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Acta Paediatr. 2014 Apr;103(4):447-54. doi: 10.1111/apa.12540. Epub 2014 Jan 7.

Extending the Developmental Milestones Checklist for use in a different context in Sub-Saharan Africa.

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Department of Nutrition, University of California Davis, Davis, CA, USA.



Sub-Saharan Africa bears a disproportionate amount of global diseases related to neurodevelopmental delays in infancy, including malnutrition, malaria and HIV. Evaluating interventions to prevent such delays requires developmental assessment tools appropriate for Sub-Saharan Africa. This study aimed to develop and evaluate such a tool.


The Developmental Milestones Checklist (DMC) was developed in Kenya to provide motor, language and personal-social scores for children aged from 3 to 24 months. We developed an extended version (DMC-II) in Burkina Faso, West Africa, and then evaluated the reliability and sensitivity of the scores to age and nutritional and environmental measures.


The internal, interinterviewer and test-retest reliability of the DMC-II scores were >0.7. In 214 children aged 11.6-25.4 months, each score correlated with age (rs > 0.7). In 1123 children aged 16.8-19.9 months, the scores were sensitive to stunting, wasting and underweight (effect sizes 0.31-0.87 SD). The scores also showed expected correlations with measures of play materials in the home and activities with caregivers (rs = 0.13-0.41).


The DMC-II is easily used by trained fieldworkers with no previous experience in developmental assessment. It is a practical, reliable and sensitive tool for evaluating motor, language and personal-social development in different contexts in Sub-Saharan Africa.


Child Development; Developmental assessment; Infant Development; Neurodevelopment; Sub-Saharan Africa

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