Descriptive Information. Title, Edition, Dates of Publication and Revision.: Denver Developmental Screening Test 2 nd ed (DDST II) 1960, 1990. Author (s): Frankenburg, WK, Dodds, J., Archers, P., Shapiro, H., Bresnick, B. Source (publisher or distributor, address):. Produced by Denver Developmental Materials, Inc.
More information and products can be found. Phone: 1-800-419-4729.
Costs (booklets, forms, kit): The following items and others can be found at:. Test Forms: $40. Training manual–$40. Test kit–$100. Technical manual–$45.
Complete package–$160. Training DVD–$220.
Availability:. Materials can be purchased at:. Purpose: screening for developmental problems to confirm suspected problems using an objective measure; to monitor children at risk for developmental delay.
Type of Test: First-level comprehensive screening. Target Population and Ages: birth to 6 years of age. Time Requirements: takes about 20-30 min to administer and interpret.
Test Administration. Administration: trained professional—clinical, teacher or early childhood professional.
Different Types Of Developmental Screening
Administrators are to have child perform easies tasks first and praise the child’s efforts despite success or failure. Children are given up to 3 trials per task before moving on. Scoring:.
Items are in sub-sample categories including race, less educated parents, and place of residence. There are 125 performance-based and parent reported items on the test in the following four areas of functioning: fine motor-adaptive, gross motor, personal-social, and language skills. Scoring per item is rated as follows:. P: pass-child successfully performs item or caregivers reports the child can do the item. F: fail—child does not successfully perform the item and/or the caregiver reports the child cannot do the item. NO: No opportunity—the child has not had the opportunity to perform the task due to restrictions.
R: Refusal—the child refuses to attempt and the parent cannot report. These items are scored to a normative age line with notation to caution, advanced and delayed items.
These lines represent the normative data and the percentile ranks. Percentile ranks include: 25 th, 50 th, 75 th, and 90 th. Ages should be adjusted for prematurity as needed. Some items for the youngest ages do not have percentile ranks.
Items involved 90% performance rate for inclusion in the screen. The number of scores a child received below the normal expected range classifies the child as within normal, suspect, or delayed. Scores are recorded per item through direct observation of the child and in some cases what the parent reports.
The test is interpreted to place the child into two categories: normal or suspect. If the child is suspect it is recommended that rescreening occur in 1-2 weeks. One of the new editions to the DDST-II was the addition of a behavioral scale. The DDST-II also increased language items by 86%, included two articulation items, a new category of item interpretation to ID milder delays, and new training material.
Type of information, resulting from testing: Percentile ranks. Environment for Testing: designed to be able to be conducted in busy professional settings. Equipment and Materials Needed:. Writing implement for the examiner.
Trained professional with test forms. Training packages are also available. Various items for test items and available in the testing kit:. Red yarn pom-poms of 4” diameter,. an “O” shaped cereal,.
rattle with narrow handle,. 10 1” colored wooden blocks,. small clear glass bottle with 5/8” opening,. small bell,. tennis ball,.
red pencil,. small plastic doll with bottle,. plastic cup with hand,.
a blank piece of paper. A blanket or a pad/mat is needed for babies.
Table and chairs will also be needed if the examinee is a child.not provided in the testing kit. Examiner Qualifications: health care professionals, social service professionals, and paraprofessionals. Psychometric Characteristics:. Standardization/normative data: normative data was developed from 2096 children at the University of Colorado Medical Center. Evidence of Reliability:.
Inter-rater reliability is reported as high to strong results. The Persian version of the DDST-II has been found to have good validity and reliability finding a test-retest Cronbach’s and Kappa measure of agreement of 92% and 87%, respectively. Inter-rater reliability was also a Kappa measure of 76% in the Persian version.
More information may be available in the DDST-II manual. Evidence of Validity:. Sensitivity: reported to be between 56-83%. Specificity: reported to be between 43-80%. Validity of the DDST II was tested concurrently with the ASQ-34 resulting in a fair to moderate agreement.
