MMDST -Pencil

Metro Manila Development Screening -Bond paper

Test (MMDST)
● Simple, clinically useful tool
● Culture -based, research - based,
recognized developmental
screening test among Filipino
children
● Developed by Dr. Phoebe Dauz
Williams
● a modification & standardization of
the original Denver Developmental
Screening Test (DDST) by Dr.
William Frakenberg & his
associates
● Developed for health professionals
such as nurses, doctors & others
health workers
● Designed to detect developmental
delays in children 2 weeks to 6%
yrs old
● Evaluates 4 aspects of child
development
a. personal-social
b. fine motor-adaptive
C. language
d. gross motor
● Made up of 105 items
● MMDST bag
4 SECTORS:
● Personal -social
○ Tasks which indicate the
child's ability to get along
with people and take care
of himself
● Fine motor-adaptive
○ Tasks which indicate the
child's ability to see and to
use his hands to pick up
objects and to draw
● Language
○ Tasks which indicate the
child's ability to hear, follow
directions and to speak
● Gross motor
○ Tasks which indicate the
child's ability to sit, walk &
jump

MMDST Kit:
● manual
● sample test form
● test materials
-a bright red yarn pom-pom
-a rattle with a narrow handle
-eight 1-inch colored wooden blocks
(red, blue, yellow, green)
-A small clear glass/bottle w/5/8 inch
opening
-A small bell w/ 2% inch diameter
mouth
-A rubber ball 12 % inches in
circumference
-Cheese curls
Selecting Items to be administered
1. All items crossing the line should be
administered.
2. The child should have a minimum of 3
passes to the left of any failure
3. Each sector should have at least 3
passes & 3 failures.

