Post on 10-Apr-2018
8/8/2019 Developmental Screening 1 (1)
1/23
Developmental Screening
DDST II
Betsy Johnson, MSN, CRNP
8/8/2019 Developmental Screening 1 (1)
2/23
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
8/8/2019 Developmental Screening 1 (1)
3/23
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
8/8/2019 Developmental Screening 1 (1)
4/23
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).
8/8/2019 Developmental Screening 1 (1)
5/23
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
8/8/2019 Developmental Screening 1 (1)
6/23
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%
8/8/2019 Developmental Screening 1 (1)
7/23
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.
8/8/2019 Developmental Screening 1 (1)
8/23
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.
8/8/2019 Developmental Screening 1 (1)
9/23
Test Categories
Social/personal: aspects of socialization inside
and outside the home
-smiles spontaneously-wave bye-bye
-feed doll
-dress self
8/8/2019 Developmental Screening 1 (1)
10/23
Test Categories
Fine motor function: eye/hand co-ordination,
and manipulation of small objects
Grasp rattle
Thumb-finger grasp
Tower of cubes
Copying shapes
8/8/2019 Developmental Screening 1 (1)
11/23
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
8/8/2019 Developmental Screening 1 (1)
12/23
Test Categories
Gross motor functions: motor control, sitting,
walking, jumping, and other movements
Holds head up
Stand/walk
Throws
Jumps
Balance
8/8/2019 Developmental Screening 1 (1)
13/23
Kit contains:
Bell
Glass bottle
Set of 10 blocks
Rattle
Pencil Tennis ball
Wool
Raisins
Bag
Cup Doll
Baby bottle
8/8/2019 Developmental Screening 1 (1)
14/23
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.
8/8/2019 Developmental Screening 1 (1)
15/23
Practice
Date Today-
Child born February 7, 2007
Child born October 28, 2008
Child born at 32 weeks on December 15, 2008
8/8/2019 Developmental Screening 1 (1)
16/23
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.
8/8/2019 Developmental Screening 1 (1)
17/23
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)
8/8/2019 Developmental Screening 1 (1)
18/23
Interpretation
8/8/2019 Developmental Screening 1 (1)
19/23
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.
8/8/2019 Developmental Screening 1 (1)
20/23
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.
8/8/2019 Developmental Screening 1 (1)
21/23
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
8/8/2019 Developmental Screening 1 (1)
22/23
Clinical development assessment
See handouts in syllabus book.
8/8/2019 Developmental Screening 1 (1)
23/23
Questions???