1. Denver Developmental Screening Test Ppt
2. Denver Developmental Screening Test Ii Pdf Free Printable
3. Denver Developmental Screening Test Ii Pdf Free Download

MethodsAfter translation and back translation, the final Persian version of test was verified by three pediatricians and also by reviewing relevant literature for content validity. The test was performed on 237 children ranging from 0 to 6 years old, recruited by convenient sampling, from four health care clinics in Tehran city. They were also evaluated by DDST II simultaneously. Interrater methods and Cronbach's α were used to determine reliability of the test. The Kappa agreement coefficient between PDQ and DDST II was determined. The data was analyzed by SPSS software.

FindingsAll of the questions in PDQ had satisfactory content validity. The total Cronbach's α coefficient of 0–9 months, 9–24 months, 2–4 years and 4–6 years questionnaires were 0.951, 0.926, 0.950 and 0.876, respectively. The Kappa measure of agreement for interrater tests was 0.89. The estimated agreement coefficient between PDQ and DDST II was 0.383. Based on two different categorizing possibilities for questionable scores, that is, 'Delayed' or 'Normal', sensitivity and specificity of PDQ was determined to be 35.7–63% and 75.8–92.2%, respectively.

IntroductionEarly detection of developmental disorders has an important role in the well-being of children and their families. This is a basic responsibility for pediatric primary care providers.

About 16–18% of children in various populations have developmental disorders but only 20–30% of them are recognized before school entrance.This fact shows that early detection of developmental disorders must be provided in primary child health care services. Today there is an increasing effort for detection of developmental disorders at an earlier age because intervention services are cost effective and when provided in early childhood, have greater efficacy. These services improve the developmental prognosis and have short and long term benefits –.

In order to detect developmental disorders at an early age, the American Academy of Pediatrics (AAP) has recommended that pediatricians use developmental screening tools at 9, 18, 24 (or 30) months child health visits.Developmental screening means using a brief, valid, rapid and standardized tool in order to detect those children who are at risk for developmental disorders and to help find those children who need an extensive developmental assessment , –.Although there are numerous developmental screening tools, each uses different approaches. There is no unique tool that can be used for all populations and all age groups. For selecting a suitable tool we must consider the age range of the desired population, the time and expenses of training test providers and of administering and interpreting the test, the developmental domains that must be assessed in the desired population, the validity, reliability, sensitivity, specificity and all other positive and negative points about the tool of the test, –.

There are two types of developmental screening tools: 1) screening tests which examiners directly observe and interpret the child‘s behavior and 2) developmental questionnaires that are completed by the child‘s care provider.Parental information about child developmental status has been considered reliable and useful for many years –. Research shows that if questionnaires are presented correctly to the parents, almost all parents regardless of their socioeconomic status, geographic setting or health background and child rearing experiences, can give correct information about their child and their opinions have high validity and will lead to increasing rates of early detection and intervention of developmental disorders , –. Furthermore, if parents have a role in the developmental screening process, they can be more effective in the detection of learning needs of their children.

One must keep in mind that screening tools are usually used for two step diagnosis and their suspicious or delayed results must be confirmed with diagnostic or more specialized tools that need more time and expertise to administer. Research has shown that using Prescreening Developmental Questionnaire 2 (PDQ-II) decreases the use of Denver Developmental Screening Test-II (DDST-II) that needs more time, expense and expertise to administer, by 69%.This study was performed from February 2008 to January 2009 in Tehran, Iran to determine validity and reliability of PDQ and to estimate its sensitivity and specificity in comparison to its origin, the DDST-II. Subjects and MethodsAt first the questionnaires were translated into Persian by two experts in English language. Then the Persian version was back translated to English by two other English experts who were unfamiliar with the original version of the test. After comparing the back-translated versions of the test with the original version, the problematic parts were identified and corrections were made in the Persian translation, after which the Persian version was finalized. Next the content validity of the final Persian version was verified by three pediatricians familiar with child development and also by reviewing relevant sources and references.PDQ-II is a developmental prescreening tool that is derived from DDST-II. 97 of 105 items of DDST-II are changed to questions that can be answered by “YES” or “NO” by the care-giver.They are categorized into 4 questionnaires for 0–9 month, 9–24 month, 2–4 year and 4–6 year old children.

