Test of Gross Motor Development-3 (TGMD-3) with the Use of Visual Supports for Children with Autism Spectrum Disorder: Validity and Reliability

Combined Virtual-Reality- and Gym-Based Physical Activity Intervention for Children With a Developmental Disability: Effects on Physical Activity Levels, Motor Skills, and Social Skills

This study examined the effects of a combined virtual-reality- and gym-based physical activity (PA) program on PA levels, motor skills, and social skills of children with a developmental disability (DD). Twenty-five children with DD were randomly assigned to experimental and control groups. The intervention was conducted for 60 min, two times a week, for 12 weeks. Pre- and postintervention assessments encompassing PA levels measured via Gravity Estimator of Normal Everyday Activity, motor skills evaluated using the Test of Gross Motor Development-Third Edition, and social skills gauged via the Social Skills Rating System-Parent were conducted. Additionally, a follow-up assessment was administered to the experimental group 12 weeks postintervention. The findings unequivocally demonstrate that the combined virtual-reality- and gym-based PA program yielded significant enhancements in PA levels, motor skills, and social skills among children with DD in the experimental group. Notably, these improvements were sustained 12 weeks after the intervention. These findings may help professionals develop and implement better PA programs for children with DD.

Focused attention and intrinsic motivation using animations for instruction of fundamental motor skills in children with Down syndrome

BACKGROUND

Children with Down syndrome (DS) demonstrate poorer performance in locomotor and ball skills than children with typical development. During motor assessment, keeping children's attention and motivation is challenging, especially for children with DS, which may affect the test outcomes. This study aimed first to examine the impact of examiner and App-animation demonstrations during the assessment on the performance of fundamental motor skills, focus of attention and intrinsic motivation for children with DS and neurotypical development (NTD). The secondary aim was to examine the differences in those outcomes between children with DS and neurotypical development.

METHODS

A sample of 24 children (10 with DS and 14 with NTD) aged between 3 and 10 years were subjected to two motor performance assessment protocols: a traditional protocol using the Gross Motor Development Test-3 (TGMD-3) and a protocol using animations from an application as support for TGMD-3 (AppP). The focus of attention was obtained from video recordings during protocol instruction (number of eye shifts, eye shift time, instruction focus time, number of instructions required and total instruction time). Intrinsic motivation was assessed by the Intrinsic Motivation Inventory (IMI) at the end of each protocol.

RESULTS

The results showed no significant differences between the protocols for locomotor skills, ball skills and gross motor index. However, children with NTD outperformed those with DS in these skills. When analysing the focus of attention, children with DS showed greater ocular deviations and longer instruction time requested in the traditional protocol compared with AppP, even when compared with NDT children. When comparing protocols in both groups, AppP demonstrated fewer ocular deviations and shorter ocular deviation times. Regarding intrinsic motivation, children with DS in the traditional protocol had lower motivation scores than those with NTD. Regarding the purchase of protocols, in both groups, the AppP presented higher scores for interest/pleasure, perceived competence and general motivation, with lower pressure/tension.

CONCLUSION

The animated application (AppP) proved effective as a visual support during the TGMD-3 assessment, particularly benefiting children with DS by enhancing motivation and attention.

Getting into the game: evaluation of the reliability, validity and utility of the Ignite Challenge scale for school-aged children with autism spectrum disorder

PURPOSE

Evaluate reliability, concurrent validity and utility of the Ignite Challenge motor skills measure for children with autism spectrum disorder (ASD).

MATERIALS/METHODS

In this measurement study, children completed the Ignite Challenge twice, 1-3 weeks apart. A physiotherapist assessor (one of seven) conducted a child's test-retest assessments and scored administration ease and child engagement (/10 visual analogue scale). A second assessor rated baseline assessment videos. Validity data (parent-report PEDI-CAT) were collected at baseline. Reliability analysis employed ICCs (95% CI) and evaluated minimum detectable change (MDC80). Pearson's correlations (r) estimated validity.

