MMDST

Lecture by: Madeline N. Gerzon, RN, MM Clinical Instructor

METRO MANILA DE ELO!MENT "CREENING TE"T

Overview
# "creenin$ is a %resu&%ti'e identi(ication o( unreco$nized disease or de(ect # Early detection &odel # Test c)ildren *it) %roble& # +acilitates early re(erral and treat&ent

Overview
# Detection o( de'elo%&ental disabilities # C)ildren , - years and belo*

.)at t)en is MMD"T/

MMDST
# "i&%le and clinically use(ul tool # To deter&ine early serious de'elo%&ental delays

MMDST
# Dr. .illia& 0. +ran1enbur$ # Modi(ied and standardized by Dr. !)oebe D. .illia&s DD"T to MMD"T

MMDST
# De'elo%ed (or )ealt) %ro(essionals 2MDs, RNs, etc3 # It is not an intelli$ence test

MMDST
# It is a screenin$ instru&ent to deter&ine i( c)ild4s de'elo%&ent is *it)in nor&al

Purposes
# Measures de'elo%&ental delays # E'aluates 5 as%ects o( de'elo%&ent

Aspects of development
# # # # !ersonal6social +ine6&otor ada%ti'e Lan$ua$e Gross &otor be)a'ior

MMDST Kit
# # # # Manual "a&%le test (or& Test &aterials MMD"T ba$

Test materials
# A bri$)t red yarn %o&6%o& # A rattle *it) narro* )andle # Ei$)t 76inc) colored *ooden bloc1s 2red, yello*, blue $reen3

Test materials
# A s&all clear $lass8bottle *it) 98: inc) o%enin$ # A s&all bell *it) ; - inc)6dia&eter &out)

Test materials
# A rubber ball 7; - inc)es in circu&(erence # C)eese curls # A %encil # C)eese curls

Important considerations
# C)ild4s a$e is crucial< initial ste% in test ad&inistration # Test ite&s *ill be de%endent on a$e o( c)ild

Important considerations
# A$e < $uide t)e selection o( test ite&s and subse=uent inter%retation o( results

Scoring the Test

# # # # !assed +ailed Re(used, or No o%%ortunity

Scoring the test

# +ailure o( an ite& t)at is co&%letely to t)e le(t o( t)e c)ild4s a$e is considered a de'elo%&ental delay

The Test Form

# Made o( 7>9 ite&s *ritten in t)e ran$e o( de'elo%&ent o( c)ildren bet*een birt) and si? years o( a$e

Four Sectors
# Personal-Social @ tas1s *)ic) indicate t)e c)ild4s ability to $et alon$ *it) %eo%le and to ta1e care o( )i&sel(

Four Sectors
# Fine-Motor Adaptive @ tas1s *)ic) indicate t)e c)ild4s ability to see and use )is )ands to %ic1 u% obAects and to dra*

Four Sectors
# Language @ tas1s *)ic) indicate t)e c)ild4s ability to )ear, (ollo* directions and to s%ea1B and

Four Sectors
# Gross-Motor @ tas1s *)ic) indicate t)e c)ild4s ability to sit, *al1 and Au&%

Test Directions
7. Try to $et t)e c)ild to s&ile by s&ilin$, tal1in$ or *a'in$ to )i&. Do not touc) )i&. C. .)en t)e c)ild is %layin$ *it) toy, %ull it a*ay (ro& )i&. !ass i( )e resists.

Test Directions
# C)ild does not )a'e to be able to tie s)oes or button in t)e bac1 Mo'e yarn slo*ly in an arc) (ro& one side to t)e ot)er, about ,D abo'e c)ild4s (ace. !ass i( t)e eyes (ollo* E>o to &idline. 2%ast &idlineB 7:>o3

Test Directions
# # !ass i( t)e c)ild $ras%s rattle *)en it is touc)ed to t)e bac1s or ti%s o( (in$ers !ass i( t)e c)ild continues to loo1 *)ere yarn disa%%eared or tries to see *)ere it *ent. Farn s)ould be dro%%ed =uic1ly (ro& si$)t (ro& tester4s )and *it)out ar& &o'e&ent

Test Directions
7. !ass i( t)e c)ild %ic1s u% c)eese curl *it) any %art o( t)e t)u&b and (in$er C. !ass i( c)ild %ic1s u% c)eese curl *it) t)e ends o( t)u&b and inde? (in$er usin$ an o'er )and a%%roac)

Test Directions
7. !ass any enclosed (or&. +ail continuous round &otion.

