Denver developmental screening assessment of toddler

Denver Developmental Screening Assessment of the Toddler

Although toddlers do not develop at as rapid a pace as they did during their first twelve months, they continue to grow very quickly over the next two years. The majority of toddlers will develop along the same rate, reaching milestones at predicted months, though some toddlers may not proceed through these stages in the same way or at the same time. Each child's development is greatly influenced by factors in their environment as well as their own one-of-a-kind experiences so it is important to keep in mind that all toddlers will grow on their own unique timetable.

One of the most important and significant developments toddlers make is learning to walk; but walking is not the only physical development that toddlers make. Toddlers further develop both fine and gross motor skills during this time. During the toddler years, language skills rapidly expand. In addition, foundations for future relationships are also formed as the social and emotional development of toddlers continue.

Caregivers may find it beneficial to know what to expect and to see how most children have developed when compared with another child of the same age. Parents and caregivers can use reputable sources to look month-by-month and become more familiar with what most toddlers can do, what some have started to do, and what very few may be able to do at various ages. While reviewing the expectations for a child to achieve during a given time period it is pertinent to consider what is read in the context of an individual child's unique development.

For the purpose of the remainder of this paper the text will be referring to the age group of 21-months-old therefore commonly referring to the development of one to two year olds.

According to Toddler Development: Month 19 to 21 (2009), parents of twenty-one-month-old children can be expected to experience that most toddlers should be able to start to learn up to five or more words per day, walk up stairs with some assistance, and make structures out of toys or blocks. Some parents may find that some toddlers will probably be able to start to learn up to ten or more words per day, show good signs of bladder control, throw balls overhand, and open doors. Few parents can expect to find that some toddlers could possibly be able to name people and pets when shown a picture, form short but complete and understandable sentences, walk down stairs with some assistance, and open and close doors.

Because every child develops in his or her own way it may be easier for some caregivers to look and see if a child is developing appropriately in the bigger picture of a year time span rather than a specific month.

In regards to physical development, many dramatic changes from previous months are made with both gross motor and fine motor skills. One-year-olds make impressive physical progress. Progress is seen from crawling, all the way to running by about twenty months. They can be observed holding their hands out to the side or poking their abdomen out for balance purposes. Due to the fact that walking is still new and their gait is a bit awkward and clumsy, falls are a common occurrence. Toddlers use their new skill to push and pull toys, dance, and climb. Also seen during this time is the ability to pull oneself up to a standing position as well as bend over from a standing position to pick up an object and recover from it. One-year-olds also improve in hand and finger coordination, but skills at this age are still immature, so they fumble and drop objects frequently. Toddlers at this age find enjoyment in turning objects in all directions, banging them, and bringing them to the mouth. They are able to scribble and have gained the concept of using a fork and a spoon, they can throw a ball, clap hands, and can build towers of cubes (Child development tracker: Physical health, 2010)

Besides noted physical development is the addition of speech. One-year-olds are building a foundation for language. They soak up the language around them as they steadily build their vocabularies. They understand common phrases and simple directions used in routine situations. Most have great difficulty with pronunciation in the beginning, and familiar adults almost always need to relay for others. During this year, communication skills typically progress from grunting and pointing to speaking single words and experimenting with simple word combinations. By 18 months the toddler can understand about 200 words a day and say approximately 68 words. During a "spurt" between 16 and 23 months, children typically acquire one or two words per day (Child development tracker: Language, 2010).

The significance of social and emotional development is seen in every area of a child's life. A child has the ability to form a strong foundation for later development if he or she can learn to manage personal feelings, understand others' feelings and needs, and interact positively with others. Differences in social and emotional development result from a child's inborn temperament, cultural influences, disabilities, behaviors modeled by adults, the level of security felt in a child's relationships with adults, and the opportunities that are provided for social interaction.

