Validation of key Denver Developmental Screening Test items: a preliminary study.

Three sequential studies were undertaken to identify a subset of 39 key Denver Developmental Screening Test (DDST) items covering the ages from birth to 6 years. The first study used binary integer programming with a sample of 2343 children evaluated with the DDST in Denver's Neighborhood Health Program. It identified 35 DDST items that would identify 100% abnormal and 97.9% abnormal and questionable DDSTs. A further validation with 113 Pitt County, North Carolina, children indicated that the addition of four more DDST items to the previous 35 would identify 100% abnormal and 92.6% abnormal and questionable DDSTs. A third study cross-validating the 39 items with a sample of 180 children at "high risk" identified 100% abnormal and 91.7% abnormal and questionable DDSTs. The 39 key DDST items ranged throughout the entire age span and among the DDST's four sectors. Use requires the administration of approximately four items at any one age, on average. Those children with suspect scores on the key DDST items (about 19% of a low-income population) should be screened with the remainder of the DDST to decrease overreferrals. For accuracy, the key DDST items must be administered in the manner prescribed in the DDST manual.