Test Directions
7. .)ic) line is lon$er 2not bi$$er3. Turn t)e %a%er u%side do*n an re%eat 2C8C or 98,3

Test Directions
7. !ass any crossin$ line

Test Directions
7. Ga'e c)ild co%y (irst. I( (ailed, de&onstrate

Test Directions
# Note
@ .)en $i'in$ ite&s E, 77 and 7;, do not na&e t)e (or&s. Do not de&onstrate E and 77.

Test Directions
7. .)en scorin$, eac) %air 2; ar&s, ; le$s, etc3 counts as one %art C. !oint to %icture and )a'e t)e c)ild na&e it. 2No credit is $i'en (or sounds only3

Test Directions
7. Tell t)e c)ild to: $i'e bloc1 to &o&&yB %ut bloc1 on tableB %ut bloc1 on (loor. !ass ; o( C. 2Do not )el% c)ild by %ointin$, &o'in$ )ead or eyes.3 C. As1 c)ild: .)at do you do *)en you are cold/ Gun$ry/ Tired/ !ass ; o( C.

Test Directions
# Tell c)ild to: !ut bloc1 on tableB under tableB in (ront o( c)air, be)ind c)air. !ass C o( 5. 2Do not )el% c)ild by %ointin$, &o'in$ )ead or eyes.3 As1 c)ild: I( (ire is )ot, ice is/ Mot)er is a *o&an, Dad is a/, a )orse is bi$, a &ouse is / !ass ; o( C.

Test Directions
7. As1 c)ild: .)at is a ball/ Ri'er/ Des1/ Gouse/ Hanana/, Curtain/ Roo(/ +ence/ "treet/ !ass i( de(ined in ter&s o( use, s)a%e, *)at is it &ade o( or its $eneral cate$ory 2suc) as banana is a (ruit, not Aust yello*3. !ass , o( E.

Test Directions
# As1 c)ild: .)at is a s%oon &ade o(/ A s)oe &ade o(/ A door &ade o(/ 2no ot)er obAects can be substituted.3 !ass C o( C. .)en %laced on sto&ac), c)ild li(ts c)est o(( table *it) su%%ort o( (orear&s and8or )ands.

Test Directions
7. .)ile c)ild is on bac1, $ras% )is )ands and %ull )i& to sittin$. !ass i( )ead does not )an$ bac1 C. C)ild &ay use *all or rail only, not %erson. May not cra*l.

Test Directions
7. C)ild &ust t)ro* ball o'er)ead C (eet to *it)in ar&4s reac) o( tester C. C)ild &ust %er(or& standin$ broad Au&%s o'er *idt) o( test s)eet 2: inc)es3

Test Directions
7. Tell c)ild to *al1 (or*ard, )eel *it)in 7 inc) o( toe. Tester &ay de&onstrate. C)ild &ust *al1 5 consecuti'e ste%s, ; out o( C trials.

Test Directions
7. Hounce ball to c)ild *)o s)ould stand C (eet a*ay (ro& tester. C)ild &ust catc) ball *it) )ands, not ar&s, ; out o( C trials.

Test Directions
7. Tell c)ild to *al1 bac1*ard toe *it)in 7 inc) o( )eel. Tester &ay de&onstrate. C)ild &ust *al1 5 consecuti'e ste%s, ; out o( C trials.

Important
# Date and He)a'ioral Obser'ations
@ Go* c)ild (eels at ti&e o( test, relations to tester, attention s%an, 'erbal be)a'ior, sel(6 con(idence, etc3

The Test Form

# Across t)e to% and botto& o( (or& are a$e scales # A$e is &ar1ed in &ont)s 76;5, and a$e in years (ro& ; - to ,.

The Test Form

# Eac) ite& is re%resented in t)e test (or& by a bar # T)e bar is %laced alon$ t)e a$e scale to s)o* *)en ;9I, 9>I 2indicated by t)e )atc) &ar13 J9I and E>I o( t)e nor&al c)ildren are able to %ass t)e ite&.

