Creating a Cambodia-specific developmental milestone screening tool - a pilot study

Background

Approximately 600 million people are living with various types of disabilities throughout the world and over 200 million children under age of 5 years old not reach their developmental potential. These adverse outcomes can be prevented through early detection and treatment. To accurately assess the development of children, a culturally appropriate screening tool must be used. Cambodia lacks such tool and other studies have shown that western tools are not valid in other cultures.

Aims

This study aimed at creating a culturally appropriate screening tool – called the Angkor Hospital for Children Developmental Milestone Assessment Tool (AHC DMAT) – for screening neurodevelopmental disability in Cambodian children.

Study design, subject, outcome measures

Western milestones from the DDST II were used with cultural modifications. Children of both genders and aged from 1 month to 6 years assumed to have normal development were included in two pilot screenings (N = 100 and N = 63) with further modifications to the AHC DMAT made as necessary after each screening.

Results

The final AHC DMAT consists of 140 milestones (49% directly from DDST II, 17% modified DDST II, 34% added through expert opinion).

Conclusion

Extensive revision of the DDST II was needed in order to create a more valid Cambodian screening tool. This study was the first step to create a Cambodian-specific screening tool but further large-scale testing of the AHC DMAT is needed to strengthen the tool's validity and to identify the age-range percentiles of each milestone before it can be used for neurodevelopment screening.