Developmental Screening 1 (1)

8/8/2019 Developmental Screening 1 (1)

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Developmental Screening

DDST II

Betsy Johnson, MSN, CRNP


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Developmental delays

Developmental delay occurs in up to 15% of

children under 5 years of age.

This includes delays in speech and languagedevelopment, motor development, social-

emotional development, and cognitive

development.

Only 50% delays are picked up prior to

attending school


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Purpose of Testing

Pick up neurologic issues in early infancy

Reassure parents of developmental

appropriateness or identify early issues Identify social or cognitive issues prior to

school and initiate early intervention


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DDST II

The DENVER II (1992) is a revision and timely

update of the Denver Developmental

Screening Test, DDST (1967).

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).


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Advantages

Not just reports from parents: actual

observations from examiner used to evaluate. Boxes with R in left corner can be assessed by

report.

Numbers in box have footnote on back.

rR1


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Advantages

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.

25% 50% 75% 90%


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Application

No special training is required.

The test takes approximately 20 minutes toadminister and interpret.

Interviews can be performed by almost anyonewho works with children and medicalprofessionals.

The 125 items are recorded through direct

observations of the child plus, for some pointsmarked with an R, the caregivers report onwhether the child is capable of performing agiven task.


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Application

Young children sit on parents lap or have

parent close by.

Give exam slowly. Results depend on cooperation of child.

Results may be influenced by the childs

health, stress and fears or behavior.


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Test Categories

Social/personal: aspects of socialization inside

and outside the home

-smiles spontaneously-wave bye-bye

-feed doll

-dress self


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Test Categories

Fine motor function: eye/hand co-ordination,

and manipulation of small objects

Grasp rattle

Thumb-finger grasp

Tower of cubes

Copying shapes


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Test Categories

Language: production of sounds, ability to

recognize, understand, and use of language.

Squeals

Mama/dada specific

Words and word combinations

Knows actions

Knows adjectives

Knows definitions


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Test Categories

Gross motor functions: motor control, sitting,

walking, jumping, and other movements

Holds head up

Stand/walk

Throws

Jumps

Balance


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Kit contains:

Bell

Glass bottle

Set of 10 blocks

Rattle

Pencil Tennis ball

Wool

Raisins

Bag

Cup Doll

Baby bottle


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Determining Age Line

Take date today.

Subtract date of birth.

Borrow days from months and months fromyears if needed.

Round up or down to months for age line: 16 days up Adjust for prematurity of less than 37 weeks.

Subtract weeks premature from current age.


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Practice

Date Today-

Child born February 7, 2007

Child born October 28, 2008

Child born at 32 weeks on December 15, 2008


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Interpretation

Draw a vertical line at the child's chronological

age on the charts; if the infant was premature

subtract the months premature from

chronological age.


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Interpretation

Assess for any items that falls on the age line

to the left and right.

Place a P (Pass) or F (Fail) for each itemassessed.

Fail for item is if F falls completely to the right

of the box. Caution for item if fail falls within

blue shaded area of box (90% peers can

perform)


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Interpretation


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Interpretation

The more items a child fails to perform

(passed by 90% of his/her peers), the more

likely the child manifests a significant

developmental deviation that warrants further

evaluation

If child refuses a number of items, have them

return in week or two to retest.

May get number of refusals in hospital setting.


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Referral

If development appears normal, then

reassuring anxious parents is always

rewarding. On the other hand if there is

developmental delay, intervention at the

earliest possible time can make a significant

difference to outcome.


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Referral

Refer back to pediatrician or to specialist in

area.

Howard County Child find is early interventionprogram who send specialists out to home

and evaluate/treat any developmentally

delayed children in Howard County


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Clinical development assessment

See handouts in syllabus book.


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Questions???

Developmental Screening 1 (1)

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