DDST-II: Denver Developmental Screening Test, 2nd Edition

Posted on: March 16, 2015 | By: achristian5 | Filed under: Denver Developmental Screening Test-2nd ed (DDST-II)

Descriptive Information

  • Title, Edition, Dates of Publication and Revision*:  Denver Developmental Screening Test 2nd ed (DDST II)  1960, 1990
  • Author (s): Frankenburg, WK, Dodds, J., Archers, P., Shapiro, H., Bresnick, B..
  • Source (publisher or distributor, address):
    • Produced by Denver Developmental Materials, Inc
    • More information and products can be found at
    • Phone:  1-800-419-4729
  • Costs (booklets, forms, kit): The following items and others can be found at :
    • Test Forms: $40
    • Training manual–$40
    • Test kit–$100
    • Technical manual–$45
    • Complete package–$160
    • Training DVD–$220.
  • Availability:
  • Purpose: screening for developmental problems to confirm suspected problems using an objective measure; to monitor children at risk for developmental delay.
  • Type of Test:  First-level comprehensive screening.
  • Target Population and Ages: birth to 6 years of age.
  • Time Requirements: takes about 20-30 min to administer and interpret.

Test Administration

  • Administration: trained professional—clinical, teacher or early childhood professional.
    • Administrators are to have child perform easies tasks first and praise the child’s efforts despite success or failure.
    • Children are given up to 3 trials per task before moving on.
  • Scoring:
    •  Items are in sub-sample categories including race, less educated parents, and place of residence.
    • There are 125 performance-based and parent reported items on the test in the following four areas of functioning: fine motor-adaptive, gross motor, personal-social, and language skills.
    • Scoring per item is rated as follows:
      • P: pass-child successfully performs item or caregivers reports the child can do the item
      • F: fail—child does not successfully perform the item and/or the caregiver reports the child cannot do the item
      • NO: No opportunity—the child has not had the opportunity to perform the task due to restrictions
      • R: Refusal—the child refuses to attempt and the parent cannot report.
    • These items are scored to a normative age line with notation to caution, advanced and delayed items. These lines represent the normative data and the percentile ranks. 
      • Percentile ranks include: 25th, 50th, 75th, and 90th.  Ages should be adjusted for prematurity as needed.
      • Some items for the youngest ages do not have percentile ranks.
    • Items involved 90% performance rate for inclusion in the screen.
    • The number of scores a child received below the normal expected range classifies the child as within normal, suspect, or delayed.
    • Scores are recorded per item through direct observation of the child and in some cases what the parent reports.
    • The test is interpreted to place the child into two categories: normal or suspect.  If the child is suspect it is recommended that rescreening occur in 1-2 weeks.
    • One of the new editions to the DDST-II was the addition of a behavioral scale.
    • The DDST-II also increased language items by 86%, included two articulation items, a new category of item interpretation to ID milder delays, and new training material.
  • Type of information, resulting from testing: Percentile ranks.
  • Environment for Testing: designed to be able to be conducted in busy professional settings.
  • Equipment and Materials Needed: 
    • Writing implement for the examiner
    • Trained professional with test forms.
    • Training packages are also available.
    • Various items for test items and available in the testing kit:
      • Red yarn pom-poms of 4” diameter,
      • an “O” shaped cereal,
      • rattle with narrow handle,
      •  10 1” colored wooden blocks,
      • small clear glass bottle with 5/8” opening,
      • small bell,
      • tennis ball,
      • red pencil,
      • small plastic doll with bottle,
      • plastic cup with hand,
      • a blank piece of paper*
    • A blanket or a pad/mat is needed for babies.
    • Table and chairs will also be needed if the examinee is a child.

*not provided in the testing kit

  • Examiner Qualifications: health care professionals, social service professionals, and paraprofessionals.

 Psychometric Characteristics:

  • Standardization/normative data:  normative data was developed from 2096 children at the University of Colorado Medical Center.
  • Evidence of Reliability: 
    • Inter-rater reliability is reported as high to strong results.
    • The Persian version of the DDST-II has been found to have good validity and reliability finding a test-retest Cronbach’s  and Kappa measure of agreement of 92% and 87%, respectively.   Inter-rater reliability was also a Kappa measure of 76% in the Persian version.
    • More information may be available in the DDST-II manual.
  • Evidence of Validity: 
    • Sensitivity: reported to be between 56-83%
    • Specificity: reported to be between 43-80%
    • Validity of the DDST II was tested concurrently with the ASQ-34 resulting in a fair to moderate agreement.
    • DDST II and BINS were found to have a moderate positive correlation at the 12 and 24 month as well as with the Neurological assessment, and BSID II.
    • Face Validity: The DDST-II has good face validity with the use of a curve similar to a growth curve with norms developed from a representative population.
    • More information may be available in the DDST-II manual.
  • Predictive: This information may be available in the DDST-II manual.

