Republic of the Philippines

Bulacan State University

City of Malolos

NCM 104B RLE

Community Health Nursing 1:
Individual and Family as Clients

UNIT 2: The Individual as a Client (Child)

Prepared by:

ROWENA P. SANTOS, MAN,RN

ERWIN GUEVARRA,RN

BRIAN ALFONSO, MAN,RN

A.Y. 2020-2021- 1st Semester

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Table of Contents

Overview ....................................................................... Error! Bookmark not defined.

COURSE SYLLABUS .................................................... Error! Bookmark not defined.

Unit 1: Skill for Demonstration ................................ Error! Bookmark not defined.

Lesson 1: Bag Technique .............................................. Error! Bookmark not defined.

Lesson 2: The Performance Checklist.......................... Error! Bookmark not defined.

Unit 2: The Individual as a Client ........................... Error! Bookmark not defined.

Lesson 1: Assessment of Child ages 0-6 years old .................................................. 3

Lesson 2: Metro Manila Developmental Screening Test ........................................ 10

Unit 3: The Family as a Client.................................. Error! Bookmark not defined.

Lesson 1: Assessment Data Base ................................ Error! Bookmark not defined.

Lesson 2: Family Nursing Assessment and Diagnosis ............. Error! Bookmark not

defined.

Lesson 3: Family Nursing Care Plan ............................ Error! Bookmark not defined.

Lesson 4: Health Teaching Plan ..................................... Error! Bookmark not defined.

Unit 4: Implementation of the Plan .............................. Error! Bookmark not defined.

Lesson 1: Strategies for Implementing the Teaching Plan....... Error! Bookmark not

defined.

Lesson 2: The Pamphlet ................................................. Error! Bookmark not defined.

Glossary of Terms ........................................................ Error! Bookmark not defined.

Answer Key................................................................... Error! Bookmark not defined.

References .................................................................... Error! Bookmark not defined.

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Unit 2: The Individual as a Client

Continuity of tasks transitioning from your first client for NCM 107B, the
pregnant individual, your next client within the context of the community nursing
practice (NCM 104) is a child whose age ranges from zero to six years old.

In the care of pediatric clients in the community, growth and development are
not in confinement. We as nurses being competent in the aspects of growth and
development are in the best position to counsel their parents. Having background
knowledge on growth and development, nurses are equipped with assessment skills
to determine developmental delays through the aid of screening tests.

Several factors affect a child’s growth and development including

environmental factors or with the secrets of heredity. In each developmental stage,
there are certain needs and activities that must be met in order to identify that they
are following the sequence of growth and development.

Nurses must understand how the behavior of a child works by understanding

the developmental theories made by renowned theorists such as Sigmund Freud,
Erik Erikson, Jean Piaget and Albert Bandura. These theories can surely help us
better understand such process and how to properly address and counsel these
younger age groups. Always remember that the people in this age group are still
learning by exploring their environment and satisfying their consciousness and it is
our duty to educate their parents or guardian about the normal stages of
development.
This particular module is divided into 2 lessons:
● Lesson 1 Assessment of Child ages 0-6 years old
● Lesson 2 Metro Manila Developmental Screening Test

Objectives/Competencies

Upon completion of this module, you are expected to:

1. Perform a comprehensive physical assessment of a selected client

ages 0 to 6 years old
2. Accomplish Metro Manila Developmental Screening Test to a selected
client ages 0 to 6 years old
3. Complete the documentary paper requisite in the final requirement

Pre-Test

Multiple choice. Encircle the best answer

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1. Tasks which indicate the child’s ability to see and use his hands to pick up
objects and to draw.

a. Fine Motor Adaptive

b. Personal-Social
c. Language
d. Gross Motor

2. When performing physical assessment you will need the following

materials except:

a. Thermometer
b. Stethoscope
c. Syringe
d. Tape measure

3. Tasks which indicate the child’s ability to sit walk and jump

a. Fine Motor Adaptive

b. Personal-Social
c. Language
d. Gross Motor

4. Smiling responsively when being spoken to is an example of:

a. Fine-Motor Adaptive
b. Persona-Social
c. Gross Motor
d. Language

5. Approaching child from behind, whispering their name, and seeing if the child
turns to voice is an example of:

a. Language
b. Gross Motor
c. Personal-Social
d. Fine Motor Adaptive

6. Expected normal findings of normocephalic with closed anterior fontanelle and

posterior fontanelles if you are asseing the:

a. Ears
b. Head
c. Nose
d. Vital signs

7. Lungs are clear to auscultation bilaterally. No stridor , wheezes, crackles are

normal findings of?

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a. Nose
b. Abdomen
c. Chest
d. Head

8. If the criteria has a 2 or more sectors with 2 or more interpretation would be;

a. abnormal
b. questionable
c. untestable
d. normal

9. When refusal occur in a several items, there is an expected result of:

a. abnormal
b. normal
c. questionable
b. untestable

10. If one or more sectors with 1 delay and in that same sector the result is
expected as:

a. abnormal
b. questionable
c. untestable
d. normal

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Lesson 1: Assessment of Child ages 0-6 years old
Duration: 8 hours

Physical assessment is one of the most frequently practiced skills of a nurse.

The scope and extent of pediatric physical assessment vary, like health interviewing,
depending on the circumstances of each health visit. Children usually receive a
complete physical examination. Mastery of physical examination techniques is
essential to incorporating physical assessment data into the assessment step of the
nursing process.

Presented below are some techniques to help you in performing physical

examination based on the child’s age.

Table 1 Techniques of Physical Examination Based on Child’s Age

Age Techniques

Newborn  Undress only the body part being examined or use a radiant
heat warmer to conserve heat (be certain all body parts are
exposed during examination).
 Examine heart and respiratory systems first before newborn
cries, then follow head-to-toe procedure, performing all
manipulative procedures such as throat and eyes last.
 Examine newborn with parents present, using this assessment
time to teach them about normal appearance and development.

Infant  As with newborns, begin examination with heart and respiratory

assessment, and then follow head-to-toe procedure, performing
all manipulative procedures such as throat and ears last.
 Begin examination while parent holds infants in arms or lap to
calm the child
 Talk to the infant as you proceed; infants calm to sound of your
voice or the feeling tone that you radiate as much as they do to
what you actually say.
 A positive tone (“This is like a game”) therefore often brings
better cooperation than a strict, business-like approach. Infants
older than 3 months like to handle tongue blades.
 They can be distracted by brightly colored toys while you listen
to their heart or lungs.
 They cooperate if a parent holds them for major portion of
examination. Offering a bottle of water or pacifier may be
necessary during heart assessment.

Toddler  Allow toddler to handle equipment; include games such as

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blowing out otoscope light, to relax the child.
 Ask parent to remove clothing or allow child to do it
independently.
 Use head-to-toe procedure, leave uncomfortable procedures
such as throat and ear examination for last

Preschooler  Use games such as “Simon Says” to ease child’s fright.

 Ask child to undress, do not remove underpants. Keep in mind
that preschoolers are extremely threatened by intrusive
procedures. Thus, they are frightened of examining
instruments.
 Allow them to handle instruments before use. Assure them that
instruments do not hurt.
 Children up to school age often need to be restrained for ear
and throat examination because they grow fearful about
procedures performed on s part of the body they cannot see
(ears) or about a throat examination that me be uncomfortable.

School-aged  Ask whether child wants parent present or not.

child  Proceed with head-to-toe assessment, leave genital for last.
Allow child to undress except of underpants; supply gown.
 Explain equipment and reasons for procedures. Teach whys
and how’s of procedures.

Applying the skills learned in Unit 3 of NCM 107B, Physical Assessment, you
need to perform a comprehensive head to toe physical assessment of your client.
The form for Pediatric Physical Assessment Checklist can be found on our Google
Classroom. Notice that data are presented following this sequence:

 Vital Signs
 General Survey
 Integument
 Head
 Eyes
 Ears
 Nose
 Mouth and Throat
 Chest
 Cardiovascular
 Abdomen
 Musculoskeletal

Use the results of the checklist to create a narration of the child’s physical
assessment. For the final requirement part of this unit, you will need to narrate your
findings for physical assessment in the form of a “Clinical Portrait of the Child”. A
sample narration is presented below.

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Vital Signs: Temperature noted as 37.8C rectally, pulse at 156 beats per
minute, respirations at 45 cycles per minute.

Anthropometric Measurements: Patient weighs 3.41 kg, stands at 54 cm

with a head circumference 37.5cm.

General Survey: Patient is a well-developed, well-nourished Filipino male in

no apparent distress. Patient is asleep but is easily arousable. Appears
well hydrated.

Integument: Skin color is appropriate to race varying from light brown to

exposed areas and fair complexion on areas covered by clothes.
Vesicular lesions filled with whitish-yellow fluid covering the lower
abdomen, inguinal region and upper thighs. The largest lesions
measure 2mm by 3mm in size. Several small pea sized nodes
palpable in both inguinal regions. No edema and with good skin turgor
noted. Pink nail beds with brisk capillary refill noted at 2 seconds.

Head: Normocephalic with closed anterior fontanelle and posterior

fontanelles.

Eyes: Pupils equal, round and reactive to light. No discharge, conjuctivitis or

scleral icterus.

Ears: Normal ear placement and clear external auditory canals. Pinnae
normal is shape and contour. No pain or tenderness noted on both
ears. Moderate xax build up observed on both ears.

Nose: Normal pink mucosa, no discharge or blood visible.

Mouth and Throat: Moist mucous membranes. No evidence of a cleft on

palpation of roof. Unable to visualize tonsils. Pharynx shows no
erythema or ulcerations. Normal movement of soft palate.