The Test Form

7> 77 7; 7C
Gatc) Mar1 9>I .AL0" .ELL

75

7,

7:

!ercenta$e o( nor&al c)ildren %assin$ t)e ite&

;9I

J9I

E>I

The Test Form

# "o&e ite&s )a'e a s&all (ootnote nu&ber at t)e le(t end o( t)e bar # +ootnote indicates corres%ondin$ instruction (or ad&inisterin$ t)e ite& (ound at t)e test (or&
Ite&s *)ic) can be %assed by re%ort +ootnote nu&ber R .AL0" K! "TE!"
;C

The Test Form

# "o&e ite&s &ay be passed by report o( t)e %arent 2R3 # Only ite&s *it) an R on t)e (or& can be passed by report # Go*e'er, *)ene'er %ossible tester s)ould obser'e *)at t)e c)ild can %er(or&

The Test Form

# T)e ite&, equal movements, )as an asteris1 2L3 at t)e ri$)t end o( its bar # Indicates 7>>I o( nor&al c)ildren %ass t)is ite& at birt) # It is t)e only ite& *it) an L 2(ine6&otor ada%ti'e sector

The Test Form

# E ite&s )a'e arro*s 2 3 at t)e ri$)t end o( t)ese bars # T)is includes t)e ite&s, de(ines *ords and co&%osition o( MM. # Arro*s indicate t)at nor&al c)ildren &ay %ass t)ese ite&s e'en beyond , - y.o.

Calculating Child s Age

# +or&ula
Date o( test Hirt)date A$e o( c)ild Fear EE 6EJ ; Mont) 77 6 C : Day 79 67> 9

Calculating Child s Age

# +or&ula
Fear Date o( test Hirt)date A$e o( c)ild EE 6EJ 7 Mont) ; 6 C 7> Day : 67> ;9

Calculating Child s Age

# +or&ula
Fear E: Date o( test Hirt)date A$e o( c)ild EE 6EJ 7 Mont) 7C ; 6 C 7> Day C9 : 67> ;9

Drawing the Age !ine

# Kse a$e scale s)o*n at t)e to% and botto& o( t)e (or& # Mar1 t)e a$e and dra* a line t)rou$) all (our sectors # ")o* acetate

Drawing the Age !ine

# Location o( a$e &ust be accurate inter%retation de%ends on correct %lace&ent o( t)e line # "%ace bet*een a$e @66 ; *ee1s until 75 &os, 7 &o (ro& 75 to ;5 &os # +ro& ;5 &os to 9 yrs s%aces bet*een re%resent C &os and t)erea(ter , &os

Ad"usting for Prematurit#

# !re&aturity a((ect ability to %er(or& t)at nor&al c)ild %ass at t)e sa&e a$e # AdAust (or c)ildren ; years or youn$er # A(ter ; years, it is no lon$er necessary to co&%ensate 2+ran1enbur$, et al3 # No adAust&ent is &ade on %ostter&

Ad"usting for Prematurit#

# As1 &ot)er i( c)ild *as born %re&aturely # +or t*o or t)ree *ee1s earlier, subtract t)e nu&ber o( *ee1s (ro& actual a$e # Dra* a$e line based on adAusted a$e

Selecting Items to $e administered

# Ad&inister (irst t)ose t)rou$) *)ic) c)ild4s c)ronolo$ical a$e line %asses # I( (ailure occurs in any ite&s, %roceed to ad&inister ite&s to t)e le(t o( t)e a$e line until you obtain C %asses t)en sto%

Selecting Items to $e administered

%&AT TO K''P I( MI(D)))))

Selecting Items to $e administered

# All ite&s crossin$ t)e a$e line s)ould be ad&inistered # C)ild s)ould )a'e a &ini&u& o( t)ree %asses to t)e le(t o( any (ailureB and # Eac) sector s)ould )a'e at least C %asses and t)ree (ailures

The Test Procedure

# !reli&inary !)ase
@ Establis) ra%%ort @ Ma1e t)e c)ild as co&(ortable as %ossible
# I( in(antNon &ot)er4s la% # Materials s)ould be accessible

The Test Procedure

# I( c)ild is one year older, %ut c)ild at ease
@ ")o* toysNetc

The Test Procedure

# "tart *it) Personal-social sector # Gi'es c)ild c)ance to $et used to tester # Gi'es tester c)ance as1 %arents *)ic) can be scored based on re%ort and can also directly obser'e it

The Test Procedure

# Fine motor-adaptive sector (ollo*s # C)ild can %er(or& tas1s e'en *it)out )a'in$ to directly tal1 to tester # +ili%ino c)ildN..*ar&in$ u%

The Test Procedure

# T)ird is, language sector # T)is ti&e c)ild is &ore co&(ortable *it) you 2tester3 # .ill tal1 as &uc) to you

The Test Procedure

# Lastly, gross-motor sector # Many c)ildren are too s)y at t)e be$innin$ o( t)e test

The Test Procedure

.GAT MAF NOT HE CGANGED/

The Test Procedure

# Manner in *)ic) eac) test is ad&inistered # .ords or direction &ay not be c)an$ed #