DEVELOPMENT ASSESSMENT SCALES

CHAIR PERSON : DR.AMI PATEL SPEAKER :DR.YOGESH

INTRODUCTION
DEVELOPMENT It is acquisition of qualitative and quantitative skills in a social environment

FOUR AREAS Gross motor development Fine motor development Personal /social development Language development

SIGNIFICANT DELAY Discrepancy 25% or more OR 1.5 to 2 SD from normal GLOBAL DEVELOPMENT DELAY Delay in 2 or more domains of development DEVELOPMENT DEVIANCE When child develop milestone or skill outside typical acquisition of sequence

DEVELOPMENT DISSOCIATION When child has widely differing rates of development in different domains of development DEVELOPMENT REGRESSION When child loses previously acquired skills or milestone

SURVEILLANCE

Is flexible ,longitudinal ,continuous process through which potential risk factors for developmental and behavioral disorder can be identified 5 components Eliciting and attending to the parents concern about their childs development Documenting and maintaining a developmental history Making accurate observations of child Identify risk and protective factors Maintaining accurate record of the surveillance process and findings

SCREENING

It is brief ,formal ,standardized evaluation aid in the early identification of pt. with development / behavioral delay

TYPES Informal screening Routine formal screening Focused screening - more important -When parents or teacher suspect -High risk neonates > BIOLOGICAL : IVH,HIE,VLBW babies ,low apgar ,persistent seizures ,meningitis ,hyperbilirubinemia >ESTABLISHED : Cerebral palsy , down syndrome >ENVIRONMENTAL : Orphan child , single parent , negligence

GUIDELINES

Screening instrument should be reliable ,culturally relevant and used only for specific purpose Multiple sources of information should be used Should be done only by trained personales Screening should be on recurrent and periodic basis Family members should be part of process

DENVER DEVELOPMENT SCREENING TEST

Assessment of infant & pre school children Include 4 vital area 105 items Not promising results DENVER 2 (Modified DDST ) 125 items Increase in language items 2 articulation items Behavior rating scale New training materials Higher test retest reliability Can identify milder delay DOES NOT MEASURE INTELLIGENCE OR DQ

GESSEL DEVELOPMENT SCHEDULE

Up to 5 years of age Include 4 major functional areas Take 30 -40 minutes more concern with diagnosis and evaluation of abnormalities than attainment of various milestones

BAYLEY SCALE OF INFANT DEVELOPMENT

Based on motor scale , mental scale and infant behaviour Up to 30 months of age Takes 30-60 minutes 67 motor scale ,107 mental scales

BARODA DEVELOPMENTAL SCREENING TEST

Based on BSID ,baroda norms developed by dr.phatak ,suitable for indian children Not required any standardized equpment 25 items Up to 30 months Domains evaluated are gross motor, fine motor ,cognitive Take 10 minutes Sensitivity 0.66-0.93 specificity 0.77-0.94

TRIVANDRUM DST

Based on baroda norms Domains are gross motor, fine motor and cognitive 0-2 years by para medical health worker Take 5 minutes Sensitivity 0.67 specificity 0.79

INCLUDE 17 ITEMS 1. Social smile 2. Eyes follow pen/pencil 3. Holds head steady 4. Rolls from back to stomach 5. Turns head to sound of bell/ rattle 6. Transfer objects hand to hand 7. Raises self to sitting position 8. Standing up by furniture 9. Fine prehension pellet 10. Pat a cake 11. Walk with help 12. Throws ball 13. Walk alone 14. Says two words 15. Walks backwards 16. Walks upstars wiyh help 17. Points to part of a doll

DEVELOPMENT ASSESSMENT TOOL FOR ANGANWADIS (DATA )

Brief ,simple and psychometrically sound measure for anganwadis Mainly for toddlers Identify at risk ,mild delay ,moderate deley and severe delay

12 ITEMS
GROSS MOTOR Kicks stationary ball Jumps in place FINE MOTOR Folds paper in to half in imitation Opens stacking barrel and takes out beads COGNITIVE Finds specific objects on request Places objects on request

PERSONAL SOCIAL Differentiate between edible and non edible substances Proper bowel /bladder control EXPRESSIVE LANGUAGE Combine two words to express possesion Can ask what is this ? RECEPTIVE LANGUAGE Points to common objects described by its use Points to picture of action

DEVELOPMENT SCREENING TEST(DST): - simple scale & administered up to age of 15 years - it was standardized on indian children BRAZELTON NEONATAL BEHAVIOURAL ASSESSMENT SCALE : -based on observation of baby &

DEVELOPMENTAL OBSERVATION CARD(DOC) : -designed in child development centre of SAT Hospital ,trivandrum -using four key milestones namely social smile,head holding , sitting alone & standing alone generally appear not later than 2,4,8 &12 months

DQ = Developmental age /chronological age 100 IQ = Mental age /chronological age 100
Level of retardation
Borderline/average Mild/educable

IQ
70-85 50-70

Moderate/trainable
Severe Profound

35-50
20-35 <20

ASSESSMENT OF INTELLIGENCE

GOOD ENOUGHS DRAW A MAN TEST : - 3 to 13 years of age -51 items -receive 1 point for each item - for each 4 points , one year is added to the basal age of 3

STANFORD BINET INTELLIGENCE SCALE : - Include verbal ability ,perceptual skills , short term memory & hand and eye co-ordination -takes 45-60 minutes BINET KAMAT TEST -indian adaptation of stanford - binet scale - also available in hindi

WECHSLER INTELLIGENCE SCALE FOR CHILDREN (WISC): - verbal and performance scale -5 to 15 years -takes 45-60 min MALIN INTELLIGENCE SCALE FOR INDIAN CHILDREN: - Indian adaptation of WISC - It may not give real capabilities in non school going children as mostly influenced by formal schooling system