The 75 th and 95 th percentiles for each question and also the developmental domain to which it belongs are shown in front of it. Caregivers must continue answering questions until they arrive at 3 “NO” answers (it is not necessary that the NO answers be consecutive). The answer to each question can be: normal (which means the child is able to do the task), delayed (which means the child is not able to do the task that 90% of his/her age-matched children can do) and caution (which means the child is not able to do the task that 75% of his/her age matched children can do). For interpretation of the results, if the child has ≤1 delay or ≤2 cautions (considered as suspicious), developmental advices are given to parents and the child must return for retesting by the PDQ-II one month later. If the child is still in a ‘suspicious’ condition in the second visit then he/she should be referred for screening by the DDST-II. If in the first prescreening visit child has ≥2 delays or ≥3 cautions (considered as delayed), he/she should be screened by the DDST-II as soon as possible.For performing the study, 8 examiners (with a B.S.

Degree in occupational therapy or clinical psychology) were trained. Convenient sampling was used and 237 children aged 0–6 years (divided to 4 age groups, without any obvious disability were tested in 4 primary health care centers situated in south, north, east and western regions of Tehran (sample size was determined by correlation coefficient formula, with 90% power and 95% confidence interval and was calculated to be 48 children in each age group). For those who were younger than 24 months and were born prematurely, we calculated and considered the corrected age. The study was approved by the research committee and thereafter by the ethical committee of the University of Social Welfare and Rehabilitation Sciences.

Parents were informed about the importance of developmental screening and how the test was performed. Then their written consent was acquired. For all children, at first, age-related questionnaires were completed by caregivers and then examiners performed the DDST-II. Because we did not have accessibility to any diagnostic developmental gold standard test and also because PDQ-II is a prescreening test, we used the DDST-II as gold standard test, so that the results of the PDQ-II were cross tabulated against DDST-II to obtain its sensitivity and specificity in comparison to DDST-II and also to determine their Kappa agreement coefficient. By considering this limitation, we used co-positivity of the two tests as a substitute for sensitivity and their co-negativity, for specificity. In 10% of children in order to determine the interrater reliability of the PDQ, after parents completed the questionnaires and the DDST-II was performed, the examiners asked the parents the PDQ questions again and completed the related forms. Also, Cronbach's α was used to determine reliability of the test.

Results were interpreted by researchers. Data were coded and analyzed by SPSS software. For ethical purposes, all parents whose children were detected as delayed or suspicious were referred for additional evaluations and interventions. FindingsIn the present study 237 children consisting of 108 (46%) girls and 129 (54%) boys aged 0–6 years were screened by PDQ and DDST. 96% of cases were born term. Maternal education of 84% of children was at high school level or higher. In prescreening by PDQ the 'normal', 'delayed' and 'suspect' cases were 62%, 18% and 20% respectively.

Denver Developmental Screening Test Ppt

In screening by DDST-II 64.5% of children (68% of girls and 62% of boys) were normal and 35.5% of them were detected as delayed. The results of the two tests are shown in. DDST-II: Denver Developmental Screening Test-IIUsing the PDQ-II, the number of children falling in the categories of “caution” and “delayed” was higher in the gross motor and language domains. Whereas with DDST-II, “delays” and “cautions” were higher in the language domain and “delays” alone, were higher in fine and gross motor domains.For determining the measure of agreement between PDQ and DDST results, considering the fact that for cross tabulating two tests, they must have similar number of answer choices, we first considered the “suspect cases” of the PDQ as “normal” and the next time, as “delayed”. When suspect cases were considered as delayed, the kappa measure of agreement was 0.383 ( P. DiscussionIn our study the content validity of PDQ was verified and there was no need to change any of the questions in the questionnaires.A study was performed in Saudi Arabia on 1219 children. In order to use PDQ as a prescreening tool for their population, researchers made some changes in the contents of the questionnaires, age intervals, normal age consideration for acquisition of developmental skills and also their order of emerging.

These changes were greater in the language domain and showed the importance of adapting developmental screening tools before using them in other countries. Another study in India showed that because of cultural differences between USA and India, PDQ was not suitable for that country.We evaluated the reliability of the test by the Cronbach's α determination. It was 'very good' for the 0–9, 9–24 months and 2–4 years questionnaires and 'good' for the 4–6 years questionnaire. The interrater method was also used as another way for reliability determination and it was 0.89 which was also “very good”.

