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

Abstract

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.