Lecture on DDST for Children from birth to six years old

2. Denver Development Screening Test (DDST)
Overview
The Denver is most way to detect the development problems in children
Administered to children from birth to 6 years
Assess the child’s performance on age appropriate tasks
Screens for possible problems
Designed to compare a given child’s performance with the performance of other children the
same age
Test is primarily based on examiner’s actual observation rather than parent support.

3. What the Denver is not
1. Not an I.Q. test 2.not a diagnostic tool

4. DDST
 Consists of 125 tasks, or items. (covering four areas) :
1. Personal –Social: (getting along with people)
2. Fine Motor-Adaptive: (Manipulation of small object )
3. Language: (saying some thing, hearing, understanding)
4. Gross Motor: (sitting, walking, jumping)
 The children are tested on the tasks or items pertinent to
their age
 It must be conducted in a standardized manner
 Kit come with necessary supplies and scoring sheets

5. Value of the Denver II
To detect the
1. Impression of a child’s overall development
2. potential developmental difficulties
3. compares to other children
Note: It is not a predictor of later development

6. Test Materials:
₰ Red yarn pom-pom (4” in diameter)
₰ Rattle with narrow handle
₰ 10 1” square colored wooden blocks
₰ Small, clear glass bottle with a 5/8 inch
₰ Small bell
₰ Tennis ball
₰ Red pencil
₰ Small plastic doll with feeding bottle
₰ Plastic cup with handle
₰ Blank paper
Note: Children need to be supervised appropriately with test materials to prevent choking or injury

7. Test Form
Note: After 24 months, each mark equals 3 month intervals
Report
Information

8. Test Administration
1. Should be given with the parent or primary caregiver present
2. Make caregiver and child comfortable to elicit most natural response
3. Remove boots or shoes that might restrict the child motor movements
4. Young child may sit on caregiver’s lap, older child should sit so arms can
rest upon the table & elbows should be level with table top & Infants may
be evaluated on the floor
5. It should be shared with parent that the tool is to determine the child’s
current developmental status and that the child is not expected to pass all of
the items.

9. 6. Tasks & Items that the child can perform easily should be administered first
7. Items in Fine Motor-Adaptive next (items that do not require child to speak)
8. Language items next and last the Gross Motor items which is gained as test progresses.
9. Praise child’s efforts even if they fail on an item
10. Keep kit out of sight & only materials being used for current activity on the table
11. For infants (all items be administered with the baby lying down to be tested together)
12. Testing should begin with items that fall completely to the left of the child’s age line,
and continue to the right

10. Age Calculations
Example:
Year Month Day
Date of Test 2011 10 17
Date of Birth - 2008 - 8 - 20
Age of Child
9 30 +17= 47
273 1

11. 1.At least three items nearest to and
totally to the left of the age line
2. Three trials to perform each item
Left side of age line
Right side of age line

12. Age of child Year Month Day
Age of Child 2 19
6 weeks premature -1
(30days)
-14
(14 days)
Adjusted age of
Child
Adjusting for prematurity:
₰ Born more than 2 weeks before expected delivery date
₰ Are less than 2 years of age
51

13. 1.At least three items nearest to and
totally to the left of the age line
2. Three trials to perform each item

14. Number of Items to be tested
Depends on age and ability of child
Step 1: in each sector, administer at least three items nearest to and totally to the left of the age line
and every item that is intersected by the age line
Step 2: if the child is unable to perform any item in step 1 (fails, refuses, has had no opportunity)
administer additional items to left in the appropriate sector until child passes three consecutive
items
 Continue to administer items to the right of any passes in each sector until three failures are
recorded
 The child may be given up to three trials to perform each item, when appropriate, before
scoring a failure
 Ask the caregiver or parent if the results are typical of child’s performance.
Note: Consider if the child is ill, hungry, upset, etc.
 Rescheduling may be necessary if child is not being cooperative

15. Item scoring
The score for each item should be recorded the bar near the 50% hatch mark. The
following scores are used for the Denver II:
1. “P” for pass – the child successfully performs the item, or the caregivers report
(when appropriate)
2. “F” for Fail- the child does not successfully performs the item, or the
caregivers report (when appropriate) that the child does not do the item.
3. “N.O” for No Opportunity- the has not had the chance to perform the item,
due to restrictions from the caregivers or other reasons. This score may only be
used on “report” items.
4. “R” for Refusal – the child refuse to attempt the item. Refusals can be
minimized by telling the child what to do rather than asking. Report items
cannot be scored as refusals.

16. Interpretation of individual items
Individual items are interpreted first, and then the entire test is interpreted.
a. “ Advanced” Items
If a child passes an item that falls completely to the right of the age
line, the child’s development is considered advanced on that item.

17. b.“Normal” item
Failure or Refusal of individual items do not necessarily indicated a delay in
development. For example, if a child fails or refuses an item that falls completely to
the right of the age line, the child’s development is considered normal.
a child can Pass, Fail, or Refuse an item on which the age line falls between the 25th and
75th percentile, and the child’s development on that item will be considered normal.

18. c. “Caution” Items
Caution when line falls between 75 and 90 percentile and child fails or refuses “C” just to the right of
the bar.
d. “Delayed” Items
A delay is indicated when a child fails or refuses an item that falls completely to
the left of the age line

19. e. “No Opportunity” Items
Report items which the parent says the child has
not had an opportunity to try are scored as “N.O.”

20. Interpretation of the Test
Suspect:
 Delay (1 ore more) & Caution (2 or more)
 Rescreening after 1-2 weeks to rule out temporary factors such as fatigue, fear,
illness
Untestable:
 Refusal scores on one or more items completely to the left of the age line or on
more than one item intersected by the age line in the 75th to 90th area.
 Rescreening after 1-2 weeks
Normal :
 No delay & a maximum of 1 caution
 Rescreening at next child’s visit.

21. Suspect:
Delay (1 ore more) &
Caution (2 or more)
Rebar 3 month at calculating
1 Delay & 2 Cautions
Normal
No delay
1 caution
Ruhan 3 months old
There is No any delay & cautions

22. Referral Considerations
1. After rescreening, test result is suspect or untestable
2.Number of cautions and delays
3.Clinical history, examination
4.Availability of referral resources

23. Have you any question