William K. Frankenburg

The revised Denver Developmental Screening Test: Its accuracy as a screening instrument

This report encompasses 3 studies pertaining to the validity and reliability of theDenver Developmental Screening Test (DDST). On the basis of the first 2 studies the interpretation of the test scores was revised. A third study was then undertaken to cross-validate the revised method of interpretation. Nonprofessional health screening aides tested 2,000 children; the results in 237 were validated by testing with the Revised Bayley Infant Scale or the Stanford-Binet Intelligence Scale. Analysis of these data revealed that with the use of a revised method of interpretation, overreferrals were decreased from 21 per cent to 11 per cent and underreferrals increased slightly from 2 per cent to 3 per cent. A total of 186 children varying in age between 1.5 and 76 months were tested with the DDST on two occasions 7 days apart; use of the revised method of interpretation yielded 97 per cent agreement. The health aides were then retrained in the administration and interpretation of the DDST; cross validation of the revised method of interpretation with another sample of 246 children indicated only 3.2 per cent overreferrals and 0.4 per cent underreferrals.

Development of preschool-aged children of different social and ethnic groups: Implications for developmental screening

The developmental status of 1,180 children representing a cross section of Denvers ethnic and parental occupational groups was compared with that of 1,055 children (349 Anglo, 354 Spanish surname, and 352 Black) whose parents were unskilled workers. The children varied in age from 2 weeks to 6.4 years and were evaluated with the Denver developmental screening test. Comparisons were made in developmental achievements as reflected by individual item differences for Anglo children from unskilled families with Anglos from cross-sectional families. A second comparison of Anglo, Spanish, and Black children of the unskilled sample was also made. The first analysis comparing 910 Anglo children from the cross-sectional sample with 349 Anglo children from the unskilled families demonstrated significant differences (p smaller than 0.05) for 39 of the 105 items. Below 20 months of age, children of the unskilled sample were more advanced, whereas after 20 months of age, the children of the cross-sectional sample were advanced in all test sectors except for items in the personal-social sector. Comparisons of Anglo, Black, and Spanish surname children from the unskilled families showed fewer differences in rates of development.

Early childhood development of four boys with 47, XXY karyotype.

In an epidemiological study, infants identified at birth as having sex chromosome anomalies are enrolled in a voluntary, long term evaluation program. Case histories are presented of the first four boys in the series to have a 47, XXY karyotype. They have been followed from birth for 6 to 9 years, with physical and psychological evaluations. Parents were informed in general terms of the childs genetic defect, and were offered continuing support and encouragement throughout the study. Close cooperation with the families was maintained. So far, the development of all these children has fallen clearly within the normal range and a reasonable healthy developmental pattern has been secured. Minor deviations in motor, speech and emotional development suggest a common underlying pattern, but four cases are too few on which to establish a relationship between karyotype and phenotype. The data suggest that the symptomatology reported in selected children with a 47, XXY karyotype may be strongly dependent on factors other than the chromosomal constitution, and that an appropriate familial and environmental situation may minimize elevated risks due to the marked genetic defect.

Training the Indigenous Nonprofessional: The Screening Technician.

The ever increasing shortage of professional health manpower and the skyrocketing costs of medical care necessitate a better utilization of available manpower. This paper presents steps which must be taken to develop new careers. The new career of screening technician is utilized to illustrate each of the steps.