UNIT 3

ASSESSMENT OF DEVELOPMENT OF
CHILDREN
• Development is the individual level of
functioning, a child is capable of, as a result of
maturation of the nervous system and
psychological reactions
• It is the qualitative and quantitative changes
and acquisition of a variety of competencies
for functioning optimally in a social setting
• FOUR AREAS
• Gross motor development
• Fine motor development
• Personal /social development
• Language development
• Normal development
• Pattern is constant
• Skills acquired sequentially
• Rate varies from child to child
• Later goals depend on achieving earlier goal in
same field eg. sit before stand, then walk
• Genetic and environmental factors contribute
positively and negatively
 Principles of Development

• Development is a continuous process from

conception to maturity
• Sequence of development is same in all children
but rate varies
• Development is intimately related to maturation
of nervous system- opportunity to practice
• Generalized mass activity replaced by specific
individual response
• Development is in cephalocaudal direction,
proximodistal trend.
• Certain primitive reflexes lost before corresponding
voluntary movement is acquired
• Generalizations about development cannot be
based on the assessment of skills in a single
developmental domain. However, skills in one
developmental domain do influence the acquisition
and assessment of skills in other domains
 Terminology

• DEVELOPMENT 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
 Assessment of Development
• Developmental milestones serve as the basis of most
standardized assessment and screening tools
• Multiple developmental assessments over time are
more predictive than a single one.
• Developmental monitoring not only should be aimed
at
identifying children who have low function, but at
directing the focus of anticipatory guidance to help
promote normal development.
 Need
Reassure if normal development pattern and
timings, discuss good parenting
•Any genetic disorder?
• Identify those with specific areas of impairment
or global concerns
• Allows early support or interventions
– eg. hearing aids, physiotherapy, ?
• Give Parents time to adjust
 Purpose of Assessment
• Whether there is impairment or not in development
• Make a diagnosis if possible
• Seek to intervene positively to improve outcome and
function for the child and family
– Reinforcing acquired skills
– Teach developmentally appropriate skills
– Provide missed experience
– Make use of other skills to overcome difficulties
– Use learning style to promote learning
 Challenges
• Infant/ child’s temper, physical status, influence of
drugs
• Clarity on the purpose of assessment – pick relevant
tool
• Assessor’s skills, training and experience
• Standardised sample
• Psychometric issues
• Testing situation
• Parent’s report – biased?
SOME POPULAR DEVELOPMENTAL TESTS
 THE APGAR SCALE
• The Apgar score is a scoring system doctors and nurses use to
assess newborns one minute and five minutes after they’re born.
• Dr. Virginia Apgar created the system in 1952, and used her name
as a mnemonic for each of the five categories that a person will
score. Since that time, medical professionals across the world
have used the scoring system to assess newborns in their first
moments of life.
• The Apgar scoring system is divided into five categories. Each
category receives a score of 0 to 2 points. At most, a child will
receive an overall score of 10. However, a baby rarely scores a 10
in the first few moments of life. This is because most babies have
blue hands or feet immediately after birth.
A: Activity/muscle tone
0 points: limp or floppy
1 point: limbs flexed
2 points: active movement

P: Pulse/heart rate
0 points: absent
1 point: less than 100 beats per minute
2 points: greater than 100 beats per minute

G: Grimace (response to stimulation, such as suctioning the baby’s nose)

0 points: absent
1 point: facial movement/grimace with stimulation
2 points: cough or sneeze, cry and withdrawal of foot with stimulation

A: Appearance (color)
0 points: blue, bluish-gray, or pale all over
1 point: body pink but extremities blue
2 points: pink all over

R: Respiration/breathing
0 points: absent
1 point: irregular, weak crying
2 points: good, strong cry
• The Apgar scores are recorded at one and five minutes. This is because if
a baby’s scores are low at one minute, a medical staff will likely intervene,
or increased interventions already started.
• A total score of 7 to 10 after five minutes is “reassuring.” A score of 4 to 6
is “moderately abnormal.” A score of 0 to 3 is concerning. It indicates a
need for increased intervention, usually in assistance for breathing.
• At five minutes, the baby has ideally improved. If the score is very low
after five minutes, the medical staff may reassess the score after 10
minutes. Doctors expect that some babies may have lower Apgar scores.
These include:
• premature babies
• babies born via cesarean delivery
• babies who had complicated deliveries
 ARNOLD L. GESELL TESTS
• One of the earliest development tests was designed by Arnold L. Gesell,
who founded the Clinic of Child Development at Yale University in 1911.
By observing and filming infants and young children, and analyzing their
functioning by studying the films frame by frame, Gesell delineated 10
normal stages of early childhood development. Gesell's tests include:
• Gesell Developmental Schedules
• Gesell Child Developmental Age Scale (GCDAS)
• Gesell Preschool Test to measure relative maturity in four basic fields of
behavior
• Gesell Developmental Observation to assess a child's developmental
age for grade placement and the development of instructional
programs
 NANCY BAYLEY SCALES OF INFANT
DEVELOPMENT
• Developmental psychologist Nancy Bayley authored the Bayley Scales of Infant Development in the mid-twentieth
century. Her mental scale evaluates various abilities, yielding a normalized standard score called the Mental
Development Index.

• The Bayley Scales of Mental and Motor Development are used worldwide as standardized measures of infant
development at eight months of age. The motor scale assesses:
• the degree of body control
• large-muscle coordination
• fine-motor manipulatory skills
• postural imitation
• motor quality

• The behavior rating scale consists of 30 items, which measure the following:
• attention
• arousal
• orientation
• engagement
• emotional regulation
• test-taking behaviors
• Bayley – III – all facets of child’s development 1 to 42
months
• 5 scales – Cognitive, Language, Motor, Social-emotional,
Adaptive Behaviour
• Cognitive – 91 ite,s
• Language – 48 items
• Motor – 138 items
• Social emotional – 35 items
• Adaptive behaviour – practical skills - communication,
community use, health and safety, self care etc
Phatak’s Baroda Screening Test
• Indian adaptation of Bayley’s Development
scale
• India’s best known development testing
System
• Used by child psychologists rather then
physicians
• The test items are arranged according to age.
• The Denver Developmental Screening Test
(DDST) is a widely-used test of motor,
language, speech, and interpersonal skills for
children from birth to six years of age. It is
used by physicians in well-baby visits and may
include parental questionnaires.
• Denver II Developmental Screening Test
• Most widely used test for screening
• Assesses child development in four domains
– Gross motor
– Fine motor adaptive
– Language
– Personal social behavior
• These domains are presented as age norms,
just like physical growth curves.
• in well-baby visits and may include parental questionnaires.
 Other screening tests
• Infant Developmental Screening Scale
• ages and stages questionnaires
• Battelle Developmental Inventory (BDI) screening test for screening, preliminary assessment,
and/or initial identification of possible developmental strengths and weaknesses
• Brigance Early Preschool Screen for two-year-old and two-and-a-half-year-old children
• Brigance K and 1 Screen for kindergarten and first-grade children
• Miller FirstSTEP Screening Test for evaluating preschoolers
• Preschool Development Inventory, a brief screening inventory to help identify children with
developmental, behavioral, or health problems
• Children at Risk Screener: preschool and kindergarten
• Early Screening Inventory for children aged three to six
• Howell Prekindergarten Screening Test
• Humanics National Child Assessment Form
• Kindergarten Screening Inventory
• Milani-Comparetti Motor Development Screening Test