RESULTS

Forty-seven children with ASD (mean 9.34 years [SD = 2.35]; 10 girls; independent social communication) were tested at baseline; 45 were retested. Ignite Challenge baseline and retest mean scores were 69.0% (SD = 17.1) and 69.5% (SD = 16.6) respectively, with excellent inter-rater/test-retest reliability (ICC = 0.96 [95% CI 0.92, 0.97] and ICC = 0.91 [95% CI 0.84, 0.95]) respectively, and MDC80 = 9.28. Administration ease and child engagement were 6.5/10 (SD = 2.4) and 6.7/10 (SD = 2.2). Ignite Challenge and PEDI-CAT Social/Mobility (n = 45) associations were r = 0.54 and 0.57. Minimal suggestions for measure revisions arose from child/assessor feedback.

CONCLUSIONS

Ignite Challenge can reliably identify movement strengths and challenges of children with ASD. Use may permit more appropriate evaluation and goal setting within physical activity-based programs.

Motor problems in autism: Co-occurrence or feature?

Motor features of autism have long been acknowledged by clinicians, researchers, and community stakeholders. Current DSM-5 and ICD-11 guidelines allow clinicians to assign a co-occurring diagnosis of developmental [motor] coordination disorder (DCD) for autistic individuals with significant motor problems. DCD is characterized by poor motor proficiency with an onset of symptoms in early development. Studies have shown considerable overlap in the behavioral motor features observed in autism and DCD. However, others indicate that motor problems in autism and DCD may stem from different underlying sensorimotor mechanisms. Regardless of whether autism has a unique motor phenotype or an overlap with DCD, changes need to be made in the clinical pipeline to address motor problems in autism at the stages of recognition, assessment, diagnosis, and intervention. Consensus is needed to address unmet needs in research on the etiology of motor problems in autism and their overlap with DCD, to optimize clinical practice guidelines. The development of screening and assessment tools for motor problems that are valid and reliable for use with autistic individuals is essential, and an evidence-based clinical pipeline for motor problems in autism is urgently needed. WHAT THIS PAPER ADDS: Motor problems in autism are highly prevalent, yet underdiagnosed and poorly managed. An evidence-based clinical pipeline for motor problems in autism is urgently needed.

Configurations of actual and perceived motor competence among elementary school children in China: differences in physical activity

Background

Actual motor competence (AMC) and perceived motor competence (PMC), as determinants of children's active participation in physical activity (PA), were important for children's healthy development. The correlation between the two had been confirmed. To further understand this relationship, this study investigated the current status of AMC, PMC, and PA in Chinese school-age children, used a person-centered approach to reveal the characteristics of the development of motor competence (MC) in Chinese school-age children and the differences in the level of PA among different MC profiles of children.

Materials and methods

A total of 532 children (age: M = 9.37, SD = 1.80 years-old) from grades 1 to 6 participated in this cross-sectional study (male, n = 284, 53.4%; female, n = 248, 46.6%). The Test of Gross Motor Development-3 (TGMD-3) was used to measure children's AMC, the Pictorial Scale of Perceived Movement Skill Competence (PMSC) to measure children's PMC, and the revised Chinese version of Physical Activity Questionnaire for Older Children (PAQ-C) to assess children's PA levels.

Results

There were some gender differences in AMC but no significant gender differences in PMC and PA in children. AMC and PA levels increased as the children aged, while PMC showed some decline. Cluster analysis identified four groups of children with different MC profiles. Two groups of children had corresponding AMC and PMC levels (the "high-high" cluster, N = 200, 38.91%; the "low-low" cluster, N = 63, 12.26%), and the other two groups were inconsistent in AMC and PMC (the "high-low" cluster, N = 100, 19.46%; the "low-high" cluster, N = 151, 29.38%). Significant differences in PA levels were found between children with different MC profiles. The "high-high" cluster children had the highest PA levels, whereas the "low-low" cluster children demonstrated the lowest PA levels.

