DEVELOPMENT ASSESSMENT SCALES

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

INTRODUCTION

DEVELOPMENTIt 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 DELAYDiscrepancy 25% or more OR 1.5 to 2 SD

from normalGLOBAL DEVELOPMENT DELAYDelay in 2 or more domains of

developmentDEVELOPMENT DEVIANCEWhen child develop milestone or skill

outside typical acquisition of sequence

DEVELOPMENT DISSOCIATIONWhen child has widely differing rates of

development in different domains of development

DEVELOPMENT REGRESSIONWhen 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 child’s 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 ITEMS1. Social smile2. Eyes follow pen/pencil3. Holds head steady4. Rolls from back to stomach5. Turns head to sound of bell/ rattle6. Transfer objects hand to hand7. Raises self to sitting position8. Standing up by furniture9. Fine prehension pellet10. Pat a cake11. Walk with help12. Throws ball13. Walk alone14. Says two words15. Walks backwards16. Walks upstars wiyh help17. 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 MOTORKicks stationary ballJumps in place FINE MOTORFolds paper in to half in imitationOpens stacking barrel and takes out beads COGNITIVEFinds specific objects on requestPlaces 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 & response to 20 primitive reflexes

•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 × 100Level of retardation IQ

Borderline/average 70-85

Mild/educable 50-70

Moderate/trainable 35-50

Severe 20-35

Profound <20

ASSESSMENT OF INTELLIGENCE

GOOD ENOUGH’S 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