Eighty percent of the world’s disabled population live in low income countries, many of these in Africa. The World Health Organization has made early identification of children with disabilities a high priority, especially as early rehabilitation may reduce the impact of impairments. To identify these children and provide basic services, developmental milestones need to be clearly identified. Furthermore, clinical studies investigating interventions in children require normal parameters. In this study, the researchers aimed to create a simple, culturally appropriate developmental assessment tool adapted and modified from Western tools and standardised for use in rural Malawi. The study concludes that when creating developmental tools for a rural African setting, many items from Western tools can be adapted. The gross motor domain is more culturally adaptable, whereas social development is difficult to adapt and is culturally specific.