Chest: Round chest cavity. No increase of accessory muscles – no evidence

of increased work of breathing. Lungs are clear to auscultation
bilaterally. No stridor, wheezes, crackles, or rubs. Good air movement.

Cardiovascular: Normal S1 with normally split S2 on respiration. No

murmurs, gallops or rubs.

Abdomen: Soft, non-tender, non-distended. Bowel sounds active on all four

quadrants. Formula fed in the morning and breast fed in the evening.

Musculoskeletal: Straight posture, no lordosis, no kyphosis. There is full

range of motion on upper and lower extremities.

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Let’s Do This 1!

Go to the Final Requirement part of this unit.

1. Download the Pediatric Physical Assessment Checklist in our Google

Classroom.
2. Select a child whose age ranges from zero to 6 years old within your circle of
family.
3. Obtain consent from guardian or parents for the procedure.
4. Perform a comprehensive head to toe assessment of the child using the skills
you have learned in Unit 3 of NCM107B Physical Assessment.
5. Narrate your findings in the form of a Clinical Portrait of a Child.

After your first encounter with your client, advise the parents that you will
be back for another day so you can perform further assessment regarding the
child’s growth and development. The obtained data during your interview and
physical assessment will serve as building blocks so you can prepare the
necessary materials for the next lesson, the Metro Manila Developmental
Screening Test.

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Lesson 2: Metro Manila Developmental Screening Test
Duration: 8 hours

The Metro Manila Developmental Screening Test (MMDST) is a screening

test to note for normalcy of the child’s development and to determine any delays as
well in children 6 ½ years old and below. This is a Simple and clinically useful tool to
determine early serious developmental delays. The test was modified and standardized
by Dr. Phoebe Williams from the original Denver Developmental Screening Test
(DDST) by Dr. William K. Frankenburg, MMDST evaluates 4 sectors of
development:
 Personal-Social – tasks which indicate the child’s ability to get along with
people and to take care of himself
 Fine-Motor Adaptive – tasks which indicate the child’s ability to see and use
his hands to pick up objects and to draw
 Language – tasks which indicate the child’s ability to hear, follow directions
and to speak
 Gross-Motor – tasks which indicate the child’s ability to sit, walk and jump

Preparing for the Administration of the Test

A. THE MMDST KIT

Preparation for test administration involves the nurse ensuring the

completeness of the test materials contained in the MMDST Kit. These
materials should be followed as specified:
 A bright red yarn pom-pom
 A rattle with a narrow handle
 Eight 1-inch colored wooden blocks (red, blue, yellow, green)
 A small clear glass/bottle with 5/8 inch opening
 A small bell with 2 ½ inch-diameter mouth
 A rubber ball 12 ½ inches in circumference
 Cheese curls
 A pencil
 Bond paper

Figure 1. The MMDST Kit

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B. CALCULATING THE CHILD'S AGE

Determining the child's age and indicating the age line is vital 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. Thus, this will
influence the selection of test items to be administered and the
following interpretation of the MMDST results. Review your calculation very
well before placing the age line on the form.

Using the formula below calculate the exact age; ask for the birth date
of the child: date of test minus birth date equals age of child. Calculate first
the days, then months, and then years. Example, if the birth date is March
10, 1997 and the date of test is November 27, 1999 then:

Age of this child is therefore 2 years 8 months and 15 days.

Occasionally, to “borrow” in the subtraction is needed. Make sure 30

days are borrowed from the month column and 12 months from the year
column. For example, if the same child was tested on February 5, 1999,
then;

o Step 1. Convert the date of test from 99 year, 2 months and 5 days
into 98 years, 13 months (12+1) and 35 days (30 + 5).
o Step 2. Subtract the birth date from the converted date of test.

Therefore, the age of the child at the time of testing is 1 year, 10

months and 25 days

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C. DRAWING THE AGE LINE

You can use the age scale displayed at the top and bottom of the test
form (see Figure 2). Draw and line on the scale through the four sectors of
the test form. Mark the calculated age of the child on the scale. Write the
date of the test at the top of the age line.
Definite location of the age line is vital because correct placement of
this line will build on the test interpretation. The space between age marks
represents 2 weeks until age 14 months and 1 months from 14 to 24 months.
From 24 months to 5 years, spaces between marks represent 3 months, and
thereafter, 6 months to the end of the age scale.

To illustrate, in Figure 2, the test was administered on March 1, 1996

to a child 3 years and 3 months of age ( line is halfway between 3 and 31/2
years).

Figure 2. Sample Age Line

Adjustment for Prematurity

One factor that may affect the ability of the child to perform is
prematurity, there are items that other normal children can demonstrate and
pass at the same 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 necessary to compensate for prematurity (Frankenburg, et al., 1970).
No adjustment should be made for children born later than expected.

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You can ask the parent if the child was born prematurely. If the child is
born two or more weeks earlier than the expected date, subtract the number
of weeks of prematurity from the actual age of the child. This is the adjusted
age. Draw the age line based on adjusted age, not the chronological age.

To illustrate, in Figure 3, the actual age of the child is 14 months. The

child was born 6 weeks premature or 12 months earlier than the due date.
Therefore, the age line is drawn 6 weeks earlier than the actual age of 12 ½
months, and not at 14 months.

Figure 3. Adjusted Age

D. THE TEST FORM

Like the DDST, the MMDST is made up of 105 items written in the
range of accomplishments for children between birth and six years of age.
The sample test form is shown in Figure 4. These items are categorized in
four sectors:
 Personal-Social tasks which illustrate the child's ability to get
along with people and to take care of himself.
 Fine Motor-Adaptive - tasks which demonstrate the child's ability
to see and to use his hands to pick up objects and to draw.
 Language - tasks which express the child's ability to hear, follow
directions and to speak; and
 Gross Motor - tasks which indicate the child's ability to sit, walk,
and jump.

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Figure 4. The MMDST Test Form

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Across the top and bottom of the test form are age scales marking
ages in months from 1 to 24, and ages in years from 2 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 25%, 50% (indicated by the hatch mark) 75% and 90% of
normal children are able to pass the item. A sample test item and the
corresponding age scale is shown in Figure 5.

Figure 5. Sample Test Item

The bar showing the item, walks well, in Figure 5 is located between
ages less than 12 months and 17 months. The left end of the bar denotes that
25% of normal children walk well at less than 12 months. Fifty, percent (50%)
as indicated by a hatch mark at 13 ¼ months, left end of shaded area shows
75% do so at 15 months, and right end of bar shows 90% walk well at about
17 months. All test items are described alike.

Few test items have a small footnote number at the left end of the bar
(Figure 6). This number marks the corresponding instruction for carrying out
the item that is found at the next section of this lesson (instructions for
footnoted items.) .For example, the instruction for the item, walks up steps, is
#23 at the footnoted items.

Figure 6. Sample Test Item with a Footnote

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Some test items may be passed by report of the parent. The letter R
in the bar as shown in Figure 6 indicates this. Only items with an R on the
form may be passed by report. However, whenever possible, the tester
should observe what the child can actually perform rather than ask the parent,
even though the item may be passed by report.

The item, equal movements, has an asterisk (*) at the right end of its
bar. This indicates that 100% of normal children pass this item at birth. The
item is hardly seen in the form but it is the only item with an * and is located in
the fine motor adaptive sector of the test form.

Nine items have arrows (→) at the right end of these bars. This
includes the items, defines words and composition of. The arrows indicate
that normal children may pass these items even beyond 61/2 years of age.

E. TEST DIRECTIONS FOR FOOTNOTED ITEMS

1. Try to get child to smile by smiling, talking or waving to him. Do not touch
him.

2. When child is playing with toy, remove it away from him. Pass if he resists.

3. Child does not have to be able to tie shoes or button in the back

4. Move yarn slowly in an arch from one side to the other, about 6" above child's
face. Pass if eyes follow 90° to midline. (Past midline; 180°).

5. If the child grasps rattle when it is touched to the backs or tips of fingers. You
can mark it as Pass.

6. Pass if child continues to look where yarn disappeared or tries to see where it
went. Yarn should be dropped quickly from sight from the tester's hand
without arm movement.

7. Pass if child picks up cheese curl with any part of thumb and finger.

8. Pass if child picks up cheese curl with the ends of thumb and index finger
using an over hand approach.

9. Pass any enclosed form. Fail continuous round motion

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10. Which line is longer (not bigger) Turn paper upside down and repeat (3/3 or
5/6)

11. Pass any crossing line

12. Have child copy first. If failed, demonstrate

For items 9, 11, 12 do not name the forms. Demonstration is not

necessary on item no 9 and11

13. During scoring, each pair ( 2 arms, 2 legs, etc.) should be counted as one
part.
14. Have the child name the indicated picture (no credit is given for sounds only).

15. Tell the child to: pass the block to Mommy; put block on table; put block on
the floor. Pass 2 of 3. (Do not help child by pointing, moving head or eyes.)

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16. Ask child: What do you do when you are cold? hungry? tired? Pass 2 of 3.

17. Tell child to: Put block on table; under table; in front of chair; behind chair.
Pass 3 of 4 (Do not help child by pointing, moving head or eyes.)

18. Ask child: If fire is hot, ice is?; Mother is a woman, Dad is a ?: a horse is big,
a mouse is? Pass 2 of 3.

19. Ask child: What is a ball? river? desk? house? banana? curtain? roof?
fence? street? Pass if defined in terms of use, shape, what it is made of or its
general category (such as banana is a fruit, not just yellow). Pass 6 of 9.