Summary Comments:

  • Strengths:
    • Ease of administration,
    • High inter-rater reliability,
    • provides separate norms for subgroups,
    • uses a curve that approximates a growth curve for ease of use
    • relatively short testing time
    • addresses four areas of development
    • has a behavioral scale
  • Weaknesses:
    • The DDST-II is a screening tool and is not a diagnostic tool.
    • The normative data from 2096 children does not represent the national population with the following misrepresentations: overrepresented Hispanic infants, under represented African-American Children, and disproportion of mother’s education greater than 12 years.
    • It has also been reported that the screen misses children with developmental delay.
    • Does not cover all developmental needs.
  • Clinical Applications: 
    • The DDST-II can be used as a screening tool and is currently being used across the country and around the world to screen children from birth to 6 years of age who are at risk of developmental delays.  The test can be easily administered in about 20 minutes and scoring is based on observation and parental reporting.  The data is scored in relation to normative values on a curve similar to a growth curve putting each child in a percentile rank.  The ease of use and simple equipment that is needed and comes with the testing kit making this screening tool advantageous around the world.  Many different professionals and paraprofessionals can administer this screening tool including but not limited to: teachers, physical therapists, occupational therapists, social services, and school counselors.


Denver Developmental Materials, Inc. Denver II Online. 2015. Available at  Accessed: 12 March 2013.

Filgueiras A., Pires P., Maissonette S., Landeira-Fernandez J.Psychometric properties of the Brazilian-adapted version of the Ages and Stages Questionnaire in public child daycare centers Early Human Development, Volume 89, Issue 8, August 2013, Pages 561-576

Frankenburg WK, Dodds J, Archer P, Shapiro H, Bresnick B. The Denver II: a major revision and restandardization of the Denver Developmental Screening Test. Pediatrics. 1992 Jan;89(1):91-7. PubMed PMID: 1370185.

Frankenburg, W.K., Dodds J. et al. DENVER II Training Manual. Denver Developmental Materials, Inc., Denver, CO. 1996:18-21

Ringwalt, Sharon.  Developmental Screening and Assessment Instruments with an Emphasis on Social and Emotional Development for Young Children Ages Birth through Five. The National Early Childhood Technical Assistance Center. 2008.  Available at: Accessed: 16 March 2015.

Shahshahani, S., Vameghi, R., Azari, N., Sajedi, F., Kazemnejad, A. Validity and Reliability Determination of Denver Developmental Screening Test-II in 0-6 Year-Olds in Tehran. Iranian Journal of Pediatrics. September 2010(20):3.

Stephan, Linda. Denver II. Modestor Junior College. 17 October 2011. Available at, Accessed:  March 12, 2015.


Article Summary

Sambandam E, Rangaswami K, Thamizharasan S. Efficacy of ABA programme for children with autism to improve general development, language and adaptive behaviour. Indian Journal of Positive Psychology. 2014;5(2):192-195.

The purpose of this study was to monitor the effects of applied behavioral analysis (ABA) versus traditional treatment in thirty children with autism.  The study looked at testing results pre and post intervention and used the following tools to validate the severity of disorder, developmental levels, language and adaptive functioning before and 1 year after implementing treatment: Shildhod Autism Rating Scale (CARS), DDST-II, Receptive Expressive Emergent Language Scale (REELS), and Wineland Social Maturity Scale (VSMS).  Data was analyzed using a paired t-test and a one way ANOVA.  The study found that ABA had a significant improvement in symptom manifestation and improvements in specific behaviors.  Significant changes were also seen in the intervention group in the overall CARS scores.  The DDST-II revealed various areas of improvement in developmental areas amongst the intervention group as well.  No significant differences were seen in the control group save language however, improvements were not as great as that of the intervention group.

One of the strengths of this study is the length of the intervention.  One year allows a normal progression of yearly academics in school and a standardized time frame that is identical to that of how ABA would continue if implemented.  Another strength is the use of multiple tests for pre and post testing–including the DDST-II. A follow up testing would have benefitted this study to show the potential lasting benefits of the intervention. Another restraint on the power of this study is the small population size.  15 participants were in the ABA group and 15 in the control group–a number that is too small to represent the population of children with autism.




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