mmdst - gordon

PERSONAL-SOCIAL

Procedure Score Analysis Interpretation

Imitates housework

Uses spoon, spilling little

Puts on clothing

Failed

Passed

Failed

The examiner checked with the parents if the child can imitate housework like wiping, dusting off, etc.

Pass if the child copies any type of housework.

The examiner observed and asked the parents if the child can use spoon and if he spills a little while using it.

Pass if the child can use spoon or fork to get food to his mouth without spilling much.

The examiner explored with the parents if the child can put on his/her clothes.

Pass if the child can put any of his own clothing. Shoes do not have to be tied or on the correct foot.

JAM was not able to imitate house work; he just looked as the examiner demonstrated it. And according to her grandmother, J.A.M. cannot do this because he still cannot walk. The cognitive abilities of the client were not yet that fully developed as he cannot coordinate yet his memory and imitation.

J.A.M. was able to use a spoon while eating and according to his grandmother, some-times, he spills a little bit. The eye-hand coordination is present results to abilities of manipulation, as he able to self-fed himself

His grandmother said that she usually assists J.A.M. to put on his clothes because if he let J.A.M. to do that, he wouldn’t finish it. Autonomy is not yet established to the client. He is not yet capable of using his memory and imitation to act.

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Helps in house – simple tasks

Removes Garments

Plays ball with examiner

Indicates wants (not cry)

Failed

Failed

Passed

Passed

The examiner asked the parents if the child was able to do simple task like keeping his stuff neatly arranged in one place.

Pass if the child actually helps in the house in anyway.

The examiner check with the parents if the child can remove his garments.

Pass if the child can remove clothing other than his hat, socks, or diaper on purpose.

The examiner passes the ball to the child and the child must pass it back to the examiner.

Pass if the child rolls or tosses the ball toward the tester.

The examiner asked the parents regarding to how the child acts when he wanted something Pass if

According to his grandmother, he just stayed in one place and play. He is not yet concerned in helping house tasks. Autonomy is not yet established

J.A.M. cannot remove it by himself. He still needs assistance. His grandmother said that he wasn’t capable of doing it yet. The client is not yet capable of using his memory and imitation to do the item. His autonomy is not yet established

JAM was able to get the tossed ball and tossed it back towards the examiner. The hand coordination is present results to manipulation of objects. Increasingly enthusiastic about the introduction of toy

According to her grandmother, J.M.A. is pointing to some-thing that he wanted. The client is still developing gross

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Drinks from cup

Separates from mother easily

Passed

Passed

the child lets someone know what he wants by pointing, pulling or saying a word.

The examiner checked with the parents if the child is able to drink on a cup without spilling some.Pass if the child can drinks from cup.

The examiner asked the parents to leave for a while. And see if the child will follow. Pass if the child does not become upset easily.

discrimination by distinguishing dissimilar sounds. The client uses gestures and other cues in indications

His grandmother verbalized that the infant usually drinks on a cup when he is thirsty. The eye-hand coordination is developed resulting to mobility and manipulation of objects

JAM did not become upset when his grandmother left for a while. Object permanence becomes complete.

INTERPRETATION

JAM failed a lot of items. He failed somewhat difficult tasks like imitation of

house woks and in helping some simple tasks in the house. He also failed in putting on

his clothes and removing his garments.

On the other hand, he passed simple tasks like using spoon with little spill. He

also played a ball with the examiner. He can tell or indicate what he wants and also, he

can drink from a cup.

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Based on the scores at the different test items administered to the child and at his

age, it indicates that J.A.M. has a delay. He is not yet developing some of his personal

abilities and is needed to be assisted by a caregiver.

FINE-MOTOR ADAPTIVE


Tower of 4 cubes

Dumps cheese curl from bottle – spontaneously

Failed

Failed

The examiner introduces blocks to the child. And allow the child to form a tower of 4 blocks. The child is given more blocks than necessary. Then the child is given chances if he failed to do it at first.Pass if the child balances 4 blocks on top of one another so that they do not fall.

The examiner puts the cheese curls on the bottle. And the examiner instructed the child to get it out without giving any hint how to do it.Pass if the child dumps the cheese curl out of the bottle without being shown how to do it

J.A.M. wasn’t able to build tower blocks. Instead of putting it together to form a tower he just held it and scrambled it The cognitive abilities of the client was not yet that fully developed. And balancing of objects is not well coordinated.

