Denver Developmental Screening Tool

Sophia Gabriella Garcia is a happy 2 year and 5 months old girl who only understands and responds to Spanish for now. He lives with his parents. He likes to play shark with his dad.

· Patients Name: Sophia Gabriella Garcia

· Gender: female

· DOB: August 30, 2020

· Age: 2 year and 5 months

Personal -social:

Use a spoon/fork –P

Remove garment ---P

Feed doll ----P

Put on clothing ---R

Fine Motor – Adaptive

Dump raisin, demonstrate ----P

Tower of 2 cubes ---P

Tower of 4 cubes---P

Tower of 8 cubes---P

Imitate vertical line--- No

Language:

Combine word---P

Name 1 picture----P

Body part 6----P

Point 4 picture---P

Speech half understanding ----No

Gross Motor

Walk up step---P

Kick ball Forward---P

Jump up---P

Throw ball overhand---P

Broad jump--- P

P: Pass

F: Fail

No: NO Opportunity