20. Ask child: What is a spoon made of? a shoe made of? a door made of? ( No
other objects may be substituted.) Pass 3 of 3

21. When placed on stomach, child lifts chest off table with support of forearms
and/or hands.

22. While child is on his back, grasp his hands and pull him to sitting. Pass if
head does not hang back.

23. Child may use wall or rail only, not person. May not crawl.

24. Child must throw ball overhead 3 feet to within arm's reach of tester.

25. Child must perform standing broad jumps over width of test sheet (8 1/2
inches)

26. Tell child to walk forward, heel within 1 inch of

toe.
Tester may demonstrate. Child must walk 4 consecutive steps, 2 out of 3
trials.

27. Bounce ball to child who should stand 3 feet away form tester.. Child must
catch ball with hands, not arms, 2 out of 3 trials.

28. Tell the child to walk back ward toe within 1 inch of heel,
Tester may demonstrate.
Child must walk 4 consecutive steps, 2 out of 3 trials.

F. TEST ITEMS AND SCORING DIRECTIONS

There are 105 test items in MMDST but not all are administered. The
examiner prioritizes items that the age line passes through. It is however
important to explain to the parent or caregiver that the child is not expected to
perform all the tasks correctly. If the sequence were to be followed, the
examiner should start with personal-social then progressing to the other
sectors.
The test items are scored as either Passed (P), Failed (F), Refused
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(R), or Nor Opportunity (NO). Failure of an item that is completely to the left
of the child’s age is considered a developmental delay. Whereas, failure of an
item that is completely to the right of the child’s age line is acceptable and is
not a delay.

Personal-Social

Regards face
Administration Place the child on his back. The tester
should come face to face to within 12
inches of the child
Scoring Pass if the child actually looks at tester

Smiles responsively
May pass by report (R)
Administration Smile and talk to the child. Do not touch him
Scoring Pass if the child smiles back. If this cannot
be seen, ask the parent if the child smiles
without being touched
(R) Question Ngumingiti na ba ang bata kung kinakausap
mo, kahit hindi hinahawakan?

Smiles spontaneously
May pass by report (R)
Administration During the test see if the child smiles at
tester or parent without any stimulation,
either by touch or sound
Scoring Pass if the child smiles on his own at any
time during the test. If this cannot be seen,
ask the parent, “Does your child smile
without you touching or talking to him
(R) Question Ngumingiti ba and bata kahit hindi
kinakausap o hinahawakan?

Feeds self with a cracker

May pass by report (R)
Administration Ask parent if the child feeds himself a
cracker or cookie.
Scoring Pass if the parent says the child can do this.
Score “NO” if for some reason the child has
not been allowed to have a cracker or
cookie.
(R) Question Nakakakain na ba siya ng mag-isa ng cookie
o cracker?

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Resist toy pull
Administration Give the child a toy. While he is playing with
it, gently try to pull it away from him.
Scoring Pass if the child pull back on the toy. Child
should actually resist having the toy taken
from him.

Plays peek-a-boo Make a small hole in the middle of the test

form with a pencil or pen. When the child is
looking at the tester, the tester hides his face
with the test form. Tester then looks around
the test form twice and says “Peek-a-boo.”
Look through the hole to see if the child
watches for you to reappear. Do not move
the paper or the child will watch it.
Scoring Pass if the child looks in the direction where
the tester's face appeared before.

Works for toy out of reach

Administration Place a toy that the child seems to enjoy on
the table a little out of his reach. Do not
leave toy out of reach too long or too far
away. This may upset the child.
Scoring Pass if the child tries to get the toy. Any
stretching of arm or arms or body to get the
toy is a pass. Child does not have to
actually pick up the toy.

Initially shy with strangers

May pass by report (R)
Administration See if the child seems to be shy or wary of
the tester when he first sees the tester
Scoring Pass if the child at first shows some
hesitation or a little shyness of the tester. If
this cannot be seen, ask the parent if the
child acts differently towards strangers than
he does to people he is familiar with. (It is
important not to ask if he is afraid strangers.
This may be misleading)
(R) Question Nangingilala na po ba ang bata?

Plays pat-a-cake
May pass by report (R)
Administration Try to get the child to play pat-a-cake or
Wave bye-bye. Do not touch the child’s
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hand or arms
Scoring Pass if the child responds to this. If this
cannot be seen, ask the parent if the child
plays such games as pat-a-cake, so-big, or
bye-bye without the parent moving the
child’s hands or arms.
(R) Question Nakakapagbabay o nakakapalakpak na ba
siya nang hind hinahawakan ang mga
kamay?

Plays ball with examiner

Administration Roll the ball to the child and try to get him to
roll it or toss it back.
Scoring Pass if the child rolls or tosses the ball back
toward the tester. (Handling the ball to the
tester is not a pass)

Indicates wants (not cry)

May pass by report (R)
Administration Ask the parent how the child lets one know
what he wants. (How does (name) let you
know he want something such as glass of
water or a toy?”)
Scoring Pass if the child lets someone know what he
wants by pointing, pulling or saying a word.
(Crying is not a pass)
(R) Questions Paano niya ipinaaalam na may gusto siya,
gaya ng laruan o inumin atbp.?

Drinks from cup

May pass by report (R)
Administration Ask the parent if the child can hold a cup or
glass and drink from it without spilling much.
Scoring Pass if the child can do this. (The cup must
not be the type that has a spout.)
(R) Question Nakakahawak na ba siya ng tasa o baso at
nakakainom na kaunti lang ang natatapon?

Removes garments
May pass by report (R)
Administration Ask the parent if the child can remove any of
his clothing such as coat, shoes or
underpants.
Scoring Pass if the child can remove clothing other
Than his hat, socks, or diaper on purpose.
(R) Question Naaalis na ba niya ang kanyang damit,
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sapatos, o panty ng hindi tinutulungan?
Imitates housework
May pass by report (R)
Administration Ask the parent if the child imitates household
chores such as dusting and sweeping.
Scoring Pass if the child copies any type of
housework.
(R) Question Gumagaya ba ang bata ng trabahong bahay
katulad ng pagpupunas, pagwawalis?

Uses spoon, spilling little

May pass by report ( R)
Administration Ask the parent if the child uses a spoon or
fork to eat. If so how much does he spill?
Scoring Pass if the child can use the spoon or fork to
get food to his mouth without spilling much.
(R) Question Nakakagamit ba ang bata ng kutsara na
kaunti lang ang natatapon? Naisusubo ba
niya ang pagkain gaya ng kanino gulay na
kaunti lang ang natatapon?

Helps in house-simple tasks

May pass by report (R)
Administration Ask the parent if the child helps in the house
by doing simple things like putting toys away
or getting something for a parent when
asked.
Scoring Pass if the child actually helps in the house
in any way.
(R) Question Nakakatulong na ba siya sa gawaing bahay
tulad ng pagliligpit ng kanyang laruan?
Nauutusan na ba ninyo, gaya ng “Paabot
ng...?”

Puts on clothing
May pass by report (R)
Administration Ask the parent if the child can put on any of
his own clothing such as underpants, socks
or shoes.
Scoring Pass if the child can put any of his own
clothing.. Shoes do not have to be tied or on
the correct foot. (Fail, if child can put on only
adult-size clothing.
(R) Question Nakapag-susuot na ba siyang mag-isa ng
kanyang damit, panty, medyas, sapatos o

22
tsinelas?

Washes and dries hands

May pass by report (R)
Administration Ask the parent if the child can wash and dry
his own hands.
Scoring Pass only if the child can do all parts of the
two tasks without help, except turning on
faucets that are out of his reach. Hands
should be almost completely free of soap
and almost completely dry to pass.
(R) Question Kapag siya ay naghuhugas ng kamay, kaya
na ba niyang magsabon, mag banlaw
magpatuyo nang mag-isa, at hindi na
kailangan ulitin pa?

Plays interactive games

May pass by report (R)
Administration Ask the parent what kind of games the child
plays with other children.
Scoring Pass if the parent says the child plays
games in which he takes turns with other
children.
Examples: hide and seek, tag, cops and
robbers. Chasing and fighting are not
passes. (If the child plays with cars or dolls
by himself but where other children are
playing, this is not a pass.)
(R) Question Ano-anong uri ng laro ang sinasalihan niya
kasama ng ibang bata?

Separates from mother easily

May pass by report (R)
Administration At the end of the test, see how the child acts
when he is asked to stay with the tester
while the parent leaves the room, or see if
the child will leave the room with the tester
without the parent. This should not be done
before the end of the test in case the child
gets upset.
Scoring Pass if the child does not become too upset.
If this cannot be seen, ask the parent if the
child can be left with a babysitter, other than
someone living in the household, without
getting too upset. Pass if the parent answer
23
yes.
(R) Question Naiiwanan na ba si (name) sa hindi
kasambahay ng hindi iiyak?

Dresses with supervision

May pass by report (R)
Administration Ask the parent if the child can dress himself.
If so, how much help is needed?
Scoring Pass if the child can put on and take off his
clothes, knows the front from the back, and
needs no help except for 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?

Buttons up
May pass by report (R)
Administration Ask the parent if the child can button any
piece of clothing.
Scoring Pass if the parent says that the child can.
Buttons do not need to be in the correct
holes.
(R) Question Naibubutones/naikukutiyetes na ba ni
(name) ang damit niya?

