Senin, 16 Mei 2011
TREND ACCORDING DENVER II (DDST II)
Definition
The development is the increasing ability of the structure and function of the body that is more complex in a pattern of regular and predictable, as a result of the maturation process. Here, concerning the process of differentiation of cells, tissues, organs and organ systems that develop in such a way that each can fulfill its function.Including also the development of emotional, intellectual and behavioral disorders as the result of interaction with the environment (Soetjiningsih, 1997).
According to the Denver II Development
Denver II is a major revision of the re-standardization of the Denver Development Screening Test (DDST) and Denver Developmental Screening Test Revisied (DDST-R). Is one of the methods of screening for disorders of child development. These tests are not diagnostic tests or IQ tests. Time needed 15-20 minutes.
a. Development Aspects assessed
Consists of 125 development tasks.
The task is checked every time the screen is only about 25-30 tasks
There are 4 sector development assessed:
1) Personal Social (social behavior)
Aspects related to the ability of independent, socialize and interact with their environment.
2) Fine Motor Adaptive (fine motor movements)
Aspects related to the child's ability to observe something, doing movements that involve certain body parts and do the small muscles, but it requires careful coordination.
3) Language (language)
The ability to respond to sound, follow orders and speak spontaneously
4) Gross motor (gross motor movement)
Aspects related to movement and posture.
b. The instrument used
Ø Props: red wool yarn, raisins / beads, Equipment eating, brushing equipment, card / game Snakes and ladders, clothing, books drawing / paper, pencil, cubes of red-yellow-green-blue, the color of paper (depending on chronological age of children when examined).
Ø DDST II sheets form
Ø as a reference guide that explains the ways and means test assessment.
c. DDST procedure consists of 2 stages:
1) The first stage: are periodically performed on all children aged:
3-6 months
9-12 months
18-24 3-24 months
3 years
4 years
5 years
2) Step two: done on those suspected the existence of barriers to progress in the first stage. Then proceed with a complete diagnostic evaluation.
d. Rating
If Passed (Passed = P), fail (Fail = F), or the child does not get a chance to do a task (No Opportunity = NO).
HOW DDST II EXAMINATION
§ Set the chronological age of the child, ask your date of birth of children to be examined. Use the standard 30 days to one month and 12 months for one year.
§ If in the calculation of age less than 15 days rounded down, if equal to or more than 15 days rounded upwards.
§ Pull the line based on chronological age that cuts the horizontal line on the form DDST development tasks.
§ After that calculated in each sector, how much and how the F. P
§ Based on the guidelines, test results are classified into: Normal, Abnormal, doubtful and can not be tested.
1) Abnormal
a) If you got 2 or more delays, on 2 or more sectors
b) If within a sector or more get 2 or more delays Plus 1 sector or more with a delay and in the same sector is missing a pass in the box that intersects the vertical lines of age.
2) Doubtful
a) When at 1 sector got 2 or more delays
b) When on a sector or more get a delay and in the same sector do not have a pass in the box that intersects the vertical lines of age.
3) It can not be tested
In the event of rejection that causes the test results become abnormal or doubtful.
4) Normal
All that is not listed in the above criteria.
In children who were born prematurely, age adjusted only to children aged 2 years:
Example calculation of a child with premature:
An. Lula was born prematurely at 32 weeks gestation, was born on August 5, 2006. Checked its development with DDST II on April 1, 2008. Calculate An chronological age. Lula!
Given:
Date of birth An. Lula: 5-8-2006
Check date: 1-4-2008
Premature: 32 weeks
Asked:
How An chronological age. Lula?
Answer:
2008 - 4-1 An. Lula's 32 weeks premature
2006 - 8-5 aterm = 37 weeks
_________ - So 37-32 = 5 weeks
1-7 -26
Ø So the age of An. Lula if aterm (not preterm) is 1 year 7 months 26 days or
1 year 8 months or 20 months
Keprematurannya age minus age of 5 weeks X 7 days = 35 days, so that the chronological age of An. Lula to DDST II examination are:
Ø 1 year 7 months 26 days - 35 days = 1 year 6 months 21 days
Or
1 year 7 months or 19 months
Interpretation of the Denver II
Ø Advanced
Passing through the principal in full to the right of the line of chronological age (passed in less than 25% of children at ages greater than the child)
Ø OK
Pass, fail, or refuse principal withheld based on age lines between the 25th percentile and 75th
Ø Caution
Principal fails or refuses to be cut based on chronological age line above or between the 75th percentile and 90th
Ø Delay
Failed in a subject as a whole to the left line of chronological age; rejection to the left of age line can also be regarded as a delay, for reasons to reject may be the inability to perform certain tasks
Interpretation of test
Ø Normal
There is no delay and a maximum of one caution
Ø Suspect
One or more delays and / or two or more vigilance
Ø Untestable
Rejection of one or more principal with the full path to the left of the age or on more than one principal cut points based on age lines in the area of 75% to 90%
Recommendations for referral tests and Untestable Suspect:
Repeated screening at 1 to 2 weeks to rule out temporary factors
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