Developmental screening in context: adaptation and standardization of the Denver Developmental Screening Test‐II (DDST‐II) for Sri Lankan children

Abstract

General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. AbstractBackground Developmental problems in children can be alleviated to a great extent with early detection and intervention through periodic screening for developmental delays during pre-school ages. Currently, there is no established system for developmental screening of children in Sri Lanka. Although some developmental norms, which are similar to those of Denver Developmental Screening Test-II (DDST-II), have been introduced into the Sri Lankan Child Health Developmental Record (CHDR), those norms have not been standardized to the Sri Lankan child population. The aim of this research was to establish Sri Lankan norms for DDST-II and to test the universal and regional applicability of developmental screening tests by comparing the Sri Lankan norms with the norms of DDST-II and DDST-Singapore norms, the geographically nearest standardization of DDST-II. The norms were also compared with the milestones already available in the CHDR. Methods DDST-II was adapted and standardized on a sample of 4251 Sri Lankan children aged 0-80 months. Thirteen public health nursing sisters were trained to collect the data as part of their routine work. The 25th, 50th, 75th and 90th percentile ages of acquiring each developmental milestone were then calculated using logistic regression. Results The Denver Developmental Screening Test for Sri Lankan Children (DDST-SL) was created. Most of the established DDST-SL norms were different to the comparable norms in DDST-II, DDST-Singapore and the CHDR. Conclusions In view of the results of the study, it is imperative that developmental screening tests are used in context and are adapted and standardized to the populations in question before utilization.

Translations of Developmental Screening Instruments

“…Some articles gave specific examples of changes that were made. Sometimes, 24 Persian, 25 French, [26][27][28][29] Chinese, 30 Portuguese, 31 Hindi, 32,33 Dutch, 34 Thai, 35 Norwegian, 36,37 Korean, 38 Turkish, 39 56 Native African, 57 Japanese, [58][59][60][61] Cambodian, 62 Portuguese, 63 Spanish, [64][65][66] Cree, 67 Romanian, 68 Turkish, [69][70][71] Hmong, 62 Sinhalese, 72 Hebrew, 73,74 Indian, 51 Tamil, 72 Filipino, 75,76 Laotian, 62 Thai, 77 items were adapted to account for local conditions that were not specifically related to language. For example, in the translation of the Korean ASQ, the word for "black bean" was substituted for "Cheerio" in a question that asked if a child could pick up a small item with his/her thumb and finger as Cheerios are unfamiliar in Korean culture.…”

Edad de presentación de los reactivos del Test de Denver II en Niños de 0 a 4 años de edad del Estado de Morelos

“…Por lo mismo, parte de su utilidad y validez en otros contextos específicos depende de la edad y orden en que los niños adquieren los reactivos que conforman la prueba. 22 Aunque existen muchos trabajos que utilizan el Denver, pocos reportan la edad de presentación de sus reactivos, 5,6,9,16,17,19,20,[24][25][26][27] lo que constituye el punto central que se La metodología utilizada corresponde a los procedimientos empleados para la construcción de la prueba y por los principales trabajos reportados en los últimos años. Ella permite además establecer los intervalos de confianza de las estimaciones y de esa manera determinar si existen o no diferencias estadísticas significativas.…”

“…También en Morelos el cargado es menos frecuente por el calor y casi nunca en la espalda como en Alaska, el cual le permite al niño recibir la misma información visual que los padres, lo que facilita la orientación espacial. 5 El 90% de los niños de Morelos, como los de Singapur 9 y Sri Lankan, 20 adquirieron el reactivo "Levanta cabeza 90º" a los 5.7 meses de edad, lo que muestra un retraso en comparación con las edades reportadas por otras pruebas como Gesell y Capute, que la refieren cerca de los cuatro meses.…”

“…18 En Argentina, Lejarraga et al 8 analizaron la edad de presentación de pautas de desarrollo comparándolas con lo indicado por varias pruebas, entre ellas el Denver II, respecto a la cual encontraron 32% de conductas retrasadas, 43% adelantadas y sólo 25% sin diferencia. 8 Igualmente se han realizado estudios en otros lugares como Brasil, 6 China, 16 Alaska, 5 Trinidad y Tobago, 17 Singapur 19 y Sri Lanka, 20 observándose en general un carácter variable en la edad de presentación de las conductas del Denver según el contexto en que se valoren. Las pruebas tamiz buscan diferenciar sujetos normales de sujetos con alteración.…”

Preschool Developmental Screening with Denver II Test in Semi-Urban Areas

“…The Denver II Developmental Test is a practical observational screening test which has been standardized in many countries including Turkey [4][5][6][7]. Previous experience in children with various disorders support Denver II's sensitivity in detecting adverse neurodevelopmental outcome [8][9][10][11][12][13][14][15].…”