Fine Motor Adaptive

Follows to midline
Administration Place the child on his back. (At this age the
child's face will be turned to one side or the
other.) Hold the red yarn about 6 inches in
front of the child's face. Shake the yarn to
attract the child's attention and then move it
slowly from one side in an arc (or half
circle) over the middle of the child's head to
the other side. If necessary, the movement
of the yarn may be stopped to reattract the
child's atten tion and then continue the arc.
This may be repeated three times. Watch
24
the child's head and eye movements.
Scoring Pass if the child follows the yarn to the
middle point of the arc with either his eyes
alone or his head and eyes altogether.
Make sure that the yarn has attracted the
child's attention and that he did not follow it
before a failure is given.

Equal movements
Administration While the child is on his back or being held
by the parent, watch the activity of the
child's arms and legs.
Scoring Pass if the child moves his arms and legs
equally. (Fail if one leg or arm does not
move as much as the other.)

Follows past midline

Administration Place the child on his back. Hold the red
yarn about 6 inches in front of the child's
face. Shake the yarn to attract the child's
attention and then move it slowly from one
side in an arc over the middle of the child to
the other side. necessary, the movement of
the yarn may be stopped to reattract the
child's attention and then continue the arc.
This may be repeated three times. Watch
the child's head and eye movements.
Scoring Pass if the child follows the yarn past the
middle point of the arc with either eyes
alone or his head and eyes together. Make
sure that the wool has attracted the child's
attention, and that he did not follow it before
a failure is given.

Follows 180°
Administration Place the child on his back. Hold the red
25
yarn about 6 inches in front of the child's
face. Shake the yarn to attract the child's
attention and then move it slowly from one
side in an arc over the middle of the child's
head to the other side. If necessary, the
movement of yarn may be stopped to
reattract the child's attention and then
continue the arc. This may be repeated
three times. Watch the child's head and
eye movements.
Scoring Pass if the child follows the wool with his
head and eyes through the complete arc
from one side to the other.

Hands together
May pass by report (R)
Administration Watch child to see if he touches his
hands together in the midline (middle of his
body). If this cannot be seen, ask the parent
if child has done this before.
Scoring Pass, if child touches his fingers together in
the midline. Fail if this happens only when
child is being cradled in parent's arms and
the hands are forced together.
(R) Question Napag-aabot na ba ng bata ang kanyang
mga daliri sa gitna ng katawan
(demonstrate) na hindi ninyo tinutulungan o
kinakarga?

Grasp rattle
Administration Place a rattle touching the back or tips of
the child's fingers when he is on his back on
the table or is being held by his parent.
Scoring Pass if the child grasps the rattle for a few
seconds.

26
Regards cheese curl
Administration The child should be held on the parent's lap
so that he can place his hands on the table.
Drop a cheese curl directly in front of the
child within easy reach. (The cheese curl
should be dropped on a surface that gives a
good contrast, such as white paper, so that
it can easily be seen). The tester may point
to or touch the cheese curl to attract the
child's attention. See whether the child
looks at the cheese curl.
Scoring Pass if the child looks at the cheese curl.
(Fail if the child looks at the finger or hand
instead of the cheese curl.)

Reaches for object

May pass by report (R)
Administration The child should be held on the parent's lap
so that his elbows are level with the table
top and that he can easily place his hands
on the table. Place a toy (such as the rattle)
within easy reach of the child and tell him
with words or motion to pick it up.
Scoring Pass if the child reaches toward the toy. He
does not need to touch or pick up the toy
for a pass. If this cannot be seen, ask the
parent if the child has done this.
(R) Question Kapag may laruan sa kanyang harapan,
nagtatangka na ba siyang abutin ito?

Sit, looks for yarn

Administration While the child is sitting on the parent’s lap,
attract his attention with the red yam. When
he is looking at the yarn, drop it so that it
falls out of his line of vision. Tester should
not move hand or arm except to let go of
the yarn.
Scoring Pass if child continues to look where the
red yarn disappeared or tries to see where
it went.

Sit, takes 2 cubes

May pass by report (R)

27
Administration Place 2 blocks on the table in front of the
child. Tell the child to pick up the with words
or motion, but not hand the blocks to the
child
Scoring Pass if the child picks up 2 blocks and
holds 1 in each hand at the same time. If
this cannot be seen, ask the parent if the
child picks up 2 objects like this.
(R) Question Kapag nakaupo ang bata, nakakapulot na
ba siya ng dalawang bagay at
nahahawakan ito ng sabay sa tig isang
kamay?

Rakes cheese curl, attains

Administration The child should be held on the parent's lap
so that he can place his hands on the table.
Drop a cheese curl directly in front of the
child within easy reach. (The cheese curl
should be dropped on a surface that gives a
good contrast, such as white paper, so that
it can easily be seen). The tester may point
to or touch the cheese curl to attract the
child's attention. See how the child picks up
the cheese curl.
Scoring Pass if the child picks up the cheese curl
with his hand using a raking motion, Make
sure that the child was not able to pick it up
only because of sticky fingers. He should
also be passed if he uses a thumb-to-linger
or neat pincer grasp.

Passes cube hand to hand

May pass by report (R)
Administration See whether or not the child passes a block
from one hand to the other. The tester may
encourage this by giving the child a block
and then presenting a second block to the

28
hand that is already holding one. The child
will often pass the first block to the other
hand so that he can pick up the second
block
Scoring Pass if the child passes the block from one
hand to the other without using his mouth,
body or table. If this can not be seen, ask
the parent if the child passes small items
from one hand to the other. (Long objects
such as spoons and rattles do not count.)
(R) Question Maliban sa malalaking bagay gaya ng rattle
o kutsara, nakapaglilipat-lipat na ba siya ng
maliliit na bagay sa kanyang mga kamay?

Bangs 2 cubes held in hands

May pass by report (R)
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 action for him. The tester may show
the child as long as the tester does not use
the child's hands.
Scoring Pass if the child hits the blocks together in
front of himself. If this cannot be seen, ask
the parent if the child has banged small
objects, such as blocks, together like this.
(Pots and pans or other large objects do not
count)
(R) Question Maliban ho sa malalaking bagay,
nakakaganito (demonstrate) na ba siya ng
mga laruang kasing liliit nito?

Thumb-finger grasp
Administration The child should be held on the parent's lap
so that he can place his hands on the table.
Drop a cheese curl directly in front of the
child within easy reach. (The cheese curl
should be dropped on a surface that gives a
good contrast, such as white paper, so that
it can be easily seen). The tester may
demonstrate, point to or touch the cheese
curl to attract the child's attention. See how
the child picks up the cheese curl.
Scoring Pass if the child picks up the cheese curl
29
using any part of the thumb and a finger by
bringing them together. He should also be
passed if he uses a neat pincer grasp.

Neat pincer grasp of cheese curl

Administration The child should be held on the parent's lap
so that he can place his hands on the table.
Drop a cheese curl directly in front of the
child within easy reach. (The cheese curl
should be dropped on a surface that gives a
good contrast, such as white paper, so that
it can be easily seen). The tester may point
to or touch the cheese curl to attract the
child's attention. See how the child picks up
the cheese curl.
Scoring Pass if child picks up the cheese curl using
the ends of thumb and index finger with an
overhand approach..

[NOTE: For items involving drawing by the child, use plain paper and a pencil.
A pen is more difficult for most children to handle, and lined paper can be
distracting.]

Scribbles spontaneously
May pass by report (R)
Administration Place a piece of paper and a pencil in front
of the child on the table so that he can
reach them easily. The tester may place the
pencil in the child's hand, but may not show
the child how to scribble.
30
Scoring Pass if the child makes two or more
purposeful marking on the paper. (Fail
accidental marks or stabbing with pencil.) If
this cannot be seen, ask the parent if the
child scribbles without help
(R) Question Kapag siya ay binigyan ng lapis at papel,
siya ba ay nakapag-guguhit guhit ng mag-
isa?

Tower of 2 cubes
Administration Place blocks on the table in front of the
child. The tester may encourage him to
stack the blocks one upon the other as high
as he can by showing him how and /or
handing the child the blocks. (The very
young child is sometimes distracted by a
number of blocks and will perform this item
more easily when given the blocks one at a
time.) The child may have up to three trials.
(Pagpatung-patungin mo ito tulad nito.)
Scoring Pass if the child puts one block on top of
another so that it does not fall when he
removes his hands.

Tower of 4 cubes
Administration Place blocks on the table in front of the
Child. The tester may encourage him to
stack the blocks one upon the other as high
as he can by showing him how and /or
handing the child the blocks. The child may
have up to three trials. Give more blocks.
(Dagdagan mo pa para tumaas).
Scoring Pass, if the child balances 4 blocks on top
of one another so that they do not fall.

Tower of 8 cubes
Administration Place blocks on the table in front of the
child. The tester may encourage him to
stack the blocks one upon the other as high
as he can by showing him how and / or
handing the child the blocks. The child may
have up to three trials. Present rest of
blocks. (Gamitin mong lahat ito.)
Scoring Pass if child balances 8 blocks on top of
one another so that they do not fall.

31
Imitates vertical line
Administration The child should be seated at the table so
that he is at a comfortable writing level.
Place paper and pencil in front of the child
and tell him to draw lines like the tester.
The tester should demonstrate how to draw
vertical lines in the up and down (vertical)
position for the child. Do not guide the
child's hand. Draw vertical line. (Gayahin
mo ito.)
Scoring Pass if the child makes 1 line or more on
the paper, at least 1 inch long and not
varying from the vertical line by more than
30 degrees (see example). Lines do not
have to be perfectly straight.

Dumps cheese curl from bottle - spontaneously

Administration Place a cheese curl in the bottle and tell the
child to get it out. Do not use the word
"dump”, or tell the child how to get the
cheese curl out. (llabas mo ang iyong
cheese curl.)
Scoring Pass if the child dumps the cheese curl out
of the bottle without being shown how to do
it. (Dumping the cheese curl directly into the
mouth or raking it out of the bottle with a
finger is not a pass.)

