Dr.

Ni Made Dwiyathi Utami, SpA

∎ The Denver II is designed to be used with apparently
well children between birth and six years of age
∎ The Denver II is not an IQ test, nor is it a definitive
predictor of future adaptive or intellectual ability

∎ The Denver consists of 125 tasks, or items, which are

arranged on the test form in four sectors to screen the
following areas of function:
♦ Personal Social - getting along with people & caring for
personal need
♦ Fine Motor adaptive - eye hand coordination, manipulation
of small objects, and problem solving
♦ Language - hearing, understanding and using language
♦ Gross motor - sitting, walking, jumping, & overall large
muscle movement
 A. TEST MATERIALS

- Red yarn pom-pom (approximately 4” diameter)

- Raisins
- Rattle with narrow handle
- 10 1-inch square colored wooden blocks
- Small, clear glass bottle with a 5/8 inch opening
- Small bell
- Tennis ball
- Pencil
- Small plastic doll with feeding bottle
- Plastic cup with handle
- Blank paper
B. TEST FORM
TEST FORM
● Each of the 125 test items is represented on the form
by a bar that spans the ages at which 25%, 50%, 75%,
& 90% of the standardization sample passed that item

Age scale in months

6 9 12 15

Percent of normal children passing item:

25% 50% 75% 90%

WALK WELL

“ Walk well”
25% of the sample children walked well at a little over 11 months
50% did this at 12 1/3 months
75% walked well at 13 1/2 months
90% of the sample children could walk well at a little under 15 months
 R indicates item may be passed by report R
Foot not number refers to instructions on 1
the back of the test form

► Some of the items have a small footnote number on

the left and of the bar:

“R” (Report)  Some items may be passed by

report of the caregiver

Small footnote number  numbered instructions

found on the back of the test form that remind
the examiner how to administer and/or interpret
such items
 C. CALCULATING THE CHILD’S AGE AND
DRAWING THE AGE LINE

1. General Instruction

● The child’s name, birth date and test date should

be recorded first on the test form
● The child’s age is computed by subtracting the
date of the birth from the date of testing

(When it is necessary to “borrow” in the subtraction,

30 days are borrowed from the month column and 12
months are borrowed from the year column)
■ 1 year = 12 months; 1 month = 4 weeks; 1 week = 7 days

▼ Example 1. Year Month Day

Date of test 06 3 11
Date of birth 05 1 5
Age of child 1 2 6

▼ Example 2. Year Month Day

02 2 +12 (14) (41)
Date of test 03 3 11
Date of birth 02 7 20
Age of child 0 7 21
2. 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 3 Year Month Day

Date of test 03 3 11
Date of birth 02 2 4
--------------------------------------------------------------------
Age of child 1 1 7
6 weeks premature -1 -14
--------------------------------------------------------------------
Adjusted Age of child 11 16
3. - Use the age scales and a straight edge to accurately
draw an “age line” from the top the bottom of the form

- Each space between age mark at the top and bottom

of the form represents one month until 24 months;
thereafter, each space represents 3 months

Age scale in months

09-12-06
6 9 12 15

The child is 131/2 mo; the date of the test is Dec 9, 2006

After drawing the age line, write the date of the test above it
 D. TEST ADMINISTRATION

1. General Instructions

● The Denver II can be used to screen a child repeatedly

● To use the same test form on more than one
occasion, it is suggested that a new age line (with
the date of testing entered above it) be drawn each
time child is screened

2. Building Rapport
● To make the caregiver and child comfortable
3. Introduction
● Asked when the child was born & whether the child
was born prematurely
● Calculate the child’s test age
● Explain that the Denver II is administered to determine
the child’s current development status, that the test is
not an IQ test, the child is not expected to pass all the
items administered

4. Order of Testing

- The order of presenting the items should be flexible,

and the sequence should be adjusted according to
the responsiveness of the child
5. Number of items to be given
● To determine if the child is developmentally at risk,
administer the test as follows:

Step 1: In each sector, administer at least three items

nearest to and totally to the left of the age line,
and every item that is intersected by the age
line

Step 2: If the child is unable to perform any item in Step

1 (fails, refuses, has had no opportunity),
administer additional items to left in appropriate
sectors until the child passes three items
 …Number of items to be given

● To determine the child’s relative strengths (a ceiling),

administer the test as follows:

Step 1: In each sector, administer at least three items

nearest to and totally to the left of the age line,
and 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 three failures are
recorded
6. Test Behavior Ratings

● The “Test Behavior” ratings are scored after

completion of the test

● The screener can compare the behavior of the child

during the test with the child’s previous performance

● Sometimes a child may be too ill, tired, hungry, or

upset when tested to display actual capabilities

● In such cases, the test may be rescheduled on different

day at a time the child is likely to be more cooperative
7. Item scoring

● “P” / Pass
The child successfully performs the item, or the
caregiver reports (when appropriate) that child does the
item

● “F” / Fail
The child does not successfully perform the item, or the
caregiver reports (when appropriate) that child does not
do the item
● “NO” / No Opportunity
The child has not had the chance to perform the item,
due to restrictions from the caregiver or other
reasons. This score may only be used on “report”
items

● “R” / Refusal /
The child refuses to attempt the item. Refusals can be
minimized by telling the child what to do rather than
asking. If given instruction in proper administration,
the caregiver may administer the item. Report items
can not be scored as refusals
E. INTERPRETATION ■ 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’s development is
considered advance on that item
Age line

b. “Normal” Items
► Ifa child fails or refuses an item that falls completely to the
right of the age line, the child’s development is considered normal

Age line Age line

F R
► Ifa child can pass (P), fail (F), or refuse (R) an item of which the
age line falls between the 25th and 75th percentile

Age line Age line Age line

P F R

c. “Caution” Items
If a child fails (F) or refuses (R) an item on which
the age line falls on or between the 75th and 90th
percentile
Age line Age line Age line Age line

F C R C R C F C
d. “Delayed” Items
If a child fails (F) or refuses (R) an item that falls
completely to the left of the age line
Age line Age line

F R

e. “No Opportunity” Items

Report items which the parent says the child has not had an
opportunity to try, are scored as No Opportunity (NO)

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 Caution 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
Normal
There are no Delays

Since there is only

one caution (Throw
Ball Overhand), the
test is normal
Normal

There are no Delays

and no Cautions

Failures are to the right

of the age line or
intersect between the
25th percentile and the
75th percentile
Suspect
There are one delay
(hops), and 3 cautions
(pick longer line; know
3 adjectives; balance
each foot-3 seconds)
Suspect
There are 2 delays
(work for toy and
reaches)
Untestable
There are 2 Cautions
(feed doll and tower of
2 cubes). Since these
items are refusals, the
test is untestable
Untestable
There are 4 Delays
(thumb wiggle, use of 3
objects, use of 2
object, and name 1
color). Since these
items are refusals, the
test is untestable