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Developmental Screening test

Objective- To assess the developmental quotient of an individual using


Developmental Screening Test by Bharat Raj.
Introduction-
Definition of Intelligence
Intelligence is one of those concepts that are easier to recognize than to define.
Over the years various people have tried to define intelligence.
According to Wechsler Intelligence is the aggregate global capacity of the
individual to act purposefully, to think rationally and to deal effectively with the
environment.
As per Binet and Simon (1905) Intelligence is the ability to judge well, to
understand well, to reason well.
Robert Sternberg (1997) defines intelligence as the mental capacity to
automatize information processing, to formulate new ideas and to emit
contextually appropriate behaviour in response to novelty which includes not
only adaptation but also shaping and selection of any environmental context.
History of Intelligence

2300 years ago, the famous Greek philosopher, Aristotle made first reference to
something close to the idea of intelligence, but he called it “reason.” Reason,
according to Aristotle, was about humans’ ability to reign in their passions, i.e.,
our ability to resist the urge of our instincts. This was what separated us from
the animals: humans had reason, beasts did not. In the the 1600s, thinkers still
described reason as this “all or none” ability, but 200 years later with Charles
Darwin behind the pen, the notion that there may be degrees to this “reason”–
which he called“mental powers.” Later on in 1903, Alfred Binet published his
methods for an “intelligence test,” and its application to schools became quickly
apparent–so much so, that classrooms themselves were altered and standardized
to foster a better testing environment for determining students’ intelligenceA
few years after intelligence testing burst onto the scene, World War I broke out,
and America, who had a relatively small army at the time, began to mass enlist
people into the military. However, this proved a terrible mess for military
officials because they had no way to categorize new recruits’ aptitude for
different jobs. To resolve this, researchers created a standardized, multiple
choice test that could spit out a number that told you a person’s “intelligence.”
Hence, the IQ was born.

Concepts of development
Development describes the growth of humans throughout the lifespan, from
conception to death. It refers to development as patterns of change over time. It
does not just involve the biological and physical aspects of growth, but also the
cognitive (changes in thought processes), emotional (changes in emotional
understanding and experiences), and social aspects (relationships, self-concept
and identity formation) related to development.
The Denver Developmental Screening Test (DDST) was introduced in 1967 to
identify young children, up to age six, with developmental delays or disabilities.
Its revised version, Denver II, was released in 1992. It assesses children's
development in four key domains: personal-social, fine motor-adaptive,
language, and gross motor skills. Bharathraj ( 1977,1983) designed the
Developmental Screening test for the purpose of measuring mental development
of children from birth to 15 years of age.
DQ is a ratio/a numerical value indicating child’s development and growth to
maturity. DQ measures child’s development with correspondence to the social
norms. In other words, DQ corresponds to a vast range of psychosocial
competencies. Thus, DQ and IQ are not the same.
The concept of DQ is better understood one wants to understand motor, speech
& language, cognitive and personal-social development of a child in context to
her society. Thus, any developmental test measures the development of fine &
gross motor skills, expressive & receptive speech & language, perceptual skills,
initiative & independence, cognitive skills and personal-social development in a
child. DQ is usually used by professionals to gain detailed information for
specific domains of a child’s development and growth. Therefore professionals
working in the field of child care uses DQ for indicating a child’s diagnosis and
to plan an intervention program.
The Developmental screening test provides for a brief and fairly dependable
assessment without requiring the use of performance tests. Appraisal can be
done in a semi-structured interview with the child and a parent or a person well
acquainted with the child. In its present form the DST can be repeatedly used in
assessments
Bharatraj in the year 1983 developed the Developmental Screening
Test (DST) to measure mental development of children between age 0 to 15
years. The test developed correspond to the motor, speech & language, and
personal-social development of a child. Test have total 88 items used for a semi-
structured interview. The interview is scheduled with the primary caregiver of
the child. Scores on DST is obtained by the IQ calculator developed especially
for DST to assess the level of development in a child.
Research data on validity study indicatcd that DST was correlated with Seguin
Fonn Board fD the eitent of 0.8 and with Columbia Mental Maturity Scale, r =
0.75. High positive correlation was observed in the cross validation study of
DST. The interscorer reliability worked out between two trained clinical
psychologists was found to be as high as 0.92. The test-retest reliability was
obtained as 0.98 which is positive, significant and satisfactory.
Preliminaries –
Subject details-
Name of the subject – X
Age - 4 years 2 months
Gender – Male
Materials Required –
DST manual, pen, paper, DST questionnaire.
Instructions –
The informant was asked to answer the questions honestly as per the
Developmental screening test
Procedure –
The informant in this study was the mother of the subject. Initially, she was
queried about aspects related to her pregnancy, delivery, and any associated
complications. Subsequently, inquiries extended to cover each age level of the
subject, with the assessment concluding at the age of 5. During this process, the
mother responded to questions about the subject's developmental milestones at
each age level. Scores were determined by counting the number of correctly
marked items at each age level, representing the developmental age. To compute
the developmental quotient (DQ), the chronological age was converted into
days from months and years, and the accumulated days were totalled. The
developmental age was then divided by the chronological age and multiplied by
100 to yield the developmental quotient. This method provides a standardized
measure that reflects the subject's developmental progress in comparison to their
chronological age.
Case History –
Chief Complaints
● Sun nahi pata
● bolta nahi hai
● baat nahi maanta
● baat na maano toh gussa karta hai
Developmental Milestones Achieved
The subject demonstrated developmental milestones in a sequential pattern. The
birth cry, while eventually present, was delayed. The ability to hold the neck
independently was achieved at 3.5 months. By the age of 8 months, the subject
began sitting unassisted. Babbling commenced at 9 months, reflecting emerging
language development. Subsequently, at 14 months, the subject achieved the
significant milestone of walking without external support, marking a notable
advancement in motor skills and overall development.
Pregnancy and Perinatal History
The delivery process was uneventful, characterized as a normal and full-term
delivery. At the time of birth, the child's weight measured 3 kilograms,
indicating a healthy birth weight within the expected range.
Pregnancy and birth complications
Following birth, the child experienced an infection, necessitating a 3-day stay in
an incubator for medical care. Notably, there was no occurrence of birth
asphyxia during this period.
Results-

Developmental milestones (as per Score (in days)


DST)
3 months 78
6 months 90
9 months 68
1 year 68
½ year 135
2 year 90
3 year 305
4 year 216
5 year 120
DA= 1170

Calculations-
Chronological age- 4 years 2 months
= 1520 days
Developmental age- 3 years 3 months
=1170 days
Developmental quotient- DA/ MA × 100
1170/1520 × 100
= 76.9
=77 (rounding off)

Interpretation-
The developmental quotient of the subject lies in the Borderline range (75-79)
as per ICD-10 classification indicating subnormal intelligence level

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