Kami Export MMDST

METRO MANILA
DEVELOPMENTAL sCREENIN9
TEST MANUAL
PHOEBE DAUZ WILLIAMS, RN, PhD
ADELINA B. ABAD SANTOS, RN, MN

LUZ B. TUNGPALAN, RN, MA
JOSEFINA A. TUAZON, RN, MN
Editors
Research and Creative Writing Program

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Foreword / v
Preface / vi
Metro Manila Developmental Screening Test Manual Overview of the MMDST / 1
Second Edition Test Form / 4
Copyright 0 1999 Preliminary Phase

by University of the Philippines Manila College of Nursing Test Administration
Test Items: Administration and Scoring Directions / 15
First Edition, 1985
Scoring Delays in Development / 66
Editors: Adelina B. Abad Santos
Interpreting Test Results / 67
Luz B. Tungpalan
Discussing Test Results / 68
All rights reserved. No part of this work covered by copyright Retesting / 68
herein may be reproduced or copied in any form or by any means Difficult Test Situations / 69
without written permission 'Of the publisher. Practice Testing / 73
Published by References / 74
University of the Philippines Manila Appendices / 76
College of Nursing A. Sample Protocols / 77
Pedro Gil St., Malate, Manila
B. NB/IDST Administration Checklist / 81
Philippines
C. Denver Developmental Screening Test
n 523-1472/523-1494 / 83
ISBW/971-93089-o-7
Foreword
The Metro Dv'lanila Developmental Screening Test

(MNIDST) devised by Dr. Phoebe Williams as a pediatric
screening test is a milestone in nursing. Being culture-
based, it has been widely used by nurses, physicians and
other workers for nearly two decades now. Indeed, its
culture sensitivity makes it easy to use for Filipino

childrem
is research—based and, as such, ShCU!Cl be

inherent to nursing practice. Developmental screening
should be made an integral part of the nursing curriculum
to enhance the competency of professional nurses,
specially would-be child health nurses, family nurse
practioners and nurse specialists.
The publication of this revised edition is part of the

U.P. College of Nursing's commitment towards
professional advancement in nursing and the enhancement
of the Filipino nurse's involvement in promoting wellness
and preventing disability.
This project has been made possible with the support of

the Commission on Higher Education (CHED) in
recognition of the UPCN's role as a center of excellence in
nursing education.
M. LAURENTE, Ph.D
Dean, U.P. College of Nursing
This second edition of the MMDST Manual is a project
of the Research and Creative Writing Program of the UP
College of Nursing, just as the first edition was. This edition
promises a format and language that is user-friendly. Its
more compact size makes it handier that will fit snugly into
the MMDST bag with the test materials. The topics have
also been rearranged for easier comprehension. Some of the
Preface illustrative examples were updated and made consistent with
the test form for better integration of learning.
This manual describes a screening process using the Metro This project is the result of a collaborative effort of many
Manila Developmental Screening Test (MINDS T). This test people. We specially acknowledge the editorial expertise of
was the product of a normative study in 1980 by the author, Prof. Luz B. Tungpalan whose assistance was invaluable,
Dr. Phoebe Dauz Williams, on Metro Manila children to and to the editorial staff, Sheila R. Bonito who prepared thé
standardize the widely recognized Denver Developmental manual for publication with the assistance of Erlinda S.
Screening Test of Frankenburg and his associates. Since then, Bilog and Glorie C. Mangalino. Special mention has to be
the MTv1DST has been validated and well utilized not only in given to Prof. Ma. Estela M. Layug whose expertise in the
research but in practice as well by nurses, pediatricians and 31uable comments helped direct the revisions
other health workers. Today, William's lvflv1DST remains to undertaken. Lastly, this project would never have reached
be the recognized developmental screening test among this stage without the urging and suppolt of Dean Cecilia M.
Filipino children. Laurente.
The author is a nurse researcher and professor with a BS in The project of writing the second edition is a personal
Nursing and MAPsychology from the University of the
in fulfillment because as a young graduate, my first job was as
Philippines, and Masters in Nursing and PhD from the a research assistant to Dr. Williamss normative study. And
University of Pittsburgh. She was a former professor and it is a privilege for RCWP to be given the chance to be a
head of the Department of Research, University of the collaborative panner with the likes of Dr. Williams and
Philippines College of Nursing. She is currently Professor of Prof. Tungpalan.
the University of Kansas School of Nursing and the only
Filipino Fellow of the American Academy of Nursing
(FAAN). Although she has been abroad for almost two
decades now, she remains to be an active member of the U.P. Josefina A. Angeles Tuazon
College of Nursing. From across the miles, she produced the Head, Research and Creative
first edition of the lvWIDST Manual in collaboration with the Irriting Program (RCVVP)
EZtJPCN Department of Research in 1985. Adelina B. Abad
Santos and Luz B. Tungpalan edited this first edition.
vii
An Overview
Screening is the presumptive identiflcation of an

umecognized disease or defect by the application of tests,
examinations or other procedures that can be applied rapidly.

Screening testy sort out apparently well persons who
probably have the problem from those who probably do not,
permitting those with positive or suspicious findings to be
referred for. diagnosis and appropriate treatment as early as
possible. One such screening tést is the Metro Manila
Development Screening Test (MMDST). It is an early
detection model that applies to the detection of developmental

disabilities in children aged six and a half years old and
younger.
OST is a useful tool used in the

early detection of children with serious developmental delays
developed by Dr. Phoebe D. Williams. It is a modification and
standardization of the original Denver Developmental
Screening Test (DDST) by Dr. William K. Frankenburg
and his associates (1970) on 6,006 Metro Manila children. It
was developed for health professionals such as nurses, doctors

and other health workers so that slow dev elopment may be
recognized, referrals made, and appropriate therapy prescribed
as soon as possible. Just like the DDST, the NINIDST is not an
intelligence test. It is intended as a screening instrument to
determine whether a child's development is within normal
range.
The B/D/IDST is designed to detect developmental delays in

children 2 weeks to 6 h years old. It evaluates four aspects of
a child's development: personal-social, fine motor-adaptive,
1
MMDS'T Manual
UMDST Manual
The test is administered using the MMDST kit which

includes the manual, sample test form, test materials and the
MMDST bag. The test materials are standard and shown in
Figure l. These consist of the following:
A bright red yarn pom-pom

A rattle with a narrow handle
Eight I-inch colored wooden blocks
(red, blue, yellow, green)
A small clear glass/bottle with 5/8 inch opening
A small bell with 2 h inch-diameter mouth
A rubber ball 12 lh.inches in circumference
Cheese curls
A pencil
Bond paper
Calculating the child's age-and-indicating the age line is
crucial, if not the most important, initial step in test

administration. The test items that will be administered will
depend on the calculated age of the child. Therefore, this will
guide the selection of test items to be administered and the
subsequent interpretation of the tvWIDST results.
Four kinds of scores may be given for eact test item:
passed, failed, refused or no opportunity. Failure of an item

that is completely 'to the left of the child's age line is
wonsidered a developmental delay and is therefore referred to

in the MMDST as a delay.
The succeeding sections of this manual will describe the
test form, steps in administering the NWLDST, scoring each

test item, and interpreting the test. Difficult test situations are
also presented plus the conditions under which retesting is Figure l. Test Materials
—.acceptable.
MONTHS YEARS
2 3 4 5 g 9 11 12 13 16 18 20 22 24 21/2 4
3 31/2 1/2 5 6
SHY
INITIALLY
WITH STRANGERS
C)
R PAT.A-CAXE
m rn
m o
WANTS a ORIES O
z 2 nzusrs (NOT CRY) z
TOY
n HELP8
R uiEBSES CUPERVIOON z
PCEk.A.bOO o
DRINKS FROM cup SEPARATES BOTHER EASILY
FOR T
an OF REACH
OCIES8ES 'MTHCRJI
2)
REMOVES GARMENT
3 m
m
SCREOLES
PONTANEOJSCY COPIES 17 COPIES
4
PAST MIDLINE
ø COPIES O
2 CUBES
I'..'TATES
teo• TN,'ER 05 BRJOGE DEMONSTR 33
a a.tØES
o TOGETHER n BANGS
HELD
2 cue€s
HANDS 8 ams c
INIIATES
VERTICAL
13 DRAWS 'H 3 PARTS
cu
z
NMPSCh C FROM BOTTLE
TRANSFERS 13 MAN e PARYS
C FR BOTTLE OEUONSTR
mcxs LONGER LINES
a OAOA og MAUA COMAENEQDS

NONSPEüFiC TIRED
COMEINES 2
L.AIÆHS
z
R e00EA&S
SPEECF SOUNDS
USES PLURALS
OZ-FINES
i A 1ST LAST NAME

coup
LEGS SAL-AWE
FOOT 10 SEC.
PR HEAD
e.u..A&CE ON
stoops
STEAOY
ROLLS OVER
SACXWARO
HEEÜroe
5 6 10 11 12 18 20 4
1/2 1/2 5
SYMMETRICAL MOVEMENTS (R) May pass by report.
Pass at 0.6 MONTH
MMDST Manual
Test Directions for Footnoted Items
Like the DDST, the MMDST is made up of 105 items

1. Try to get child to smile by smiling, talking or waving to him.
written in the range of accomplishments for children between
Do not touch him
birth and six years of age. The sample test form is shown in
2. When child is playing with toy, pull it away from him. Pass if
Figure 2. Instructions for administering footnoted items are
he resists.
placed at the back of the test form. These items are Child does not. have to be able to tie shoes or button in the back.
3.
categorized in four sectors: 4. Move yarn slowly in an arch from one side to the other, about 6"
l. Personal-Social tasks which indicate the child's above child's face. Pass if eyes follow 900 to midline. (Past
ability to get along with people and to take care of midline; 1800)
himself. 5. Pass if the child grasps rattle when it is touched to the backs or
2. Fine Motor-Adaptive - tasks which indicate the child's tipsof fingers.:
6. Pass if child continues to look where yarn disappeared or tries to
ability to see and to use his hands to pick up objects and
see where it Went.Yarn should be dropped quickly from sight
to draw.
from tester's hand without arm movement.
3. Language - tasks which indicate the child's ability to
7. Pass if child picks up cheese curl with any part of thumb and
hear, follow directions and to speak; and
finger.
4. Gross Motor - tasks which indicate the child's ability
Pass if child picks up cheese curl with the ends of thumb and
8.
to sit, walk, and jump. fingerusing an overhand approach.
Across the top and bottom of the test f01T1 are age scales
marking ages in months from I to 24, and ages in years from
to 6. Each of the test items is represented in the test form
by a bar. The bar is placed along the age scale to show when
9. Pass any en- 10. Which line is 11. Pass any cross- 12. Have child
25%, 50% (indicated by the hatch mark) 75% and 90% of copy first.
closed form. longer (not ing line
normal children are able to pass the item. A sample test item Fail contin- bigger). Turn If failed,
and the corresponding age scale is shown in Figure 3. uous round paper upside
motions down and re- strate
AGE SCALE (months) peat (3/3 or

10 11 12 13 14 16 18 20 5/6)
WYhen giving items 9,11 and 12, do not name the forms. Do not
hatch mark
Percentage of demonstrate 9 and 11.
50% 75% 90%
normal children
passing the item
WALKS LL 13. When scoring, each pair ( 2 arms,2 legs, etc.) counts as one part.
14. Point to picture and have child*lame it. ( No credit is given for
Figure 3
4
MMDST Manual
The bar representing the item, walks well, in Figure 3 is
located between ages less than 12 months and 17 months. The

left end of the bar denotes 25% of normal children walk
that
well at less than 12 months, 50% (indicated by hatch mark) at