Conclusion

AMC, PMC, and PA in Chinese school-age children were consistent with the pattern of child growth and development. Children with high AMC and high PMC usually had high levels of PA. Therefore, it was recommended to seize the best opportunity to intervene with children, and family, school, and community should synergize to help children improve AMC and PMC, and then actively participate in PA.

Examining the neurodevelopmental and motor phenotypes of Bohring-Opitz syndrome (ASXL1) and Bainbridge-Ropers syndrome (ASXL3)

Background

Chromatin Modifying Disorders (CMD) have emerged as one of the most rapidly expanding genetic disorders associated with autism spectrum disorders (ASD). Motor impairments are also prevalent in CMD and may play a role in the neurodevelopmental phenotype. Evidence indicates that neurodevelopmental outcomes in CMD may be treatable postnatally; thus deep phenotyping of these conditions can improve clinical screening while improving the development of treatment targets for pharmacology and for clinical trials. Here, we present developmental phenotyping data on individuals with Bohring-Optiz Syndrome (BOS - ASXL1) and Bainbridge-Ropers Syndrome (BRS - ASXL3) related disorders, two CMDs highly penetrant for motor and developmental delays.

Objectives

To phenotype the motor and neurodevelopmental profile of individuals with ASXL1 and ASXL3 related disorders (BOS and BRS). To provide a preliminary report on the association of motor impairments and ASD.

Methods

Neurodevelopmental and motor phenotyping was conducted on eight individuals with pathogenic ASXL1 variants and seven individuals with pathogenic ASXL3 variants, including medical and developmental background intake, movement and development questionnaires, neurological examination, and quantitative gait analysis.

Results

Average age of first developmental concerns was 4 months for individuals with BOS and 9 months in BRS. 100% of individuals who underwent the development questionnaire met a diagnosis of developmental coordination disorder. 71% of children with BOS and 0% of children with BRS noted movement difficulty greatly affected classroom learning. Participants with BRS and presumed diagnoses of ASD were reported to have more severe motor impairments in recreational activities compared to those without ASD. This was not the case for the individuals with BOS.

Conclusion

Motor impairments are prevalent and pervasive across the ASXL disorders with and without ASD, and these impairments negatively impact engagement in school-based activities. Unique neurodevelopmental and motor findings in our data include a mixed presentation of hypo and hypertonia in individuals with BOS across a lifespan. Individuals with BRS exhibited hypotonia and greater variability in motor skills. This deep phenotyping can aid in appropriate clinical diagnosis, referral to interventions, and serve as meaningful treatment targets in clinical trials.

Comprehensive Evaluation of Fundamental Motor Skills: Insights From the Test of Gross Motor Development-3

BACKGROUND

A comprehensive evaluation of basic motor abilities is provided by the Test of Gross Motor Development-3 (TGMD-3), which assesses 13 basic motor skills. These skills are categorized into locomotor and ball skill subsets.

OBJECTIVE

An assessment of gross motor skills in diverse populations with the TGMD-3 is the goal of this study.

METHODS

From control and intervention groups, locomotor subset scores were collected. In addition to identifying developmental delays, the study highlights the TGMD-3's ability to detect deficits in motor skills. Depending on whether a skill meets the criteria, it is scored as either a 1 or a 0. A locomotor score of 46, a ball skill score of 54, and an overall gross motor score of 100 are the maximum scores.

RESULTS

The control group's baseline scores increased from 34.3±0.9 to 37.3±0.7 by the sixth week (p = 0.03), while the intervention group's scores rose from 36.5±1.1 to 40.9±0.6 (p = 0.0007). Both groups also showed similar trends in gross motor coordination scores.

CONCLUSION

Gross motor skill assessment is robust across different populations, making the TGMD-3 an effective tool for improving motor development and performance.

