What is the AGTE test, which developmental areas does it screen in children aged 0 to 6, how is it given and what do the results mean? A calm guide for parents.
At your eighteen-month-old daughter's check-up, the paediatrician asks a few questions, makes some notes and says, "Let's arrange a developmental screening." Or the nursery teacher mentions that your three-and-a-half-year-old son talks less than children his age and brings up something called the AGTE test. From that moment on, most parents find the same questions going round in their heads: What does this test measure, is something wrong with my child, and what happens if the result is bad? The AGTE test, the Ankara Developmental Screening Inventory (Ankara Gelişim Tarama Envanteri), is a screening tool developed in Turkey and used to give a broad overview of the development of children from birth to six years old. In this article I explain what the inventory is, how it is administered, how the results should be read, and the steps you can take after screening.
What Is the AGTE Test?
The Ankara Developmental Screening Inventory is a developmental screening tool developed in Turkey with the developmental characteristics of Turkish children in mind. It covers the period from birth to the end of the sixth year. Its most important feature is that it bases its picture of a child's development largely on information from the person who knows the child closely, that is, the mother, the father or a relative who looks after the child regularly.
The word "screening" deserves emphasis here. Screening tests do not make a diagnosis. Their purpose is to distinguish children whose development is progressing along the expected path from children who need a more detailed look. In a sense, a developmental screening is like a warning sign on the road: it says, "It may be worth stopping here and looking more closely," but on its own it cannot tell you what lies where along the road.
The inventory is made up of a large number of items arranged by age group. These items ask about behaviours the child does or does not show in everyday life: Does the baby turn their head towards a toy that makes a sound, do they put two words together, can they eat with a spoon, can they stand on one foot, and so on.
Which Developmental Areas Does the AGTE Assess?
The Ankara Developmental Screening Inventory looks at a child's development in four main areas, together with an overall developmental score made up of their total.
- Language-cognitive area: Understanding sounds and words, speaking, recognising objects, grasping simple concepts (big and small, colours, counting), and responding appropriately to questions.
- Fine motor area: Hand and finger skills, such as holding small objects, stacking blocks, holding a pencil, drawing lines and shapes, and cutting with scissors.
- Gross motor area: Movements using the large muscle groups, such as holding up the head, sitting, crawling, walking, running, jumping and climbing stairs.
- Social skills and self-care area: Interacting with others, play, taking turns, and daily living skills such as eating, dressing and using the toilet.
- General development: The overall score in which all areas are considered together.
This distinction matters, because children do not progress at the same pace in every area. A baby who learns to walk early may be slightly behind their peers in talking, and a very chatty three-year-old may struggle to use scissors. The AGTE test makes these differences visible and shows which area needs to be watched more closely.
How Is the Ankara Developmental Screening Inventory Administered?
The assessment usually takes the form of a structured interview with the parent in a quiet room. Starting from the items appropriate for the child's age, the practitioner asks questions and the parent says whether the child does that particular thing. For some items, the practitioner may observe the child directly or ask them to do something small: put a cube into a box, point to a picture or copy a line.
How long it takes depends on the child's age and how much detail the parent gives; it usually takes less than an hour. There is nothing tiring or painful about it for the child. No blood is taken, no medication is given, and the child is not put through an exam.
Knowing the following before you go will make things easier:
- The person who knows the child closely should attend. If the person who spends the day with the child is a grandmother or a childminder and the mother works, having that person at the interview too makes the information more accurate.
- Answer with what "is", not with what "should be". Being honest about the difference between "Actually they can, but they don't" and "They can't yet" works in your child's favour, not against you.
- Say when you are not sure. "I don't know, we've never tried" is a perfectly acceptable answer. If needed, the practitioner will try that item with the child.
- Choose a time when your child is not sleepy, hungry or unwell. For items that involve observation, a tired child may not show what they can do.
Let's say the mother of a two-year-old immediately answers "Yes" to the question, "Does he come down the stairs on his own?" Then she thinks about it: in their block of flats they always carry him down, and he has never actually tried. Saying so prevents the practitioner from forming a false impression.
A developmental screening is not a school report; it is a lamp switched on so that you can see together where your child stands and what they need.
How Are AGTE Test Results Interpreted?
After the AGTE test, each area is assessed in relation to the child's age. Results are usually interpreted in terms of whether the child's development is in line with their peers, whether it is borderline, or whether it is clearly behind. The practitioner should explain these results to you area by area.
There are a few points to bear in mind when reading the results:
- A low score in one area does not mean there is a general problem. For example, a child who is behind only in the fine motor area may well make progress quite quickly with games that support this area.
- The observations of the person giving the information affect the result. A parent who is anxious, or overly optimistic, may answer differently. That is why the screening result is considered together with the specialist's own observations.
- Corrected age is used for babies born early. In the first years, the development of a premature baby is assessed not according to their date of birth but according to the age calculated from their expected due date.
- Bilingual environments should be taken into account. In families where Kurdish, Arabic or another language is spoken at home, items in the language-cognitive area should not be interpreted solely on the basis of the child's Turkish.
- The result is a snapshot in time. Children change quickly. An area that looks borderline today may become age-appropriate within a few months, and the reverse can also happen. That is why follow-up matters.
No developmental screening can make a diagnosis such as "your child is autistic", "has an intellectual disability" or "has attention deficit". Assessments of this kind require more comprehensive processes that also involve child psychiatrists and paediatric neurologists.