13 months, left end of shaded area shows 75% do so at 15
1/4
15. Tell child to: give block to Mommy; put block on table; put months, and right end of bar shows 90% walk well at about 17
block on floor. Pass 2 of 3. (Do not help child by pointing,
months. All test items are represented similarly.
moving head or eyes. )
16. Ask child: What do you do when you are cold? hungry? tired? Some test items have a small footnote number at the left end
Pass 2 of 3. of the bar. This number indicates the corresponding instruction
17. Tell child to: Put block on table; under table; in front of chair, for administering the item that is found at the back of the test-
behind chair. Pass 3 of 4. (Do not help child by poiut.igg, form (see Figure 2). For example, the instruction for the item,
moving head or eyes. )
walks up steps, is #23 at the back of the test form (see Figure
18. Ask child: If fire is hot, ice is?; Mother is a woman, Dad is a ?;
4).
a horse isebig, a mouse is? Pass 2 of3.
19. Ask child: What is a ball? river? desk? house? banana? curtain? Some test items may be passed by report of the parent.
roof? fence? street? Pass if defined in terms of use, shape, what The letter R in the bgr as shown in Figure 4 indicates this. Only
is made of or its general category (such as banana is a fruit, not
it
items with an R on the form may be passed by report. However,
just yellow). Pass 6 of 9.
vvåmeverposslble, the tester should &rve the child can actually
20. Ask child: What is a spoon made off? a shoe made
made of? ( No other objects may be substituted.) Pass 3 of 3.
pérform rather than ask the parent, even though the item may
21. When placed on stomach, child lifts chest off table with support be passed by report.
of forearms and/or hands. Items lvhich can
22. While child is on his back, grasp his hands and pull him to be passed b) report
sitting. Pass if head does not hang back. WALKS UP STEPS

23. Child may use wall or rail only, not person. May not crawl. Footnote Number
24. Child must throw ball overhead 3 feet to within arm's reach of
tester. Figure 4
25. Child must pgrform standing broad jumps over width of test
sheet ( 8 h inches). The item, equal movements, has an asterisk ( * ) at the right
26. Tell child to walk forward, heel within end of its bar. This indicates that 100% of normal children pass
1 inch of toe. Tester may demonstrate. Child must walk 4 this item at birth. The item is hardly seen in the form but it is
consecutive steps, 2 out of 3 trials.
the only item with an * and is located in the fine motor adaptive
27. Bounce ball to child who should stand 3 feet away form tester.
sector of the test form.
Child must catch ball with hands, not arms, 2 out of 3 trials.
28. Tell child to walk backward toe within Nine items have arrows (4) at the right end of these bars.
1 inch of heel. Tester may demonstrate. Child must walk 4 This includes the items, defines words and composition of
consecutive steps, 2 out of 3 trials.
DATE AND BEHAVIORAL OBSERVATIONS (how child feels at ttme of test, relations even beyond 61 'ears of age.
to tester. attention span, verbal behavior, self-confidence. etc.)
MUDST Manual MMDST Manual
Calculating the Child's Age Drawing the Age Line
The first step is to calculate the child's age. This will be the Use the age scale shown at the top and bottom of the test
basis for drawing the age line later and determining the test form as a guide (see Figure 5). Mark the calculated age of the
items to be administered. Check the calculation very well child on the scale and draw a line through the four sectors of the
before placing the age line on the form test form. Write the date of the test at the top of the age line.
Ask for the birth date of the child and calculate the exact age
The location, of the age line must he accurate because the
using this formula: date of test minus birth date equals age of 1
depends upon correct placement of this line.
test interpretation
child. Calculate first the days, then months, and then years. To
The space between age marks represents 2 weeks until age 14
illustrate, if the birth date is March 10, 1997 and the date of test
months and 1 month from 14 to 24 months. From 24 months to
is November 27, 1999; then:
5 years, spaces between marks represent 3 months, and there-
Year Month Day after, 6 months the end of the age scale.
-to
Date of Test 99 11 15
To illustrate, in Figure 5, the test was administered on
Birth date - 97 -10 March 1, 1996 to a child 3 years and 3 months of age (line is
Age of Child 2 8 5 halfway between 3 and 3 h years).

Age of this child is therefore 2 years 8 months and 15 aåys.- 3-1-80
Somdimes, it becomes necessary to bonow• ' Make sure Months Years
30 days are bonovæd flom die month column md 12 months fiom the yar
20 21 22 23 24 3 4 41/2 5 51/2 6
column. For example, if the same child was tested on February
5, 1999, then: Puts on clothing
Year Month Day Buttons up
Washes and dries hands

98 13 35
Dresses with
96
'
Date of Test
Birth date _ 97 -3 -10 R Separates from mother

R Pliy•s games e.g., Tag
Age of Child 1 10 25
R Dresses w/0 5.rperviQi
Step 1. Convert the date of test from 99 years, 2 months and

5 days into 98 years, 13 months (12 + 1) and 35
days (30 + 5).
Step 2. Subtract the birth date from the converted date of Figure 5
test.
The age of the child at the time of testing is therefore I year,

10 months and 25 days.
MML)SI Manual
MMDST Manual
Adjustment for Prematurity clue date. Therefore, the age line isdrawn 6 weeks
Prematurity may affect the ability of the child to perform or earlier than the actual age of 12 h months, and not at 14
demonstrate items that other normal children pass at the same jnonths.
age. There is therefore a need to make adjustment for
prematurity for children aged 2 years or younger. After 2 years
of age, it is no longer necessal•y to 30mpensate for prematurity Selecting Items io be Administered
(Frankenburg, et al., 1970). No adjustment should be made for

Items to be are those though which the
children born later than expected.
child's chlonological age Imepasses. Lfa failui? occurs ih any of
3-1-80 these items, proceed to administer items to the left ofthe age line
ADJ 6 WEEKS
unfil you oåain passes, then stop. Ln items passed,
13 14 15 16 17 18 19
9 10 11 12
continue testing to the right where the items become
progressively more difficult until the child fails three times
R Imitates bousev.zork
in that sector.
Pat-a-ca ke R Uses spoon. *'illing little
RW Keep the following in mind in selecting the items to

Plays ball witli examiner
be administered:
R Helps in house siu2Pie
i) all-itemscrossing-theageline should be adminis-
indicates wants (Not cry)
tered
R Drinks from cup

2) the child should have a minimum of three passes
to the left of any failure; and
R Removes garmeut
3) each sector should have at least three passes and
three failures.
The number of items to be administered will vary

Figure 6
with the age and abilities of the child. Normally, a
First, ask the parent if the child was born prematurely. For child is on only twenty simple tasks or items.
tested
children born two or more weeks earlier than the expected date, The child may accomplish some of the tasks on his own
subtract the number of weeks of prematurity from the actual age of without being asked. One example is the item on the
the child. This is the adjusted age. Draw the age line based on the child's ability to sit alone. If the tester observes the
adjusted age, not the chronological age. child doing so at any time during the interaction, then
this is passed without asking the child to demonstrate it
To illustrate, in Figure 6, the actual age of the child is 14 months.
again.
The child was born 6 weeks premature or I Y2 months earlier than the
II
10
MMDST Manual
MMDST Manual
Administering the Test
Generally, the test starts with the personal-social sector.

Preliminary Phase
This gives the child a chance to get used to the tester while
Establish rapport with the mother/caregiver. State that the tester asks the parent/caregiver items which can be
you are interested in observing what babies and children can scored based on report but can also be directly observed.
do at celtain ages. State also that this is a screening test and The items that need to be administered directly in this sector
not an intelligence or IQ test. Reassure the mother/caregiver are given next. Fine motor-adaptive sector follows. In
that the child is not expected to be able to do all that the
this seetor, the. child can perfonil the task at hand without
child iS• åsked noi pass all the items administered. You having to talk to the tester directly as yet. For the shy
might explain it this way: Filipino child, this is an essential warming-up period.
"Maglalaro ho kami ng inyong anak at titignan
ko kung ano ang kanyang magagawa sa pamamagi-
The language sector is tested next. As Frankenburg et
tan nitongmga laruan. May mga tatanungin di ako
al. (1970) have observed: "By the time you have reached this
tsa inyo. HuwaÉ kayong mabahala kung hindi niya
point in the test, the child will be more comfortable with you
magawa lahat ng aking ipagagawa o hindi niya
masagot ang aking mga katanungan. '
and much more likely to answer questions and talk to you.
The gross motor sector is tested last. Many children are too
Make the child as comfortable as possible during the
shy to try these items at the beginning of a test.
test. on the mother's or caregiver's lap is the best
Sitting
position for the infant or toddler. The table on Winen-test
Although the above sequence is recommended, there are
materials are set should be easily accessible to the child. A
instances when you may vary the sequence of some items in
mat on the floor with you, the test administrator, in a
order to take advantage of the child's interest. For example,
kneeling position is recommended young infants
for testing
test items using common test materials like blocks may be
or even older children who live in poorer homes where
administered in sequence although these test items may
tables and chairs are not common fixtures in the houses.
belong to different sectors. This enables you to put the
Ifthe child is one year old or older, put the child at ease blocks away and divert the child's attention to the next task.
In general, clearing the table/floor of all materials except
by saying:
"(Name). ntay Inga laruan akong dala. those for the task at hand minimizes distractions.
Tingnan mo, o (Show a block)."

What may not be changed, however, is the manner in
Every eff01t is made to observe what the child can which each test item is administered. Words or directions
actually do rather than simply asking the parent. This is
may not be changed. Otherwise, test administration will not
done even if 46% of may be passed by verbal
the items
be standard. Avoid asking questions in such a way that you
report of a parent or other caregiver who knows the child suggest the answer.
well. Avoid testing the child when he is ill, sleepy, tired,
-hungry or upset.
13
12
MMDSI' Manual
MMDSTMa„ua1
For each sector, stan with items that the child is able to
perform easily. This motivates the child to perform the
more difficult tasks later on and provides the parent some
satisfaction as well. Praise the child for his/her efforts.
When the child has had 3 failures in one sector, move on to Personal-Social
the next sector of the test. In general, the child is allowed 3
trials to perform each item before a score of failure is given. Regards face
Please note that some items have required number of trials.
This is specified in the section on specific test item Administration Place the child on his back. The tester
administration. should come face to face to within 12
inches of the child.
To minimize refusals, the following suggestions made by Pass if the child actually looks 7t
Scoring
Frankenburg et al. are recommended'. Tell the child what to
tester.
do (Gawin/gayahin mo ito) and not ask "can he" or "will
he." If the child refuses to do any of the items, the parent/
Smiles responsively
caregiver should be asked to administer the item instead. It
is important that the parent/caregiver be told exactly how to May pass by report (R)
do this. Ifthe child still refuses, score the item R Administration Smile and talk to the child. Do not
to liéhliim.
Scoring Pass if the child smiles back. If this