Dumps cheese curl from bottle - demonstrated

Administration First see if the child does this
spontaneously. If not, place a cheese curl in
the bottle and tell the child to get it out. If
the child does not dump the cheese curl
from the bottle on his own, show him how to
32
do it 2 or 3 times. (Gawin mo ito.)
Scoring Pass if the child dumps the cheese curl out
of the bottle, either on his own, or after he is
shown how to do it. (Dumping the cheese
curl directly into the mouth or raking it out of
the bottle with a finger is not a pass.)

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, but not touching.
Place a third block on top of these so that it
covers the space between. The tester then
gives 3 blocks to the child and tells him to
build a bridge like the one the tester built.
The bridge should be left standing for the
child to copy. The tester should not point
out the opening. (Masdan mong mabuti
itong ginagawa ko.) Demonstrate. (Gawin
mo rin ang ganito.) Give blocks.
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.

Picker longer line

3 of 3 or 5 of 6
Administration Show the parallel lines on the back of the
test form (Footnote # 10) to the child and
ask him, “Which line is longer ?” (The word
bigger cannot be changed.) After the child
33
has pointed to the line he thinks is longer,
turn the sheet upside down and ask the
question again. This must be done at least
3 times. (Alin ang mahaba, ito o ito?) Point
to lines.
Scoring Pass if the child picks the longer line 3 out
of 3 times. If he fails to do this, the tester
must give the item 3 more times. A pass is
given if the child picks the longer line 5 out
of 6 times. The child receives a pass only if
he is correct 3 out of 3 times or 5 out of 6
times.

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. (Gawin mo ito.) Point to
the picture.
Scoring Pass any enclosed form that is not made up
Of continuous round motions. (See
examples.)

Imitates demonstrated D
34
Administration First, see if child can copy from the picture
without being shown how to draw the figure.
If he cannot, show the square on the back
of the test form 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. If he is unable to copy the picture,
the tester should show him how by drawing
two opposite sides first and then the other
two opposite sides rather than drawing the
square with a continuous motion. When the
square is drawn with a continuous motion it
may appear round to the child. (Gumawa ka
ng tulad nito.) Demonstrate
Scoring Pass if the child draws a figure with straight
lines and with 4 square corners. The
corners may be formed by lines that
intersect, but the corners must be
approximately right angles (L) and not
rounded (v ) or pointed ( v ). The length
should be less than 2 times the width

Copies +
Administration Show the cross on the back of the test form
(Footnoted Item #11) 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. (Gayahin o gawin mo
ito.) Point to the picture.
Scoring Pass if the child draws 2 lines which
intersect at any point. The lines do not need
to be exactly straight. If the child uses 3 or
4 strokes to draw the cross, any 2
Intersecting is a pass.
35
Draws man - 3 parts
Administration Give the child pencil and paper and tell him
To draw a picture of a boy or girl (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?" If the child answers, “Yes,” score
the drawing. (Magdrawing ka ng tao. Tapos
ka na ba?) If yes, then score.
Scoring Pass if the child has drawn 3 or more body
parts. One point is given for each pair (ears,
eyes, etc.) as well as for each part which is
not a pair (head, neck. body, etc). (See
example.) If one part or pair is not drawn, it
is not counted. Note in the test observations
any unusual drawings, even if the child has
identified acceptable parts.

Copies
Administration Show the square on the back of th form
(Footnoted item #12). Do name it or move
your finger or your pencil to show how to
draw it. Tell the ci draw one like the picture.
(Gumawa ka, ng tulad nito.) Point to the
picture.
Scoring Pass if the child draws a figure with straight
lines and with 4 square corners without
being shown how to draw it. The corners
36
may be formed by lines that intersect. The
corners must not be rounded or pointed.
(See example) The length should be less
than 2 times the width.

Draws man - 6 parts

Administration Give the child a pencil and paper and tell
him to draw a picture of a boy or girl (man
or woman). Do not tell him to add other
parts to his drawing. When he seems to
have finished his drawings, ask, “Are you
finished?” If the child answers “Yes,” score
the drawing.
Scoring Pass if the child has drawn 6 or more body
parts. One point is given for each pair (ears,
eyes, etc.) as well as for each single part
(head, neck, body, etc.) See example. Note
in the test observations any unusual
drawing, even though the child has
identified acceptable parts.

37
Language

Responds to bell
Administration Hold the bell so that the child cannot see it
(to the side and a little behind his ear). Ring
the bell quietly. If the child does not seem to
notice, try it again later in the test session.
Pass if the child shows in any way that he
has heard the bell, such as movement of
eyes, change in breathing rate, or any other
change in the child's activity.
Scoring Pass if the child shows in any way that he
has heard the bell, such as movement of
eyes, change in breathing rate, or any other
change in the child's activity.

Vocalizes - not crying

May pass by report (R)
Administration During the test, listen for sounds other
than crying, such as cooing sounds.
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 ka na
bang ibang tinig salita sa kanya? Anu-
anong tinig salita ang nagagawa niya?

Laughs
May pass by report (R)
Administration During the test check whether the child
laughs aloud.
Scoring Pass if the child laughs aloud without being
tickled. If this cannot be heard, ask the
parent if the child does this
(R) Question Tumatawa na ba siyang malakas kahit
hindi kinikiliti?

Squeals
Administration During the test check whether the child
makes high-pitched, happy, squealing
sounds.
Scoring Pass if the child makes these sounds. If
these cannot be heard, ask the parent if the
38
child does this.
(R) Question Tumitili na ba siya na parang masayang
masaya? Paano siya tumitili?

Turns to voice
Administration While the child is seated on the parent's lap
or on the table facing the parent, approach
the child from behind to within 8 inches of
either ear. Whisper the child's name several
times taking care that tester's breath does
not touch the child (child might then turn to
where he feels the breath rather than to the
sound). Give up to 3 trials.
Scoring Pass if the child turns to the direction of the
voice

Da-da or Ma-ma, non-specific

May pass by report (R)
Administration Check whether the child says “da-da" or
“ma-ma” at any time during the test.
Scoring Pass if the child says either “da-da” or “ma-
ma”. The child does not have to associate
these with a parent. If this cannot be heard,
ask the parent if the child does this.
(R) Question Nakakapagsabi na ba siya ng dada o mama
/tata o papa? (Hindi kailangan na ang
mommy o daddy and kanyang tinutukoy.)

Imitates speech sounds

May pass by report (R)
Administration Check whether the child imitates sounds
made by his parent or the tester.
Scoring Pass if the child makes sounds that are like
those he has heard within the last minute. It
these cannot be heard, ask the parent if the
child does this.
(R) Question Nakakagaya na ba siya ng inyong mga
salita? Anong mga salita ang nagagaya
niya?

Da-da or Ma-ma, specific

May pass by report ( R)
Administration Check whether the child says "da-da" to his

39
father or “ma-ma” to his mother during the
test.
Scoring Pass if the child uses either “ma-ma” or
"da-da” correctly for his mother or father. If
this cannot be heard, ask the parent if the
child does this.
( R) Question Nakapagsasabi na ba siya sa inyo ng
ta-ta/da-da sa kanyang ama, o na-na/ ma-
ma sa kanyang ina?

3 words other than ma-ma, da-da

May pass by report (R)
Administration Ask the parent what words the child uses
regularly for specific objects, persons, or
actions.
Scoring Pass if parent reports child uses at least 3
specific words other than "da-da" or “ma-
ma". The words do not have to be
understandable but must mean the same
thing each time they are used. (No credit is
given for "da-da” or "ma-ma'')
(R) Question May nasasabi na ba siyang ibang salita
maliban sa tata/dada o nana/ mama sa
tuwing gagamitin niya ay pareho ang ibig
sabihin?

Combines 2 different words

May pass by report (R)
Administration Check whether the child combines 2 or
more words to make a meaningful phrase.
. Scoring Pass if the child says a meaningful phrase
of 2 or more words such as “play ball”, “
want milk” and “get down”. (No credit is
given for a single-idea combination such as
“bye bye”, “thank you”, and “peek-a boo".) If
this cannot be heard, ask the parent if the
child does this.
( R) Question Nakapagdudugtong-dugtong na ba siya ng
2 o higit pang salita kung may ibig siyang
sabihin, tulad ng “laro ako", "gusto ko”,
atbp?

Names one picture

Administration Point to the pictures on the back of the test
form (Footnoted item #14) one at a time and
40
ask the child, “What is this?” (Ano ito?)
Scoring Pass if the child correctly names any one
picture. Words such as horsey are
acceptable. Pass also if the child gives the
name of his pet if it is the same animal as
pictured. (Fail animal sounds like 'Meow” or
“Woof")

Follows directions
2 of 3
Administration The tester should tell the parent not to move
and then give the child a block. Tell him to
do the following, one at a time:
“Give the block to Mommy" (Ibigay mo ito sa
Nanay.)
“Put the block on the table” (llagay mo ito
sa mesa.)
“Put the block on the floor” (Ilagay mo ito sa
sahig.)
The tester and the parent should be careful
not to give the child help by looking or
pointing at Mommy, table or floor.
Scoring Pass if the child follows 2 of the 3 directions
correctly.

