The Denver II Developmental Screening Test (DDST-II) is a widely used tool designed to assess the developmental progress of young children. It helps healthcare providers identify children who may be at risk for developmental delays, allowing for early intervention. This test is a screening instrument, which means it indicates a potential need for further evaluation rather than providing a definitive diagnosis.
Developmental Areas Assessed
The Denver II assesses a child’s abilities across four specific developmental domains. The Personal-Social domain evaluates how a child interacts with others, including skills related to self-help and social engagement, such as eating independently or playing with peers.
The Fine Motor-Adaptive domain focuses on the use of small muscle groups and hand-eye coordination. This includes tasks like building a tower with blocks, holding a pencil, or manipulating small objects.
The Language domain measures a child’s ability to hear, understand, and use speech, encompassing skills like forming two-word sentences or responding to instructions.
Finally, the Gross Motor domain examines skills involving large muscle movements. This area covers abilities such as sitting, standing, walking, running, climbing stairs, and jumping. The test consists of 125 items, with specific tasks tailored to different age ranges within these four categories.
The Testing Process
The Denver II test is typically administered by trained healthcare professionals, such as pediatricians, nurses, or other specialists familiar with child development. It is designed for children from birth up to six years of age. The screening usually takes approximately 20 to 30 minutes to complete, though this can vary depending on the child’s cooperation.
During the test, the professional observes the child directly performing age-appropriate tasks using specific materials provided in the Denver II kit. These materials might include items like a red yarn pom-pom, raisins or O-shaped cereal, small wooden blocks, and a small bell. In addition to direct observation, information about the child’s abilities is also gathered through reports from parents or primary caregivers. The testing environment is usually set up to make the child and caregiver comfortable, often including a table and chairs, and a space for movement.
Understanding Test Outcomes
After the Denver II screening, a child’s developmental progress is categorized into one of three possible outcomes: “Normal,” “Suspect,” or “Untestable.” A “Normal” outcome indicates that the child shows no developmental delays and has a maximum of one “caution” on specific items. This suggests that the child’s development aligns with typical milestones for their age.
A “Suspect” outcome signifies that the child has one or more “delays” or two or more “cautions.” A “delay” occurs when a child fails an item that 90% of children their age can typically complete, while a “caution” is for items that 75%-90% of children can perform but the child failed.
An “Untestable” outcome occurs if a child refuses to attempt enough items that, if failed, would result in a “Suspect” score. This can happen if the child is uncooperative during the test, or due to other temporary factors like illness or fatigue.
Next Steps After Screening
For a child receiving a “Normal” outcome on the Denver II, routine developmental monitoring continues during subsequent well-child visits. This ongoing observation ensures that developmental progress remains on track.
If a child receives a “Suspect” or “Untestable” outcome, the typical next step involves a referral for a more comprehensive diagnostic evaluation. This evaluation is conducted by specialists, such as developmental pediatricians, speech therapists, or occupational therapists, who can provide a more in-depth assessment. Early intervention services may also be recommended if concerns persist after rescreening. It is important to remember that the Denver II is a screening tool, and a professional diagnosis is necessary to confirm any developmental delays.