Score "R" instead of "F" only if you feel certain that the
child can perfonn the item but refuses to do so at the time of cannot be seen, ask the parent if the
the test. A good way to validate this is to ask the parent if child smiles without being touched.
the child has performed whatever is being asked of him at (R ) Question Ngumingiti na ba ang bata kung
some previous time. For example, the child refuses to jump kinakausap mo, kahit hindi hina-
at the time of the test yet the parent reports that the child
hawakan?
jumps all the time at home. Since this item cannot be passed
by report, "R" twould be the approximate score. Smiles spontaneously
May pass by report (R)

Once you have completed the test administration, note During the test see if the child smiles
Administration
pertinent observations on the child's cooperation, attention
at tester or parent without any stimu-
span, verbal behavior, self-confidence, nervous habits,
lation, either by touch or sound
parent-child relationships, as well as your own overall
Scoring Pass if the child smiles on his own at
feeling about the testing. In some instances, a child may any time during the test. If this can-
have a normal test result, yet, he/she may present some
not be seen, ask the parent, "Does
problems in certain areas that need to be addressed by the
your-childsmilewithoutyou-touching
health care worker.
or talkT1@tOhim2"
15
MUDS/' Manual
MUDST Manual
Ngumingiti ba ang bala kahil hindi Works for toy out of reach
(R ) Question
kinakausap o hinahawakan? Place a toy that the child seems to
Achuinistration
enjoy on the table a little out of his
Feeds self cracker reach. Do not leave toy out of reach

too long or too far away. This may
Ask pal ent if the Child feeds himself a upset the child.
Administration
Pass if the child tries to get the toy.
cracker or cookie. Scoring
Any stretching of arm or arms or
Scoring Pass if the parent says the child can do
•this. Score "NO" if for some reason body to get the toy is a pass. Child
does not have to actually pick up the
the child has not been allowed to have
a cracker or cookie. toy
(R ) Question Nakakakain na ba Siya ng mag-isa ng
cookie o cracker? Initially shy with strangers

Resists toy pull Administration
See seems to be shy or
if the child
wary of the tester when he first sees

Administration Give the child a toy. While he is
the tester.
playing with it, gently try to pull it
atStrst shows•ome
away from him. cormg
hesitation or a little shyness of the
Scoring Pass if the child pulls back on the toy.
tester. If this cannot be seen, ask the parent
Child should actually resist having the
if the chüd acts diffetently towards strangers
toy taken from him.
than he does to peopleheis familiar with. (It
is important not to ask if he is afraid of

Plays peek-a-boo
Administration Make a small hole in the middle of the strangers. This may be misleading.)
Nangingilala na ba ang bata?
test form with a pencil or pen. When (R ) Question
the child is looking at the tester, the
tester hides his face with the test Plays pat-a-cake
form. Tester then looks around the
test form twice and says, "Peek-a- Administration Try to get the child to play pat-a-cake
boo." Look through the hole to see if or wave bye-bye. Do not touch the
the child watches for you to reappear. child's hands or arms.
Do not move the paper or the child
Scoring
Pass if the child responds to this. If
will watch it. this cannot be seen, ask the parent if
coring Pass if the child looks in the direction the-chill-playssugb_games as pat-a-

where tester's face appeared before without Atw
17
16
MMDST Manual MMDST Manual
parent moving the child's hands or Scoring Pass if the child can do this. (The cup
arms. must not be the type that has a spout.)
(R ) Question Nakakapagbabay o nakakapalakpak (R ) Question Nakakahawak na ba Siya ng tasa o

na ba Siya nang hindi hinahawakan baso at nakakainom na kaunti lang
ahg mga kamay? ang natatapon ?
Plays ball with examiner Removes garments

Administration Roll the ball to the child and try to get May pass by report (R)
him to roll it or toss it back. Administration Ask the parent if the child can remove
Scoring Pass if the child rolls or tosses the ball any of his clothing such as coat, shoes
back toward the tester. (Handin> the or underpants.
ball to the tester is not a pass.) Scoring Pass if the child can remove clothing
other than his hat, socks; or diaper
Indicates wants (not cry) on purpose.
(R ) Question Naaalis na ba niya ang kawang damit,
Ask the parent how the child lets one sapatos, o panty ng hindi tinutulzmgah?
Administration
know what he wants. ("How does
Imitates-housework
(name) let you know wheii-lE wants
something such as glass of water or a May pass by report (R)
Administration Ask the parent if the child imitates
Scoring Pass if the child lets someone know household chores such as dusting and
what he wants by pointing, pulling or sweeping.
saying a word. (Crying is not a pass.) Scoring Pass if the child copies any type of
(R ) Question Paano niva ipinaaalam na map gusto housework.
Siva, cava ng laruan o inumin atbp.? (R ) Question Gumagaya ba ang bata ng trabahong-
bahay katulad ng pagpupunas, pag-
Drinks from cup wawalis?

Administration Ask the parent if the child can hold a Uses spoon, spilling little
cup or glass and drink from it without May pass by report (R)
spilling much. Administration Ask the parent if the child uses a
spoon or fork to eat. If so, how much
does he spill?
19
MMDST MMDS'T' Manual
Scoring Pass if the child can use the spoon or Washes and dries hands
fork to get food to his mouth without
spilling much.
Administration Ask the parent if the child can wash
(R ) Question Nakakagamit ba ang bata ng kutsara na
and his own hands.
kaunti lang ang natatapon? Naisusubo
Scoring Pass only if the child can do all parts
ba niya ang pagkain gaya ng kanin o
of the two tasks without help, except
gulay na kaunti lang ang natatapon ?
turning on faucets that are out of his
reach. Hands should be almost come
Helps in house - simple tasks
pletely free of soap and almost com-,€
May pass by report (R) pletely dry to pass.
Administration Ask the parent if the child helps in the (R ) Question Kapag Siya ay naghuhugas ng kamay,
house by doing simple things like kaya na ba niyang magsabon, mag-
putting toys away or getting something for banlaw at magpatuyo nahg mag-isa,
a parent when asked. at hindi na kailangan ulitin pa?
Scoring Pass if the child actually helps in the
house in any way. Plays interactive games
(R ) Question Nakakatulong na ba Siya sa gawaing
bahay tulad •
Administration Ask the parent what kind of games
laruan? Nauutusan na ba ninyo,
the child plays with other children.
gaya ng "Paabot ng... ? "
Scoring Pass if the parent says the child plays
games in which he takes turns with
Puts on clothing
other children. Examples: hide and
May pass by repott (R) seek, tag, cops and robbers. Chasing
Administration Ask the parent if the child can put on any and fighting are not passes. (If thed
of his own clothing such as underpants, child plays with cars or dolls by himself
socks or shoes. but other children are playing, this*
Scoring Pass if the child can put any of his is not a pass.)
own clothing. Shoes do not have to (R ) Question Anu-anong wi ng Ico mg sinasalihan niya
be tied or on the correct foot. (Fail, if
kasama ng ibang bata?
child can put on only adult-size
clothing.) Separates from mother easily
(R ) Question Nakapag-susuot na ba siyang mag-isa
ng kanyang damit, panty, medyas, Administration At the end of the test, see how the
sapatos o tsinelas?
with the tester while the parent leaves

MMDST Manual Manual
the room, or see if the child will leave Buttons up

the room with the tester without the
parent. "Illis should not be done beforc
Administration Ask the parent if the child can button
the end of the test in case the child gets
any piece of clothing.
upset. Pass if the parent says that the child
Scoring
Scoring Pass if the child does not become too can. Buttons do not need to be in the
upset. If this cannot be seen, ask the
correct holes.
parent if the child can be left with a
(R ) Question Naibubutones/naikukutiyetes na ba ni
baby sitter, other than someone living
(name) ang damit niya?
in the household, without getting too
upset. Pass jfthe parent answers yes.
(R ) Question Naiiwanan na ba si (name) sa hindi

Dresses without supervision
kasambahay ng hindi iiyak?
May pass byreport (R)
Administration Ask the parent if the child can dress
himself without any help.
Dresses with supervision
Scoring Pass if the child can dress himself
May pass by report (R) completely and correctly without
Administration Ask the parent dreg have hélp only for
himself. If so, how much help is
tying shoe laces, and for girls, button-
needed? ing or zipping the back of the dresses.
Scoring Pass ifthe child can put on and take off
(R ) Question Kayang-kaya na ba ni (name) ang
his clothes, knows the front from the
magbihis ng tama at tapos na tapos
back, and needs no help except fol
ng hindi tinutulungan?
tying shoes or putting buttons into the
right holes. Parent may help the child
by telling him what to do as long as
the parent does not actually help the
child put on the clothes.
(R ) Question Nakapagbibihis na bang mag-isa si
(name)? Sa anong bagay Siya

nangangailangan ng tulong kung
Siya ay nagbibihis?
22
MUDST Manual UMDST Manual
Equal movements
Fine Motor Adaptive Administration While the child is on his back or being
held by the pæent, watch the activity
Follows to midline of the child's arrns and legs.
Place the child on his back. (At this Scoring Pass if the child moves his arms and
Administration
age the child's face will be turned to legs equally. (Fail if one leg or arm
eone side or the other. ) Hold the red does not move as much as the other.)
yarn about 6 inches in front of the

Follows past midline
Child's face. Shake the yarn to attract
Administration Place the child on Ilis back. Hold the
the child's attentionand theL move it.
red yam about 6 inches in front of the
slowly from one side in an arc (or half
child's face. Shake the yarn to attract
circle) over the middle of the child's
and then move it
the child's attention
head to the other side. If necessary,
slowly from one side in an arc over the
the movement of the yarn may be
middle of the child to the other side. If
stopped to reattract the child's atten-
necessary, the movement of the yarn
tion and then continue the arc. This
may be stopped to reattract the child's
may be repeated three times. Watch
are«
the child's head and eye movemerits.
This may be repeated three times.
Watch the cffld'she€d md eye movements.
Scoring Pass if the child follows the yarn to the
Scoring Pass if the child follows the yarn past
middle point of the arc with either his
the middle point of the arc with either
eyes alone or his head and eyes alto-
eyes alone or his head and eyes to-
gether. Make sure that the yarn has
gether. Make sure that the wool has
attracted the child's attention and that
attracted the child's attention, and that
he did not follow it before a failure is
he did not follow it before a failure is
given.
given.
Follows 1800
Administration Place the child on his back. Hold the red

yam about 6 inches in front of the child's
face. Shake the yam to atuact the child's
attention and then move it slowly fiom one
side in an ait over the middle of the child's
——headftoZthe=otherMde. #necessmy, the

movement of yam may be stopped to
24
MMDST Manual MAIDS]' Manual
reattract the child's attention and then Grasp rattle