When Is a Developmental Screening Recommended?
Developmental screening can be done not only when a problem is suspected but also as part of routine child health monitoring. However, a screening is particularly worthwhile in the following situations:
- The baby does not make eye contact, does not return a smile, or does not turn when called by name
- Talking noticeably less than peers, or no longer using words they used before (the article on speech delay may be helpful here)
- Delays in motor skills such as walking, sitting or holding objects
- Premature birth, low birth weight or difficulties during birth
- Concrete observations raised by the nursery teacher or paediatrician
- A parent's sense that "something is different", even if they cannot quite name it
That last point is sometimes dismissed, yet parental intuition is valuable information. Many observations brushed aside with "Parents always worry" later turn out to show how important early support is. Voicing your concern does not mean you are exaggerating.
Another situation families in Turkey often face is conflicting voices from those around them. The mother-in-law says, "Ours didn't talk until three either, there's nothing wrong with him," the neighbour says, "Take him to the doctor straight away," and social media says something else entirely. In the midst of all this noise, a developmental screening offers a structured view that is independent of personal opinion.
The Difference Between the AGTE and Other Developmental Tests
Other developmental tools are also used in Turkey during infancy and the pre-school years. The most widely known of these is the Denver Developmental Screening Test. In the Denver, the practitioner observes a large share of the items by working directly with the child, whereas the AGTE relies mainly on information from the parent. This difference shapes the strengths of each tool: direct observation shows performance in the moment clearly but can be affected by the child being unsettled that day. Parent report reflects the child's real behaviour in daily life but depends on the perception of the person reporting. For more detail, you can take a look at the article on the Denver developmental test.
Which tool is used depends on the child's age, the nature of the concern and the clinical judgement of the person carrying out the assessment. Sometimes the two are used together, and sometimes more detailed tests follow the screening. If you are curious about the general logic of psychological assessment, the article what is a psychological test may be a good starting point.
What Should You Do After the Screening?
If your child's result is age-appropriate, that is a reason to feel relieved and to keep supporting their development, not to stop monitoring. If the result is borderline or behind in one or more areas, rather than panicking, you might consider these steps:
- Ask questions in the feedback meeting. Find out which items your child found difficult and what this corresponds to in daily life. "The language-cognitive area is behind" remains abstract; "He doesn't put two words together and struggles to understand simple instructions" shows you what to do at home.
- Follow up on any referral. If needed, an assessment by child psychiatry, paediatric neurology, audiology (a hearing test) or speech and language therapy may be recommended. Checking hearing is particularly important when speech is delayed.
- Plan play-based support at home. Reducing screen time, talking to your child face to face, looking at books together, playing with materials such as play dough and paint, and going to the park to give opportunities for climbing and running all contribute to almost every area of development.
- Ask for a reassessment after a set period. Looking again a few months later to see the child's progress is a natural part of the process.
- Don't blame yourself. Most developmental differences are not caused by any single thing a parent did or did not do.
A practical example: Let's say the screening shows that a two-and-a-half-year-old is behind in the social skills and self-care area. As the family talks, it emerges that the grandmother does everything for the child, and the child has never been given the chance to eat on their own or take off their shoes. In such a case, the answer is often small changes to daily routines before any treatment.
How Does Psychological Support Help With Developmental Concerns?
The support needed after a developmental screening may involve different professionals depending on the child's situation: a paediatrician, a child psychiatrist, a speech and language therapist, an occupational therapist, a special education specialist and a psychologist. The psychologist's role in this process usually falls under a few headings.
The first is to assess the child's emotional and social development more closely and to observe parent-child interaction. In some cases, what looks like developmental delay may in fact be linked to intense anxiety, a sudden change (a new sibling, moving house, starting nursery) or a lack of stimulation.
The second is to guide parents. Planning games, daily routines and ways of communicating that support the child's development together with the family has far more impact than a one-hour weekly session.
The third is to make room for the child to express themselves through approaches such as child-centred play therapy, especially when there are emotional and behavioural difficulties. In child and play therapy, play is the child's language; at an age when children cannot yet put their experiences into words, they tell them through toys.
Finally, supporting parents in coping with their own anxiety is also an important part of this process. The thought "There may be something wrong with my child" can leave a parent sleepless, create tension between partners, and become even heavier with interventions from older relatives.
Frequently Asked Questions
Up to what age is the AGTE test used?
The Ankara Developmental Screening Inventory is used from birth to the end of the sixth year. For older children, other assessment tools focusing on areas such as school readiness, intelligence or attention are preferred.
My child didn't do anything during the test. Does that make the result invalid?
No. Because a large part of the AGTE relies on information from the parent, the child's restlessness in the moment does not decisively affect the result. If the child did not cooperate on items that require observation, the practitioner notes this and may try again on another day if needed.
What does a borderline result mean?
A borderline result indicates that the child may be slightly behind their peers in that area and needs to be watched closely. It is not a diagnosis in itself. Often, supportive activities at home are recommended, followed by a reassessment after a set period.
Will my child be given a label as a result of the screening?
A screening result is not a diagnosis or a label; it only shows whether a more detailed assessment is needed. If a diagnosis is in question, it can only be made through a comprehensive specialist assessment, and the results should be shared with you openly.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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