DDST II and BINS were found to have a moderate positive correlation at the 12 and 24 month as well as with the Neurological assessment, and BSID II. Face Validity: The DDST-II has good face validity with the use of a curve similar to a growth curve with norms developed from a representative population. More information may be available in the DDST-II manual. Predictive: This information may be available in the DDST-II manual.
Summary Comments:. Strengths:. Ease of administration,. High inter-rater reliability,. provides separate norms for subgroups,. uses a curve that approximates a growth curve for ease of use.
relatively short testing time. addresses four areas of development. has a behavioral scale. Weaknesses:. The DDST-II is a screening tool and is not a diagnostic tool. The normative data from 2096 children does not represent the national population with the following misrepresentations: overrepresented Hispanic infants, under represented African-American Children, and disproportion of mother’s education greater than 12 years. It has also been reported that the screen misses children with developmental delay.
Does not cover all developmental needs. Victor Tsao. Clinical Applications:.
The DDST-II can be used as a screening tool and is currently being used across the country and around the world to screen children from birth to 6 years of age who are at risk of developmental delays. The test can be easily administered in about 20 minutes and scoring is based on observation and parental reporting. The data is scored in relation to normative values on a curve similar to a growth curve putting each child in a percentile rank. The ease of use and simple equipment that is needed and comes with the testing kit making this screening tool advantageous around the world.
Many different professionals and paraprofessionals can administer this screening tool including but not limited to: teachers, physical therapists, occupational therapists, social services, and school counselors. References: Denver Developmental Materials, Inc. Denver II Online. Accessed: 12 March 2013.
Filgueiras A., Pires P., Maissonette S., Landeira-Fernandez J.Psychometric properties of the Brazilian-adapted version of the Ages and Stages Questionnaire in public child daycare centers Early Human Development, Volume 89, Issue 8, August 2013, Pages 561-576 Frankenburg WK, Dodds J, Archer P, Shapiro H, Bresnick B. 1992 Jan;89(1):91-7. PubMed PMID: 1370185. Frankenburg, W.K., Dodds J. Et al. DENVER II Training Manual.
Denver Developmental Materials, Inc., Denver, CO. 1996:18-21 Ringwalt, Sharon. Developmental Screening and Assessment Instruments with an Emphasis on Social and Emotional Development for Young Children Ages Birth through Five.
The National Early Childhood Technical Assistance Center. Available at:. Accessed: 16 March 2015.
Shahshahani, S., Vameghi, R., Azari, N., Sajedi, F., Kazemnejad, A. Validity and Reliability Determination of Denver Developmental Screening Test-II in 0-6 Year-Olds in Tehran.
Iranian Journal of Pediatrics. September 2010(20):3. Stephan, Linda. Modestor Junior College. 17 October 2011.
Available at, Accessed: March 12, 2015. Article Summary Sambandam E, Rangaswami K, Thamizharasan S.
Efficacy of ABA programme for children with autism to improve general development, language and adaptive behaviour. Indian Journal of Positive Psychology. The purpose of this study was to monitor the effects of applied behavioral analysis (ABA) versus traditional treatment in thirty children with autism. The study looked at testing results pre and post intervention and used the following tools to validate the severity of disorder, developmental levels, language and adaptive functioning before and 1 year after implementing treatment: Shildhod Autism Rating Scale (CARS), DDST-II, Receptive Expressive Emergent Language Scale (REELS), and Wineland Social Maturity Scale (VSMS). Data was analyzed using a paired t-test and a one way ANOVA.
The study found that ABA had a significant improvement in symptom manifestation and improvements in specific behaviors. Significant changes were also seen in the intervention group in the overall CARS scores.
The DDST-II revealed various areas of improvement in developmental areas amongst the intervention group as well. No significant differences were seen in the control group save language however, improvements were not as great as that of the intervention group. One of the strengths of this study is the length of the intervention. One year allows a normal progression of yearly academics in school and a standardized time frame that is identical to that of how ABA would continue if implemented. Another strength is the use of multiple tests for pre and post testing–including the DDST-II.
