development is within normal range.
 This test is concerned with the four domains of development: the personal-social, the
Language Skills, the Gross-motor Skills and the Fine-motor skills. The personal-social skill
refers to that of the child’s ability to interact with other people and to take care of his self. The
language skill refers to the child’s ability to use the sense of hearing in grasping and following
instructions and the ability to speak. the Gross motor skills refers to the ability of the child to
perform physical activities that involves the use of the large muscles like walking or jumping
while the fine-motor skills refer to the child’s ability to perform physical activities using the
small muscles like picking up or touching small objects.
 The test though is neither an intellectual test nor a diagnostic test. It does not give a future
interpretation of the child’s future intellectual capability but only acts a screening test.

B. General Objectives
 This study aims to measure the developmental skills and capacity of the child that is
appropriate to the child’s age and to identify any developmental delays so that
appropriate interventions could be made as soon as possible
C. Specific Objectives
a. To be able to identify the clients age accurately.
b. To be able to draw the clients age line accurately and give appropriate test items
suitable for the child’s age
c. To be able to assess the Four Major Aspects of the Childs development
d. To be able to identify any developmental delays in the child and give appropriate
interventions that could help lessen the severity of the delay or correct the delay.
e. To be able to give referral and appropriate therapy to the patients developmental delay
f. To be able to give separate health teachings to the parents and to the child’s health
condition regarding the clients condition.
D. Glossary of Terms
a. MMDST- (Metro Manila Developmental Screening Test) a tool used by a health worker
to assess any developmental delays within a child at a certain age.
b. Developmental delay- refers to when a child's development lags behind established
normal ranges for his or her age. Sometimes the term is used for mental retardation,
which is not a delay in development but rather a permanent limitation. If most children
crawl by eight months of age and walk by the middle of the second year, then a child five
or six months behind schedule in reaching these milestones may be classified as
developmentally delayed regarding mobility.
c. Passed Score- given when the child is able to perform the tasks or skills that has been
given by the examiner that is appropriate for the child’s age
d. Failed- a score given when the child is able to perform a certain item being tested but
does not manifest or give the appropriate response.
e. Refused- when the child manifests lack of interest and does not want to perform the
task.
f. No Opportunity- given when the child does not bother to participate to answer or
cooperate to perform a specific task or skill.
g. Personal-Social- one of the four aspects that are tested in which the child’s ability to
interact with others and his ability to take care of his self is being assessed.
h. Language- an aspect in the development of a child which refers to the child’s ability to
grasp and perform instructions and the ability to speak.
 i. Gross-Motor- an aspect in the child’s development in which the child’s ability to
perform physical activities such as jumping, sitting ore walking using the large muscles
is being assessed.
j. Fine-Motor- one of the aspects in the child’s development in which the child’s ability to
perform physical activities such as picking up or touching small objects using the small
muscles and the ability to use the child’s sense of sight is being assessed.

E. Significance of the Study

 This study will help the community to be aware about the developmental abilities of the
children in the area. The results will be significant especially to the parents in detecting
any developmental disabilities and delays in their child. It will also help in recognizing
slow development among children so that referrals may be made and appropriate
therapy prescribed as soon as possible to prevent any further complication.
II. PATIENT’S PROFILE
A. Family History
• Christopher T. Retiza (father) – alive and well
• Susan D. Retiza (mother) – DM and HTN
• Mary Bless D. Retiza, 22 (daughter) – alive and well
• Mary Grace D. Retiza, 20 (daughter) – alive and well
• Christopher D. Retiza, 17 (son) – alive and well
• Mary Joy D. Retiza, 16 (daughter) – alive and well
• Christian D. Retiza, 11 (son) – alive and well
• Bien Joseph D. Retiza, 9 (son) – alive and well
• Mary Chris D. Retiza, 5 (daughter) – aive and well
B. Medical History
• Developmental History

Type of Stage Appropriate Actual Findings

Development
Jean Piaget Intuitive Thought However, there is still a
(Cognitive tendency to focus
development) attention on one aspect
of an object while
ignoring others.

Concepts formed are

crudeand irreversible.

Easy to believe in
magical increase,
decrease,
disappearance.

Reality not firm.

Perceptions dominate
judgment.

In moral-ethical realm,
the child is not able to
show principles
underlying best
behavior.

