MMDST

MMDST
Erwin Miliang-Escober BSN RN LPT MAN(c)

Professor
METRO MANILA DEVELOPMENT
SCREENING TEST
Overview
• Screening is a presumptive
identification of unrecognized disease
or defect
• Early detection model
• Test children with problem
• Facilitates early referral and treatment
Overview
• Detection of developmental disabilities
• Children 6 ½ years and below
What then is MMDST?
MMDST
• Simple and clinically useful tool
• To determine early serious developmental

delays
MMDST
• Dr. William K. Frankenburg
• Modified and standardized by Dr.

Phoebe D. Williams DDST to MMDST
MMDST
• Developed for health professionals (MDs,
RNs, etc)
• It is not an intelligence test

MMDST
• It is a screening instrument to
determine if child’s development is
within normal
Purposes
• Measures developmental delays
• Evaluates 4 aspects of development

Aspects of development
• Personal-social
• Fine-motor adaptive
• Language
• Gross motor behavior
MMDST Kit
• Manual
• Sample test form
• Test materials
• MMDST bag
Test materials
• A bright red yarn pom-pom
• A rattle with narrow handle
• Eight 1-inch colored wooden blocks (red,
yellow, blue green)
Test materials
• A small clear glass/bottle with 5/8 inch
opening
• A small bell with 2 ½ inch-diameter mouth

Test materials
• A rubber ball 12 ½ inches in circumference
• Cheese curls
• A pencil
• Cheese curls
Important considerations
• Child’s age is crucial= initial step in test
administration
• Test items will be dependent on age of

child
Important considerations
• Age = guide the selection of test items and
subsequent interpretation of results
Scoring the Test
• Passed
• Failed
• Refused, or
• No opportunity
Scoring the test
• Failure of an item that is completely to the
left of the child’s age is considered a
developmental delay
The Test Form
• Made of 105 items written in the range of
development of children between birth and
six years of age
Four Sectors
• Personal-Social – tasks which indicate
the child’s ability to get along with people
and to take care of himself
Four Sectors
• Fine-Motor Adaptive – tasks which
indicate the child’s ability to see and use
his hands to pick up objects and to draw
Four Sectors
• Language – tasks which indicate the
child’s ability to hear, follow directions and
to speak; and
Four Sectors
• Gross-Motor – tasks which indicate the
child’s ability to sit, walk and jump
Test Directions
1. Try to get the child to smile by smiling,
talking or waving to him. Do not touch
him.
2. When the child is playing with toy, pull it

away from him. Pass if he resists.
Test Directions
3. Child does not have to be able to tie
shoes or button in the back
4. Move yarn slowly in an arch from one

side to the other, about 6” above child’s
face. Pass if the eyes follow 90o to
midline. (past midline; 180o)
Test Directions
5. Pass if the child grasps rattle when it is
touched to the backs or tips of fingers
6. Pass if the child continues to look where

yarn disappeared or tries to see where it
went. Yarn should be dropped quickly from
sight from tester’s hand without arm
movement
Test Directions
7. Pass if the child picks up cheese curl
with any part of the thumb and finger
8. Pass if child picks up cheese curl with

the ends of thumb and index finger using
an over hand approach
Test Directions
9. Pass any enclosed form. Fail continuous
round motion.
Test Directions
10. Which line is longer (not bigger). Turn
the paper upside down an repeat (3/3 or
5/6)
Test Directions
11. Pass any crossing line
Test Directions
12. Have child copy first. If failed,
demonstrate
Test Directions
• Note
– When giving items 9, 11 and 12, do not name
the forms. Do not demonstrate 9 and 11.
Test Directions
13. When scoring, each pair (2 arms, 2 legs,
etc) counts as one part
14. Point to picture and have the child name

it. (No credit is given for sounds only)
Test Directions
15. Tell the child to: give block to mommy;
put block on table; put block on floor.
Pass 2 of 3. (Do not help child by
pointing, moving head or eyes.)
16. Ask child: What do you do when you are

cold? Hungry? Tired? Pass 2 of 3.
Test Directions
17. Tell child to: Put block on table; under
table; in front of chair, behind chair.
Pass 3 of 4. (Do not help child by
pointing, moving head or eyes.)
18. Ask child: If fire is hot, ice is? Mother is
a woman, Dad is a?, a horse is big, a
mouse is ? Pass 2 of 3.
Test Directions
19. Ask child: What is a ball? River? Desk?
House? Banana?, Curtain? Roof? Fence?
Street? Pass if defined in terms of use,
shape, what is it made of or its general
category (such as banana is a fruit, not
just yellow). Pass 6 of 9.
Test Directions
20. Ask child: What is a spoon made of? A
shoe made of? A door made of? (no
other objects can be substituted.) Pass 3
of 3.
21. When placed on stomach, child lifts
chest off table with support of forearms
and/or hands.
Test Directions
22. While child is on back, grasp his hands
and pull him to sitting. Pass if head does
not hang back
23. Child may use wall or rail only, not

person. May not crawl.
Test Directions
24. Child must throw ball overhead 3 feet to
within arm’s reach of tester
25. Child must perform standing broad jumps