A follow up testing would have benefitted this study to show the potential lasting benefits of the intervention. Another restraint on the power of this study is the small population size. 15 participants were in the ABA group and 15 in the control group–a number that is too small to represent the population of children with autism. Tags:, Tags:, Posted in Leave a Reply You must be to post a comment.
The Denver Developmental Screening Test (DDST), commonly known as the Denver Scale, is a test for screening cognitive and behavioral problems in preschool children. The scale reflects what percentage of a certain age group is able to perform a certain task. In a test to be administered by a pediatrician or other health or social service professional, a subject's performance against the regular age distribution is noted. Tasks are grouped into four categories (social contact, fine motor skill, language, and gross motor skill) and include items such as smiles spontaneously (performed by 90% of three-month-olds), knocks two building blocks against each other (90% of 13-month-olds), speaks three words other than 'mom' and 'dad' (90% of 21-month-olds), or hops on one leg (90% of 5-year-olds).
The test was first introduced in 1967, and a revised as Denver II in 1992. It was widely used, and translated for use in twelve different languages. It has proven to be reliable, but its validity has been questioned and it has fallen out of favour with some organizations.
Contents. History It was developed by and first introduced by him and Josiah.B. Dobbs in 1967.
The test was previously marketed by Denver Developmental Materials, Inc., in, hence the name. As of June 8, 2015, the company has closed. However, the test, manuals, and other materials are available at no cost online at www.DenverII.com. The test kit can be ordered from Oxford,England, at www.hogrefe.co.uk. The test can be used in electronic medical records for free. On June 8, 2015, the Denver company posted the following on their website: 'We thank you for your business over the last 29 years. As of June 8th we closed operations and will no longer be offering The DENVER II and related products'.
However, the test, manuals, and other materials are available at no cost online at www.DenverII.com. The test kit can be ordered from Oxford, England, at www.hogrefe.co.uk. The test can be used in electronic medical records for free. DENVER II The DENVER II (1992) is a revision and update of the Denver Developmental Screening Test, DDST (1967). Both were designed for use by the, teacher, or other to monitor the development of infants and preschool-aged children. Doing so, enables the clinician to identify children whose development deviates significantly from that of other children warranting further investigation to determine if there exists a problem requiring treatment.
Denver Developmental Screening Test
The tests cover four general functions: personal social (such as smiling), fine motor adaptive (such as grasping and drawing), language (such as combining words), and gross motor (such as walking). Ages covered by the tests range from birth to six years. Since its publication the test has enjoyed widespread popularity as reflected by its use in many of this nation's medical schools.
The DENVER II, published in 1992, was standardized on 2,096 children. Its interpretation was slightly modified from the DDST giving greater emphasis to a comparison of the child's performance on each item with the new norms, much as clinicians have compared children's growth on individual parameters as height, weight and head circumference to ascertain a child's health status.
There are five unique features of the test that generally differentiates it from most other developmental screening tests:. Its validity rests upon its meticulous and careful standardization reflecting the US 1980 census population. Most other developmental screening tests base their validity on measures of sensitivity and specificity. Most such studies suffer from one or more of the following: small sample size, verification bias, inappropriate/non-equivalent test bias, procedural bias, spectrum bias and incomplete reporting of results.
Since the test depicts in graphic form the ages at which 25%, 50%, 75% and 90% of children performed each item, it enables the examiner to visualize at any age from birth to six years how a given child's development compares with that of other children. The test has separate norms for subgroups of the population based on sex, ethnicity and maternal education when the subgroups differed by a clinically significant amount from the total group or composite norms.
The test is primarily based upon an examiner's actual observation rather than parental report. It is ideal for visualizing on one page the developmental progress of children whether or not their development is being monitored for well child care or because the child's development is of special concern. The above unique features of the test as well as its ease of administration and interpretation contribute to its widespread use in screening programs as public child health clinics, private practices, early education programs such as, nursery schools and day care centers. In fact, the DDST and the DENVER II test have been translated into numerous foreign languages, as well as re-standardized on over 1,000 children in each of 12 countries to obtain national norms, resulting in its use to screen millions of children throughout the world.