continue the arc. This may be repeated Administration Place a rattle touching the back or
three times. Watch the child's head and
tips of the child's fingers when he is
eye movements. on his back on the table or is being
Scoring Pass if the child follows the wool with his
held by his parent.
head and eyes through the complete arc Pass if the child grasps the raffle for
Scoring
from one side to the other. a few seconds.
Regards-cheese-curl—
Administration The child should be held on the
parent's lap so that he can place his
Hands together hands on the table. Drop a cheese
May pass by report (R) curl directly in front of the child
Administration Watch child to see if he touches his
within easy reach. (The cheese curl
hands together in the midline (middle of
should be dropped on a surface that
his body). If this cannot be seen, ask the
gives a good contrast, such as white
parent if child has done this before.
paper, so that it can easily be seen).
Scoring Pass, if child touches his fingers together
The tester may point to or touch the
in the midline. Fail if this happens only cheese to attmct the cffld's attenfion.
when child is being cradled in parent's See whether the child looks at the cheese
arms and the hands are forced together ctrl.
(R ) Question Napag-aabot na ba ng bata ang kanyang Scorino Pass if the child looks at the cheese
mga daliri sa gitna ng katawan curl. (Fail if the child looks at the
(demonsåate) na hindi ninyo tinutulungan o
finger or hand instead of the cheese
kinakarga? curl.
26
MUDST Manual MUDST Manual
Reaches for object Scoring Pass if the child picks up 2 blocks and
holds I in each hand at the same time.
Administration If this callnot be seen, ask the parent if
The child should be held on the parent's lap
the child picks up 2 objects like this.
so that his elbows ate level with the table top
and that he can easily place his hands on the (R ) Question Kapag nakaupo ang bda nakakcpulot na
table. Place a toy (such as the rattle)

ba Siya ng dalawang bagay at
within easy reach of the child and nahahawakan ilo ng sabay sa tig-
tell him with words or motion to pick isang kamay?
it up.
Pass if the child reaches toward the
Rakes cheese curl, attains
Scoring
toy. He does not need to touch or Administration The child should be held on the pa-
pick up the toy for a pass. If this rent's lap so that he can place his
cannot be seen, ask the parent if the hands on the table. Drop a cheese
child has done this. curl directly in front of the child with-
(R ) Question Kapag may laruan sa kanyang hcra1)04 in easy reach. (The cheese curl
nagtatangka na ba Siyang abutin ito? should be dropped on a surface that
gives a good contrast, such as white
Sit, looks for yarn paper, so that it can easily be seen).
Administration While flie child is sitting on the palent's lap, The tester may point to or touch the cheese
attract his attention widi the yam. When to atfiactthe child's attenGon. See how
he is lookingatthe yarn, drop it so that it the child picks up die cheese curl.
falls out of his line of vision. Tester Scoring Pass if the child picks up the cheese
should not move hand or arm except curl with his hand using a Inking motion.
to let go of the yarn. Make that the clild was not able to
Scoring pass if child continues to look where pick it up only because of sticky fin-
the red yarn disappeared or tries to see gerso He should also be passed if he
where it went. uses a thumb-to-finger or neat pincer
grasp.
Sit, takes 2 cubes

Administration Place 2 blocks on the table in front of
the child. Tell the child to pick up the
blocks with words or motion, but do
not hand the blocks to the child.
28
MUDST Manual
MMDSTManua1
Passes cube hand to hand child has banged small objects, such
as blocks, together like this. (Pots
and pans or other large objects do not
Administration
See whether or not the child passes a
block from one hand to the other. The count.)
(R ) Question Maliban ho sa malalaking bagay,
tester may
encourage this by giving
nakakaganito (demonstrate) na ba
the child a block and then presenting
a second block to the hand that is Siya ng mga laruang kasing liliif nito?
already holding one. The child will
often pass the first block to the other Thumb-finger grasp
hand so that he can pick up the second Administration lhe dild should be held on the parent's lap so
block. ffatlmanplæehishandsmtletable.
Pass if the child passes the block froin cheese curl directly in front of the child
Scoring
one hand to the other without using within easy reach.(The cheese curl
his mouth, body or table. If this can- should be dropped on a surface that
not be seen, ask the parent if the child gives a good contrast, such as white
passes small items from one hand to paper, so that it can be easily seen).
the other. (Long objects such as The tester may demonstrate, -point to
spoons •wuu -'It) or touch the cheese curl to attract the
(R ) Question Maliban sa malalaking bagay gaya ng child's attention. See how the child
rattle o kutsara, nakapaglilipat-lipat picks up the cheese curl.
na ba Siya ng maliliit na bagay sa Scoring Pass if the child picks up the cheese
kanyang mga kamay? curl using any palt of the thumb and a
finger by bringing them together. He
Bangs 2 cubes held in hands should also be passed if he uses a neat
pincer grasp.
Administration A block is placed in each hand of the
child. The tester may encourage the
child to hit the blocks together with
banging motions, but he may not
touch the child's hands or do the ac-
tion for him. The tester may show the
Neat pincer grasp of cheese curl
child as long as the tester does not use
Administration The child should be held on the parent's
the child's hands.
Scoring
Pass W the childAiits the blocks
lap so that he can place his hands on the
together in front of himself. If this

cannot be seen, ask the parent if the
MMDST Manual
MMDSTManua1
Drop a cheese curl directly in front of (R ) Question Kapag Siya ay binigyan ng lapis at
the child within easy reach. (The papel, Siya ba ay nakapag-guguhit-

cheese curl should be dropped on a guhil ng mag-isa?
surface that gives a good contrast,
such as white paper, so that it can be Tower of 2 cubes
easily seen). The tester may point to Administration Place blocks on the
or touch the cheese curl to attract the table in front of the child. The tester
child's attention. See how the child may encourage him to stack the
picks•up the cheese curl. blocks one upon the other as high as
Scoring Pass if child picks up the cheese curl he can by showing him how and /or
using the ends of thumb and index handing the child the blocks. '(Thé
finger with an overhand approach. very young child is sometimes dis-
tracted by a number of blocks and
will perform this item more easily
when given the blocks one at a
e" time.) The child may have up to
three trials. (Pagpatung-patungin
mo ito tulad nito.)
Scoring Pass if the child puts one block on
[NOTE: For items involving drawing by the child, use plain paper and a top of another so that it does not fall
pencil. A pen is more difficult for most children to handle, and
when he removes his hands.
lined paper can be distracting.]
Scribbles spontaneously Tower of 4 cubes
Administration Place blocks on the table in front of

Administration Place a piece of paper and a pencil in the child. The tester may encourage
on the table so that
front of the child him to stack the blocks one upon the
he can reach them easily. The tester other as high as he can by showing
may place the pencil in the child's him how and /or handing the child
hand, but may not show the child how the blocks. The child may have up
to scribble. to three trials. Give more blocks.
Scoring Pass if the makes two or more

child (Dagdagan mo pa para tumaas).
purposeful marking on the paper. Scoring Pass, if the child balances 4 blocks
(Fail accidental marks or stabbing on top of one another so that they do

with pencil.) If this cannot be seen, not fall.
ask the parent -if the child scribbles

without help.
32 33
MMDST Manual MUDST Manual
Tower of 8 cubes Dumps cheese curl from bottle - spontaneously

Administration Place blocks on the table in front of Administration Place a cheese curl in the bottle and
the child. The tester may encourage tell the child to get it out. Do not use
him to stack the blocks one upon the the word "dump", or tell the child
other as high as he can by showing how to get the cheese curl out.
him how and / or handing the child (Ilabas mo ang iyong cheese curl.)
the blocks.The child may have up to Scoring Pass dumps the cheese curl
if the child
three trials. Present rest of blocks. out of the bottle without being shown
(Gamitin mong lahat ito.) how to do it. ((Dumping the
Scoring Pass if child balances 8 blocks on top e curl directly into the mouth or raking
of one another so that they do not it out of the bottle with a fingel is not/
fall.
a pass.)
Imitates vertical line

Dumps cheese curl from bottle - demonstrated
Administration The child should be seated at the table
Administration First see if child does this sponta-
•so that he is at a comfofiable writing
neously. If not, place a cheese curl in
level. Place paper and pencil in front
the bottle and tell the child to get it
of the child and tell Imim
out. If the child does not dump the
like the tester. The tester should
cheese curl, from the bottle on his
demonstrate how to draw vertical
own, show him how to do it 2 or 3
lines in the up and down (venical)
position for the child. Do not guide
times. (Gawin mo ito.)
Scoring Pass if the child dumps the cheese curl

the child's hand. Draw vertical line.
out of the bottle, either on his own, or
(Gayahin mo ito.)
after he is shown how to do it.
Scoring Pass if the child makes 1 line or more
(Dumping the cheese curl directly
on the paper, at least I inch long and
into the mouth or raking it out of the
not vatying lirE by more dun
bottle with a finger is not a pass.)
30 (see example). LilB d) not hive to
straight.
Imitates bridge
Administration The tester should tell the child to

watch closely while the tester
builds a bridge. Place 2 blocks side
by side with less than a block's space
between, buVnot touching. Place a
30 degree angle less than 30 degree angle third block on top -of these so—that it
wron&g angle
PASS PASS FAILURE
34
covers the space between. The tester (Alin ang mahaba, ito o ito?) Point to
then gives 3 blocks to the child and lines.
tells him to build a bridge like the one
Scoring Pass if the child picks the longer line
the tester built. The bridge should be 3 out of 3 times. If he fails to do this,
left standing for the to copy. the tester must give the item 3 more
The tester should not point out the times. A pass is given if the child
opening. (Masdan mong mabuti picks the longer line 5 out of 6 times.
itong ginagawa ko.) Demonstrate. The child receives a pass only if he is
(Gawin mo rin ang ganito.) Give correct 3 out of 3 times or 5 out of 6

blocks. times.
Scoring Pass if the child copies the block
bridge that the tester built. If the 2
blocks on the bottom of the bridge are
touching, ask the child "Is your bridge
like my bridge?" If the child's bridge
is not right, the tester should not give
hints to the child for correcting his
error.
Copies O
Administration Show the circle on the back of the test
form (Footnoted item #9) to the child.
Do not name it or move your finger or
pencil to show how to draw it. Tell
the child to draw one like the picture.
Picks longer line
(Gawin mo ito.) Point to the picture.
3 of 3 or 5 of 6
Scoring Pass any enclosed form that is not
Administration Show the parallel lines on the back of made up of continuous round mo-
the testform (Footnote # 10) to the tions. (See examples.)
child and ask him, "Which line is
longer ?" (The word bigger cannot be
changed.) After the child has pointed
to the line he thinks is longer, tum the
sheet upside down and ask the ques-
tion again. This must be done at least
Continuous Not
3 times. Rout!d-motiqns Closed
FAILURE FAILURE
36
Imitates demonstrated C] Copies +

Administration First, see if child can copy from the Administration Show the cross on the back of the test
picture without being shown how to form (Footnoted Item 1) to the child.
draw the figure. If he cannot, show the Do not name it or move your finger or
square on the back of the test form to the pencil to show how to draw it. Tell the
child. Do not name it or move you] child draw one like the picture.
to
finger or pencil to show how to draw it (Gayahin o gawin mo ito) Point to the
Tell dE childtodrawme Ifheic picture.
unable to copy picture, the tester shoulc Scoring Pass if the child draws 2 lines which
show him how by drawing two opposite any The do not
sidöfitst and dmtheother two
raffErthandrawing tlE square with a cominuots
opposite & intersect at
need to be exactly
point.
straight.
lines
If the child
uses 3 or 4 strokes to draw the cross, any
rndion Wen the square is davm a 2 intersecting is a pass.
motion it may to the
(Gwnawa kangtuladnito.) Demmstrate.