One-year-olds are just learning to recognize and manage their feelings. They experience a wide range of emotions and commonly have tantrums when they are tired, frustrated, or when they have not yet learned to express themselves using words. They may also respond to conflict by hitting, biting, screaming, or crying. One-year-olds seek autonomy and may say, "No!" to adult suggestions or insist that they, "Do it byself!" Then, moments later, they might seek comfort by clinging to an adult's leg or they may ask for help. Toddlers at this age are aware of their name but frequently use "me" or "my" or "mine." They are ashamed if they know they have done wrong. They look at familiar persons' expressions for reinforcement and often mimic the emotions of others (Child development tracker: Social and emotional growth, 2010).

Commonly used to determine if a child's development is within normal range is the Denver II Developmental Screening Test. The Denver II can be used to screen children from birth to 6 years of age for possible developmental problems, to confirm suspected problems with an objective measure, and/or to monitor children at risk for developmental problems.

According to Willacy (2010), developmental delay occurs in up to 15% of children under five years of age. This includes delays in speech and language development, motor development, social-emotional development, and cognitive development. It has been estimated that only about half of the children with developmental problems are detected before they begin school. Parents are usually the first to pick up signs of possible developmental delay, and any concerns parents have about their child's development should always be taken seriously. However, the absence of parental concern does not necessarily mean that all is well. Parental recall of their child's developmental milestones has been demonstrated to be inaccurate in a number of studies, but it is generally more accurate when milestones are significantly delayed.

The main purpose of developmental assessment depends on the age of the child. Tests may detect neurological problems such as cerebral palsy in the neonate. Tests may reassure parents or detect problems in early infancy. Testing in late childhood can help detect academic and social problems early enough to minimize possible negative consequences (although parental concern may be just as good a predictor for some problems).

In regards to the Denver II developmental screening assessment the results correspond to a 21-month-old girl. Through observation it was noted that by age twenty-one months she was able to strap herself into a seat at the table but needed assistance getting out. She was unable to name any of the given pictures associated with the Denver II. Her mom reported that she would be able to recognize a picture of a man if it was referred to as dad. Her mother also pointed out that she would not know what a cat was but would be able to accurately identify a live dog. It was reported that she was able to crawls up stairs but was not able to walk up or down stairs. It was inferred that walking up stairs was being postponed by the parents and that no opportunity has been given to the child. In regards to simple commands and routines, it was reported that she knew to put on jacket when leaving the house. She was able to stack 6 blocks but did not align them and therefore they were unstable and fell over. She was unable to imitate the drawn line and could only scribble.

She passed the majority of items to the left of her drawn age line except for walking up steps (which was addressed above), and pointing to two pictures (this item intersected her age line and failure could be linked to never being shown pictures similar to the ones used for the Denver II).

Three consecutive failures in all four areas occurred to the right of the age line. The personal-social items that caused the most trouble were related to getting dressed independently. It was not questioned whether she may be able to put on and/or take off one article of clothing such as pushing arm into sleeve and foot into shoe. Fine motor-adaptive consecutive failures occurred attempting to imitate vertical line, build a tower of 8 cubes, and thumb wiggle independently from fingers. Three consecutive failures in the language area were naming four pictures, knowing two actions, or knowing two adjectives. Gross motor failures were performing a broad jump, balancing on each foot for one second, and balancing on each foot for two seconds.

The Denver II proved to be an accurate way to assess children for developmental delays but it still must be taken to account that all children develop on their own unique timetable and development is greatly influenced by factors in their environment as well as their own one-of-a-kind experiences. The results of this particular screening showed no developmental delays. Accuracy on results also varies with each test and the age of the child. Anxiety can cause child to behave uncharacteristically and this can lead to inaccurate results therefore it is very important to ask the parent who was present during the screening if their child's behavior was typical. It is also important to make sure not all screening items are reported by parent and that some performance is observed directly by screener.


  • Child development tracker: Language. (2010). PBS Parents. Retrieved March 9, 2010, from
  • Child development tracker: Physical health. (2010). PBS Parents. Retrieved March 9, 2010, from
  • Child development tracker: Social and emotional growth. (2010). PBS Parents. Retrieved March 9, 2010, from
  • Toddler development and developmental milestones: Month 19 to 21. (2009). The New Parents Guide. Retrieved March 7, 2010, from
  • Willacy, H. (2010). Denver Developmental Screening Test. Patient UK. Retrieved March 9, 2010, from

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