Module 02: Metro Manila Development Screening Test

Question 1

Who devised the Metro Manila Development Screening Test?

Answer 1

Devised by Phoebe Williams, who is a pediatric nurse and a professor of BS Nursing at UP

Question 2

The Metro Manila Development Screening Test is a modified standard of what?

Answer 2

Denver Developmental Screening Test (DDST) of Dr. William K. Frankenberg

Question 3

This is a simple, clinically useful tool used in the early detection of children with serious developmental delays in children 2 weeks to 6 1/2 years old.

Answer 3

Metro Manila Development Screening Test

Question 4

What are the most common misconceptions of the Metro Manila Development Screening Test?

Answer 4

(1) It is not an intelligence test.
(2) It is not a diagnostic test.
(3) It is not a predictor of future adaptive or intellectual ability.

Question 5

What are the four (4) purposes of the MMDST?

Answer 5

To evaluate the four (4) aspects of a child’s development.
(1) Personal or social
(2) Fine motor or adaptive
(3) Language
(4) Gross Motor Behavior

Question 6

This aspect of a child’s development pertains to the task which indicate the child’s ability to get along with people and take care of himself.

Answer 6

Personal or social

Question 7

This aspect of a child’s development pertains to the take which indicate the child’s ability to see and use his hands to pick up objects and to draw (hand eye coordination). (e.g. pen or cup grip, stacking blocks, associating shapes.)

Answer 7

Fine motor or adaptive

Question 8

This aspect of a child’s development pertains to the task which indicate the child’s ability to hear, follow directions and to speak.

Answer 8

Language

Question 9

This aspect of a child’s development pertains to the task which indicate the child’s ability to sit, walk and jump.

Answer 9

Gross Motor Behavior

Question 10

What are the standard test materials of the MMDST kit?

Answer 10

(1) A bright red yarn pom-pom
(2) A rattle with narrow handle
(3) 8 1-in colored wooden blocks (2 red, 2 blue, 2 yellow, 2 green)
(4) Small clear glass/bottle with 5 or 8 inch opening
(5) Rubber ball 12 ½ inches in circumference
(6) Cheese curls (purchased separately)
(7) Pencil
(8) Bond paper

Question 11

What are the important considerations to notice when conducting the MMDST?

Answer 11

(1) Child’s age is crucial (The initial step is to always ask the child’s birthdate)
(2) Test items will be dependent on the age of the child.

Question 12

This is characterized to guide the selection of test items and subsequent interpretation of results.

Answer 12

Age

Question 13

How should one score the MMDST Test?

Answer 13

(1) Passed (P)
(2) Failed (F)
(3) Refused (R)
(4) No opportunity (NO)

Question 14

When should the nurse record failed in the MMDST Scoring Sheet?

Answer 14

After three preceding tries

Question 15

When should the nurse record refused in the MMDST Scoring Sheet?

Answer 15

When the child was able to do prior the assessment, but does not want to do it during the test (always verify with the parents).

Question 16

When should the nurse record no opportunity in the MMDST Scoring Sheet?

Answer 16

If material needed for a specific item in the test is not on hand.

(Score completely to the left of age line (which may indicate a development delay. The score should be specified in the middle (50%) of the rectangle)

Question 17

The test form is constituted of how many items?

Answer 17

(1) 105 items
(2) Written in the range of accomplishments for children between birth and 6 years of age

Question 18

The instructions for administering the footnoted items of the MMDST test can be located where?

Answer 18

Instructions for administering footnoted items are placed at the back of the test form.

Question 19

Where is the BAR representing the item located?

Answer 19

The BAR representing the item is located between 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.

Question 20

Some items have a small footnote number at the left end of the bar. This number indicates what?

Answer 20

The corresponding instructions for administering the item that is found at the back of the test form.

Question 21

What items in the MMDST scoring sheet can be passed by report?

