Developmental Assessment

One of the most essential components of a complete health appraisal is assessment of

developmental functioning. Screening procedures are designed to identify those children
whose development is less than normal, also provides a means for recording objective
measurements of present developmental functioning for future reference.
Validity : The extent to which the screening procedure measures, what it purports to measure.
Sensitivity : Sensitivity is the percentage of children with true problem who are correctly
detected, approximately 80% is preferable.
Specificity : Percentage of children without problem who are correctly detected.
Positive Predictive Valve : Percentage of children who sail the screening test and have true
problems on diagnostic test.
Denver –II
Most widely used development test for young children developed by Dr. William Frankenburg
and his colleagues. The older and the best known the Denver Developmental screening test
and its Revision DDSTR have been revised, re-standardized and renamed as Denver-II.
Denver-II differs from DDST in items, test forms, interpretation and referrals. Total points is
125. This test form contains a place to rate child’s behavioral characteristics.
To identify cautions, all items intersected by the age line are administered. Criteria for referral
are based on availability of resources in community.
Preparation
1) Ask and find out birth history i.e. if child is premature or not.
2) Tell parents that results will be explained afterwards.
3) For toddlers and pre-schoolers present if as a game.
Revised Pre screening Developmental Questionnaire (R-PDQ)
This is the revision of original PDQ.
Advantages
1) Simplified parent scoring.
2) Easier comparison with DDST norms for professionals.
3) More age appropriate addition and arrangements of items.
Four different forms are available on the basis of age.
1) Orange 0 – 9 months.
2) Purple 9 – 24 months.
3) Gold 2 – 4 years.
4) While 4 – 6 years.
The care given answers the questions until
(1) 3 ‘NO’s are circled.
(2) All the questions on both sides are answered.
Scoring is based on number of delays. If child has more than one delay Denver-II is
administered.
Developmental Profile-II
Developmental profile-II is designed for use with children from birth through the functional age of
9½ years. For normal children it can be used appropriately from birth through age 7 years. 5
scales are included :
1) Physical
2) Self help
3) Social
4) Academic
5) Communication.
Administration time varies from 20 – 40 minutes depending on childs age and the approach
used.
Mc.Carthy Scale of children’s Abilities
The MCSCA is a developmental assessment tool for children 2½ - 8½ years old.
It includes six scales :
1) Verbal
2) Memory
3) Motor
4) Perceptual performance.
5) Quantitative.
6) General cognition.
Administration time is from 45 minutes to 1 hour. Eighteen separate tests are administrated to
the child and the scores from these tests contribute to one or more of the scope of the six
scales. The final score correlates well with intelligence quotients from other standardized tests.
The MCSA may be used for follow up when a child fails screening tests or is suspected of
having delayed development. A details self instructional manual is used for training.
Draw A Person Test (DAP)
Children’s drawings follow a developmental sequence, tests have been developed to estimate
development on intelligence on the basis of elements present in the drawing. Good enough
constructed has Draw-a-man test for children ages 3 to 10 years, which was later revised to
include a drawing of a woman and a drawing of the self based on nationally representative
norms, that included ages 3 through 15 years. The current form of the test 1 Draw a person; A
quantitative scoring system is a more recent standardization for children ages 5 to 17 years. In
this 64 items are scored for 14 criteria. Points are given for the items presence, detail and
proportion as well as bonus credit for some items if these three elements are presents. Artistic
ability is not correlated with scoring.
Advantages
- it’s non verbal
- it’s non threatening.
- it’s culturally unbiased.
- it’s easy to administer.
For this test child is told to draw a person with pencil on a paper. To determine the scoring,
give 1 point for each item included in the drawing. Each point is equal to 3 months. Convert
the number of points to months and / or years and add to the base age of 3 years. The final
score in months / hears is approximately equal to the child’s mental age.
GROSS MOTOR DEVELOPMENT
15 Months : * Walks without help
* Creeps up stairs.
* Cannot walk around corners / stop suddenly without losing balance.
* Assumes standing position without support.
* Cannot throw ball without falling.
18 Months : * Runs clumsily, fall often.
* Walks upstairs with one hand held.
* Pulls and pushes toys.
* Seats self on chair.
* Throws ball overhand without falling.
24 Months : * Goes up and down stairs alone with 2 feet on each step.
* Runs fairly well with wide stance.
* Picks up object without falling.
* Kicks ball forward without overbalancing.
30 Months : * Jumps with both feet.
* Jumps from chair to step.
* Stands on one foot momentarily.
 * Takes a few steps on tip toe.
Preschoolers
3 years : * Rides a tricycle
* Jumps off bottom stop.
* Stands on one foot for a few seconds.
* Goes upstairs using alternate feet.
* May still come down using both feet on the step.
* Broad jumps.
* May try to dance but balance may not be adequate.
4 years : * Skips and hops on one foot.
* Catches ball reliably.
* Throws ball overhead.
* Walks down stairs using alternate footing.
5 years : * Skips and hops on alternate feet.
* Throws and catches ball well.
* Jumps rope, skates with good balance.
* Walks backward with heel to toe.
* Jumps from height of 12 inches, lands on toes.
* Balances on alternate feet with eyes closed.
Jean Piaget
SENSORIMOTOR
Sensorimotor period - Piaget’s 1st stage of cognitive development, lasting from birth to about 2
years.
Upto 2 years : world only by look, grasping, mouth and other act?
THE SENSORIMOTOR PERIOD
* Adaptation : Child is into look, mouth, grasping & barging. With each new object, child
makes minor changes in their action, patterns or schemes, grasp and
mouth must accommodate the new object. Gradually, through
assimilation and accommodation, these action patterns become modified
and basic sensorimotor schemes develop into more complex cognitive
capacities. Much of what child learns in accidental.
* Play objects : By 12 months, they stop 1st & experience objects closely before putting
them in their mouth.
 By 15 months – 18 months, they try to use objects as they wee intended.
Ex. Pretend to drink from a cup.
Brush hair of toy.
Make doll sit up.
By 21 months, they use objects appropriately.
Play becomes realistic by 24 months.
Toddlers take dolls for walk and line up trucks in order.
By 3 years, preschooler may make dolls into imaginary people.
* Imitation : Object play of 2 years old is rich with imitation of their world. During 2 nd
year, child begins to imitate series of actions or gestures.
Some toddler even train themselves to use forks with relatively little
struggle. It is found that toddlers have more ability to remember and
imitate an action sequence, even after long time, than was previously
thought.
* Object permanence : it’s the 1o accomplishment of sensorimotor period. This is an
awareness that an object exists in time and space regardless of one’s
own perception of it.
* Symbolic Representation : Some of the earliest forms of representation are actions. There
is a dramatic increase in range and amount of pretend activities. By 15-
18 months, they feed brother & sister, dolls and adults with seal cups, top
spoons etc. Child needs realistic objects to support their pretend game.
By 20-26 months, they pretend that an object is something other than
what it is :
Ex : A broom may become horse etc.
By noting rough similarities, they have a distant concept with a
familiar one and thus establish a symbolic relationship between the
two.
6 STAGES of Sensorimotor Period
Stage Age Characteristics
Reflex Action. Birth – 1 Month -
o
1 circular section 1 – 4 month -
2 o circular section 4 – 9 month -
Coordination of
2o scheme 9 – 12 month -
* Tertiary circular 12 – 18 month Child activity seeks new, unexpected
section. and interesting results. They
engage in trial & error experimentation
they can comprehend a series of
object movement or displacements
as long as these are visible.
* Beginning of 18 – 24 months Child show flashes of insight. They
develop potential for mental
separation. They attain true object
permanence.