A Tool for Assessing Child Development Globally


Professor Gladstone experienced working in the clinical setting in Malawi, early in her career.  She recognized the lack of tools to measure child development in a simple, cheap, culturally specific way for children from 0-5 years.  With no clear knowledge as to what was normal for children’s development in Malawi or elsewhere in Africa, it was not possible to track children’s developmental trajectories at an individual, programmatic or population level. Identifying delayed developmental trajectories enables the appropriate support to be provided.


In response, Dr Gladstone has worked over the past twenty years to address this. Her first detailed study was in 2006 [1] and further qualitative studies aimed to unravel the understanding and conceptual framework of child development by parents and children in Malawi, to enable a tool to be created that was relevant to children living in Malawi [2].


The resulting MDAT was robustly validated  and evaluated with known developmental delay vs normal children. Population based age-bands for developmental milestones were created for 1446 children from 0-6 years. The research was published in a high-impact open-access journal in 2010 [3].


MDAT References:

1. Gladstone, M., Lancaster, G., Jones, A., Maleta, K., Mtitimila, E., Ashorn, P. & Smyth, R. L. 2008. Can Western developmental screening tools be modified for use in a rural Malawian setting? Archives of Diseases of Childhood, 93, 23-29.doi: 10.1136/adc.2006.095471
2. Gladstone, M., Lancaster, G., Umar, E., Nyirenda, M., Kayira, E., Van Den Broek, N. & Smyth, R. L. 2010a. Perspectives of normal child development in rural Malawi – a qualitative analysis to create a more culturally appropriate developmental assessment tool. Child Care Health Dev, 36, 346-53.doi: 10.1111/j.1365-2214.2009.01008.x
3. Gladstone, M., Lancaster, G. A., Umar, E., Nyirenda, M., Kayira, E., Van Den Broek, N. R. & Smyth, R. L. 2010b. The Malawi Developmental Assessment Tool (MDAT): the creation, validation, and reliability of a tool to assess child development in rural African settings. PLoS Med, 7, e1000273. doi: 10.1371/journal.pmed.1000273



The MDAT takes around 30-40 minutes to complete depending on the age of the child

Who can use the MDAT

The MDAT requires some training but it can be used by anyone with a high school education. The questionnaire comes as a simple grid with pictures and prompts and there are videos which can be provided for training to help you conduct the assessment. 

It is inexpensive to use, open access and does not require you to buy an expensive kit to conduct the assessments.

How much does it cost

The cost of the MDAT questionnaire and manual is free.  The cost of the rest of the materials varies depending on the scope and scale of your project. It also depends if you require training, data collection tools or support with scoring. 

Prices vary from no payment (e.g. to access the forms and basic materials), to daily consultancy rates (e.g. for detailed support in training for a large field study).  Any costs which we incur for consultancy work for the MDAT are used entirely to improve the site and the materials for the MDAT and to keep the administration of the MDAT going.

Contact us for more information on pricing. 

Get access to the MDAT

The MDAT is available in paper form (you can download it) or for use on a  computer or tablet. The cost of using MDAT varies depending on the scale and scope of your project. 
The full MDAT is in a locked part of this website. If you would like to use the tool or find out more, simply request access