over width of test sheet (8 ½ inches)
Test Directions
26. Tell child to walk forward, heel within 1
inch of toe. Tester may demonstrate.
Child must walk 4 consecutive steps, 2
out of 3 trials.
Test Directions
27. Bounce ball to child who should stand 3
feet away from tester. Child must catch
ball with hands, not arms, 2 out of 3
trials.
Test Directions
28. Tell child to walk backward toe within 1
inch of heel. Tester may demonstrate.
Child must walk 4 consecutive steps, 2
out of 3 trials.
Important
• Date and Behavioral Observations
– How child feels at time of test, relations to
tester, attention span, verbal behavior, self-
confidence, etc)
The Test Form
• Across the top and bottom of form are age
scales
• Age is marked in months 1-24, and age in
years from 2 ½ to 6.
The Test Form
• Each item is represented in the test form
by a bar
• The bar is placed along the age scale to
show when 25%, 50% (indicated by the
hatch mark) 75% and 90% of the normal
children are able to pass the item.
The Test Form
10 11 12 13 14 16 18
Hatch Mark
25% 50% 75% 90%
Percentage of
normal children
passing the item WALKS WELL
The Test Form
• Some items have a small footnote number
at the left end of the bar
• Footnote indicates corresponding
instruction for administering the item found
at the test form
Items which can
be passed by report R
WALKS UP STEPS
23
Footnote number
The Test Form
• Some items may be passed by report of
the parent (R)
• Only items with an R on the form can be
passed by report
• However, whenever possible tester should
observe what the child can perform
The Test Form
• The item, equal movements, has an
asterisk (*) at the right end of its bar
• Indicates 100% of normal children pass
this item at birth
• It is the only item with an * (fine-motor
adaptive sector
The Test Form
• 9 items have arrows ( ) at the right end
of these bars
• This includes the items, defines words and
composition of __.
• Arrows indicate that normal children may
pass these items even beyond 6 ½ y.o.
Calculating Child’s Age
• Formula
Year Month Day
Date of test 99 11 15
Birthdate -97 - 3 -10
Age of child 2 8 5
• Formula
Year Month Day
Date of test 99 2 8
Age of child 1 10 25
• Formula
Year Month Day
98 13 35
Date of test 99 2 8
Age of child 1 10 25
Drawing the Age Line
• Use age scale shown at the top and
bottom of the form
• Mark the age and draw a line through all
four sectors
• Show acetate
Drawing the Age Line
• Location of age must be accurate
interpretation depends on correct
placement of the line
• Space between age –-- 2 weeks until 14
mos, 1 mo from 14 to 24 mos
• From 24 mos to 5 yrs spaces between
represent 3 mos and thereafter 6 mos
Adjusting for Prematurity
• Prematurity affect ability to perform that
normal child pass at the same age
• Adjust for children 2 years or younger
• After 2 years, it is no longer necessary to
compensate (Frankenburg, et al)
• No adjustment is made on postterm
Adjusting for Prematurity
• Ask mother if child was born prematurely
• For two or three weeks earlier, subtract
the number of weeks from actual age
• Draw age line based on adjusted age
Selecting Items to be
administered
• Administer first those through which child’s
chronological age line passes
• If failure occurs in any items, proceed to
administer items to the left of the age line
until you obtain 3 passes then stop
administered
WHAT TO KEEP
IN MIND!!!!!
administered
• All items crossing the age line should be
administered
• Child should have a minimum of three
passes to the left of any failure; and
• Each sector should have at least 3 passes
and three failures
The Test Procedure
• Preliminary Phase
– Establish rapport
– Make the child as comfortable as possible
• If infant…on mother’s lap
• Materials should be accessible
The Test Procedure
• If child is one year older, put child at ease
– Show toys…etc
The Test Procedure
• Start with Personal-social sector
• Gives child chance to get used to tester
• Gives tester chance ask parents which
can be scored based on report and can
also directly observe it
The Test Procedure
• Fine motor-adaptive sector follows
• Child can perform tasks even without
having to directly talk to tester
• Filipino child…..warming up
The Test Procedure
• Third is, language sector
• This time child is more comfortable with
you (tester)
• Will talk as much to you
The Test Procedure
• Lastly, gross-motor sector
• Many children are too shy at the beginning
of the test
The Test Procedure
WHAT MAY NOT BE CHANGED?

The Test Procedure
• Manner in which each test is administered
• Words or direction may not be changed
•

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MMDST

Erwin Miliang-Escober BSN RN LPT MAN(c)

• To determine early serious developmental

• Modified and standardized by Dr.

• It is not an intelligence test

• Evaluates 4 aspects of development

• A small bell with 2 ½ inch-diameter mouth

• Test items will be dependent on age of

2. When the child is playing with toy, pull it

4. Move yarn slowly in an arch from one

6. Pass if the child continues to look where

8. Pass if child picks up cheese curl with

14. Point to picture and have the child name

16. Ask child: What do you do when you are

23. Child may use wall or rail only, not

25. Child must perform standing broad jumps

WHAT MAY NOT BE CHANGED?

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