The child wasn’t able to follow the instruction given to him. He just held it and didn’t let go of it. He ate some of the cheese curls while doing the task. The cognitive abilities of the client was not yet that fully developed resulting to inability to perform the item. he has hand-mouth coordination

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Dumps cheese curl from bottle – demonstrated

Tower of 2 cubes

Scribbles spontaneously

Passed

Passed

Passed

The examiner demonstrated to the child how to do it for 2-3 times before the child can perform the itemPass if the child dumps the cheese curl out of the bottle either i9t on his own , or after he is shown how to do it

The examiner gave blocks to the child and instructed him to build 2-block tower. The child is given the number of needed blocks to minimize distractions Pass if the child puts one block on top of another so that it does not fall when he removes his hands.

The examiner showed the paper and pen to the child. The examiner handed the pencil over the child. The examiner did not assist the child to what to write in the paper

Pass if the child makes two or more purposeful marking on the paper.

J.A.M. was able to do it after the examiner showed how the item is done. The eye-hand coordination is developed resulting manipulation of objects

J.A.M. was able to put a block over the other and it did not fall.

J.A.M. was able to draw lines not straight, and he is not stabbing. The hand-finger control of the client is starting to develop

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Neat pincer grasp of cheese cur

Passed The examiner asked the mother to hold the child, place a cheese curl in front of the child. Observe how the child grasps the cheese curl Pass if the child picks up the cheese curl using the ends of thumb and index finger with an overhand approach.

Without any difficulty, the child was able to pick up the cheese curl using his index finger and thumb. The eye-hand coordination manual dexterity is present.

INTERPRETATION

J.A.M. failed the two out of the six tasks in this sector. He failed to build a tower

made up of 4 cubes. He also failed to dump cheese curl from a bottle with just the

instruction of the examiner.

The client passed most of the simple tasks like he was able to dump the cheese

curl to the bottle with the demonstration of the examiner. He also passed the task of

building a tower of 2 cubes. He was also able to draw a line with a pencil and scribble.

He also can do a neat pincer grasp with picking up cheese curl using index finger and

thumb.

Although the child failed the two tasks, it doesn't mean that the child is delayed in

this sector. His cognitive development is in the normal rate of progress regarding his age.

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LANGUAGE


3 words other than ma-ma, da-da

Combines two different words

Points to one named body part

Failed

Failed

Passed

The examiner checked with the parents if the child can verbalize other words

Pass if parent reports child uses at least 3 specific words other than “da-da” or “ma-ma”.

The examiner asked the mother if the child can formulate two different wordsPass if the child says a meaningful phrase of two or more words such as “play ball”, thank you”, and “peek-a-boo”.

The examiner says a body part like nose, eyes, ears, etc. then she ask the child to point that specific body part.Pass if the child point’s one named body part that is being asked by the

According to her grandmother, J.A.M. only verbalizes 3 words mama, papa and boom-boom. And as the examiner encourages the child to speak he wasn’t able to express the words that his grandmother told. The client is still developing gross discrimination by distinguishing dissimilar sounds. He lacks imitation

JAM can only say 3 words (mama, papa, and boom-boom), he still cannot formulate two different words. And at the time of the test, he was not saying any word. The client is still developing gross discrimination by distinguishing dissimilar sounds.

JAM was able to point a named body part, specifically the nose. The client recognizes familiar objects

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Follows directions

Da-da, ma-ma, specific

Passed

Passed

examiner.

The examiner instructed the child to do something, like place the block to the table, then to the chair, then to the floor. The examiner did not allow the parents to help or assist the child in doing the item. It may affect the result of this item.

Pass if the child follows two of the three directions correctly.

The examiner asked the parent if the child can say mama, papa during the exam

Pass if the child uses either “ma-ma” or “da-da” correctly for his mother or father.

JAM was able to follow the directions given to him. The client is developing his comprehension skills

He did not say it but according to JAM’s grandmother, every morning he called her mama and papa. His grandmother said maybe he is just a little bit shy. The client is still developing gross discrimination by distinguishing dissimilar sounds.

INTERPRETATION

JAM failed two out of three tasks in the language sector. He failed to speak 3

words aside from “ma-ma” and “da-da”. He also failed to combine two different words.

But for his age, he can name a part of his body, his nose specifically. He can also follow

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the directions instructed by the examiner. His grandmother reported that he can already

say “mama” and “papa”, usually every morning.

In this sector, the child is not yet indicated as delayed. His language ability is still

developing just right with his age.

