Table 1 Descriptions of adaptation made to the Denver II test items to make Denver II- Jimma

Work for toy ^a

PS5

Rattle or culturally used tools such as small pebbles “ calle” or “ elela” were selected.

Feed self

PS6

The items "cracker", "cookie" or “any finger food” were replaced by locally used food such a piece of "bread", "cake", "biscuit", "injera" or a piece of sugar-cane.

Play pat-a-cake

PS7

Replaced by "play a clapping game": a culturally equivalent game played by clapping hands.

Wave bye-bye

PS9

Modified Cultural difference in expressing goodbye: "saying" or "waving" goodbye

Imitate (household) activities

PS11

Activities such as "vacuuming", or "talking on the phone" were replaced by activities such as ...."cooking" or "washing clothes".

Drink from cup

PS12

….child can hold a regular cup or glass and drink from it without help replaced by a regular "cup or glass" or any suitable container used in the family.

Use spoon/fork

PS14

Modified as "eat using hand or sppon/fork. The child uses a spoon or fork to eat. is modified as “the child is able to eat independently by using his/her fingers or a spoon or fork”

Remove garment

PS15

… items such as…."jackets", "pants", are modified as… items such as "blouse", "dress" or "trousers"

Feed doll

PS16

The criterion to pass the test item “ if the child places the bottle to the doll's mouth, or tries to put it to the mouth"… is modified as “if the child imitates putting food into the doll’s mouth or if the child imitates breast feeding”. The use of bottle feeding is being discouraged and many mothers do not practice. Since toy bottle was found strange for many children, performing the task is not expected to pass the test item .

Put on clothing

PS17

….clothing, such as "underpants", "socks" are modified as … clothing, such as "blouse", "trousers", "dress", "skirt"

Brush teeth with help

PS18

Replaced by "wash mouth with help"… if the child "brushes his/her teeth with some help"…is modified as if the child "washes his/her mouth with some help"

Wash and dry hands

PS19

Criteria for passing the test item is modified as … child can "wash both sides of hands properly" (because hands are culturally dried by dripping water off the hands). Use of soap and towels are not required to pass the item.

Name friend

PS20

Replaced by "name playmate"

Put on T-shirt

PS21

"pullover" …is replaced by "T-shirt" or "blouse" …

Dress, no help

PS22

First: "at least play-clothes" …is modified as …"his/her own clothes", because children may not have many alternative clothing.

Finally: adaptation dropped

Play board/card games

PS23

Modified as "play social games" …. "board" or "card" games, … “Candy Land” or “Old Maid”… is modified as “joins in simple "group games", like "hide and seek"

Brush teeth, no help

PS24

"brush teeth, no help" replaced by "clean face, no help". … if the child "washes his/her own teeth" …is replaced by… if the child "washes and dries" his/her face (eyes, nose, mouth and teeth) …. this is usually done by using water and fingers)

Prepare Cereal

PS25

First: … if the child can prepare a bowl of cereal …… is modified as …if the child can prepare his/her own breakfast, including taking bread (or injera,…) from the shelf, taking a cup and pouring a liquid (water, milk, juice) in it..

Finally: modified as "serve oneself 'injera'" (cultural food served with stew)

Toilet going ^b

PS26

First: Toilet going (new item): Ask the caregiver if the child can independently use latrine or other facilities available for the family. PASS if they report the child can independently use toilet or latrine or available facility

Finally: item dropped

Regard raisin

FM6

Is replaced by "Regard coffee bean".

Rake raisin

FM9

Is replaced by "Rake coffee bean"

Thumb-finger grasp

FM12

… "raisin" which is used as an object for child to grasp is replaced by "coffee bean"

Scribbles

FM15

The instruction …”do not show him/her how to scribble”… is modified as.… you may write your name using the pencil to let the child who have never ever seen a pencil before that it is something to write with

Dump raisin, demonstrated

FM16

Replaced by "dump coffee bean, demonstrated"

Copy 0

FM23

The instruction “ you may show how to hold the pencil” is added to familiarize a child who has never seen a pencil before

Draw person – 3 parts, 6 parts

FM24 & FM 28

The instruction… “You may show how to hold the pencil”… is added to familiarize a child who has never seen a pencil before

Copy + 

FM25

The instruction… “You may show how to hold the pencil”… is added familiarize a child who has never seen a pencil before

Copy □

FM29

The instruction… “You may show how to hold the pencil”… is added to familiarize a child who has never seen a pencil before

Body parts – 6

LA21

A testing object "white doll" replaced by a black or chocolate colour doll.

The use of either a white doll or a chocolate colour doll based on need of child was suggested based on repeated observation.

Name colours – 1,4

LA27 & LA34

First: Criterion for passing test item modified as, “ Child could pass the test if he/she refers to an object with the same colour: sky/water for blue, grass/tree for green, sun for yellow and blood for red.

Finally: The "blue" and "green" colour cubes are replaced by "black" and "white" colour cubes.

Use of objects – 2, 3

LA28 & LA 30

....“What is a 'pencil' used for?”…. is replaced by ….“What is a 'bed' used for?”….

Define words – 5, 7

LA35 & LA39

The words "desk", "curtain", "lake", are replaced by the words "knife", "firewood", "river"

Opposites – 2

LA37

“If 'fire' is 'hot', 'ice' is..." was replaced by "if a stone is heavy, a feather/leaf is …..”

Walk up step^c

GM20

Walk up steps where there are steps in homes, and/or walk up-ward on steep location/ climbs and passes over an elevated door-step