Developmental Screening Test : Report

This test measures mental development of children from birth to 15 years of age. The test was
developed by Bharat Raj (1977, 1983). It is used for assessment of (1) development according to
normative development expectation at each age, (2) small gains in development. It is also useful
(1) choosing IEP goals, and (2) guiding parents for further management of a child. This test has
been standardized on Indian sample by J. Bharat Raj based on a study of 35 (19 boys and 16 girls)
varying in age from 4-11 years. It was further validated by Verma, S. K., Pershad, D. and Menon, R.
in a study conducted on 170 children (108 male, 62 female) divided into three age groups, viz. 1-
5, 6-10, and 11-15.

Name :................................................................. Date :...............................

Gender : Male / Female Education :...............................
Date of Birth :................................................................. Age :...............................
Address :.........................................................................................................................
:.........................................................................................................................
e-mail :................................................................... Phone :...............................
Referred by :.........................................................................................................................
Reasons for referral :................................................................................................................
Associated Conditions :............................................................................................................
........................................................................................................................................................
Epilepsy Locomotor Disability Partially sighted ADHD
Speech Deficits Cerebral Palsy Hearing impaired PDD

Chronological Age :......................................

Developmental Age ::.........................................
Developmental Quotient :......................................

Interpretation : .......................................................................................................................
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TEST CONDUCTED BY PSYCHOLOGIST

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 Developmental Screening Test : Report
150 150

145 145
Superior 140 140

135 135

130 130

125 125

120 120

115 115

110 110
Average
105 105

100 100

95 95

90 90

85 85

Borderline 80 80

Deficit 75 75

70 70

65 65
Mild
60 60
Subnormality
55 55

50 50

45 45

40 40
Moderate
35 35
Subnormality
30 30

25 25

20 20

15 15
Severe
10 10
Subnormality
5 5

COGNITIVE EMOTIONAL MOTOR SPEECH

/ SOCIAL

Dimension Social Age Computation Formula SQ Interpretation

Cognitive DQ = ( DA / 180 ) * 100

DQ = ( DA / CA ) * 100

Emotional / Social DQ = ( DA / 153.6 ) * 100

DQ = ( DA / CA ) * 100

Motor DQ = ( DA / 129 ) * 100

DQ = ( DA / CA ) * 100

Speech DQ = ( DA / 132 ) * 100

DQ = ( DA / CA ) * 100
* For computation of Social Quotient, use first formula if CA is equal to or more than the denominator. If CA is less than the denominator use second formula.
* Maximum chronological age considered for calculation is 15 years.
 15Y 180.00 88 88 180.00 15Y
175.20 87 87 175.20
170.40 86 86 170.40
165.60 85 85 165.60
160.80 84 84 160.80
13Y 156.00 83 83 156.00 13Y
153.60 82 82 153.60
151.20 81 81 151.20
148.80 80 80 148.80
146.40 79 79 146.40
12Y 144.00 78 78 144.00 12Y
140.00 77 77 140.00
136.00 76 76 136.00
11Y 132.00 75 75 132.00 11Y
129.00 74 74 129.00
126.00 73 73 126.00
123.00 72 72 123.00
10Y 120.00 71 71 120.00 10Y
117.60 70 70 117.60
115.20 69 69 115.20
112.80 68 68 112.80
110.40 67 67 110.40
9Y 108.00 66 66 108.00 9Y
106.00 65 65 106.00
104.00 64 64 104.00
102.00 63 63 102.00
100.00 62 62 100.00
98. 00 61 61 98. 00
8Y 96. 00 60 60 96. 00 8Y
93. 00 59 59 93. 00
90. 00 58 58 90. 00
87. 00 57 57 87. 00
7Y 84. 00 56 56 84. 00 7Y
81. 60 55 55 81. 60
79. 20 54 54 79. 20
76. 80 53 53 76. 80
74. 40 52 52 74. 40
6Y 72. 00 51 51 72. 00 6Y
69. 60 50 50 69. 60
67. 20 49 49 67. 20
64. 80 48 48 64. 80
62. 40 47 47 62. 40
5Y 60. 00 46 46 60. 00 5Y
58. 00 45 45 58. 00
56. 00 44 44 56. 00
54. 00 43 43 54. 00
52. 00 42 42 52. 00
50. 00 41 41 50. 00
4Y 48. 00 40 40 48. 00 4Y
45. 60 39 39 45. 60
43. 20 38 38 43. 20
40. 80 37 37 40. 80
38. 40 36 36 38. 40
3Y 36. 00 35 35 36. 00 3Y
34. 00 34 34 34. 00
32. 00 33 33 32. 00
30. 00 32 32 30. 00
28. 00 31 31 28. 00
26. 00 30 30 26. 00
2Y 24. 00 29 29 24. 00 2Y
22. 50 28 28 22. 50
21. 00 27 27 21. 00
19. 50 26 26 19. 50
18. 00 25 25 18. 00
16. 50 24 24 16. 50
15. 00 23 23 15. 00
13. 50 22 22 13. 50
1Y 12. 00 21 21 12. 00 1Y
11.75 20 20 11.75
10. 25 19 19 10. 25
9.75 18 18 9.75
9M 9.00 17 17 9.00 9M
8.25 16 16 8.25
7.50 15 15 7.50
6.75 14 14 6.75
6M 6.00 13 13 6.00 6M
5.50 12 12 5.50
5.00 11 11 5.00
4.50 10 10 4.50
4.00 9 9 4.00
3.50 8 8 3.50
3M 3.00 7 7 3.00 3M
2.58 6 6 2.58
2.15 5 5 2.15
1.72 4 4 1.72
1.29 3 3 1.29
0.86 2 2 0.86
0.43 1 1 0.43

Years Months No. COGNITIVE EMOTINAL MOTOR SPEECH Months Years

SOCIAL
* Plain box indicates activities not able to do or is partially able to do so far.