About the MDAT

Under-5 child mortality dropped by 53% between 1990 and 2015.

But do children whose lives are being saved fare well in their childhood development (are they thriving)?


Some risks to early child development involve maternal factors such as infections during pregnancy, Malnutrition, iron deficiency, brain infections (HIV, cerebral malaria), chronic illness (HIV, TB), lack of stimulation, birth factors (prematurity, neonatal sepsis) and adverse environmental factors (poor maternal education, poor maternal mental health).

Malawi is the third poorest country in the world with high rates of malnutrition and stunting. The prevalance of a poor social-economic environment has led to children being used to less possessions ( toys and other cognitive stimulation materials) in the house. MDAT was created as a result of some preliminary studies involving focus groups to gain a better understanding of communties’ (in Malawi) knowledge and understanding of early child development.


The MDAT is a directly assessed (with some parent report items) developmental tool that was first created in 2004 and revised with a detailed validation completed in 2008 in Malawi. MDAT consists of a toolkit that is used for administration. It measures development in four areas (gross motor, fine motor, language and social adaptive development) with cognitive development being measured across the domains but particularly across the tool’s fine motor and language domains.

It is best used for providing information about children’s development for programmatic purposes e.g., for evaluating whether an intervention or risk factor is affecting children’s development in large numbers of children.




MDAT has been translated in more than 50 languages and used in different countries in different settings.

It has shown efficiency as a clinical tool for the early identification of neuro-disabilities, school assessments, and as an outcome measure in international intervention programmes designed to improve child development.