Criticism, reliability, validity and accuracy According to a study commissioned by the in 1994, the DDST is the most widely used test for screening developmental problems in children. While this study acknowledges the test's utility for detecting severe developmental problems, the test has been criticized to be unreliable in predicting less severe or specific problems. The same criticism has been upheld for the currently marketed revised version of the Denver Scale, the DENVER II. Frankenburg has replied to such criticism by pointing out that the Denver Scale is not a tool of final diagnosis, but a quick method to process large numbers of children in order to identify those that should be further evaluated. This revised definition of the Denver's function remains commensurate with what screening tests are designed to do: sort those who probably have problems from those who probably don't. Thus standards for screening test construction still apply to the Denver.
Although the instrument has proven reliability, it was not constructed on a large, current, nationally representative sample. It has not been studied for validity (given alongside diagnostic measures to view their relationship or researched for the kinds of problems it may or may not detect). As a consequence, the measure was not studied by its authors for the most critical attribute of any screen, its accuracy. Studies by other researchers showed it to detect only about 50% of children with disabilities, although its specificity in identifying normally developing children is high (when questionables are grouped with normal scores) and the converse when questionable scores are grouped with abnormal results.
Since 1991, researchers have appealed to the author to recall and improve the measure but to no avail. Currently the measure is excluded from lists of recommended tools in several states (e.g.,. For a list of accurate alternatives see In 2006 the American Academy of Pediatrics Council on Children with Disabilities; Section on Developmental Behavioral Pediatrics published a list of screening tests for clinicians to consider when selecting a test to use in their practice. This list includes the DENVER II among its choices. Most recently, the Denver II has fallen out of favor with early childhood organizations.
The Minnesota Department of Public Health stated, 'The Denver II (1989) is no longer a recommended developmental screening instrument for use in Minnesota public programs. The Denver II failed to meet review criteria. Review criteria is available online. (accessed September 5, 2012 at ) In addition, a leading provider of early childhood research based curriculum, Parents as Teachers, has told its affiliates that the Denver II is no longer a valid instrument for use in its affiliate programs.
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See also. References. Frankenburg, William K.; Dobbs, J.B. 'The Denver Developmental Screening Test'. The Journal of Pediatrics. 71 (2): 181–191.
Denver Developmental Materials. Denver Developmental Materials. Retrieved 15 July 2015. Denver Developmental Materials. Denver Developmental Materials. Retrieved 15 July 2015. Frankenburg, W.K.
And Dodds, J.B.: The Denver Developmental Screening Test. Pediat., 71:181, 1967. Frankenburg, W.K., Dodds, J., Archer, P. Et al.: The DENVER II: A major revision and restandardization of the Denver Developmental Screening Test. Pediatrics, 89:91–97, 1992.
Frankenburg, W.K., Dodds, J., Archer, P. Et al.: The DENVER II Technical Manual 1990, Denver Developmental Materials, Denver, Co.
Camp, B.W.: Evaluating bias in validity studies of developmental/ behavioral screening tests, 2007,28,234–240. Begg, C.B.Biases in the assessment of diagnostic tests. Stat Med 1987;6:411–423.
Altman, D.G.: Some common problems in medical research. Practical statistics for medical research. New York, N.Y; Chapman and Hall; 1991:396–438. Canadian Task Force on the Periodic Health Examination (1994) The Canadian Guide to Clinical Preventive Health Care. Ottawa: Minister of Supply and Services Canada. Chapter 26 'Preschool Screening for Developmental Problems'.
Glascoe, Frances Page; et al. 'Accuracy of the Denver-II in Developmental Screening'.
Pediatrics (89): 1221–1225. Frankenburg, William K. 'Developmental Surveillance and Screening of Infants and Young Children'. 109 (1): 144–145. American Academy of Pediatrics, Council on Children with Disabilities; Section on Developmental Behavioral Pediatrics; Bright Futures Steering Committee; Medical Home Initiatives for Children with Special Needs Project Advisory Committee. Identifying infants and young children with developmental disorders in the: an algorithm for developmental surveillance and screening.
Pediatrics, 2006;118:405–420 External links. at American Academy of Pediatrics. on patient.info.