Scoring Pass" if the child draws a figure with
straight lines and with 4 square corners.
The corners may be f.
that intersect, but the corners must be
approximately right angles ( L. ) and not
rounded ( ) or pointed ( ). The
length should be less than 2 times the
width. PASS FAILURE
Draws man - 3 parts
Administration Give the child pencil and paper and tell
him to draw a picture of a boy or girl

PASS
(man or woman). Do not tell him to add
other parts to his drawing. When he
seems to have finished his drawing, ask,
"Are you finished?" Ifthe child answers,
"Yes," score the drawing. (Magdrawing
ka ng tao. Tapos ka na ba?) If yes, then
FAILURE FAILURE
38
Scoring Pass if the child has drawn 3 or more

body parts. One point is given for each Scoring Pass if the child draws a figure with
pair (ears, eyes, etc.) as well as for each straight lines and with 4 square corners
part which is not a pair (head, neck, without being shown how to draw it.
body, etc). (See example.) If one part or The corners may be formed by lines that
pair is not drawn, it is not counted. Note intersect. The corners must not be
in the test observations any unusual rounded or pointed. (See example) The
drawings, even if the child has identified length should be less than 2 times the
acceptable pans. width.
2
—2
—3
3
3 parts 3 parts parts

Pass
PASS PASS PASS
because only bccausc

eye. Must only limb.
have 2 for Must have 2
credit.
tor credit.
FAILURE FAILURE
Failure Failure
Copies Ü Draws man 6 parts

Administration Show the square on the back of the test Administration Give the child a pencil and paper and tell
form (Footnoted item #12). Do not him to draw a picture of a boy or girl
name it or move your finger or pencil to (man or woman). Do not tell him to add
show how to draw it. Tell the child to other parts to his drawing. When he
draw one like the picture. (Gumawa ka seems to have finished his drawings,
ng tulad nito.) Point to the picture.
ask, 0"Are-yowfmisIred?" If the child
answereyeÄ score the drawtno.
40 41
Language
Scoring Pass if the child has drawn 6 or more

body parts. One point is given for each Responds to bell
pair (ears, eyes, etc.) as well as for each Hold the bell so that the child cannot
Administration
single part (head, neck, body, etc.) See see it (to the side and a little behind
example. Note in the test observations
his ear).Ring the bell quietly. If the
any unusual drawing, even though the child does not seem to notice, tw it
child has identified acceptable parts. again later in the test session.
Scoring Pass if the child shows in any way that

the WI, swh as movement of
eyes, change in breaming or my other
change in
——5 activity:
Vocalizes - not crying

Administration During the tests listen for sounds other
6 parts 6 patiÄs
than crytng, such as cooing sounds.
PASS PASS Scoring Pass if the child makes sounds other

than crying. If this cannot be heard,
ask the parent if the child does this.
(R ) Question Maliban sa pag-iyak, may nadidinig

3 ka na bang ibang tinig/salita sa
kanya? Anu-anong tinig/salita ang
nagagawa niya?
Laughs
Administration During the test check whether the
(5 parts) child laughs aloud.
FAILURE Scoring Pass if the child laughs aloud withou

being tickled. If this cannot be heard,
ask the parent if the child does this.
(R ) Question Tumatawa na ba Siyang malakas kahit

MMDST Manual
MMDSTManua1
(R ) Question Nakakapagsabi na ba Siya ng dada o

Squeals
mama/tata o papa? (Hindi kailangan
May pass by report (R) na ang mommy o daddy and kanyang
Administration During the test check whether the
tinutukoy.)
child makes t»igh-pitched, happy,
squealing sounds.
Imitates speech sounds
Scoring Pass if the child makes these sounds.
If these cannot be heard, ask the par- May pass by report (R)
Administration Check whether the child imitates
ent if the child does this.
sounds made by his parent or the
(R ) Question Tumitilina ba Siya na parang
tester.
masayang-masaya? Paano sou twnitili?
Scoring Pass if the child makes 'sounds that are
Turns to voice like those he has heard within tie last
minute.. It these cannot be heard, ask

Administration While the child is suffed tlE patent's IQ
the parent if the child does this.
approach the
child from behind to within 8 inches (R ) Question Nakakagaya na ba Siya ng inyong
of either ear. Whisper the child's
mga salita? Anong mga saiita ang
name several times taking care that nagagaya niya?
tester's breath does -not töucn t-ne
child (child might then turn to where Da-da or Ma-ma, specific
he feels the breath rather than to the May pass by repott (R)
sound). Give up to 3 trials. Administration Check whether the child says "da-da"
Scoring Pass if the child turns to the direction to his father or "ma-ma" to his
of the voice. mother during the test.
Scoring Pass if the child uses either "ma-ma"
Da-da or Ma-ma, non-specific or "da-da" correctly for his mother or
father. If this cannot be heard, ask the
parent if the child does this.
Administration Check whether the child says "dawda"
or "ma-ma" at any time during the (R ) Question Nakapagsasabi na ba Siya sa inyo ng
ta-ta/da-da sa kanyang ama, o na-na/
test.
Pass if the child says either "da-da" or ma-ma sa kanyang ina?

Scoring
"ma-ma". The child does not have tel
associate these with a parent,) If this 3 words other than ma-ma, da-da
cannot be heard, ask the parent if the May pass by report (R)
what words the child
child does this.
for specific objects,
persons, or actions.
MMDST Manual
MMDST Manual
Pass if parent reports child uses at least Scoring Pass if the child correctly names any
Scoring
3 specificwords other than "da-da" one picture. Words such as horsey
or "ma-ma". The words do not have are acceptable. Pass also if the child
to be understandable but must mean gives the name of his pet if it is the
the same thing each time they are same animal as pictured. (Fail ani-
used. (No credit is given for "da-da" mal sounds like 'Meow" or "Woof')
or "ma-ma")
(R ) Question May nasasabi na ba siyang ibang
salita maliban tata/dada o nana/
mama sa tuwing gagamitin niya ay
pareho ang ibig sabihin?
Combines 2 different words

Administration Check whether the child combines 2
or more words to make a meaningful
phrase.
Scoring Pass if theschild a neanjn5ful
phrase of 2 or more words such as
"play ball", " want milk" and "get
down". (No credit is given for a Follows directions
single-idea combination such as "bye- 2 of 3
bye", "thank you", and "peek-a- Administration The tester should tell the parent not
boo".) If this cannot be heard, ask the to move and then give the child a
parent if the child does this. block. Tell him to do the following,
(R ) Question Nakapagdudugtong-dugtong na ba one at a time:

Siya ng 2 0 higitpang salita kung may "Give the block to Mommy"
ibig Siyang sabihin, tulad ng "laro (Ibigay mo ito sa Nanay.)
ako "gusto ko", atbp? "Put the block on the table"
(Ilagay mo ito sa mesa.)
Names one picture "Put the block on the floor
Administration Point to the pictures on the back of (Ilagay mo ito sa sahig.)
the test form (Footnoted item #14) The tester and the parent should be
one at a time and ask the child, "What careful not to give the child help by
is this?" (Anoito?) at Mommy,
table or floor.
MUDST Manual MUDST Manual
Scoring Pass if the child follows 2 of the 3 di- parent if the child can give his first or
; rections correctly nickname and last name without
hints.
Uses Plurals (R ) Question Nasasabi na ba ni (child ) ang

kanyang buong pangalan ng walang
Administration Place 3 blocks in front of the child on tulong?
a cleared table. Ask the child, "What

are these?" (Ano ito?) Comprehends gold, tired, hungry
Scoring Pass if the child answers "blocks" 2 of 3
using "s" to indicate more than one Administration Ask the child the following questions,
block. Ifthis• cannot.bé observed, ask one at a•time:
the parent if the child uses "s" on the "What do you do when you are
end of words to indicate more than tired?" (Ano ang ginagawa
one of anything. To pass the child mo kung ikaw ay pagod?)
need not say "s" clearly, but he does (go to sleep, sit down, rest)
have to tell the difference between "What do you do when you are
one and more •than one. cold? (Ano ang ginagawa mo
(R ) Question Nadinig ne:-— na kung ikaw ay giniginaw?)
gumamit ng salitang "mga " o (put on a coat, go inside, turn
"marami" kung mahigit sa isa ang up the furniture.)
nakikitang mga bagay-bagay, gaya (Po not pass if the child an-
ng "mga ibon " o kaya nagdadagdag swers this with "cough", "take
ng "s " gaya ng "birds " kung English medicine" or any other answer
ang gamit na salita? about having a cold. He did
not understand what was being
Gives first and last name asked.)
May pass by repdrt (R) "What do you do when you are
Administration Ask the child, "What is name?"

you r hungry?" (Ano ang ginagawa
If he gives only his first name ask him mo kung ikaw ay gutom?)
to give his last name or both names. (eat, have supper, ask for
(Ano ang pangalan mo?) Probe. (E, something to eat.)
'yung apelyido mo ? Ano pa?) Scoring Pass if the child gives a logical answe!)
Scoring Pass if the child gives understandable for 2 out of the 3 questions. Some
(need not be perfect ) names. Nick- correct answers are listed above.
names are acceptable föf¯firsenames.

If this cannot be observed, ask the
UMI)ST Manual
MMDST
or wrong.ä Do not ask the child to
Comprehends prepositions
name the colors. (Ibigay/iluro mo sa
3 of 4
akin ang pula, dilaw, berde, asul.)
Administration The tester should tell the parent not to
Scoring Pass if the child picks 3 of the 4 colors
move and then give the child a block.
correctly, If this cannot be seen, ask
Tell him to do the following, one at a
the parent if the child can point out 3
time:
of the 4 colors shown.
"Put the block on the table."
(R ) Question Alin sa mga kulay na ito ang naituturo
(Ilagay mo ito sa ibabaw ng
niya?
mesa.)
"Put the block under the table."
Opposite Analogiés
(Ilagay mo ito sa ilalim ng mesa.)
"Put the block in front of 2 of 3
Administration Make sure the child is listening to the
Mommy's chair."
tester and then say: ( one sentence at
(Ilagay mo ito sa harap ng silya
a time, wait for the child to fill in the
ni Nanay.)
"Put the block behind her chair. blank.)
"Fire is hot, ice is
" (Ilagay mo ito sa likod ng silya
cool, freezing; not wet, melts, wa-
ni Nana;
A wrong answer should not be ter)
corrected.
[Kung ang apoy ay mainit, ang
C Pass if the child follows 3 of the 4 yelo ay
Scoring
"Mother is a woman, Dad is a
directions correctly.
(man; not Daddy, boy, husband.)
[Kung si nanay ay babae, si tatay
Recognizes colors
ay
3 of 4 A horse is big ,a mouse is
May pass by report (R) [Ang kabayo ay malaki, ang daga
Administration Place a red, blue, green and yellow
ay
block together on the table in front of
(Each sentence may be repeated 3
the child. Tell the child to point to or
times if necessary.)
give to you the red block, the blue
Scoring Pass if the child gives any appropriate
block, etc. IF the child hands the
opposite word in 2 of the 3 analogies.
block to the tester, the block should
A few of the correct answers are
be replaced on the table before the
listed above.
next color is asked for. Do not let .the)
child know if his responses are right
MMDST Manual
MMDST Manual
Defines words Composition of-
6 of 9
Make sure the child listening to Administration Make sure the child is listening to
Administration is
the tester and then ask the following
the tester and then say, "I am going
questions, one at a time: (Ano ang
to say a word and I want you to tell
me what it is." Askeachwortl oneatat ginagawang...)
"What is a spoon made of?"
a time. 'What is a
ball.. .river...desk...house...bana-
"What is a shoe made of?
na.• .curtain.. .roof.. .fence.. .road...?
.
Each word may be asked 3 times if (sapatos)