Answer 21

(1) Only items with an R on the form may be passed by report.
(2) However, whenever possible, the tester should observe what the child can actually perform rather than ask the parent, even though the item may be passed by report

Question 22

The item EQUAL MOVEMENTS has an asterisk (*) at the right end of its bar, what does that indicate?

Answer 22

This indicates that 100% of normal children pass this item at birth.

Question 23

Where can the term equal movements with an asterisk be located?

Answer 23

This is only the item with an asterisk and is located in the fine-motor adaptive sector of the test form.

Question 24

On the MMDST kit, there are nine items that have arrows (–>) at the RIGHT end of the bars, what do these indicate?

Answer 24

The arrows indicate that normal children may pass these items even beyond 6 ½ years of age.

Question 25

What do spaces between numbers indicate?

Answer 25

Spaces in between numbers indicate 2 weeks (2 weeks to 14 mos. old); 1 month (14 mos. to 24 mos.); 9 months (24mos. to 5 years); 6 months (5 years to 6 years).

Question 26

How do you calculate the child’s age?

Answer 26

Ask the birth date of the child and calculate the exact age using the formula: date of test - birth date.

Question 27

Why should you calculate the child’s current age when conducting the MMDST?

Answer 27

This is the basis for drawing the age line and determining the test items to be administered.

Question 28

How should you compute the adjustment for prematurity?

Answer 28

(1) Ask the parent if the child was born prematurely.
(2) Adjusted Age = Subtract the number of weeks of prematurity from the actual age of the child.

Question 29

When is the adjustment for prematurity be applicable?

Answer 29

For 2 years old ½ and younger

Question 30

How should you draw the age line under the adjustment for prematurity?

Answer 30

Draw the age line based on the adjusted age, not the chronological age.

Question 31

What is the formula when calculating the adjustment for prematurity?

Answer 31

Actual age - numbers of weeks of prematurity = Adjusted Age

Question 32

When selecting items to be administered, how should you choose those that should be administered first?

Answer 32

Items to be administered first are those through which the child’s chronological age line passes.

Question 33

What happens when failure occurs during the MMDST test?

Answer 33

If FAILURE occurs in any of these items, PROCEED to administer items to the LEFT of the age line until you obtain THREE PASSES, then STOP.

Question 34

What happens when the items being conducted are passed during the MMDST test?

Answer 34

In items PASSED, continue testing to the RIGHT where the items become progressively more difficult until the child fails three times in that sector.

Question 35

What are the key points to consider when selecting items to be administered?

Answer 35

(1) All items crossing the age 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 and 3 failures.

Question 36

When administering the test, what should the nurse do when starting with the personal-social factor?

Answer 36

(1) Gives the child a chance to get used to the tester.
(2) Give tester chance to ask parents or caregiver which items can be scored based on report or directly observed.

Question 37

What should the child manifest when administering the fine motor adaptive sector?

Answer 37

The child can perform the task at hand without having to directly talk to the tester.

Question 38

This part of the MMDST is characterized as the essential warming up period for a shy Filipino child.

Answer 38

Fine motor adaptive sector

Question 39

What should the child manifest when administering the language sector?

Answer 39

By this time, child will be more comfortable with you(tester) and much more likely to answer questions and talk to you – Frankenberg et al. (1970).

Question 40

Why was the gross-motor sector categorically placed last?

Answer 40

Many children are too shy to try these items at the beginning of the test.

Question 41

What may not be changed when conducting the MMDST?

Answer 41

(1) Manner in which test items is administered.
(2) Words or directions may not be changed.
(3) Avoid asking questions that you suggest the answer.

Question 42

What items should be conducted first or initially during the MMDST?

Answer 42

Items that the child is able to perform easily.

Question 43

How many trials is allowed to perform preceding before a failure score is given?

Answer 43

Three (3) Trials

Question 44

How can we minimize a refusal?

Answer 44

To minimize refusals, tell the child what to do (Gawin mo/Gayahin mo ito) and not ask “can he” or “will he” (kaya mo bang gawin) Frankenburg et al. (1970).

Question 45

When should the nurse score R instead of F?