This study showed that the reliability of PDQ was 'very good' on the whole.In 1987 Frankenburg et al showed that the reliability of PDQ in test-retest and interrater testing (parents-teacher) were 94.1% and 83% respectively.By considering suspect cases as normal, the sensitivity and specificity of the PDQ compared to the DDST-II were 35.7% and 92.2%, respectively and the referral rate (that is, the delayed cases on the PDQ who were referred for performing the DDST-II) was 12.7% and the false negative rate was high. However, if suspect cases were considered as delayed, sensitivity and specificity rose to 63% and 75.8%, respectively and the referral rate rose to 22.7%. The latter values for sensitivity and specificity are closer to the acceptable range for developmental screening tools and the referral rate is more similar to the value presented by the authors of the original test. Also because in this form, the agreement coefficient between PDQ and DDST-II is better than the previous case, it seems that for having more valid results, suspect cases must be considered as delayed.

Also it is suggested that existence of ≥1 delays or ≥2 cautions be considered as referral criteria (instead of ≥2 delays or ≥3 cautions).In India a similar study was performed using the 2–4 year-old questionnaires of PDQ and showed that if ≥1 delays were considered as abnormal, sensitivity, specificity and referral rates were 100%, 7.8% and 92.6%, respectively and thus two stage screening would not be meaningful. When they considered ≥2 delays as abnormal, sensitivity, specificity and referral rates changed to 18.2%, 42.6% and 53.9%. In this situation, sensitivity and specificity of the test were not acceptable for developmental screening. They concluded that PDQ was not suitable for use in India.The present study showed that regardless of considering suspect cases as normal or delayed, the agreement coefficients of PDQ and DDST-II were weak and the 2–4 year- old questionnaire had greatest agreement with DDST-II.Berges et al conducted a research in order to determine the agreement coefficient of PDQ, its modified version (M-PDQ) and another questionnaire named Alpern-Boil Developmental Profile-II, with DDST. They concluded that all tools had good agreement with DDST and could be used for rapid developmental screening in preschool children. Another study in India showed that the 2–4 year-old questionnaire of PDQ had no good relationship with DDST. In another study, term and Very low birth weight infants were screened by PDQ and the Grifffiths developmental scale at 12 months of age.

The study showed that these two developmental screening tools had good agreement and the PDQ was a reliable tool for infant developmental screening.There was no relationship between the presence of developmental delays and such factors as sex, place of residence and maternal education in the present study.A study in an urban area of India showed that uneducated mothers had not good information about the developmental abilities of their children such as ability to draw a circle or a straight line. Thus due to the low educational level of mothers in that area, PDQ could not evaluate the developmental status of children correctly. A study was done using the PDQ in urban and rural areas of Japan with different climates. It showed that in summer the results of children developmental screening in rural areas was lower than jn urban regions but in winter, there was no difference between them.Researchers concluded that in summer, mothers in rural areas did not have much contact with their children because of farm work, and thus were not aware of their children's developmental status.

They concluded that for using the PDQ and similar questionnaires such factors need to be considered too.In the present study developmental prescreening with PDQ showed that the number of cautions and delays were greater in the gross motor and language domains whereas by using the DDST–II the total number of cautions and delays was greater in the language domain and the number of delays alone, was more in the fine and gross motor areas. A study in Shiraz, Iran showed that by using DDST-II, the developmental status of 3–6 year old children in fine and gross motor domains was lower than the Denver normative sample. Other studies in England, Japan, Sweden and Israel showed that children in those countries had a slower rate of fine and gross motor development , –. In Cardiff, children were better in some personal-social items on the whole, and children younger than 18 months were better in the language domain.

Also children of Tokyo were faster in some personal-social items. In another study, developmental screening of children in Tehran showed that by using DDST-II and ASQ (Ages & Stages Questionnaires, developmental delays were greater in the gross and fine motor areas.The present study showed that there is a relatively weak correlation between results of PDQ and DDST-II in children of Tehran. Thus using PDQ and DDST-II in order to perform two-step developmental screening is doubtful. Other studies have previously shown that questionnaires completed by parents, may not have good agreement with each other. The important fact is that the results of screening tools should not be interpreted alone, but decision should be made by considering the child's total function and environmental factors. Furthermore, developmental screening tools are most useful when they are repeated periodically,.Different studies in Iran have shown the rather considerable prevalence of developmental disorders in Iranian children ,.