Preliminary Phase

1. Establish rapport.
● Emphasize this is not a screening
test not an iQ test
● Estimate the child's level of
development
● Child is not expected to pass all
items administered
● Make child as comfortable as
possible (sitting on lap-
infant/toddler or on mat (kneeling
position)
● Avoid testing if child is ill, sleepy,
tired, hungry or upset
2. Every effort is made to observe what
the
child can actually do rather than simply
asking the parent.
Administering the test
1. Start with personal-social sector
- To give the child a chance to get
used to the tester while the tester
asks the parent items scored
based on report but also directly
observe
2. Fine motor-adaptive sector follows
- Essential warming up period
- The child can perform task at hand
without directly talking to the tester
yet
3. Next is the language sector
4. Gross motor sector
- last because child may be too shy
to do items at beginning of test
Administering the test:
What may not be changed
1. Manner which each item is
administered. Words or directions may not
be changed because the test will not be
standardized.
2. Avoid asking questions that will suggest
answers.
3. For each sector, start with items easily
performed
- motivate child to perform more
difficult task later; praise
- provide the parent some
satisfaction
4. 3 failures in 1 sector, move on to the
next sector
5. 3 trials/test item before a score of
failure is given
6. To minimize refusals, do the following
as
suggested:
- tell child what to do and not ask "can he"
or "will he"
-if child refuses, parent/caregiver should
be asked to administer the item.
-parent/caregiver is instructed to do
exactly how to do it.
- if child still refuses, score the item "R"
* "R"- if certain that child can perform but
refuses to do so at time of test
7. Once completed, note on the following:
- child's cooperation
- attention span
- verbal behavior
- self-confidence
- nervous habits
-parent-child relationship
-tester's overall feeling about the testing
*In some instances, a child may have
normal test results but may present some
problems in certain areas that need to be
addressed by the HCW.
Scoring
Items may be scored in 4 ways:
● Pass (P)
● Failure (F)
● Refusal (R)
● No Opportunity (NO)
*Score is to be written on the 50% .
hatch mark
Delay- if test is failed and falls completely
to the left of the age line
- used to interpret the total MMDST results
- emphasized by shading right end of the
bar
- if age line touches the right end of the
bar, the item is not considered delay
 Interpretation of Test Results
PERSONAL-SOCIAL
Interpreted as NORMAL, QUESTIONABLE, ● REGARDS FACE
ABNORMAL or UNTESTABLE ● SMILES RESPONSIVELY (R)
● SMILES SIMULTANEOUSLY (R)
Steps: ● FEEDS SELF CRACKER (R)
1. Mark each delay by shading right end of ● RESIST TOY PULL
bar ● PLAYS PEEK-A-BOO
2. Count # of sectors that have 2 or more ● WATCH FOR TOY OUT OF
delays REACH
3. Count the # of sectors that have 1 delay ● INITIALLY SHY WITH STRANGER
w/ no passes intersecting the age line in (R)
the same sector ● PLAYS PAT A-CAKE (R)
4. Interpret the result using the following ● PLAYS BALL WITH EXAMINER
criteria (MMDST manual, page 67) ● INDICATES WANTS (NOT CRY)
(R)
● Bottom of age line, indicate test ● DRINKS FROM CUP (R)
result & interpretation ● REMOVES GARMENTS [R]
○ ex: Abnormal, reason: 2 ● IMITATES HOUSEWORK (R)
sectors have 2 delays ● USE SPOON, SPILLING LITTLE
(R)
● HELPS IN HOUSE-SIMPLE
DISCUSSING TEST RESULTS TASKS [R]
● PUTS ON CLOTHING (R)
● Ask whether performance is typical ● WASHES AND DRIES HANDS (R)
behavior of child ● PLAYS INTERACTIVE GAMES [R]
● Overall interpretation should be ● SEPARATES FROM MOTHER
given in general terms, rather than EASILY (R)
terms such as normal, abnormal or ● DRESSES WITH SUPERVISION
questionable (R)
● If child has done well, praise child ● BUTTONS UP [R]
& reassure parent/caregiver ● DRESSES WITHOUT
● If there are delays, remind them SUPERVISION (R)
that this is a screening test & ask if
you can test the child within 2 FINE MOTOR ADAPTIVE
weeks. ● FOLLOWS TO MIDLINE
● EQUAL MOVEMENTS
Retesting ● FOLLOWS PAST MIDLINE
● Retest on the same form ● FOLLOWS TO 180
● Draw new age line & score new ● HANDS TOGETHER (R)
test using different colored pencil ● GRASP RATTLE
● Write date of retest at top of new ● REGARDS CHEESE CURL
age line Referral to pediatrician ● REACHES FOR OBJECT(R)
who is abnormal, questionable & ● SIT, LOOKS FOR YARN
untestable on 2nd test
 ● SIT, TAKES 2 CUBES
● RAKES CHEESE CURL, ATTAINS
● PASSES CUBE HAND TO HAND
● BANGS 2 CUBES HELD IN
HANDS
● THUMB-FINGER GRASP
● NEAT PINCER GRASP OF
CHEESE CURL
● SCRIBBLES SPONTANEOUSLY
● TOWER OF 2 CUBES
● TOWER OF 4 CUBES
● TOWER OF 8 CUBES
● IMITATES VERTICAL LINE
● DUMPS CHEESE CURL FROM
BOTTLE-SPONTANEOUSLY
● DUMPS CHEESE CURL FROM
BOTTLE- DEMONSTRATED
● IMITATES BRIDGE
● PICKS LONGER LINE
● COPIES O
● IMITATES DEMONSTRATED
● COPIES +
● DRAWS MAN-3 PARTS
● COPIES
● DRAWS MAN-6 PARTS
LANGUAGE
● RESPONDS TO BELL
● VOCALIZES- NOT CRYING
● LAUGHS
● SQUEALS
● TURNS TO VOICE
● DA-DA or MA-MA, NON-SPECIFIC
● IMITATES SPEECH SOUNDS
● DA-DA or MA-MA, SPECIFIC
● 3 WORDS OTHER THAN MA-MA,
DA-DA
● COMBINES 2 DIFFERENT
WORDS
● NAME ON PICTURE
● FOLLOWS DIRECTIONS
● USES PLURALS
● GIVES FIRST AND LAST NAME
● COMPREHENDS COLD, TIRED,
HUNGRY
● COMPREHENDS PREPOSITIONS
● RECOGNIZES COLORS
● OPPOSITE ANALOGIES
● DEFINES WORDS
● COMPOSITION OF
GROSS MOTOR
● STOMACH LIFTS HEAD
● STOMACH HEAD UP 45
● STOMACH HEAD UP 90
● STOMACH CHEST UP ARM
SUPPORT
● SIT-HEAD STEADY
● ROLLS OVER
● PULL TO SIT, NO HEAD LAG
● BEAR SOME WEIGHT ON LEGS
● SITS WITHOUT SUPPORT
● STANDS HOLDING ON
● PULLS SELF TO STAND
● GETS TO SITTING
● WALKS HOLDING ON
FURNITURE
● STANDS MOMENTARILY
● STANDS ALONE WELL
● STOOP AND RECOVERS
● WALKS WELL
● WALKS BACKWARD
● WALKS UP STEPS
● KICKS BALL FORWARD
● THROWS BALL OVERHAND