Denver 2010

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DENVER II

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Introduction

• The Denver Developmental Screening Test(DDST) was first published in 1967 to help

health providers detect potential

developmental problems in young children

• 1990major revision the DENVER II

•

The DENVER is not an IQ test

• It is not a definitive predictor of future adaptive

or intellectual ability

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…Introduction

• DENVER II is not designed to generate diagnostic labels

(learning disability, language disorder or emotional

disturbance) and it should never substitute for a

diagnostic evaluation or physical examination

• The test is designed to compare a given child’s

performance on a variety tasks to the performance of

other children the same age (between birth and sixyears)

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…Introduction

• The purposes:

– screening asymptomatic children for possible

problems, in confirming intuitive suspicion with an

objective measure

– monitoring children at risk for developmental

problem (who have experienced perinatal

difficulties)

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…Introduction

• Consists of 125 tasks to screen the following areas or function:

1. Personal-Social – getting along with people and caring forpersonal needs

2. Fine Motor-Adaptive – eye-hand coordination, manipulation ofsmall objects and problem solving

3. Language – hearing, understanding and using language

4. Gross Motor – sitting, walking, jumping and overall large musclemovement

Include “Test Behavior” items assess the child’s overall behaviorand obtain a rough gauge of how the child uses his or herabilities

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…Introduction

• Was designed to be used in a clinical setting

by a variety of professionals

• The test must be administered in thestandardized manner and screeners should be

carefully trained

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Test Materials

• Needs: table, chairs, blanket

• Materials: – Red yarn pom-pom

– Raisins – Rattle with narrow handle

– 10 inch square colored wooden blocks

– Small, clear glass bottle with a 5/8 inch opening

– Small bell

– Tennis ball

– Red pencil

– Small plastic doll with feeding bottle

– Plastic cup with handle

– Blank paper

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Test Form

• Four sectors: Personal-Social, Fine-Motor-

Adaptive, Language and Gross motor

• Age scales across the top and bottom of thetest form depict ages in months and years

from birth to 6 years

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DENVER II

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…Test Form

• Each space between age marks on these

scales represent one month until 24 months

• Each of the 125 test items represented on the

form by a bar that spans the ages at which

25%, 50%, 75% and 90% of the

standardization sample passed that item.

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• Some of the items have a small footnote on

the left end of the bar:

– Number numbered instruction found on the

back of the test form

– “R”may be passed by report of the caregiver

whenever possible the examiner should

observe what the child can do

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Calculating The Child’s Age and Drawing

The Age Line

• General instruction

– Name, birth date and test

– Child’s age

• Example: Year Month Day

Date of test …………………..90…………7………..15

Date of birth …………………-88……...-3……….-10

Age of child …………………….2………….4………….5

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• Adjusting for prematurity

– For children who were born more than 2 weeks

before the expected date of delivery and who are

less than 2 years of age, the calculated age mustbe adjusted

– Example: GA 32 weeks (next slide)

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Drawing the Age Line

• Use the age scales and a straight edge to

accurately draw an “age line” from the top to

the bottom of the form

6 9 12 15

Age scale in months

The child is 13 ½ months old; the date of the test is September 8, 1997

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Test Administration

1. General instruction

– The DENVER II can be used repeatedly

– Use the same test form on more than one occasion

draw a new age line (using a different colored pencil)2. Building Rapport

– Rapport with the child and caregiver is essensial

– Every effort should be made to make caregiver and child

comfortable shoes should be moved

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3. Introduction

– The caregiver should be asked when the child

was born and whether the child was born

prematurely

– The test may cause anxiety eplain it is not an IQ

test, the child is not expected to pass all of the

items administered

…Test Administration

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4. Order of testing

• The following points are suggested:

– Items requiring less active participation should

be administered first – Tasks that the child can perform easily should be

administered first, the child’s effort should bepraised

– Items that use the same materials in the test kit administered consecutively


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– Only materials used for the specific item be placed

on the table

– For infants all items administered with the baby

lying down be tested together – In each sector testing should begin with items that

fall completely to the left of the child’s age line

and continue to the right


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5. Number of Items to be given

Depend on:

•

The time available for testing• Whether the goal is to identify developmental

delays and/or the relative strengths of the

child


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a. To determine if the child is developmentally at risk

• Step 1: In each sector, administer at least 3 item

nearest to and totally to the left of the age line & everyitem that is intersected by the age line

• Step 2: If the child is unable to perform any step 1

(fails, refuses & no opportunity) administer

additional items to the left in the appropriate sectorsuntil the child passes 3 items

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b. To determine a child’s relative strengths

• Step 1: In each sector, administer at least 3

item nearest to and totally to the left of theage line & every item that is intersected by the

age line

• Step 2: Continue to administer items to the

right of any passes in each sector until 3failures


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6. Test Behavior Ratings

• Scored after the completion of the test

•

Using the rating scale provided

comparethe behavior during test with previous

performance

• If child too ill, hungry or upset rescheduled


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7. Item Scoring

“P” for Pass successfully performs the item or the

caregiver reported

“F” for Fail does not successfully perform the item orthe caregiver reported

“N.O” for No Opportunity the child has not had the

chance to perform the item

“R” for Refusal refuses to attempt the item


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Interpretation

1. Interpretation of Individual Items

a. “Advanced” Items

– If a child passes an item that falls completely to

the right of the age line the child has passed

an item that most children do not pass until an

older age

Age line

P

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b. “Normal” Items (1)

– Failure or refusal do not necessarily indicate a

delay in development

– If a child fails or refuses an item that falls to the

right of the age line development considered

normal

Age line

R

Age line

F

…Interpretation

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• “Normal” Items (2)

– A child can pass, fail or refuse an item on which

the age line falls between the 25th and 75th

percentile considered normal

Age line

P

Age line

F

Age line

R

…Interpretation

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c. “Caution” Items

– Scored when a child fails or refuses an item on

which the age line falls on or between the 75th

and 90th percentile

Age line

F

Age line

R

Age line

R

Age line

FC C C C

…Interpretation

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d. “Delayed” Items

– When a child fails or refuses an item that falls

completely to the left of the age line the

child has failed or refused an item that 90% of

children passed at an earlier age – “Delays” coloring in the right end of the bar

Age line

F

Age line

R

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e. “No Opportunity” Items

– Report items which the parent says the child has

not had an opportunity to try are scored as “N.O”

Age line

NO

Age line

NO

…Interpretation

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Interpretation of the Test

Normal

• No delays and a maximum of 1 caution

• Conduct routine rescreening at next well-child visit

Suspect• Two or more Cautions and/or One or more Delays

• Rescreen in 1-2 weeks to rule out temporary factorssuch as fatigue, fear, illness

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Referral Consideration

• If upon rescreening the test result is againSuspect or Untestable

• To refer should be determined by the clinical

judgment of the supervising professional basedupon:

– Profile of test result

–Number of Cautions and Delays

– Rate of past development

– Other clinical consideration

– Availability of referral resources

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Documents

Denver 2010