Answer 45

Only if she is certain that the child can perform the item but refuses to do so at the same time of the test.

Question 46

When should the the nurse score a delay?

Answer 46

When a test item that is failed falls completely to the left of the age line (A child failed to pass an item which 90% of children normally can pass at a younger age.)

Question 47

How should delays be emphasized?

Answer 47

By shading the right end of the bar of the delayed item.

Question 48

When is a developmental delay not considered?

Answer 48

When the age line touches the right end of the bar.

Question 49

How should a nurse interpret the results on the scoring sheet?

Answer 49

(1) Normal
(2) Abnormal
(3) Questionable
(4) Untestable

(depends on the number of delays)

Question 50

What are the steps in interpreting the number of test results?

Answer 50

(1) Mark each delay by heavily shading the right end of the bar.
(2) Count the number of sectors that have 2 or more delays.
(3) Count the number of sectors that have 1 delay with no passes intersecting the age line in the same sector.
(4) Interpret the result using this criteria.

Question 51

Determine the interpretation.

2 or more sectors with 2 or more delays.

Answer 51

Abnormal

Question 52

Determine the interpretation.

1 sector with 2 or more delays plus 1 or more sectors with 1 delay and in that same sector, no passes intersecting the age line.

Answer 52

Abnormal

Question 53

Determine the interpretation.

1 sector with 2 or more delays.

Answer 53

Questionable

Question 54

Determine the interpretation.

1 or more sectors with 1 delay and in the same sector, no passes intersecting the age line.

Answer 54

Questionable

Question 55

Determine the interpretation.

When REFUSALS occur in numbers large enough to cause the test result to be QUESTIONABLE or ABNORMAL if these were scored as failures.

Answer 55

Untestable

Question 56

Determine the interpretation.
Any condition not listed above.

Answer 56

Normal

Question 57

How should the test result be discussed with the parents or the caregiver?

Answer 57

(1) Ask the parent or caregiver whether the child’s performance is typical of his or her ability and behavior.
(2) Give the interpretation of result in general terms rather than using the labels, abnormal, questionable or normal.
(3) Praise the child and reassure parent that the child is developing as he/ or she should be.
(4) If the child has delays, remind them that this is just a screening test and would like to retest the child again within 2 weeks.

Question 58

How should a retest be conducted?

Answer 58

(1) Use the same form and draw the new age line.
(2) Score the new test form and draw the new age line.
(3) Write the date of the retest at the top of the new age line.

Question 59

A child who is abnormal, questionable or unstable on the second test should be what?

Answer 59

Referred to a growth and development pediatrician.

Question 60

What should the nurse do when faced with a shy child?

Answer 60

(1) Offer a toy or kit item to play with.
(2) Give more time to become familiar with tester and test materials.
(3) Ask the parent to administer some items or to show how they are done.

Question 61

This difficult test situation pertains to a child who is not a shy but refuses to do what is asked of him or her.

Answer 61

Uncooperative child

Question 62

How should the nurse approach an uncooperative child during the test?

Answer 62

(1) Ask the parent to leave the room.
(2) If the child becomes upset with separation, the parent may need to leave the room but is requested to turn away within seeing distance of the child.
(3) If the parent says that the child can do certain items but is uncooperative, ask the child to do the opposite (reverse psychology).

Question 63

How should the nurse approach a child with siblings during the test?

Answer 63

(1) Explain to the parent the need to test each child individually.
(2) Ask the parent to send the siblings on errands.

Question 64

How should the nurse approach a hyperactive child during the test?

Answer 64

(1) Bring out only the materials needed for each test item.
(2) Do the test in a quiet room.
(3) Calling the child’s name or simply touching his arm can help return the child’s focus.
(4) The best way to handle the overactive child is to master the test items.

Question 65

How should the nurse approach an interfering parent during the test?

Answer 65

(1) Remind the parent that the child is not expected to perform everything asked of him or her.
(2) Have the parent leave the room if possible.
(3) Discontinue the test and reset the re-screening within 2-3 weeks.