"What is a door made of?"
necessary. Wait for the child's an-
swer after each word. (pinto)
Wait for the child's answer after
(Magbibigay ako ng isang salita at
sabihin mo kung ano ito: bola...
each question. Each question may
be repeated 3 times if necessary.
ilog... mesa ... bahay...saging... kurti
Note: If unable to understand the
na... bubong... bakod...kalsada...)
above, ask:
Scoring Pass if the child defines 7 of the 9
—Kungung mesa ay yari sa kahoy,
words in terms (B)ghape,
ang kutsara ay yari sa
(3) what it is made of, or (4) general
category (such as banana is fruit but
ang sapatos ay' yari sa
ang pintuan ay yari sa
not merely "yellow" or "banana
skin".) "Circle" is an acceptable
Scoring Pass if the child replies that:
answer for "What how-
is a ball?"•
ever, since many children seem to
0 A spoon is made of metal (or
any specific metal), plastic or

think acceptance of "circle" means
wood.
all words must be defined by shape,
it may be helpful to ask the child to

0 A shoe is made of leather, rub:
ber, cloth, plastic and wood.
"tell me something else about a
Plastic, wood or other unusual
ball". In this way a child will be
materials are acceptable if child
directed to other definitions as well
is wearing or owns such shoes,
as shape.
i.e, boots, clogs, etc.
0 A door is made of wood, metal,
or glass.
MMDST Manual
MMDST Manual
Stomach (Sto) head up 900

Gross Motor Administration Place the child on his stomach on a
flat surface.
Pass if the child lifts his head,

Stomach (Sto) lifts head Scoring
and chest up so that his face makes
May pass by report (R) a 90 degree angle with the table.
Administration Place the child on his stomach on
flat surface.
Scoring Pass if the child momentarily lifts
his head so that his chin is off the

table without being turned to
either side.
Kapag nakadapa ang bata,

Stomach (Sto) chest up, arm support
(R) Question
Place the child on his stomach on a
naitataas na ba niya ang kanyang Administratiön
baba kahit sandali? flat surface.
Pass if the child lifts. his head and
Scoring
chest up, using support of
outstretched hands or forearms so
that his face is looking straight
ahead.
Stomach (Sto) head up 450 Sit-head steady

Place the child on his stomach on Administration Hold the child in a sitting position.
Administration
Pass if child holds head upright and
a flat surface. Scoring
steady with no bobbing motion.
Scoring Pass if the child lifts his head so
(Fail if child holds head steady for
that his face makes an
only a few seconds and then drops it
approximate 45 degree angle with
to chest or sideways.)
the table.
55
Rolls over Scoring Pass if the child briefly supports most

of his weight on his legs. Ifthe child
Administration Tester should see this or ask the keeps his legs rigid to support his
parent if the child rolls from back to weight, pass the item but note on the
stomach or from stomach to back. test form that the legs were rigid.
Scoring Pass if the child rolled completely

over, not just to or from side, either Sits without support
way (not Accidentally) two times or Administration Hold the child 06 a sitting position on
more. table. Making sure child does not
(R) Question Dumadapa na ba Siyang mag-isa? fall, slowly remove your hands.
Ilang beses na niyang nagawa ito? Scoring Pass if the child sits alone for 5
seconds or more. Child may put his

Pull to sits-no head lag hands on his legs or the table for
Administration Place the child on his back. Grasp support.
his hands or wrists and gently pull to

a sitting position. Do not pull the Stands holding on
child up fast or his head will be May pass by report
forced to hang •tlaUK.-- Administrati n Place the child in a standing position
Scoring Pass if the child's head does not hang holding on to a solid object (not a
at any time while he is being pulled person.)
up. Scoring Pass if the child stands 5 seconds or
more by holding on. If this cannot be
seen, ask the parent if the child can do
this.
(R) Question Nakatatayo na ba siyang mag-isa ng

mga 5 segundo na nakahawak
lamang sa isang bagay?
PASS FAILURE Pulls self to stand
Bear some weight on legs

Administration Check or ask parent if the child pulls
Administration Hold the child upright so that his feet himself to standing position while
rest on the table. Slowly loosen your holding on to a solid object (such as
hand support but do notrelease the
child completely. -Gthout help fronya person.
56 57
Scoring Pass if the child can pull himself into Stands alone well
a standing position May pass by report (R)
(R ) Question Mula sa pagka-upo, nakatatayo na ba Administration Place the child standing on the floor.
siyang mag-isa ng walang tulong o na After he seems to have his balance,
nakahawak lamang sa isang bagay remove your support.
tulad ng silya, atbp? Scoring Pass if the child stands alone 10 or
more seconds. + If this cannot be
Gets to sitting seenøask the parent if the child can
do this.
Administration Check or ask parent if the child can get Question Nakatatayo na bang mag-isa ng
himself into a sitting position. matagal (mga 10 segundo) ang
Pass if seen or reported. bata?
Scoring
(R) Question Mula sa pagkahiga, nakauupo na ba Stoops and recovers
siyang mag-isa? May pass by report (R)
Administration While the child is.. standing on the
Walks holding on furniture floor away from all support, place a
small toy on the floor in front of him
ay pass by report (R)
Administration Check or ask the parent -i the child and tell him to pick it up.
walks around furniture w;- Scoring Pass if the child is able to bend over,
on to it. pick up toy and return to standing

Pass if seen or reported. without holding on or touching
Scoring
Nakalalakad na ba Siya na nakahawak floor. If this cannot be seen, ask the
(R) Question
parent if child can do this.
sa silya o ibang bagay?
(R) Question Kapag may pinulot siyang laruan sa
Stands momentarily sahig, nakatatayo ba Siya nang
hindi humahawak sa sahig o ano
May pass by repolt (R)
Administration Place the child standing on the floor.
mang bagay?
After he seems to have his balance,
Walks well
remove your support.
Scoring Pass if the child stands alone 2 or more May pass by report (R)
seconds.' If this cannot be seen, ask Administration Watch the child as he walks to see if
the parent if the child can do this. he has good balance and rarely falls.
Nakatitindig na ba siyang mag-isa Scoring Pass if the child does not have
(R) Question
kahit 2 Segundo tamai!g?
tip
UMDST Manual MUDST Manual
from side to side. If this cannot be Kicks ball forward

seen, ask the parent if child can do
this. Place the ball about 6 inches in front
Administration
(R) Question Malalag na ba siyang maglakad? of the standing him to kick
child. Tell
it. The tester may show him how to

Walks backwards do this.
Pass if the child kicks the ball forward

May pass by report (R) Scoring
Administration Tell the child to walk backwards. The withoutåolding on to any support.
tester may show the child how to do (Hitting the ball on the backswing,
this. stepping on the ball or using support
Scoring Pass if the child walks backwards 2 or is a failure). If this cannot be seen,
more steps. If this cannot be seen, ask ask the parent if the child kicks a ball
parent if the child walks backwards at of similar size at home.

home, possibly when pulling a toy. (R) Question Kapag inilagay ang bola sa harap
Pass if the parent reports the child can niya, nasisipa ba niya?
do this.
(R) Question Nakalalakad na ba Siya ng paurong Throws ball overhand

(paatras—• fbang -
siya? tester using an overhand throw. The

tester may show him how to throw
Walks up steps overhand.
May pass by report (R) (Ihagis mo ang bola sa akin gaya

Administration Ask the parent how the child gets up nito.)
steps. Scoring Pass if the child is standing at least 3
Scoring Pass if the child can walk up steps (not feet from tester and throws the ball
crawl). He may use the wall or rail within arm's length of tester between
for support but cannot hold on to a his knees and face. (Cannot score a
pass if child refuses to throw the ball
person.
(R) Question Paano umaakyat si (child) sa hagdan? toward tester but continually throws
(Probe to clarify) Nakaaakyat na ba away from him.)
Siya sa hagdan nang hindi
gumagapang o hinahawakan o di
kaya ay nakahawak lang sa dingding
o gabay?
60 61
Balance on I foot 1 second Nakapagbibisekleta na ba Siya mulct

(R) Question
rito hanggang doon (point to ten
2 of 3
feet)?
Administration Show the child how to stand on 1 foot
without holding on. Allow 3 trials if
Broad Jump
needed.
(Gawin mo ito.)
Administration Place a test form on floor and show
Scoring Pass if the child can stand on either
the child how to do a standing broad
foot 1 second or more in 2 of 3 trials.
jump across the width of the paper (8
(May be noted during "Balance on 1
h"), then tell him to do it. Give hiin
foot 5 seconds.")
3 trials.
(Gayahin mo ito.)
Jumps in place
Pass if the child jumps once, with both
Scoring
Administration Tell the child to jump. The examiner feet together, over the 8 1/2 inches. (If
may show him how to do this. the child leaps across, one foot at a
(Gawin mo ito.) time, this is a fåflure.j
Scoring Pass if the child raises both feet off the
flooéååhenmdiwwfrfany measur- Suseconds--m
able distance. He does not have to
2 of 3
land on the same spot from which he
started.(The child cannot run before
without holding on and then tell him
he jumps, or hold on to anything for
to do it. Time him with a watch, if
support.)
possible. Allow 3 trials if needed.
( Gayahin mo ito ) .
Pedals tricycle
Pass if the child can stand on either
Scoring
May pass by report (R) foot 5 seconds or more in 2 of 3
Administratidn Ask the parent if the child can pedal a trials. (May be noted during "Balance
tricycle. on I foot 10 seconds." )
Scoring Pass if the parent reports the child can
pedal a tricycle forward 10 feet or
more on the level ground. (Pedaling
the tricycle down a hill is not consid-
ered a pass.) If the child has not had
an opportunity to ride a tricycle of his
size, score the item "NO" for no or .2
portunity.
63
Balance on 1 foot 10 seconds Catches bounced ball
2 of3
Administration The tester stands about 3 feet from the
child and bounces the ball to him,
without holding on and then tell him
taking care to have the ball bounce
to do it. Time him with a watch, if
possible. Allow 3 trials if needed. once halfway between the tester and
the child. The ball should reach the
(Gayahin mo ito.)
child between his neck and waist. The
Scoring Pass if child can stand on either foot
child is told to catch the ball. Allow 3
10 seconds or more in 2 of 3 trials.
trials if needed. (Saluhin mo ang
Hops on 1 foot bola.)
Scoring Pass if the child catches the ball with
Administration Tell the child to hop on one foot. The his hand or hands in 2 out of 3 trials.
testermay show him how to do this.
The child may catch ball against his
(Gawin mo ito.) body if he uses his hands and not his
Scoring Pass if the child hops on 1 foot 2 or
arms. (If the child uges only his arms
more times in a row , either in place
against his body to catch the ball, this
or over a distance. on
would be a failure.)
to anything.
Backward heel-to-toe
Heel-to-toe-walk
2 of 3
2 of 3
Administration Show the child how to walk placing
Administration Show the child how
walk placing
to
the toe of one foot in back of and
the heel of one foot in front of and
touching the heel of the other. Walk
touching the toe of the other. Walk about 8 like steps this and then tell the
about 8 steps like this and tell the
child to do it. (The tester may compare
child to do it. (The tester may com- this to a backward tight rope walk.)
pare this to a tight rope walk.) If the Allow 3 trials if needed. (Gayahin mo
child does not respond, show him
ito.)
how to do it again. Allow 3 trials if
Pass if the child can walk backward in
Scoring
needed.
a straight line for 4 or more steps
(Gayahin mo ito.) placing his toe I inch or less in back
Scoring Pass if the child can walk in a straight
of his heel, 2 out of 3 trials.
line for 4 or more steps placing his
heel 1 inch or less in front of his toe,
2 out of 3 trials.
64
MUDST Manual MMDST
Items may be scored in four ways: pass (P), failure (F), The MMDST result interpreted as NORMAL, QUES-
is
refusal (R), and for items where the child has had no opportu- TIONABLE, ABNORMAL or UNTESTABLE depending
nity to demonstrate the behavior, a score of no opportunity on the number of delays. Remember that a delay is any
(NO). One example is in the item, pedals tricycle. If the child failure that falls completely to the left of the age line. To
has never had an opportunity to try a bicycle, then the item properly intelpret the result of the test, follow the steps listed
should be scored as no opportunity or NO and not failed nor below.
refused. Items sco}ed as NO are not considered in the overall Step I - Mark each delay by heavily shading the right end
test scores. The score P, F, R and NO is to be written on the of the bar.
50% hatch mark. Step 2 Count the number of sectors that have 2 or more
A test item that is failed and which falls completely to the delays.
left of the age line is considered a delay. That is, a child failed to Step 3 - Count the number of sectors that have I delay with
pass an item which 90% of children normally can pass at a no passes intersecting the age line in the same
younger age. Delays are used to interpret the total Nflv1DST sector.
results. Delays on the test form are emphasized by shading the Step 4 - Interpret the result using the following criteria.
right end of the bar of the delayed item (see Figure 7). If the INTERPRETATION
CRITERIA
right—end of the bar, the item is not
2 or more sectors with 2 or more
considered a delay.
delays ABNORMAL
13 14 15 16 17 18 19 20 21 22 23
1 sector with 2 or more delays plus 1
or more sectors with 1 delay and in ABNORMAL
it is convleety to the lef
ofthe age lire
that same sector, no passes inter-
sectin thea e line
1 sector with 2 or more delays QUESTIONABLE