GROSS MOTOR


Kicks ball forward

Throws ball overhand

Jumps in (one) place

Failed

Passed

Failed

The examiner put the ball in front of the child. The examiner instructed the child to kick the ball. The examiner demonstrated how it is done.Pass if the child kicks the ball forward without holding on to any support.

The examiner instructed the child to throw the ball over her.Pass if the child is standing at least three feet from tester and throws the ball within arm’s length of tester between his knees and face.

The examiner asked the child to jump. The examiner demonstrated it for the childPass if the child

Since J.A.M. was not able to stand on his own he wasn’t able to kick the ball. He is interested but he cannot do it. The client lacks autonomy to stand and do the item

J.A.M. was able to pass the ball but he was sitting. At first, he was in doubt of doing it. But as the examiner encourages him to do it, he was able to throw back the ball. Tertiary circular reaction is present.

J.A.M. still cannot stand so he cannot also jump. The client lacks autonomy to stand and do the item

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Walks up steps

Walks backward

Walks well

Stoops and recovers

Failed

Failed

Failed

Failed

raises both feet off the floor at the same time for any measurable distance.

The examiner checked to the parents how the child gets up stepsPass if the child can walk up steps (not crawl).

The examiner instructed the child to walk backwards. She demonstrated it for the child to know what to do.Pass if the child walks backwards two or more steps.

The examiner encouraged the child to stand and walk but he cannot stand on his own.Pass if the child does not have any difficulty walking and does not tip.

The examiner places a block on the floor and instructed the child to reach for it

He needs assistance in taking steps. He was not in stable position and then he fell when the assistance was lost. Balance is not yet established. Weak musculo-skeletal coordination. And there is lack of autonomy

The child tried to do it but he has a weak strength in his legs. Weak musculo-skeletal coordination

He got out of balanced when his grandmother let go of him. He needs assistance in doing it. Weak musculo-skeletal coordination

The child tried to pick up the block and then he almost fell on his knees while still having

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and stand afterwards.Pass if the child is able to bend over, pick up toy and return to standing without holding on or touching floor.

assistance. Balance is not yet established

INTERPRETATION

In this sector, of the seven tasks administered to J.A.M., he failed the six tasks.

The only task that he was able to perform was to throw the ball overhand. He can't do

tasks related to the use of his lower extremities like kicking the ball forward. He also

can't do the jump in place, walks up steps and walks backward as well as stooping and

recovering afterwards.

With these results, the child is considered delayed. His can't perform gross motor

activities without the assistance of his caregiver.

OVER-ALL INTERPRETATION OF MMDST

JAM performed the MMDST. He quite did a great job in doing his best just to

perform any of the items. In the personal-social sector, he was able to have 1 passed and

3 failed in the items crossing the age line. Then on the left side of that sector he was able

to have 3 passes. In the fine motor adaptive sector, he was able to have 1 passed and 2

failed in the items crossing the age line. Then on the left side of the age line 3 passed. In

the language sector, he has 2 passed and 2 failed on the items crossing the age line. Then

1 failed on the left side of the age line. In the gross motor, he has 1 passed and 3 failed in

the items crossing the age line. The 3 failed in the left side of the age line.

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Client’s status

He is delayed and considered abnormal compared to his age of development in

terms of gross motor and language development. He should have done the things that a

one year and ten months old could do, but he is not yet capable of doing it. As seen in the

tasks that he performed in different sectors of the MMDST, he was not yet that stable or

confident in what he is doing.

Personal-Social-Items crossing the age line

1 passed, 2 failed and 2 no opportunity-items on the left side of the age line

4 passed

Fine Motor Adaptive-Items crossing the age line

1 passed and 2 failed- items on the left side of the age line

3 passed

Language-Items crossing the age line


1 failed

Gross Motor-Items crossing the age line


3 failed and 1 no opportunity

Observational child study

J.A.M. welcomed the examiner with a smile as they entered the house. He seemed

to enjoy everything that they are doing. He just thought of it as a game. But there were

also instances that he became irritated because they’ve been doing the task over and over

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again. J.A.M. is a very cooperative child and he wanted to impress the examiner with his

responses to the tests.

VIII. Developmental History

Freud’s Psychosexual theory

Anal stage

Freud describe the toddler period as the ‘anal phase” because during this time ,

children’s interests focus on the anal region as they begin toilet training. Eliminations

takes on new importance for them. Children find pleasure in both the retention of feces

and defecation. This anal interest is part of toddler’s self discovery, a way of exerting

independence , and probably accounts for some of the difficulties parents may experience

in toilet training children of this age.