Uses Plurals
May pass by report (R)
Administration Place 3 blocks in front of the child on a
cleared table. Ask the child, "What are
these?” (Ano ito?)
Scoring Pass if the child answers “blocks" using “s”
to indicate more than one block. If this
cannot be observed, ask the parent if the
child uses "s" on the end of words to
indicate more than one of anything. To pass
the child need not say “s” clearly, but he
does have to tell the difference between
one and more than one.
(R) Question Nadinig na ba ninyo si (child) na gumamit
ng salitang “mga” 0 "marami” kung mahigit

41
sa isa ang nakikitang mga bagay-bagay,
gaya ng "mga ibon” o kaya nagdadagdag
ng “s” gaya ng “birds” kung English ang
gamit na salita?

Gives first and last name

May pass by report (R)
Administration Ask the child, "What is your name?” If he
gives only his first name ask him to give his
last name or both names. (Ano ang
pangalan mo?) Probe. (E,'yung apelyido
mo? Ano pa?)
Scoring Pass if the child gives understandable
(need not be perfect ) names. Nick names
are acceptable for first names. If this cannot
be observed, ask the parent if the child can
give his first or nickname and last name
without hints..
(R) Question Nasasabi na ba ni (child) ang kanyang
buong pangalan ng walang tulong?

Comprehends cold, tired, hungry

2 of 3
Administration Ask the child the following questions, one at
a time:
"What do you do when you are tired? ”
(Ano ang ginagawa mo kung ikaw ay
pagod?) (go to sleep, sit down, rest)
"What do you do when you are cold?
(Ano ang ginagawa mo kung ikaw ay
giniginaw?) (put on a coat, go inside, turn
up the furniture.)
(Do not pass if the child answers this with
“cough”, “take medicine" or any other
answer about having a cold. He did not
understand what was being asked.)
“What do you do when you are hungry?”
(Ano ang ginagawa mo kung ikaw ay
gutom?) (eat, have supper, ask for
something to eat.)
Scoring Pass if the child gives a logical answer for 2
out of the 3 questions. Some correct
answers are listed above.
42
Comprehends prepositions
3 of 4
May pass by report (R)
Administration The tester should tell the parent not to move
and then give the child a block. Tell him to
do the following, one at a time:
“Put the block on the table."
(llagay mo ito sa ibabaw ng mesa.)
"Put the block under the table."
(llagay mo ito sa ilalim ng mesa.)
"Put the block in front of Mommy's chair."
(Ilagay mo ito sa harap ng silya ni Nanay.)
“Put the block behind her chair. “
(Ilagay mo ito sa likod ng silya ni Nanay.)
A wrong answer should not be corrected
Scoring Pass if the child follows 3 of the 4 directions
correctly. .

Recognizes colors
3 of 4
May pass by report (R)
Administration Place a red, blue, green and yellow block
together on the table in front of the child.
Ask the child to point to or give to you the
red block, the blue block, etc. If the child
hands the block should be replaced on the
table before the next color is asked for. Do
not let the child know if his responses are
right or wrong. Do not ask the child to
name the colors. (Ibigay / ituro mo sa akin
ang pula, dilaw, berde, asul)
Scoring Pass if the child picks 3 on the 4 colors
correctly. If this cannot be seen, ask the
parent if the child can point out 3 of the 4
colors shown
(R) Question Alin sa mga kulay na ito ang naituturo niya?

Opposite Analogies
2 of 3
Administration Make sure the child is listening to the tester
and then say: ( one sentence at a time, wait
for the child to fill in the blank.)
“Fire is hot, ice is_________ ?" (cold, cool,
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freezing; not wet, melts, water)
[Kung ang apoy ay mainit, ang yelo ay
___________]
"Mother is a woman, Dad is a __________?
(man; not Daddy, boy, husband.)
[Kung si nanay ay babae, si tatay ay
______]
A horse is big ,a mouse is________?
(Ang kabayo ay malaki, ang daga ay
_____?]
(Each sentence may be repeated 3 times if
necessary.)
Scoring Pass if the child gives any appropriate
opposite word in 2 of the 3 analogies. A few
of the correct answers are listed above

Defines words
6 of 9
Administration Make sure the child is listening to the tester
and then say, “I am going to say a word and
I want you to tell me what it is.” Ask each
word one at at a time. “What is a
ball...river...desk...house...bana
na...curtain...roof...fence... road...? Each
word may be asked 3 times if necessary.
Wait for the child's an swer after each word.
(Magbibigay ako ng isang salita at sabihin
mo kung ano ito: bola... ilog... mesa...
bahay...saging... kurti na... bubong...
bakod.kalsada...).
Scoring Pass if the child defines 7 of the 9 words in
terms of (1) use, (2) shape, (3) what it is
made of, or (4) general category (such as
banana is fruit but not merely "yellow" or
"banana skin”.) “Circle” is an acceptable
answer for "What is a ball?”; how ever,
since many children seem to think
acceptance of “circle” means all words must
be defined by shape, it may be helpful to
ask the child to "tell me something else
about a ball”. In this way a child will be
directed to other definitions as well as
shape.

Composition of -
3 of 3
44
Administration Make sure the child is listening to the tester
and then ask the following questions, one at
a time: (Ano ang ginagawang...)
“What is a spoon made of ?" (kutsara)
“What is a shoe made of? (sapatos)
"What is a door made of?”(pinto)
Wait for the child's answer after each
question. Each question may be repeated 3
times if necessary. Note: If unable to
understand the above,, ask:
Kung ang mesa ay yari sa kahoy? ang
kutsara ay yari sa_____________.
ang sapatos ay yari sa____________.
ang pintuan ay yari sa ____________.

Scoring Pass if the child replies that:

A spoon is made of metal (or any specific
metal), plastic or wood
A shoe is made of leather, rub ber, cloth,
plastic and wood. Plastic, wood or other
unusual materials are acceptable if child is
wearing or owns such shoes, i.e, boots,
clogs, etc
A door is made of wood, metal, or glass.

Gross Motor

Stomach lifts head

May pass by report (R)
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.
( R) Question Kapag nakadapa ang bata, naitataas na ba
niya ang kanyang baba kahit sandali?

45
Stomach head up 45°
Administration Place the child on his stomach on a flat
surface.
Scoring Pass if the child lifts his head so that his
face makes an approximate 45 degree
angle with the table.

Stomach (Sto) head up 90°

Administration Place the child on his stomach on a flat
surface.
Scoring Pass if the child lifts his head, and chest up
so that his face makes a 90 degree angle
with the table.

Stomach chest up, arm support

Administration Place the child on his stomach on a flat
surface
Scoring Pass if the child lifts his head and chest up,
using support of outstretched hands or
forearms so that his face is looking straight
ahead.

Sit-head steady
Administration Hold the child in a sitting position.
Scoring Pass if child holds head upright and steady
46
with no bobbing motion. (Fail if child holds
head steady for only a few seconds and
then drops it to chest or sideways.)

Rolls over
May pass by report (R )
Administration Tester should see this or ask the parent if
the child rolls from back to stomach or from
stomach to back.
Scoring Pass if the child rolled completely over, not
just to or from side, either way (not
accidentally) two times or more.
(R) Question Dumadapa na ba siyang mag-isa? Ilang
beses na niyang nagawa ito?

Pull to sit, no head lag

Administration Place the child on his back. Grasp his hands
or wrists and gently pull to a sitting position.
Do not pull the child up fast or his head will
be forced to hang back.
Scoring Pass if the child's head does not hang at any
time while he is being pulled up.

Bear some weight on legs

Administration Hold the child upright so that his feet rest on
the table. Slowly loosen your hand support

47
but do not release the child completely.
Scoring Pass if the child briefly supports most of his
weight on his legs. If the child keeps his legs
rigid to support his weight, pass the item but
note on the test form that the legs were rigid.

Sits without support

Administration Hold the child on a sitting position on table.
Making sure child does not fall, slowly
remove your hands.
Scoring Pass if the child sits alone for 5 seconds
or more. Child may put his hands on his legs
or the table for support.

Stands holding on
May pass by report (R)
Administration Place the child in a standing position holding
on to a solid object (not a person.)
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?

Pulls self to stand

May pass by report (R)
Administration Check or ask parent if the child pulls himself
to standing position while holding on to a
solid object (such as the crib rail, a chair leg
or a table) without help from a person.
Scoring Pass if the child can pull himself into a
standing position.
(R) Question Mula sa pagka-upo, nakatatayo na ba siyang
mag-isa ng walang tulong o na nakahawak
lamang sa isang bagay tulad ng silya, atbp?

Gets to sitting
May pass by report (R)
Administration Check or ask parent if the child can get
himself into a sitting position.
Scoring Pass if seen or reported.
(R) Question Mula sa pagkahiga, nakauupo na ba siyang
mag-isa?

Walks holding on furniture

May pass by report (R)
Administration Check or ask the parent if the child walks
around furniture while holding on to it.
Scoring Pass if seen or reported.

48
(R) Question Nakalalakad na ba siya na nakahawak
sa silya o ibang bagay?

Stands momentarily
May pass by report (R)
Administration Place the child standing on the floor. After he
seems to have his balance, remove your
support.
Scoring Pass if the child stands alone 2 or more
seconds. If this cannot be seen, ask the
parent if the child can do this.
(R) Question Nakatitindig na ba siyang mag-isa kahit 2
segundo lamang?

Stands alone well

May pass by report (R)
Administration Place the child standing on the floor. After he
seems to have his balance, remove your
support.
Scoring Pass if the child stands alone 10 or more
seconds. If this cannot be seen, ask the
parent if the child can do this.
(R) Question Nakatatayo na bang mag-isa ng matagal
(mga 10 segundo) ang bata?