Rules of a game not

develop, only uses
simple do's and don'ts
imposed by authority.
Sigmund Freud Phallic Stage The pleasure zone
(psychosexual switches to the genitals.
development) During this stage girl
develop unconscious
sexual desires for their
father. Because of this,
she becomes rivals with
his mother and sees her
as competition for the
father’s affection.

Girls also develop a fear

that their mother will
punish them for these
feelings. This group of
feelings is known as
Electra Complex.
ERIK ERIKSON Initiative vs. Guilt During the initiative
versus guilt stage,
children begin to assert
their power and control
over the world through
directing play and other
social interaction.
This stage can
sometimes be
frustrating for parents
and caregivers as
children begin to
exercise more control
over the things that
impact their lives. Such
decisions can range
from the friends they
play with, the activities
they engage in, and the
way that they approach
different tasks. Parents
and other adults might
want to guide children
toward certain friends,
activities, or choices,
but children might
resist and insist on
making their own
choices. While this
might lead to some
conflicts with parental
wishes at times, it is
important to give kids a
chance to make such
choices. However, it is
important that parents
continue to enforce safe
boundaries and
encourage children to
 make good choices
through the use of
modeling
and reinforcement.

Nutritional History
 The child prefers to eat fried dishes such as fried egg, fish, chicken and meat. She doesn’t
eat vegetables. She often eats junk foods and chocolates.

Previous Illness and Medications Taken

 No previous illness noted and no medications were taken. Takes ‘Ceelin’ as a vitamin C
supplement.

III. METHODOLOGY
 This chapter presents the different procedures that were used in this case study as well as
the statistical procedures utilized in the conduct of the said study.
A. Case Locale
The MMDST (Metro Manila Developmental Screening Test) was conducted at the house of the
client, located at Purok Calachuchi, Visayan Village, Tagum City on September 8, 2017, Friday.
B. Methods Used
The methods used for acquiring the MMDST (Metro Manila Developmental Screening Test)
results were:
• Interview Method – Some of the data, specifically the patient’s profile (family history,
medical history, etc.) were obtained by the tester through interview method of the
parents.
• Questionnaire Method – The tester used series of questions to collect information
about the client.
• Used of Test Materials – the tester used the MMDST Kit and its contents in performing
the test procedure in obtaining the test results.
• Legal Documents – other information such as marriage and birth certificate were
obtained from legal documents of the family.
C. Instruments Used
The instruments used in this test are the following:
• The test form/sheet
• The MMDST kit which contains of the ff.:
Bond paper
Pencil
Eight pieces 1-inch wooden colored blocks (red, yellow,
green, blue)
Rubber ball 12 ½ inch in diameter
D. Test Procedures
The following are the test procedures being performed:
• First, the tester must state to the parent/s or guardian the reason of visit, what the test is all
about, and how they can help while the test is going on.
• Next, establish a rapport with the parent/s or guardian, especially with the child, to gain
cooperation and trust.
• Make the child as comfortable as possible to attain the best possible result.
• Calculate the child’s age to determine the tests that are applicable to the child in relation to
his/her age.
Note: if the child is premature and his/her age during the test is 2 yrs. old and below,
make adjustments by subtracting the number of weeks of prematurity.
• Draw the age line. The tests that are hit by the drawn line are the tests that the tester must
perform.
• Administer the test. Take time in administering the test to attain the best possible result.
• Score and interpret test results. This is to know if the child has developmental delays.
• Explain overall interpretation of the test result to the parent/s or guardian. This is for the
parent/s or guardian to know if their child has a developmental delay and for them to
address the problem immediately. The MMDST result is interpreted as :
 NORMAL
QUESTIONABLE
ABNORMAL
UNTESTABLE
Test Results:
Passed (P)
Failed (F)
Refused (R)
No Opportunity (NO)

E. Presentation of Computation of Child’s Age

Date of Test: October 9, 2009
Date of Birth: March 16, 2004

Year Month Day

Date of Test 09 09 17
Date of Birth 04 03 16
05 06 01
The age of the child is 5 years 6 months and 1 day

RESULTS, ANALYSIS AND JUSTIFICATION

SCORING:

P- Pass
F- Failed
NO- No Opportunity
R- Refuse

Test Procedure Score Analysis Interpretation

PERSONAL- SOCIAL -pass  Pass if the child does not  The child does not become to
1.Separates from become too upset when the upset when the mother is out of
pass
mother easily mother is out of sight. sight.
2. Dresses without  pass if the can dress  The child can dress herself
supervision herself completely and completely and correctly without
correctly without help help as evidence by the mother’s
verbalization and child’s
demonstration.

