Denver developmental assessment?

nursedawn67, LPN · Mar 28, 2002

MsPurp...this is kind of topic but not....LOL

Anyhow my daughters all had the Denver Dev Test done and the nurse doing it one time tried to tell me something was wrong with my daughter because she could not stack 3 blocks! i sat there and argued with the nurse that we didn't even own blocks at my house...while I'm arguing with her my kid is stacking all kinds of blocks....I just looked at the nurse....and she had this "never mind" look.

The reason I tell you this is I don't feel this test should be the one test you should depend on for your childs health and development. Children need to see their family doctor regularly.

Just wanted to spout off....thanks! :)

Mel3K · Mar 28, 2002

MsPurp,

I don't know where you're located, but if you contact the Early Intervention program in your community or county, the coordinator should be able to give you some information about the Denver and possibly even lead you to a trainer.

I know that if you happen to be in Ohio, there's a workshop that's given for all personnel who will use the Denver that trains them on its use. If you can't find any information locally, leave me a pm and I can contact someone within my system and get some information for you.

Veering in another direction but possibly of interest to those with young children, there's another screening tool, called Ages and Stages, that is becoming popular in this area because it can be used by parents and caregivers to estimate their children's development.

I agree with Greer that children need to see their family doctor, and at the same time, I know that family physicians aren't necessarily trained to recognize (or don't see because they only see the child at checkups) developmental disabilities that develop slowly or are more subtle. (Our family doctor and our county psychologist both told me my son was *not* autistic; he was later diagnosed by a pediatric neurologist with specific experience in the disorder. I don't blame the ones who missed it--we still visit our family doctor--and it's a good opportunity for him to be educated in this area as well.)

Stepping off my Help Me Grow soapbox,

Melissa

joyrochelle · Mar 28, 2002

hey there---had that the other semester too...there is a handout that follows the ddst...it explains what to do on the asterisked commands, otherwise, ask the child to do just as it requests in the grid. there should be a video to watch to better acquaint yourself with the procedure on the ped's unit that you are assigned to ( are you in your pediatric rotation, i hope?)

if that doesn't help i may be able to dig up my old info...lemme know! it's quite easy. just be sure to challenge the child with tasks beyond their scope/ expected for older children, as well as ask them to complete those in earlier age groups....

MollyJ · Mar 28, 2002

I am a Community Health Nurse who formerly did EPSDT testing, which included the DDST. As some respondents have indicated, if you are going to be doing DDST as part of a job role, you should be certified to do it. That means you should attend a one or two day training and submit a video of yourself doing the DDST with a child to a trainer for "grading" or whatever the training process is these days.

Like any standardized screen, the training is necessary so that the examiner knows which tasks to present, how to present the tasks, knows what to allow and what to disallow. You also need to know how to interpet your findings! I've seen well administered Denver's and not-so-well administered DDST's. The sensitivities and specificities of the Denver occur when it is presented and interpreted in a standardized fashion.

That said, it sounds like you're a student having a standard student experience. There is a manual that goes with the kit and explains how to present it, item by item. If you don't have this manual, any "testing" you do will not be worth the time it takes to perform it. (the testing grid is good but not a complete instruction to administering the DDST.) So, if you are a student having a student experience do the best you can, but realize you have not really evaluated anything.

RE: the above comments. My husband is a doc in FP residency and they work relentlessly on developmental delay case finding. Some docs will be more oriented to it than others. Additionally, when I worked with severely affected, special needs kids, many of my kids had rare disease entities OR atypical presentations of disabilities and they constantly were "teachers" to their pediatricians and FP's alike. I do not necessarily expect FP's to dx autism and it's variants or other developmental delay problems BUT I expect them to have an index of suspicion for them and to know their referral resources.

Finally, RE: the nurse mom who's kids couldn't stack blocks (but showed the ability to learn the task during the appointment time). In my experience, this was not uncommon--when the child simply had not been previously exposed to the task, they often couldn't perform it. If you have a continuous relationship with the kid (you work in a doc's office), you have the luxury of telling mom they need to have the kid stack blocks at home and retest in several weeks BUT if a child has a cluster of "Fails", has a high risk history (premie, LBW, serious illnesses) AND doesn't seem to be just having a bad day (have you ever tried to do a DDST on a toddler at their typical nap time?), then you should seriously consider referring to your early intervention team. REMEMBER, the DDST under-refers and really doesn't do a great job of testing speech or hearing. In general, nurses, the more DDST you do, the better quality product you generate so long as you stick to the testing protocol.

Good luck, Ms Purp

Mel3K · Mar 29, 2002

Molly,

I hope I didn't indicate in any way that I thought our family doctor was at fault; I really believe that what he had seen previously was more of the extreme end of delays. And I know he's been quite interested in seeing information that I have come across in our family's experiences.

The most valuable source of referrals we have found, actually, is our county health nurse. She is great!

What I was doing a bad job of trying to say was that developmental evaluations, done by a trained professional, are valuable tools in assessing a child.

Melissa

delirium · Mar 29, 2002

Wow, thanks for everyone's help.

This is just a student experience, and its part of our community rotation. Its not especially useful to me, as I was assigned to an orthopod's office, and they don't do a lot of pediatric developmental assessments there (just a lot of casts).

There is no manual or video with my kit. Just a grid. I assume I can kind of follow along with the tasks presented and 'wing it', but I was concerned that I wouldn't get an accurate picture of the child's development. It sounds as if I wouldn't get an accurate picture anyway, unless I were trained in the correct way to use/interpret this assessment.

So, I guess.... like everything else..... I'll try to get the most out of it that I can.

Thanks again everyone.

:roll