Not a delay because it is
crossed by the age line.

1 ormore sectors with 1 delay and in
that same sector, no passes inter- QUESTIONABLE
sectin the a e line
When REFUSALS occur in numbers UNTESTABLE
large enough to cause the test result
Not a delay because to be QUESTIONABLE or ABNORMAL if
bar only touches the these were scored as failures

age line.
Any condition not listed above NORMAL
At the bottom of the age line, indicate the test result and
Eigure 7 interfiiétaÄiöiY&For Reason: *ectors

have 2 delays
MMDST Manual
MMDST Manual
At the end of the test, ask the parent/caregiver whether

•Performing the MMDST is generally a pleasant task but
occasionally, one encounters a child who is difficult to test.
the child's performance is typical of his/her ability and
Before making hasty conclusions that the child is untestable,
behavior. Sometimes, a child may be too ill, tired, or upset
ask the parent if the child has always been shy, inattentive,
when tested to show what he can actually perform.
overactive, or exhibit other similar behaviors for which
Overall interpretation of test results should be given to he/she tis considered difficult. The child may simply be
the papit/caregiver in general terms rather than using the reacting to previous unpleasant experiences like an injection
labels of abnormal, questionable or normal. If the child has or a wound treatment. The "difficult" behavior may like-
done well, praise the child and reassure the parent/caregiver wise be explained by other sociocultural factors. If this is
that the child is developing as he/she should be. If, however, so, use a different approach in testing.
the child has a number of delays, remind them that this is a
screening test and that you would like to test the child again The Shy Child
within approximately two weeks.
Ages 6 — 7 months mark the beginning of the shy age.
Shyness may normally continue up to age .3. If the child's
shyness persists, he/she may need as much -help as one one
Who IS
Testing a shy child may take longer. The following

suggestions usually help:
To retest the child on the same form, draw the new age e As an icebreaker, offer the child a cheese curl or give
line and score the new test with a different color of pencil. him a block, a bell or a rattle to play with prior to
Write the date of the retest at the top of the new age line. testing.
e Stan testing with items that are scored by report. Fo-
A child who is abnormal, questionable, or untestable on
cusing attention initially on the parent gives the child a
the second test should be referred to a pediatrician or the
chance to cope with the situation and becomes more
appropriate health professional for further evaluation and
familiar with the tester and the test materials.
possible developmental stimulation program. Nurses can
• If the child remains shy and wary, ask the parent to
also be trained to teach parents skills in developmental
administer some of the test items or show how they are
stimulation of children. With severe resource constraints,
done. As the parent demonstrates, you can say, "Tignan
these health workers may be the most feasible group to tap
ko nga kung makalalakad ka din ng paurong gaya ng
for this function.
nanay mo. " Preschoolers are great show-offs. This
Continued surveillance and periodic retesting of children technique may work and if it does, reinforce the child
identified to have developmental delays or at risk should be for performing.
done. Ifalf•uggestions/üil and the test-is not Completynretest 2
or 3 weeks later.
69
MUDST Manual
MMDST Manual
recognition of colors. The sequence of testing may be
The Uncooperative Child If the tester has
jumbled depending on the situation.
mastered the test form, jumping from one sector to an-
The uncooperative child is one who is not shy but
refuses to do what is asked of him/her. Approaches for the other is easy.
shy child may also be applied to the uncooperative child. In Limit the distractions — clear the room of all distractions.
addition, the following may be tried: If this is not possible in crowded places (home, clinic or
Ask the parent to leave the room. The child may perfonn health center), arrange the table and the child's position on
better in the Éårent's absence. Anxious feelings of a parent the table in such a*way that his/her båck is to the distrac-
are communicated to the child who in turn acts negatively. tion.

If the child becomes upset by the separation, the parent Bring out only the tpst mateyials needed per item. Keep
need not leave the room but is requested to turn away the rest in the bag and do not give the child a chance to see
•while staying within seeing distance of the child. its contents or else he/she may not rest until he gets hold
Ifthe parent says that the child can do certain items but
of everything.
is just uncooperative, ask the child to do the opposite.
Another technique to is keep the bag behind you, leave it
Reverse psychology often works in the negativistic age.
open, and reach for the test materials as needed. As you
You might say, "Sa palagay ko, hindi ka marunong
do this, maintain eye contact with the child at all times to
magdrawing ng tao.
hold his
An older child is usually wiser and may realize that that
The Overactive Child you are hiding things as you fumble through the bag. If
this happens, tell the child that you have a series of
An overactive child is one whose interest shifts rapidly
surprises (young children love surprises) for him/her but
from one test item/material to another. He/she may be
that he/she has to be very attentive and follow directions.
seated beside you building blocks and as you turn to consult
the test form, the child sees the ball in the kit, drops the Direct the child's attention — gain the child's attention.
blocks, gets the ball and runs off with it. Getting him to sit Once obtained, focus it on the task to be performed. If
down to continue the tet is a chore. While you may succeed attention lags, call him by name or touch his arm gently to
in getting him to perform again, the attention span is short. bring him back to the task at hand.
Dealing with an overactive child may be a difficult Be firm and calm — Filipino children, including the over-
experience to the child, the parent and the tester. There are active, respond to authority. Uniformed people like
ways, however, of dealing with this situation. nurses, doctors and policemen are usually held in awe.
Mastery of test items based on the example given Firm but calm words from these people often work where
above, when the child drops the blocks and picks up the parents fail. TELL the child what to do. DO NOT ASK
ball, be ready to test him on other items: "Sipain mo if he can or i! he will perform the task.
'tong bola. 'j qnce done, follow with "Saluhin mo ito. "
his at R tion from the ball and test him on
the&tiilünyqur lap-Esie-nexeto
him/her. This way, It is easier to contr child's
71
T/le Child witli litany Siblings
It is sometimes difficult to control the situation in homes

The administration of the MMDST requires practice to
with many siblings. Each child wants to perform the tasks
develop an acceptable level of competency. The tester should
all at the same time; or, a child already done with the test
be competent to obtain valid test results. It is therefore recom-
tells the other what to do. Ascendant behavior or bossiness
mended that beginning use13 ofthis screening test not only ptactice but
begins at around age 3. A desire to excel is manifested as
also have someone to evaluate their competency using the MN'IDST
early as age 4. In this situation, explain to the mother the
Administration Checklist pmvided in Appendix B.
need to test each child individually. As each child, prefer-
ably starting with the eldest% accomplishes the test, ask the Williams' slide-tape program is available that you can view
mother to send the child on errands. This technique keeps. prior to practice and actual administration of the lvWIDST. If
him out of the way, thus giving the remaining children a Frankenburg et al.'s proficiency training film is available or its
chance to perform on their own, without comments or equivalent, view this also and compare your performance with
proznpting from others. the expected answérs, Proficiency on the DDSTfDenver II is a
requirement for pediatric and family nurse practitioners in the

The Interfetijzg United States.
When you do your practice, perform the test on children

The becomes too involved,
interfering parent IS c:ne vyho
with r skill. The following has
i his parent answers the questions for the child and shows
been recommended in the original DDST:
him what to do.
The following techniques are suggested: 4 children between 1 month and 9 months of age;
a. Explain to the parent, as in all test situations. that 4 children between 9 months and 2 years of age; and
the MMDST is not an intelligence test and that 4 children between 2 years and 6 years of age.
the child is not expected to pass all the items.
It is helpful to pair off with another person to practice test.
The test will only show what the child can do at
As one person tests, another observes and uses the checklist.
a certain age. Be sure the mother understands the
The observer should discuss anything omitted by the and
tester
purpose of the test.
any disagreements in administration or scoring to the manual
b. Administer the test.
and/your instructor to settle any difference.
c. If the parent interferes, repeat the explanation as
in a. After practice testing with at least 12 children, ask your
d. If the parent still tells the child what to do, instructor or test partner for a reliability testing session. This is
Frankenburg suggests that the parent leave the done with you administering the test on one to three children
room. A face-saving way is to discontinue the (of the age ranges stated above) and your instructor/partner
test. Then reset the discontinued test for re- independently scoring the test as you administer it. You should
screeping within 2 or weeks. Score the items obtain-Q4easV90% agreemenbuitll_your instru€tor(partner. If
by rt;port of interfering parents with care. They not, Indaut -tfiéß areas ofiisagreement and rßiciice in those
may hot be reliable. areas. Repeat the reliability testing session,
73
MMDST Manual
MMDST Manual
Williams, P.D. (1982) The Metro Manila Developmental Screening