FINE MOTOR -pass  Pass if the child can draw a  The child draws a figure with
ADAPTIVE -pass figure with straight lines straight lines and with 4 square
1.Copies rectangle and with 4 square corners corners without being shown
without being shown how how to draw it.
2.Imitates to draw it.
demonstrates
 Pass if the child can draw a  The child draws a figure with
square
figure with straight lines straight lines and 4 square
and 4 square corners. corners.

3. Draws man- 3 -pass -pass if the child can draw 3 or

 The child draws a figure with
parts more parts. One point is given
nine parts.
to each pair (ears, eyes, etc.) as
well as each part which is not
pair.

- pass if the child can draw 6 or

4. Draws man- 6 - pass more body parts.  The child draws a figure with 9
parts
parts.
LANGUAGE pass -pass if the child gives a logical  The child gives a logical answer
1.Comprehends cold, answer for 2 out of 3 for 2 out of 3 questions.
tired and hungry questions.
 The child points 3 out of 4
2.Recognize color pass -pass if the child picks 3 out of colored wooden blocks correctly.
four colors correctly.
3.Defines word Pass  Pass if the child defines 7  The child defined appropriately
out of nine words in terms the terms of the things asked to
of use, shape, what it is her.
made if, and its general
category.

 Pass if the child replies that  the child replies that:

4.Composition of: spoon is made of metal;
Pass  “Spoon is made up of metal.”
shoe is made of leather;
 “Door is made up of wood.”
door is made of wood, or
 “Shoe is made up of plastic.”
glass.
GROSS MOTOR -pass  pass if the child can stand  The child can stand on 1 foot for
1.Balance on 1 foot on either foot 10 seconds 10 seconds on the first trial.
for 10 seconds or more in 2 or 3 trials.

 Pass if the child can walk in 
2.Heel-to-toe walk - pass straight line for 4 or more
steps placing her heel 1
inch or less in front of her
toe, 2 out 3 trials.
3. Backward heel-to- pass  Pass if the child can walk in 
toe straight line backward for 4
or more steps placing her
toes in the back of her heel,
2 out of 3 trials.
The child can walk in straight
line for 4 steps placing her heel 1
inch in front of her toe.
The child can walk backward in
straight line for 4 steps placing
her toe 1 inch in back of her heel.

SUMMARY, CONCLUSION AND RECOMMENDATION

Summary
 The testers assess a certain family with 5 to 6 ½ years old children. The testers assessed the child’s
personal-social, fine-motor adaptive, language and gross-motor. MMDST is a screening test for the
children 6 ½ years old and younger and it is not a diagnostic test or an intelligence test.
 The tester conducted different test procedures to the child such as copying a rectangle, imitating
and demonstrating a square, drawing a man with 3 and 6 parts; defining words, recognizing 3
colors; walking heel-to-toe forward and backward and balancing on 1 foot for 10 seconds.
 The testers also gave significance to the client’s profile such as family and medical histories to have
an overview which may help in assessing the client’s condition. At the end part of the test,
pertinent documents were gathered and compiled to prove the validity of the conducted tests and
the persons involved.

Conclusion
 An over-all finding reveals that Mary Chris exhibits normal development in relation to her age. She
passed all the test procedures which means that her developmental skill is within normal range. It
is typical for a child to divert her attention to other activities while conducting the test that’s why
the tester should master the procedures so that the administration of these test procedures will be
fast and easy.

Recommendation
 It is very essential to monitor the developmental skills of the child to prevent serious
developmental delays. The support mechanism of the primary care provider is important at this
 age because they will guide their children in the right path and it can affect the development of the
child throughout her life. Parents are the one who will mold the child into a good individual.
Parents should conduct close guidance to monitor the child’s developmental abilities so that early
referrals may be made in case developmental delays are recognized.

BIBLIOGRAPHY
• http://www.childdevelopmentinfo.com
• http://www.wikipedia.org
• Nursing Health Assessment, 2nd edition, Patricia M. Dillon