Stoops and recovers

May pass by report (R)
Administration While the child is standing on the floor away
from all support, place a small toy on the
floor in front of him and tell him to pick it up.
Scoring Pass if the child is able to bend over, pickup
toy and return to standing without holding
on or touching floor. If this cannot be seen,
ask the parent if child can do this,
(R) Question. Kapag may pinulot siyang laruan sa sahig,
nakatatayo ba siya nang hindi humahawak sa
sahig o ano mang bagay?
Walks well
May pass by report (R)
Administration Watch the child as he walks to see if he has
good balance and rarely falls..
Scoring Pass if the child does not have any difficulty
walking and does not tip from side to side. If
this cannot be seen, ask the parent if child
can do this.
( R) Question Matatag na ba siyang maglakad?

Walks backwards

49
May pass by report (R)
Administration Tell the child to walk backwards. The tester
may show the child how to do this.
Scoring Pass if the child walks backwards 2 or more
steps. If this cannot be seen, ask parent if
the child walks backwards at home, possibly
when pulling a toy.
Pass if the parent reports the child can do
this.
(R) Question Nakalalakad na ba siya ng paurong
(paatras)? Nakakailang hakbang siya?

Walks up steps
May pass by report (R)
Administration Ask the parent how the child gets up steps.
Scoring Pass if the child can walk up steps (not
crawl). He may use the wall or rail support
but cannot hold on to a person.
(R) Question Paano umaakyat si (child) sa hagdan?
(Probe to clarify) Nakaaakyat na ba siya sa
hagdan nang hindi gumagapang o
hinahawakan o di kaya ay nakahawak lang
sa dingding o gabay?

Kicks ball forward

May pass by report (R)
Administration Place the ball about 6 inches in front of the
standing child. Tell him to kick it. The tester
may show him how to do this.
Scoring Pass if the child kicks the ball forward
without holding on to any support. (Hitting
the ball on the backswing, stepping on the
ball or using support is a failure). If this
cannot be seen, ask the parent if the
child kicks a ball of similar size at home.
(R) Question Kapag inilagay ang bola sa harap niya,
nasisipa ba niya?

Throws ball overhand

Administration Tell the child to throw the ball to the tester
using an overhand throw. The tester may
show him how to throw overhand. (Ihagis mo
ang bola sa akin gaya nito.)
Scoring Pass if the child is standing at least 3 feet
from tester and throws the ball within arm's
length of tester between his knees and face.
(Cannot score a pass if child refuses to
throw the ball toward tester but continually
throws away from him.)

Balance on 1 foot 1 second

2 of 3
50
Administration Show the child how to stand on 1 foot
without holding on. Allow 3 trials if needed.
(Gawin mo ito.)
Scoring Pass if the child can stand on either foot 1
second or more in 2 of 3 trials. (May be
noted during “Balance on 1 foot 5 seconds.")

Jumps in place
Administration Tell the child to jump. The examiner may
show him how to do this. (Gawin mo ito)
Scoring Pass if the child raises both feet off the floor
at the same time for any measurable
distance. He does not have to land on the
same spot from which he started. (The child
cannot run before he jumps, or hold on to
anything for support.)

Pedals tricycle
May pass by report (R)
Administration Ask the parent if the child can pedal a
tricycle.
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 considered a pass.) If the child
has not had an opportunity to ride a tricycle
of his size, score the item “NO” for no
opportunity.
(R) Question Nakapagbibisekleta na ba siya mula rito
Hanggang doon (point to ten feet)?

Broad Jump
May pass by report (R)
Administration Place a test form on floor and show the
child how to do a standing broad jump
across the width of the paper (8 1/2"), then
tell him to do it. Give him 3 trials..
Scoring Pass if the child jumps once, with both feet
together, over the 8 12 inches. (If the child
leaps across, one foot at a time, this is a
failure.)

Balance on 1 foot 5 seconds

2 of 3
Administration Show the child how to stand on 1 foot
without holding on and then tell him to do it.
Time him with a watch, if possible. Allow 3
51
trials if needed. (Gayahin mo ito.)
Scoring Pass if the child can stand on either foot 5
seconds or more in 2 of 3 trials. (May be
noted during “Balance on 1 foot 10
seconds.")

Balance on 1 foot 10 seconds

2 of 3
Administration Show the child how to stand on 1 foot
without holding on and then tell him to do it.
Time him with a watch, if possible. Allow 3
trials if needed. (Gayahin mo ito.)
Scoring Pass if child can stand on either foot 10
seconds or more in 2 of 3 trials.

Hops on 1 foot
Administration Tell the child to hop on one foot. The tester
may show him how to do this. (Gawin mo
ito.)
Scoring Pass if the child hops on 1 foot 2 or more
times in a row , either in place or over a
distance, without holding on to anything.

Heel-to-toe-walk
2 of 3
Administration Show the child how to walk placing the heel
of one foot in front of and touching the toe
of the other. Walk about 8 steps like this
and tell the child to do it. (The tester may
com pare this to a tight rope walk.) If the
child does not respond, show him how to do
it again. Allow 3 trials if needed. (Gayahin
mo ito.)
Scoring Pass if the child can walk in a straight line
for 4 or more steps placing his heel 1 inch
or less in front of his toe, 2 out of 3 trials.

Catches bounced ball

2 of 3
Administration The tester stands about 3 feet from the child
and bounces the ball to him, taking care to
have the ball bounce once halfway between
the tester and the child. The ball should
reach the child between his neck and waist.
The child is told to catch the ball. Allow 3
trials if needed. (Saluhin mo ang bola.)
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Scoring Pass if the child catches the ball with his
hand or hands in 2 out of 3 trials. The child
may catch ball against his body if he uses
his hands and not his arms. (If the child
uses only his arms against his body to catch
the ball, this would be a failure.)

Backward heel-to-toe
2 of 3
Administration Show the child how to walk placing the toe
of one foot in back of and touching the heel
of the other. Walk about 8 like steps this
and then tell the child to do it. (The tester
may compare this to a backward tight rope
walk.) Allow 3 trials if needed. (Gayahin mo
ito.)
Scoring Pass if the child can walk backward in a
straight line for 4 or more steps placing his
toe 1 inch or less in back of his heel, 2 out
of 3 trials.

G. SELECTING ITEMS TO BE ADMINISTERED

Items to be carried out first are those through which the child’s
chronological age line passes. If failure takes place in any of these items, you
can continue to administer items to the left of the age line until you reach three
passes, then stop. In item passed move ahead testing to the right where the
items become progressively more difficult until the child fails three times in that
sector.

In selecting the items to be administered you have to consider the following:

 All items crossing the age line should be administered

 The child should have a minimum of three passes to the left of any
failure and:
 Each sector should have at least three passes and three failures.

The total of items to be administered will differ with the age and abilities
of the child. Commonly, there are twenty simple tasks or items to be tested on
the child. The child may carry out some of the task on his own without being
asked. One of these is the child’s ability to sit alone. If during the interaction
you noticed that the child is doing so at any time, then this is passed without
asking the child to demonstrate it again.

53
H. IMPLEMENTING THE TEST PROCEDURE

1. Preliminary Phase

Build rapport with the mother/ caregiver. Establishing good

rapport creates an environment where there is mutual understanding; it
builds trust and creates common ground. You can mention to the
mother your interest in observing what babies and children can do at a
certain age. Tell them that this is a screening test and not an
intelligence or IQ test. Reassure the mother that the child is not
expected to perform nor pass all the items administered. You might
explain it this way:
“Maglalaro lang po kami ng iyong anak at
pagmamasdan ko lang po kung ano ang kanyang
magagawa gamit ang mga laruan na ito. May mga ilang
katanungan din po ako sa inyo. Huwag po kayong mag
alala kung hindi nya magawa lahat ng aking ipagagawa o
hindi niya masagot ang aking mga katanungan.”

Make the child as comfortable as possible during the test.

You can ask the child to sit to his/her mother’s lap if that will make
them at ease. Set all the materials needed and be sure that all is
easily accessible to the child. A mat on the floor with you in a kneeling
position is recommended since children who live in poorer homes
where tables and chairs are not common fixtures in the houses.

If the the child is one year old or older, put the child at ease by
saying:

“(Name) laro tayo, meron akong mga dalang

laruan. Tingnan mo o, (Show a block)

Pay attention to what the child can actually do, rather than simply
asking the parent. You can look at how the child does the task, if he/she
has difficulty doing it. This is done even if 46% of the items may be
passed by a verbal report of a parent or other caregiver who know the
child very well. It is not recommended to continue testing the child if
he/she feels sleepy, tired, ill, upset or hungry.

2. Administering the Test

Typically, the test starts with the personal-social sector. It

gives the child the opportunity to familiarize with the tester, while the
tester asks the parent to the items that can be scored on report but can
be observed directly. The items that need to be administered directly in
this sector are given next. Fine motor-adaptive sector is next. In this
sector the child can do the task even without talking to the tester.

54
The language sector is texted next. As Frankenburg et al. (1970)
have observed: “By the time you have reached this point in the test, the
child will be more comfortable with you and much more likely to answer
questions and talk to you.” The gross motor sector is tested last. Many
children are too shy to try these items at the beginning of a test.

In any instance you can modify the sequence of items to capture

the child’s interest. In general, clearing the working table/floor of all
materials except those needed in a particular task minimizes
distractions.

The manner of administering each test item may not be

changed. Words or direction may not be changed. Otherwise, the
standard of test administration will not be observed. Avoid asking
questions in such a way that you suggest the answer.