Thus decision makers of child health care should consider suitable strategies for control of risk factors, emphasizing on prevention and early detection of developmental disorders and providing early intervention services in the country.This study had some limitations such as limitation of time and resources for re-evaluating those children who were detected as cautious or delayed as well as absence of a gold standard developmental diagnostic test for determining the concurrent validity of the results of prescreening and screening with the PDQ-II and DDST-II, respectively.

Denver Developmental Screening TestsPurposeidentify young children with developmental issuesThe Denver Developmental Screening Test was introduced in 1967 to identify young children, up to age six, with developmental problems. A revised version, Denver II, was released in 1992 to provide needed improvements. The purpose of the tests is to identify young children with developmental problems so that they can be referred for help.The tests address four domains of: personal-social (for example, waves bye-bye), fine motor and adaptive (puts block in cup), language (combines words), and gross motor (hops). They are meant to be used by medical assistants or other trained workers in programs serving children. Both tests differ from other common developmental screening tests in that the examiner directly tests the child.

Denver Developmental Screening Test Ii Pdf Free Printable

This is a strength if parents communicate poorly or are poor observers or reporters. Other tools, for example the Age and Stages Questionnaires, depend on parent report. Contents.Denver Developmental Screening Test The test was developed in, by Frankenburg and Dodds. As the first tool used for developmental screening in normal situations like well-child care, the test became widely known and was used in 54 countries and standardized in 15.The Denver Developmental Screening Test was published in 1967. During its first 25 years of use, one study found it to be insensitive to language delays.

Denver Developmental Screening Test Ii Pdf Free Download

Other concerns arose: that norms might vary by ethnic group or mother's education, that norms might have changed, and that users needed training.Denver II Research Basis The Denver Developmental Screening Test was revised in order to increase its detection of language delays, replace items found difficult to use, and address the other concerns listed. There are 125 items over the age range from birth to six years.

An examiner administers the age-appropriate items to the child, although some can be passed by parental report. Each item is scored as pass, fail, or refused. Items that can be completed by 75%-90% of children but are failed are called cautions; those that can be completed by 90% of children but are failed are called delays. A normal score means no delay in any domain and no more than one caution; a suspect score means one or more delays or two or more cautions; a score of untestable means enough refused items that the score would be suspect if they had been delays. The Denver II is available in English and Spanish. Videotapes and two manuals describe 14 hours of structured instruction and recommend testing a dozen children for practice.

Beyond this a professional degree is not required. As with all developmental testing, one must follow the instructions in detail.The standardization sample of 2,096 children was selected to represent the children of the state of Colorado. The test has been criticized because that population is slightly different from that of the U.S. However, the authors found no clinically significant differences when results were weighted to reflect the distribution of demographic factors in the whole U.S. Significant differences were defined as differences of more than 10% in the age at which 90% of children could perform any given item. Separate norms were provided for the 16 items whose scores varied by race, maternal education, or rural-urban residence.Interpretation The author of the test, William K. Frankenburg, likened it to a of height and weight and encouraged users to consider factors other than test results in working with an individual child.

Such factors could include the parents’ education and opinions, the child’s health, family history, and available services. Frankenburg did not recommend criteria for referral; rather, he recommended that screening programs and communities review their results and decide whether they are satisfied.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.

The chairman of the committee wrote: “In the practice of developmental screening and surveillance, we recommend the incorporation of parent-completed questionnaires or directly administered screening tests into the process of surveillance and screening. However, their results should be combined with attention to parental concerns and the pediatrician’s opinion, rather than replacing them, to augment the screening process and increase identification of children with ”. Studies in practice One study evaluated the Denver II in terms of how its results matched those of a psychologist in five child-care centers: two serving the children of college-educated white parents and three serving low-income children. The psychologist evaluated 104 children, of whom 18 were judged to be delayed ). All but two of the 18 came from the low-income centers but no mention is made regarding use of separate norms for African-American children. Results of the Denver II, using an older scoring method, included 33% questionable tests, in between normal and abnormal. If their scores were considered normal, too many children with delays would be missed (low sensitivity); if their scores were considered abnormal, too many children would be referred (low specificity).