JAM hasn’t reach this stage yet. He is still on oral phase, he suck for his

enjoyment and pleasure.

Erikson’ s Psychosocial theory

Autonomy vs Shame

Erickson defines the developmental task of the toddler age as learning

autonomy versus shame or doubt .Autonomy builds on children’s new motor and mental

abilities. Children take pride in new accomplishments and want to do everything

independently.

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JAM, since he still cannot walk, he needs assistance in most of his activities. He

wasn’t able to do things independently. He seemed confidence in attempting to achieve

something.

Piaget’s Theory of Cognitive Development

Sensorimotor 6

Invention of new means through mental combinations

Transitional phase to the preoperational thought period. Uses memory and

imitation to act .Can solve basic problems ,foresee maneuvers that will succeed or fail.

Good toys for this period: those with several uses, such as blocks, colored plastic rings.

JAM was able to think through actions or mentally project the solution to a

problem. Like the way he place the cheese curl to the bottle. And how he followed the

ball that has rolled far from him.

Kohlberg’s Moral development

Punishment Obedience Orientation

Toddlers begin to formulate a sense of right and wrong, but their reason for doing

right is centered most strongly in “ Mother or father say so” rather than in any spiritual or

societal motivation. Kohlberg referred to this as a “ punishment obedience orientation”.

JAM able to obey his parents without their reinforcement. He does this because his

parents told so. He follows to prevent punishment from his parents.

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VIII. PLAY BEHAVIOR

Toddlers’ play is called parallel play. In this kind of play, two toddlers are playing

beside each other by him or her alone and not together. Parallel play is evidently seen on

JAM. He tends to play on his own without being distracted with other child playing

beside him. There were times that he wanted the other toddler’s toy. This is considered as

a normal developmental sequence at his age.

IX. GORDON'S FUNCTIONAL HEALTH ASSESSMENT

I. HEALTH PERCEPTION-HEATLH MANAGEMENT

The client has no past illness or surgery. He is complete with immunization such

as DPT, Polio and Hepatitis B. He has no present allergies and medications. His parents

have fair health perception about his health, they are aware of the client's condition but

they are not doing anything about it.

II. NUTRITIONAL-METABOLIC

The weight of the client is 12kg while his height is 78.74cm. His diet has no

restriction and regular. He has good appetite. But he can't eat alone; there should always

be an assistant.

The client usually intakes 3 bottles of milk (Bear Brand™), 2 cups of water and 4

tablespoon of rice a day. The client was reported to consume a variety of fruits such as

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banana and apple in considerable amount. He also consumes vegetables like string beans

and kangkong. The client eats meats like pork, beef, fish and poultry, which are in small

amounts.

His mouth is pinkish and moist. His skin is pinkish, warm, moist, and intact. His

body temperature is 36.5ºC.

III. ELIMINATION

The client defecates once a day and have consistent stool. He urinates 5 times a

day. His urine is amber yellow and clear.

His abdomen is symmetrical and rounded. He has normal bowel sounds and soft

to palpate abdomen.

IV. ACTIVITY-EXERCISE

The client needs assistance while eating. He also needs assistance in bathing and

dressing. The client needs to be supervised during toileting. When transferring, the client

needs support from his caregiver.

The client always needs a walker. His range of motion is normal as well as his

posture and he has no deformities.

He has a pulse rate of 110 beats per minute apical. He has warm temperature. He

has brisk capillary refill and normal nails. He has normal distribution of hairs.

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V. SLEEP-REST

The client sleeps 9 hours continuously per night and has nap for 3 hours in the

afternoon. He sleeps in a rattan bed. He has no habits prior to going to bed.

VI. COGNITIVE-PERCEPTION

The client was alert, happy and joyful during the interview. He was able to show

reflexes normal at his age line. He has strong grasp on both hands as well as his

push/pulls. He has normal sense of hearing, touch and smell.

VII. SELF-PERCEPTION -- SELF-CONCEPT

The client is calm and zero level of anxiousness. He has no body language and

eye contact. He was unable to communicate.

VIII. ROLE-RELATIONSHIP

The client is living with his family. He is the first child of family. Because of his

young age, he also acts as the baby of the family who is totally dependent to the parents.

IX. COPING-STRESS TOLERANCE

Because of his age and condition, he just shows his stresses through crying and

tantrums. Whenever he does this, his parents will comfort the baby and try to provide

whatever he needs.

X. VALUES AND BELIEFS

The client is a Catholic. He has no religious restrictions. He is not yet affected of

the religious practices because of his young age.

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mmdst - gordon

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