Denver screening test

The Denver test was first published in 1967 in Denver , Colorado by Frankenburger and Dodd ^[1] , in order to recognize possible developmental problems in early childhood. It has been adapted and standardized in more than twenty countries and has been used to test children around the world. As a result of this widespread use, much has been learned that brought about some changes and was realized in the Denver II (DII) test. Denver II appeared due to the fact that the original Denver was insensitive to language delays, as well as due to the need to replace items that are difficult to use ^{[2] [3]} .

Denver II Child Development Test is not an IQ test , it is not a test of a child’s mental or intellectual characteristics. It is not suitable for the diagnosis of serious disorders, such as speech problems, emotional delays, inability to learn. The test is also not suitable for the diagnosis of physical development. The test allows you to compare the solution of a specific child of any tasks compared to how other children of his age group solved the same problems.

Test Denver II consists of 125 tasks, which are divided into 4 blocks:

1. Personal-social characteristics, that is, the possibility of contact with people and care about their own needs.
2. Fine motor skills, i.e. coordination of eye and hand movements, manipulation
3. Language, that is, the ability to hear, understand and use language.
4. Locomotion, that is, sitting, walking, bouncing and other large movements.

Denver II also includes 5 items of the Test of Conduct, located on a test form. They are filled after the test and carry information about the child's behavior during the test, and also help the experimenter to get more information about how the child uses his or her abilities.

The dough is attached to the form with the age line. On the dough form, each task is marked with one of four signs: L-О (personal-social characteristics), TM (fine motor skills), I (language), L (locomotion). The age scale at the top and bottom of the page shows the age in months and years from 0 to 6 years. Each division is one month (up to 24 months); after, each division is three months. Each of the 125 test items is represented by a rectangle in which it is shown that 25%, 50%, 75%, 90% of children of a given age from a standardized sample completed the task correctly. Some questions can be answered by close people, and then in the left corner there will be a letter R. Only such items can be passed according to the message of the parents, but if possible they should be rechecked during the test.

All tasks must be carried out in accordance with a clearly defined procedure described in the manual; otherwise, the norms depicted on the rectangle cannot be applied. The researcher should periodically refer to the test guide to avoid unwanted deviations.

Before starting the test, it is necessary to calculate the age of the child, draw an age line on the form and prepare material for the tasks to be carried out. The objectives of testing can be different, and depending on them, one of two test strategies is possible: identifying a delay (developmental disability) or determining the level of development attained (the “strength” of a child).

1. To identify the risk in the development of the child, the test is carried out as follows:
   • In each section, you must give the child those tasks that intersect the age line, as well as the three to the left of it.
   • if the child does not fulfill these three tasks (refuses, does not work, cannot), then it is necessary to move to the left of the age line until the child completes three tasks in a row.
2. To establish the strength of the child, you must:
   • in each section, give the child tasks that intersect with the age line and the three nearest to the right.
   • continue to give him assignments, moving to the right until he can complete three in a row.

At the same time, you can give your child 3 attempts before registering the inability to perform - so the child can do what he has never done before (it must be taken into account that time is wasted on this).

For each job, the score is inscribed in each box next to the 50% mark. Test D2 uses the following scores:

• “B” - for successful fulfillment of the task, when the child completes the task (or according to the message of a close one).
• “NV” - when the child cannot complete the task (or, according to the message of a close child, cannot fulfill this task).
• “NO” - the child, in principle, is not able to perform this task - this assessment is made only according to a close message.
• "O" - when the child refuses to try to perform the task.

Tasks can be divided into 5 types: “advanced” tasks, “normal” tasks, “warning” tasks, “slow” tasks and tasks “no possibility”.

• "Advanced" tasks. When a child performs a task that is completely to the right of the age line, the development of this task is considered to be very high. "Advanced" tasks are not taken into account when interpreting the entire test.
• "Normal tasks." If a child refuses or cannot complete a task that lies completely to the right of the age line, his development will be considered normal, since at this age less than 25% of children fulfill this task. The same situation with those tasks that intersect the age line between the marks of 25% and 75%. “Normal” tasks are also not taking into account when interpreting the entire test.
• "Caution" assignments. If the child refuses or does not perform tasks in which the age line is from 75% to 90%, the task is marked as a warning. Such tasks are fixed with the letter “P” on the test form and are taken into account when interpreting the entire test.
• "Slow" job. If the child refuses or does not perform the task, which lies completely to the left of the age line, the delay in the development of this task is recorded. In this case, on the test form, you need to paint over the right side of the rectangle denoting this task.
• Buildings "no opportunity." If the parents say that the child cannot complete the task, it is recorded as “no opportunity”. These tasks are also not taken into account when interpreting the entire text.

Normal development is fixed in the case when there are no “delay” marks and at most one “caution”. In this case, retesting is recommended during the next meeting with the child.

Abnormal development is fixed in case of 2 or more “delayed” marks. It is necessary to conduct a diagnostic study.

Questionable development is recorded in the case of a single note of “delay” and 2 or more “cautions”. It is necessary to advise parents to work on problem areas, and also to re-examine if possible. If the result does not change or deteriorates, it is necessary to conduct a diagnostic study.

Failure to test may depend on the number of failures, which as a result may give a "delay" or "caution." If in the end you get the result of "abnormal" development, you should conduct a second study. If it also gives the result “anomalous” development or impossibility of interpretation, it is necessary to conduct a diagnostic study.

A study was conducted to evaluate Denver II in terms of how its results relate to psychologists at five child care centers: two groups of five children were children of white parents with higher education and three groups were African-American children from low-income families. Psychologists rated 104 children, of which 18 were rated as retarded in development ^[4] . All but two of these 18 were from low-income centers, but no mention was made of the use of differing standards for African-American children. Results Denver II, which used the old estimation method, included 33% of questionnaires about normal development and deviation. However, the test was recognized unreliable, as it turned out to be insensitive to deviations, which as a result led to the fact that many children with disabilities were missed. If we take a more rigid framework for assessing the norm, then many normal children would be classified as deviant. Thus, on the basis of this study, Denver II failed, after which it is rarely used in research, but the materials are still available from the official site www.DenverII.com.

Another study assessed Denver II as part of a public medical center program ^[5] . The criteria for abnormality were the recommendations of speech therapists and linguistic psychologists to interfere in the natural course of the child’s development. This study involved 418 children, 64 of whom needed early intervention. The success of this program was evaluated in terms of the likelihood that the child’s referral would be consistent with the results of diagnostics for receiving help and the actual need for this help. Compliance was 56%; together with the percentage of children who were referred by the test, but did not need help, the amount was 72%. Compared to examinations conducted in clinics with age tests, success was higher ^[6] . The study showed the value of taking into account additional information in addition to the test results, because the diagnosis increased the likelihood of compliance from 44% to 56%, while not sending children to the survey with minor delays.

In a population-based study on 3389 Brazilian children aged 0 to 5, regulatory development indicators were obtained based on the Denver test diagnostics. However, they can also be used for Denver II ^[7] .

1. The possibility of conducting the test not only by a certified psychologist, but also by a parent, teacher, kindergarten teacher, doctor in the clinic, etc .;
2. Gives parents useful information to interact with the child;
3. The possibility of a one-time or longitudinal study ;
4. The child is required to perform daily ordinary actions;
5. The ability to assess several lines of development at once: social contacts, personal growth, language, fine motor skills, locomotion;
6. Simple and visual way to present the results;
7. Does not require long processing.