The Molteno Adapted Scale: A child development screening tool for healthcare settings

Abstract

The Molteno Adapted Scale (MAS) is a developmental screening tool for children up to five years of age, used by medical practitioners in the Western Cape, South Africa. It generates subquotients for language, personal and social, fine and gross motor domains. The general quotient is the average of all four subquotients, with a score < 85 indicating risk for global developmental delay. The authors aimed to determine the concurrent validity of the MAS, using the Bayley Scales of Infant and Toddler Development-3rd edition (BSID) as a comprehensive assessment reference measure. A total of 103 (55 girls) participants were enrolled from a longitudinal cohort study, of which 90 (49 girls) were assessed on both the MAS and BSID at 11–14 months, 53 (27 girls) at 30–42 months of age and 44 (21 girls) at both timepoints. The low number of developmentally delayed children precluded estimation of diagnostic accuracy of the MAS. Therefore, the authors determined Pearson correlation coefficients (r) for the MAS and BSID across similar domains at 11–14 months (n = 90) and 30–42 months (n = 53) and used the Bland–Altman analysis to detect bias between the MAS and BSID domain scores. Correlation was moderate to high between MAS and BSID domains, except for fine motor in 1-year-olds (r = 0.23), but Bland–Altman analysis found discordance especially between the MAS and BSID language and motor scores at the upper and lower performance ranges. Future studies should aim to standardise the operational procedures of the MAS, validate it across a wider age-range, and include children with varying degrees of delay.