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

Document Type



Institute for Human Development


Abstract : Aim 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.

Methods 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.

Results 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).

Conclusion 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.


This work was published before the author joined Aga Khan University.


Acta paediatrica