THE DENVER DEVELOPMENTAL SCREENING TEST (DDST) and its revision, the DENVER II, are the most widely used developmental screening tests in the world. To date over 40 million children have been screened with the test. It has been in use and taught in most states of this country, translated for use in many foreign countries and even re-standardized to obtain national norms in over a dozen countries. The authors' concerns over the 23 years of the DDST's use resulted in the DENVER II which was published in 1990[1]. The major changes were the re-standardization on over 2000 Colorado children (1,000 in Denver County and 1,000 in rural Colorado counties) and the addition of more language items. Other differences were in scoring of the DENVER II, the addition of behavior items, and a new method of interpretation. The results of testing all the children were then weighted on the basis of the 1980 Colorado census to derive the 25%, 50%, 75% and 90% passing age of each item to derive the Colorado composite norms (DENVER II). These composite norms did not differ significantly from the US census of 1980 [2]. Since it was anticipated that the addition of language items might result in significant subgroup differences on the basis of ethnicity, maternal education and rural versus urban environments, equal numbers of children in these subgroups were compared on the basis of ethnicity, maternal education and rural versus urban environments. Equal numbers of children in these subgroups were then compared with the Colorado composite sample at the ages when 90% of the children passed the item. If significant differences were found, these were presented in the DENVER II Technical Manual. [3]

Ideally, specific norms would be available for every child and/or every state, but they are not. Unfortunately, one has to make do with average norms. This does not preclude the clinician from the use of his/her judgment. By using subgroup norms as presented in the DENVER ll Technical Manual when they differ significantly from the composite norms, a tester can determine the extent to which a child's failure on a particular item may be explained on the basis of the subgroup norms rather than on the composite norms. Therefore, the view that Colorado "has an over-representation of Hispanics and an under-representation of African Americans" reflects a neglect to recognize that the test's composite norms reflect the US norms [2], and that subgroup norms are available for consideration as well.

In summary the DENVER II represents a test that:

1. was carefully standardized
2. presents norms for an entire sample that simulates the Colorado 1980 census and does not differ significantly from the US population
3. provides separate norms for items of subgroups when they differ significantly from the composite sample
4. approximates a growth curve in its display of norms over time making it ideal for health surveillance
5. has numerous training materials to minimize errors in testing and interpretation

Should readers of the above have questions, it is suggested they call Dr. Frankenburg at Denver Developmental Materials (800) 419-4729.

REFERENCES

[1] Frankenburg, W.K., Dodds, J. et al. The DENVER II: A major revision and re-standardization of the Denver Developmental Screening Test. Pediatrics 1992; 89:91-97

[2] Frankenburg, W.K., Dodds J. et al. DENVER II Technical Manual. Denver Developmental Materials; Denver, CO. 1996: 10

[3] Frankenburg, W.K., Dodds J. et al. DENVER II Technical Manual. Denver Developmental Materials; Denver, CO. 1996; 2-6, 8-10, 31, 33, 55-59