Developmental Screening Test : Report
This test measures mental development of children from birth to 15 years of age. The test was
developed by Bharat Raj (1977, 1983). It is used for assessment of (1) development according to
normative development expectation at each age, (2) small gains in development. It is also useful
(1) choosing IEP goals, and (2) guiding parents for further management of a child. This test has
been standardized on Indian sample by J. Bharat Raj based on a study of 35 (19 boys and 16 girls)
varying in age from 4-11 years. It was further validated by Verma, S. K., Pershad, D. and Menon, R.
in a study conducted on 170 children (108 male, 62 female) divided into three age groups, viz. 1-
5, 6-10, and 11-15.
Name :................................................................. Date :...............................
Gender : Male / Female Education :...............................
Date of Birth :................................................................. Age :...............................
Address :.........................................................................................................................
:.........................................................................................................................
e-mail :................................................................... Phone :...............................
Referred by :.........................................................................................................................
Reasons for referral :................................................................................................................
Associated Conditions :............................................................................................................
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Epilepsy Locomotor Disability Partially sighted ADHD
Speech Deficits Cerebral Palsy Hearing impaired PDD
Chronological Age :......................................
Developmental Age ::.........................................
Developmental Quotient :......................................
Interpretation : .......................................................................................................................
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TEST CONDUCTED BY PSYCHOLOGIST
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Developmental Screening Test : Report
150 150
145 145
Superior 140 140
135 135
130 130
125 125
120 120
115 115
110 110
Average
105 105
100 100
95 95
90 90
85 85
Borderline 80 80
Deficit 75 75
70 70
65 65
Mild
60 60
Subnormality
55 55
50 50
45 45
40 40
Moderate
35 35
Subnormality
30 30
25 25
20 20
15 15
Severe
10 10
Subnormality
5 5
COGNITIVE EMOTIONAL MOTOR SPEECH
/ SOCIAL
Dimension Social Age Computation Formula SQ Interpretation
Cognitive DQ = ( DA / 180 ) * 100
DQ = ( DA / CA ) * 100
Emotional / Social DQ = ( DA / 153.6 ) * 100
DQ = ( DA / CA ) * 100
Motor DQ = ( DA / 129 ) * 100
DQ = ( DA / CA ) * 100
Speech DQ = ( DA / 132 ) * 100
DQ = ( DA / CA ) * 100
* For computation of Social Quotient, use first formula if CA is equal to or more than the denominator. If CA is less than the denominator use second formula.
* Maximum chronological age considered for calculation is 15 years.
15Y 180.00 88 88 180.00 15Y
175.20 87 87 175.20
170.40 86 86 170.40
165.60 85 85 165.60
160.80 84 84 160.80
13Y 156.00 83 83 156.00 13Y
153.60 82 82 153.60
151.20 81 81 151.20
148.80 80 80 148.80
146.40 79 79 146.40
12Y 144.00 78 78 144.00 12Y
140.00 77 77 140.00
136.00 76 76 136.00
11Y 132.00 75 75 132.00 11Y
129.00 74 74 129.00
126.00 73 73 126.00
123.00 72 72 123.00
10Y 120.00 71 71 120.00 10Y
117.60 70 70 117.60
115.20 69 69 115.20
112.80 68 68 112.80
110.40 67 67 110.40
9Y 108.00 66 66 108.00 9Y
106.00 65 65 106.00
104.00 64 64 104.00
102.00 63 63 102.00
100.00 62 62 100.00
98. 00 61 61 98. 00
8Y 96. 00 60 60 96. 00 8Y
93. 00 59 59 93. 00
90. 00 58 58 90. 00
87. 00 57 57 87. 00
7Y 84. 00 56 56 84. 00 7Y
81. 60 55 55 81. 60
79. 20 54 54 79. 20
76. 80 53 53 76. 80
74. 40 52 52 74. 40
6Y 72. 00 51 51 72. 00 6Y
69. 60 50 50 69. 60
67. 20 49 49 67. 20
64. 80 48 48 64. 80
62. 40 47 47 62. 40
5Y 60. 00 46 46 60. 00 5Y
58. 00 45 45 58. 00
56. 00 44 44 56. 00
54. 00 43 43 54. 00
52. 00 42 42 52. 00
50. 00 41 41 50. 00
4Y 48. 00 40 40 48. 00 4Y
45. 60 39 39 45. 60
43. 20 38 38 43. 20
40. 80 37 37 40. 80
38. 40 36 36 38. 40
3Y 36. 00 35 35 36. 00 3Y
34. 00 34 34 34. 00
32. 00 33 33 32. 00
30. 00 32 32 30. 00
28. 00 31 31 28. 00
26. 00 30 30 26. 00
2Y 24. 00 29 29 24. 00 2Y
22. 50 28 28 22. 50
21. 00 27 27 21. 00
19. 50 26 26 19. 50
18. 00 25 25 18. 00
16. 50 24 24 16. 50
15. 00 23 23 15. 00
13. 50 22 22 13. 50
1Y 12. 00 21 21 12. 00 1Y
11.75 20 20 11.75
10. 25 19 19 10. 25
9.75 18 18 9.75
9M 9.00 17 17 9.00 9M
8.25 16 16 8.25
7.50 15 15 7.50
6.75 14 14 6.75
6M 6.00 13 13 6.00 6M
5.50 12 12 5.50
5.00 11 11 5.00
4.50 10 10 4.50
4.00 9 9 4.00
3.50 8 8 3.50
3M 3.00 7 7 3.00 3M
2.58 6 6 2.58
2.15 5 5 2.15
1.72 4 4 1.72
1.29 3 3 1.29
0.86 2 2 0.86
0.43 1 1 0.43
Years Months No. COGNITIVE EMOTINAL MOTOR SPEECH Months Years
SOCIAL
* Plain box indicates activities not able to do or is partially able to do so far.