For each sector item that can be performed easily should be

done first. This will influence the child to complete more difficult tasks
later. Compliment the child for his/her efforts. If there are 3 failures in
one sector occur move on to the next sector of the test. The child is
given 3 chances to perform each item before a failure score is given.
Please note that some items are required for several tries. This is
specified in the section on the specific test item administration.

To lessen non-compliance of the task, Frankenburg et al are

recommended: Tell the child what to do (Gawin/ gayahin mo ito) and not
ask “can he” or “will he.” You can ask the parent for help, let them
administer the item if the child refuses to do any of the items. If the
child still refuses, score the item “R”.

Score “R” instead of “F” only if you are convinced that the child
can perform the item but refuses to do at the time of the test. To validate
your thoughts, ask the parent if the child can perform what is being
asked to perform. Item cannot be passed by report, “R” would be the
approximate score.

Once you have finished the test, note appropriate information on

the child’s cooperation, attention span, verbal behavior, self-confidence,
nervous habits, parent-child relationships.

3. Scoring Delays In Development

There are four ways to score each item, pass (P), failure (F),
refusal (R), and for items where the child has had no opportunity to
demonstrate the behavior, it can be scored as no opportunity (NO).
Example under pedals tricycle If the child has never had an opportunity
to try a bicycle, then the item should be scored as no opportunity or NO
and not failed not refused. Items scored as NO are not considered in
the overall test scores. The score P, F, R, and NO is to be written on
the 50% hatch mark.
55
It is considered a delay if the item that is failed falls totally to the
left of the age line. That is, a child failed to pass an item which 90% of
children normally can pass at a younger age. Delays are used to
interpret the total MMDST result. The shaded part on right end of the
bar is considered delay on the test form (see Figure 7)

Figure 7. Scoring Delays

4. Interpreting the Test Result

The MMDST result depends on the number of delays and

interpreted as NORMAL, QUESTIONABLE, ABNORMAL, OR
UNTESTABLE. Remember that a delay is any failure that falls
completely to the left of the age line. To properly interpret the result of
the test follow the steps listed below.

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

56
At the bottom of the age line, indicate the test result and
interpretation. For example: Abnormal, Reason: 2 sectors have 2
delays

5. Discussing the Test Result

At the end of the test, ask the parent/caregiver whether the

child’s performance is typical of his/her ability and behavior.
Sometimes, a child may be too ill, tired or upset when tested to show
what he can actually perform.

Overall interpretation of test results should be given to the

parent/caregiver in general terms rather than using the labels of
abnormal, questionable or normal. If the child has done well, praise
the child and reassure the parent/caregiver that the child is developing
as he/she should be. If, however, 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 within approximately two weeks.

I. DIFFICULT TEST SITUATION

Performing the MMDST is generally a pleasant task but occasionally,

one encounters a child who is difficult to test. Before making hasty
conclusions that the child is untestable, ask the parent if the child has always
been shy, inattentive, overactive, or exhibit other similar behaviors for which
he/she is considered difficult. The child may simply be reacting to previous
unpleasant experiences like an injection or a wound treatment. The “difficult”
behavior may likewise be explained by other sociocultural factors. If this is so,
use a different approach in testing.

The Shy Child. 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 unable to perform certain
abilities. Testing a shy child may take longer. The following suggestions
usually help.

● As an icebreaker, offer the child a cheese curl or give him a block, a

bell or a rattle to play with prior to testing.
● Start testing with items that are scored by report.. Focusing attention
initially on the parent gives the child a chance to cope with the situation
and becomes more familiar with the tester and the test materials.
● If the child remains shy and wary, ask the parent to administer some of
the test items or show how they are done. As the parent demonstrates,
you can say, “Tignan ko nga kung makalalakad ka din ng paurong
gaya ng nanay mo.” Preschoolers are great show-offs. This technique

57
may work and if it does, reinforce the child for performing.

If all suggestions fail and the test is not completed, retest 2 or 3 weeks
later.

The Uncooperative Child. The uncooperative child is one who is not

shy but refuses to do what is asked of him/her. Approaches for the shy child
may also be applied to the uncooperative child. In addition, the following may
be tried:
● Ask the parent to leave the room. The child may perform better in the
parent's absence. Anxious feelings of a parent are communicated to
the child who in turn acts negatively.
● If the child becomes upset by the separation, the parent need not
leave the room but is requested to turn away while staying within
seeing distance of the child.
● If the parent says that the child can do certain items but is just
uncooperative, ask the child to do the opposite. Reverse psychology
often works in the negativistic age. You might say, “Sa palagay ko,
hindi ka marunong magdrawing ng tao.”

The Overactive Child. An overactive child is one whose interest shifts

rapidly from one test item/material to another. He/she may be seated beside
you building blocks and as you turn to consult the test form, the child sees the
ball in the kit, drops blocks, gets the ball and runs off with it. Getting him to sit
down to continue the test is a chore. While you may succeed in getting him to
perform again, the attention span is short
Dealing with an overactive child may be difficult to experience to the
child, the parent and the tester. There are ways, however, of dealing with this
situation.

● Mastery of test items – based on the example given above, when the
child drops the blocks and picks up the ball, be ready to test him on
other items: “Sisipain mo: itong bola.” Once done,, follow with
“Sasaluhin mo ito” Divert his attention from the ball and test him on
recognition of colors. The sequence of testing may be jumbled
depending on the situation. If the tester has mastered the test form,
jumping form one sector to another is easy.
● Limit the distractions - clear the room of all distractions. If this is not
possible in crowded places (home, clinic or health center), arrange the
table and the child's position on the table in such a way that his/her
back is to the distraction.
● .Bring out only the test materials needed per item. Keep the rest in the
bag and do not give the child a chance to see its contents or else
he/she may not rest until he gets hold of everything.
58
● Another technique is to keep the bag behind you, leave it open, and
reach for the test materials as needed. As you! do this, maintain eye
contact with the child at all times to hold his attention.
● An older child is usually wiser and may realize that you are hiding
things as you fumble through the bag. If this happens, tell the child that
you have a series of surprises (young children love surprises) for
him/her but that he/she has to be very attentive and follow directions.
● Direct the child's attention - gain the child's attention. Once obtained,
focus it on the task to be performed. If attention lags, call him by name
or touch his arm gently to bring him back to the task at hand.
● Be firm and calm - Filipino children, including the over active, respond
to authority. Uniformed people like nurses, doctors and policemen are
usually held in awe. Firm but calm words from these people often work
where parents fail. TELL the child what to do. DO NOT ASK if he can
or if he will perform the task.
● If it is possible, hold the child on your lap or sit next to him/her. This
way, it is easier to control the child's

The Child with many Siblings. It is sometimes difficult to control the

situation in homes with many siblings. Each child wants to perform the tasks
all at the same time; or, a child already done with the test tells the other what
to do. Ascendant behavior or bossiness begins at around age 3. A desire to
excel is manifested as early as age 4. In this situation, explain to the mother
the need to test each child individually. As each child, preferably starting with
the eldest, accomplishes the test, ask the mother to send the child on
errands. This technique keeps him out of the way, thus giving the remaining
children a chance to perform on their own, without comments or prompting
from others.

The Interfering Parent. The interfering parent is one who becomes

too involved. This parent answers the questions for the child and shows him
what to do. The following techniques are suggested:
 Explain to the parent, as in all test situations, that the MMDST is not an
intelligence test and that the child is not expected to pass all the items.
The test will only show what the child can do at a certain age. Be sure
the mother understands the purpose of the test.
 Administer the test.
 If the parent interferes, repeat the explanation
 If the parent still tells the child what to do, Frankenburg suggests that
the parent leave the room. A face-saving way is to discontinue the test.
Then reset the discontinued test for re-screening within 2 or 3 weeks.
Score the items by report of interfering parents with care. They may not
be reliable.

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Let’s Do This 2!

Your clinical instructor will schedule a practice performance of your identified

test items after computing for the child’s age and plotting the age line in the MMDST
Test form. After the practice, go back to your client whom you performed the physical
assessment with on Lesson 1 and proceed with implementing the test procedure as
discussed in this lesson.

Post test

Fill in the blanks. Write the correct answer on the space provided. Please read
carefully

_______________ 1. A sector of development focused on task which indicate the

child’s ability to sit walk and jump

_______________ 2. Having a child hop on one foot and count how many times in a
row without support.

_______________ 3. . A sector of development focused on task which indicate the

child’s ability to learn, follow directions and to speak.

_______________ 4_ A sector of development focused on task which indicate the

child’s to take care of himself.

______________ 5. Any failure on an item in the MMDST form which is

completely to the left of the child's age line .

_______________ 6. . Smiling responsively when being called.

Ex.Personal Social PHN Bag Gross Motor

Ex. of Gross motor skills Developmental delay Language

Enumeration:

7-10 What are the contents of MMDST kit?

7. ___________________

8. __________________

9. ___________________

10. ___________________

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Final Requirement

1. Select a child within your family members whose age ranges from 0-6 years of
age. Obtain consent from the child’s parents for the procedure. Perform the
following procedure to your client.
a. Physical Assessment using Pediatric Physical Assessment Checklist
b. MMDST using the MMDST Form

You will be guided accordingly by your clinical instructor as you perform

these procedures. Checklist and Form can be downloaded via the Google
Classroom.

2. Quiz via Google Forms on Google Classroom

Suggested Readings and Websites

Yambao M, Arriola J, Mendoza E,. (2020). Unit 3 Level 1 Competencies: Physical

Assessment. NCM 107B Care of the Mother, Child and Adolescent Module.
Bulacan State University College of Nursing.

References

Williams, P Metro Manila Developmental Screening Test Manual, University of the

Philippines Manila

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