Metro Manila Developmental Screening Test (MMDST)

In the care of pediatric clients, growth and development are not in isolation.  Nurses being competent in the aspects of growth and development particularly principles, theories and milestones are in best position to counsel clients on these aspects.  Having background knowledge on growth and development, nurses are equipped with assessment skills to determine developmental delays through the aid of screening tests.

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.  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

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:

  • MMDST manual
  • test Form
  • bright red yarn pom-pom
  • rattle with narrow handle
  • eight  1-inch colored wooden blocks (red, yellow, blue green)
  • small clear glass/bottle with 5/8 inch opening
  • small bell with 2 ½ inch-diameter mouth
  • rubber ball 12 ½ inches in circumference
  • cheese curls
  • pencil

EXPLAINING THE PROCEDURE. Once the materials are ready, the nurse explains the procedure to the parent or caregiver of the child.  It has to be emphasized that this is not a diagnostic test but rather a screening test only.    When conducting the test, the parents or caregivers of the child under study should be informed that it is not an IQ test as it may be misinterpreted by them.  The nurse should also establish rapport with the parent and the child to ensure cooperation.

AGE & THE AGE LINE. To proceed in the administration of the test, the nurse is to compute for the exact age of the child, meaning the age of the child during the test date itself.  The age is the most crucial component of the test because it determines the test items that will be applicable/ administered to the child.  The exact age is computing by subtracting the child’s birth date with the test date.  After computing, draw the age line in the test form.

TEST ITEMS. 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 imperative 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.  Items that are footnoted with “R” can be passed by report.

SCORING.  The test items are scored as either Passed (P), Failed (F), Refused (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 not a delay.


  • Manner in which each test is administered must be exactly the same as stated in the manual, words or direction may not be changed
  • If the child is premature, subtract the number of weeks of prematurity.  But if the child is more than 2 years of age during the test, subtracting may not be necessary
  • If the child is shy or uncooperative, the caregiver may be asked to administer the test provided that the examiner instructs the caregiver to administer it exactly as directed in the manual
  • If the child is very shy or uncooperative, the test may be deferred

Byron Webb Romero, RN, MSN

Finished BSN at Lyceum of the Philippines University, and Master of Science in Nursing Major in Adult Health Nursing at the University of the East Ramon Magsaysay Memorial Medical Center. Currently working at Manila Doctors College of Nursing as a Team Leader for Level I and II, Lecturer for Professional Nursing Subjects, and also a Clinical Instructor.

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