On the basis of this study, the Denver II fell into disfavor, and it is now seldom mentioned in reviews. Materials may no longer be purchased in hard copy, but they are at no charge.Another study evaluated the Denver II in the screening program of a community health center. Here the criterion for abnormality was the eligibility of children for, according to the judgment of and other professionals in two suburban school districts. This study included 418 children in all and 64 who needed EI. The success of the screening program was judged in terms of predictive value: the probability that a child, if referred, would be eligible for services. The predictive value was 56%; allowing for children who were referred but not evaluated, it was 72%; this compared favorably with two studies using the Ages and Stages Questionnaire in clinics, which found comparable predictive values of 50% and 38%. The study showed the value of taking into account other information besides the test result because the screener increased the predictive value from 44% to 56% by using her judgment not to refer some children with minor delays.In a study of two-stage screening, children were prescreened with Frankenburg’s Revised Prescreening Developmental Questionnaire and 421 with suspect scores were given the Denver II and evaluated by independent examiners.

In children under 18 months the prevalence of abnormality was 0.19 on diagnostic tests, and the Denver II had a positive predictive value of 0.36, a negative predictive value of 0.90, a sensitivity of 0.67, and a specificity of 0.72. The authors concluded that a suspect Denver II “should lead to careful monitoring and rescreening unless provider or parental concern suggests the need for immediate referral.” Among children 18–72 months old, the prevalence of abnormality was 0.43 and the positive predictive value of the Denver II was 0.77, negative predictive value of 0.89, sensitivity 0.86, and specificity of 0.81. The authors concluded that in their program a suspect Denver II should usually result in referral.

(Positive predictive value meant the probability that a child with a suspect Denver II would be diagnosed as abnormal when evaluated; negative predictive value meant the probability that a child with a normal Denver II would be diagnosed as normal when evaluated.)A study of 3389 children under five in Brazil has produced a continuous measure of child development for population studies. The measure was based on the Denver Developmental Screening Test but can be used with the Denver II.See also.,.,.,.References. Frankenburg, W.K. 'The Denver Developmental Screening Test'. The Journal of Pediatrics. 71 (2): 181–191. Frankenburg, W.K.; Dodds, J.; Archer, P.

Denver II Technical Manual. Denver Developmental Materials, Inc. P. 1. Borowitz, K.C.; Glascoe, F.P.

'Sensitivity of the Denver Developmental Screening Test in Speech and Language Screening'. 78: 1075–1078. Frankenburg, W.K.; Dodds, J.; Archer, P. Denver II Technical Manual.

Denver Developmental Materials, Inc. P. 1. Frankenburg, W.K.; Dodds, J.; Archer, P.

Denver II Technical Manual. Denver Developmental Materials, Inc. P. 6,18–19.

Frankenburg, W.K.; Dodds, J.; Archer, P. Denver II Technical Manual. Denver Developmental Materials, Inc. P. 20–22. 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. Lipkin, P.H.; Gwynn, H. 'Improving developmental screening: Combining parent and pediatrician opinions with standardized questionnaires'. 119: 655–56. Glascoe, F.P.; Byrne, K.E.; Ashford, L.G. 'Accuracy of the Denver II in developmental screening'. 89: 1221–1225.

Dawson, P.; Camp, B.W. SAGE Open Medicine. 2: 56257. Guevara, J.P.; Gerdes, M.; Localio, R.

'Effectiveness of developmental screening in an urban setting'. 131 (1): 30–37. Frankenburg, W.K. 'Revision of the Denver Prescreening Questionnaire'. 110: 653–57. Burgess, D.; Camp, B.W.; Spicer, C.

'Accuracy of the Denver II in a clinical developmental screening protocol'. Abstract Presented at the Society for Developmental-Behavioral Pediatrics. De Lourdes Drachler, M.; Marshall, T.; de Carvalho Leite, J.C. 'A continuous-scale measure of child development for population-based epidemiological surveys: A preliminary study using item-response theory for the Denver test'. Paediatric and Perinatal Epidemiology.

21 (2): 138–153.External links. at American Academy of Pediatrics. American Academy of Pediatrics.