Test: a Normative Study", In Anastsiow, NJ, Frankenburg WK,
and Fandall, A. W, Identifying the Developmentally Delayed
Child. Baltimore: University Park Press
Williams, P.D. (1980a). Development of Norms for the Denver
Developmental Screening Test on Metro Manila Children 0-6
Years Old. NSDB-UPS (A) Project No. 7703 so.
References Williams, P.D. (1980b). A Comparative Study of DDST Norms
Developed in Five Locales. In: P.D. Williams (Ed)., Nursing
Research in the Philippines: a Sourcebook. JMC Press, Quezon
City
Abad Santos, A.B (•1980). An AnalysiÄ of Figure Drawing of Metro Williams, P.D. (1980c). The Reliåbility of the Denver Developmental
Manila Preschool Children. In P. Williams (ed.), Developinent Screening Test: Metro Manila version. In P. Williams (Ed.)
ofNorms for the Denver Developmental Screening Test on Development of Norms for the Denver Developmental
Metro Manila Children 0-6 Years Old, pp. 1 15-198 NSDB-UPS Screening Test on Metro Manila Children 0-6 Years Old.
NSDB- (A) Project No. 7703 so., Appendix J.
Anastasiow, N., Grimmett, S., Eggleston, P., and Brown,J. (1977). Williams, P.D, (1980d). Predictive Validity of the Metro Manila
Facilitative Environments Encouraging Development (FEED) Developmental Screening Test. Paper presented at the Philippine
Institute for Child Study, Indiana University, Bloomington. PJysi@Logical Association Convention, August 26, Manila.
Frankenburg, W. & Fandall, A. , Dodds, J. , (1970) . Denver Williams, at KISK:YPerinatal Events and their
Developmental Screening Test Manual (Revised) Denver: Effects on Development: A Cross-Sectional Study. Unpublished.
University of Colorado Press. Williams, P.D. & Williams, AR (1983) "Factors Affecting
Frankenburg, W. , Goldstein, A. , Chabot, A., Camp, B.W., and Fitch, Development of Filipino at Risk", presented at seminar on
M. (1970). Training the Indigenous Nonprofessional: The Children at Risk: An International Perspective, University of
Screening Technician. J. Pediatrics, 77: 564-570. Colorado Health Sciences Center, Denver, Colorado, September
Frankenburg, W.K Camp, , B. W, VanNatta, P.A & Demersseman, J.A 16,1983.
(1971a) Reliability & Stability of the Denver Developmental
Screening Test. Child Development, 42:475-485.
Guthrie, G., Tayag A., Jacobs, P. (1969). The Philippine Non-Verbal
Intelligence Test (PNIT) Manual, Philippine Normal College,
Manila.
Layug, E. (1980). Concurrent Validation of the DDST (Metro-
Manila version). Unpublished master's thesis, University of the
Philippines, Quezon City.

Williams, P.D. & Madrazo, C.V. (1983) Early Identification of the
Child at Risk: A Philippine Perspective, Paper presented at the
Fourth International Conference on Early Identification,
September 18-23, 1983, Snowmass, Colorado.

Appendix A
SAMPLE PROTOCOLS
Normal Test Result

Abnormal Test Result
Questionable Test Result
Untestable Test Result
76
uoaon ssou9
39vnE)NV7
3AlLdVOV uoaon äNld
IVIOOS-1VNOSB3d
GROSS MOTOR LANGUAGE FINE MOTOR ADAPT E PERSONAL - SOCIAL
GROSS MOTOR VANGUAGE FINE MOTOR ADAPTIVE PERSONAL - SOCIAL

LANGUÄGE FINE MOTOR ADAPTIVE PERSONAL SOCIAL
•
GROSS MOTOR
FINE MOTOR ADAPTIVE PERSONAL-SOCIAL

GROSS MOTOR LANGUAGE
O
3A11dVOV u010tA 3Nld IVIOOS-7VNOSU2d
U010rq SSOUO 39Vf)DNVn
Appendix B
MMDST ADMINISTRATION.CHECKLIST
Purpose: This checklist should be used regularly until the
tester becomes proficient in administermg the
O MMDST.
Instructions: To check thee accuracy of your own testing
ability, go over the checklist immediately after
you have finished giving a test. To check the
accuracy of another person's test ådministra-
BEFORE THE TEST: CORRECT INCORRECT

1. Can child see and reach test
Seated too
Yes
materials easily? high/low/far
from table
2. Did the examiner explain that Yes No

the MTv1DST is not an IQ test?
3. Did the examiner explain that Yes No
child is not expected to per-
form everything asked of him?
4. Did the examiner calculate age Yes
of child after asking parent the

child's birthdate?
5. Before drawing age line, did Yes No
examiner ask if child was born
prematurely?
Yes No
6. Was age line drawn correctly?
7 Did the examiner indicate date No
Yes
test was administered at top of
age line?
81
DURING THE TEST: CORRECT INCORRECT
Did the examiner assure cooperation
of child by:
8. giving child a chance to become Yes
used to examiner?
Yes No,
9. starting each sector
items child could pass?

of test with
sometimes Appendix C
10. telling child what to do rather Yes No,
sometimes
DENVER DEUELOPMENTAL SCREENING TEST
than asking?
11. Was table clear of materials Yes No, (Revised)
sometimes
which were not being used?
The Denver Developmental Screening Test (DDST), a
12. When asking for parent's report, No Yes, device for detecting developmental delays in infancy and the
did examiner suggest an answer sometimes
preschool yeårs, has been standardized on a large cross section
by the way question was
of the Denver population. The test is administered with ease
worded? (leading question)
No Yes; and speed and lends itself to serial evaluations on the same test
13. Did the examiner praise child
sometimes sheet.
only when he correctly per-
an item?
14. At the end of test, did the exam- Yes Skein of red wool, box of raisins, rattle with a narrow
iner ask parent if behavior of handle, Abbott aspirin bottle (Abbott 50 children's
child was typical of his usual aluminum), bell, tennis ball, test form, pencil, eight one-inch
behavior? cubical counting blocks.
15. Did examiner administer enough Yes No
General Administration Instructions
items? (At least 3 passes and 3
failures in each sector)
The mother should be told that this is a developmental
AFTER THE TEST:
screening device to obtain an estimate of the child's level of
16. Were delays emtphasized by Yes No development. This test relies on observations of what the child
shading in right end of bar?
Yes No can do and on report by a parent who knows the child. Direct
17. Were delays indicated only on
observation should be used whenever possible. Since the test
those items failed which were
requires active participation by the child, every effort should be
completely to left of age line?
made to put the child at ease. The child above six months of
18. Was test performance interpreted Yes No
age may be tested while sitting on the mother's lap. This
correctly?
Yes No should be done in such a way that the child can comfortably
19 Did the examiner write observa-
on back of form?
83
The test should be administered before any frightening or 6. Ask the parent if the child's performance was typical of
painful procedures. A child will often withdraw if the performance at other times.
examiner rushes demands on the child. One may start by 7. To retest the child on the same form, use a different
laying out one or two test items in front of the child while color pencil for the scoring and age line.
asking the mother whether the child performs some of the 8. Instructions for administering footnoted items are on the
personal-social items. It is best to administer the first few test back of test form.
items well below the child's age level in order to assure an
initial successful experience. It is best to remove all test Interpretations
materials from the table, except the one that is being The test items are placed in four categories: Gross
administered, to avoid distractions. Motor, Fine Motor-Adaptive, Language, and Personal-
Social. Each of the test items is designated by a bar which is
Steps in Administering the Test so located under the age scale as to indicate clearly the ages
l. Draw a vertical line on the examination sheet through the at which 25%, 50%, 75%, and 90% of the standardization
four sectors (Gross Motor, Fine Motor-Adaptive, population could perform the panicular test item.
Language, and Personal-Social) to represent the child's Failure to pass an item passed by 90% of children should
chronological age. Place the date of the examination at the be considered significant. Such a failure may be
the age line. For. premature children»subtractihe end_of the bar ofthe_failed
months prematurity from the chronological age. After two item. Several failures in one sector are considered to be
years of age, it is no longer necessary to compensate for developmental delays. These delays may be due to:
l. Unwillingness of the child to use his or her ability
prematurity.
The items to be administered are those through which the due to:
child's chronological age line passes unless there are a. Temporary phenomena, such as fatigue, illness,
obvious deviations. In each sector one should establish the hospitalization, separation from the parent, fear,
areawhere the child passes all of the items and the point at and so forth
which the child fails all of the items. b. General unwillingness to do most things that are
D. In the event that the child refuses to do some of the items asked such a condition may be just as
requested by the examiner, it is suggested that the parent detrimental as an inability to perform
administer the item, provided he or she does so in the 2. An inability to perform the item due to:
prescribed manner. a. General retardation

4. If a child passes an item, a large letter "P" is written on the b. Pathological factors such as deafness or
bar at the 50% passing point, "F" designates a failure, and neurological impairment
"R" designates a refusal. c. Familial pattern of slow development in one or
5. Note how the child adjusted to the examination — and how more areas
eThild related to the•parntx the examiner, and the test
laterials.
85
84
If unexplained developmental delays are noted and are a
valid reflection of a child's abilities, the child should be re-
screened one month later. Ifthe delays persist, the child should
be further evaluated with more detailed diagnostic studies.
CAUTION. The DDST is not an intelligence test. It is
intended as a screening instrument for use in clinical practice

to note whether the development of a particular child is within
the normal range.
Note Denver Developmehtal Screening Test, by W. Frankenburg, A.

Fandall, and J. Dodds, 1970, University of Colorado Medical Center,
Denver, Colorado. Reprinted with permission of the authors
86

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METRO MANILA

PHOEBE DAUZ WILLIAMS, RN, PhD

ADELINA B. ABAD SANTOS, RN, MN

Research and Creative Writing Program

Metro Manila Developmental Screening Test Manual Overview of the MMDST / 1

Second Edition Test Form / 4

Copyright 0 1999 Preliminary Phase

The Metro Dv'lanila Developmental Screening Test

culture sensitivity makes it easy to use for Filipino

is research—based and, as such, ShCU!Cl be

The publication of this revised edition is part of the

This project has been made possible with the support of

Filipino children. Laurente.

Screening is the presumptive identiflcation of an

examinations or other procedures that can be applied rapidly.

detection model that applies to the detection of developmental

OST is a useful tool used in the

was developed for health professionals such as nurses, doctors

The B/D/IDST is designed to detect developmental delays in

The test is administered using the MMDST kit which

Figure l. These consist of the following:

A bright red yarn pom-pom

Calculating the child's age-and-indicating the age line is

crucial, if not the most important, initial step in test

Four kinds of scores may be given for eact test item:

passed, failed, refused or no opportunity. Failure of an item

wonsidered a developmental delay and is therefore referred to

test form, steps in administering the NWLDST, scoring each

a OAOA og MAUA COMAENEQDS

i A 1ST LAST NAME

Test Directions for Footnoted Items

Like the DDST, the MMDST is made up of 105 items

to sit, walk, and jump. fingerusing an overhand approach.

AGE SCALE (months) peat (3/3 or

The bar representing the item, walks well, in Figure 3 is

located between ages less than 12 months and 17 months. The

well at less than 12 months, 50% (indicated by hatch mark) at

of forearms and/or hands. Items lvhich can

sitting. Pass if head does not hang back. WALKS UP STEPS

Calculating the Child's Age Drawing the Age Line

Age of Child 2 8 5 halfway between 3 and 3 h years).

Year Month Day Buttons up

Washes and dries hands

Birth date _ 97 -3 -10 R Separates from mother

Step 1. Convert the date of test from 99 years, 2 months and

The age of the child at the time of testing is therefore I year,

(Frankenburg, et al., 1970). No adjustment should be made for

Pat-a-ca ke R Uses spoon. *'illing little

RW Keep the following in mind in selecting the items to

R Drinks from cup

The number of items to be administered will vary

Administering the Test

Generally, the test starts with the personal-social sector.

Tingnan mo, o (Show a block)."

Scoring Pass if the child smiles back. If this

May pass by report (R)

Feeds self cracker reach. Do not leave toy out of reach

May pass by report (R)

wary of the tester when he first sees