DENVER II

Introduction
The Denver Developmental Screening Test
(DDST) was first published in 1967 to help
health providers detect potential
developmental problems in young children
1990 major revision the DENVER II
The DENVER is not an IQ test
It is not a definitive predictor of future adaptive
or intellectual ability

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 childs
performance on a variety tasks to the performance of
other children the same age (between birth and six
years)

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)

Introduction

1.
2.
3.
4.

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

Personal-Social getting along with people and caring for
personal needs
Fine Motor-Adaptive eye-hand coordination, manipulation of
small objects and problem solving
Language hearing, understanding and using language
Gross Motor sitting, walking, jumping and overall large muscle
movement

Include Test Behavior items assess the childs overall behavior

and obtain a rough gauge of how the child uses his or her
abilities

Introduction
Was designed to be used in a clinical setting
by a variety of professionals
The test must be administered in the
standardized manner and screeners should be
carefully trained

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

Test Form
Four sectors: Personal-Social, Fine-MotorAdaptive, Language and Gross motor
Age scales across the top and bottom of the
test form depict ages in months and years
from birth to 6 years

DENVER II

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.

Age scale in months

6

Percent of normal children

passing item

15

12

25%

50%

75%

90%

WALK WELL

In the above example for the item Walk Well, the left end
of the bar indicates that 25% of the sample children walked
well at a little over 11 months
The hatch mark 50% did this at 12-1/3 months

The left end of the shaded area shows that 75% walked well
at 13-1/2 months
The right end of bar shows that 90% of the sample children
could walk well at little under 15 months

 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

Calculating The Childs Age and Drawing

The Age Line
General instruction
Name, birth date and test
Childs age
Example:
Year Month Day
Date of test ..907..15
Date of birth -88...-3.-10
Age of child .2.4.5

 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 must
be adjusted
Example: GA 32 weeks (next slide)

 Example:
Year Month Day
Date of test ..908..20
Date of birth -90...-6..-1
Age of child ...219
8 weeks premature..-2.-0
Adjusted age of child.019

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

Age scale in months

12

15

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

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

Test Administration
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
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 childs effort should be
praised
Items that use the same materials in the test kit
administered consecutively

Test Administration
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 childs age line
and continue to the right

Test Administration
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

Test Administration
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 & every
item 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 sectors
until the child passes 3 items

Test Administration
b. To determine a childs relative strengths
Step 1: In each sector, administer at least 3
item nearest to and totally to the left of the
age 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 3
failures

Test Administration
6. Test Behavior Ratings
Scored after the completion of the test
Using the rating scale provided compare
the behavior during test with previous
performance
If child too ill, hungry or upset rescheduled

Test Administration
7. Item Scoring
P for Pass successfully performs the item or the
caregiver reported
F for Fail does not successfully perform the item or
the 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

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

Interpretation
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

Age line
F

Interpretation
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
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

Age line

Age line

Age line
C

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

Interpretation
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

Age line

NO

NO

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 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 75%-90% area
Rescreen in 1-2 weeks

Referral Consideration
If upon rescreening the test result is again
Suspect or Untestable
To refer should be determined by the clinical
judgment of the supervising professional based
upon:
Profile of test result
Number of Cautions and Delays
Rate of past development
Other clinical consideration
Availability of referral resources