Systematic Review of Variables Related to Instruction in Augmentative and Alternative Communication Implementation: Group and Single-Case Design

PURPOSE

This article provides a systematic review and analysis of group and single-case studies addressing augmentative and alternative communication (AAC) intervention with school-aged persons having autism spectrum disorder (ASD) and/or intellectual/developmental disabilities resulting in complex communication needs (CCNs). Specifically, we examined participant characteristics in group-design studies reporting AAC intervention outcomes and how these compared to those reported in single-case experimental designs (SCEDs). In addition, we compared the status of intervention features reported in group and SCED studies with respect to instructional strategies utilized.

PARTICIPANTS

Participants included school-aged individuals with CCNs who also experienced ASD or ASD with an intellectual delay who utilized aided or unaided AAC.

METHOD

A systematic review using descriptive statistics and effect sizes was implemented.

RESULTS

Findings revealed that participant features such as race, ethnicity, and home language continue to be underreported in both SCED and group-design studies. Participants in SCED investigations more frequently used multiple communication modes when compared to participants in group studies. The status of pivotal skills such as imitation was sparsely reported in both types of studies. With respect to instructional features, group-design studies were more apt to utilize clinical rather than educational or home settings when compared with SCED studies. In addition, SCED studies were more apt to utilize instructional methods that closely adhered to instructional features more typically characterized as being associated with behavioral approaches.

CONCLUSION

The authors discuss future research needs, practice implications, and a more detailed specification of treatment intensity parameters for future research.

Improving motor skills and psychosocial behaviors in children with autism spectrum disorder through an adapted judo program

Introduction

This study aimed to investigate the long-term effects of an adapted judo program on the motor skills and psychosocial abilities of children with Autism Spectrum Disorder (ASD).

Methods

All participants had been diagnosed with ASD and were assessed twice, one time at the start of the intervention and again 6 months later, with the Test of Gross Motor Development (TGMD-3) and the Gilliam Autism Rating Scale-Third Edition (GARS-3). A one-way repeated measures MANOVA was carried out in order to evaluate these assessments, and a mediation analysis was done to determine the relationship between them.

Results

The experimental group significantly improved (p < 0.05) from the pre-test to the post-test for several subtests of the TGMD-3 and the GARS-3.

Conclusion

The study shows that participation in an adapted judo program clearly helps to improve the motor skills and psychosocial behaviors of children with ASD.

Development of an ICT-Based Exergame Program for Children with Developmental Disabilities

The purpose of this study was to develop an information and communications technology (ICT)-based exergame for children with developmental disabilities (DD) and to examine its impacts on physical fitness and fundamental motor skills (FMS). The ICT-based exergame consisted of visual and auditory demonstrations of diverse locomotor movement and object manipulation activities by the virtual characters. A total of 52 children with DD participated in the present study. The participants were divided into twenty-seven children in the experimental group and 25 children with DD in the control group. The experimental group participants engaged in the exergame program for 12 weeks. All participants’ muscle strength (i.e., standing long jump) and four fundamental motor skills, such as the horizontal jump, hop, overhand throw, and dribble, were assessed during the pre- and post-test process. There were significant impacts on physical fitness and FMS (p < 0.001) between the groups. Specifically, the results of three FMS (hop, overhand throw, and dribble) and standing long jump significantly improved in children with DD except for the horizontal jump skill. The results of this study is evidence that the ICT-based exergame program for children with DD may be utilized to improve physical fitness and FMS in children with DD.

The Impact of a Rater Training Program on the TGMD-3 Scoring Accuracy of Pre-Service Adapted Physical Education Teachers

This study aimed to examine the impact of a TGMD-3 rater training program on pre-service adapted physical education (APE) teachers’ ability to score fundamental motor skills for children with developmental disabilities (DD). The training program consisted of a description of the TGMD-3 instrument and DD, as well as content focused on skill performance and correct scoring through systematic analysis of 13 FMS via the instrument. Three experts established the standard score through the TGMD-3 performance evaluation of a child with DD. Thirty-nine pre-service APE teachers in the experimental group and 30 pre-service teachers in the control group completed the pre- and post-test process in this study. There were significant impacts on the pre-service teachers’ ability to score the locomotor, ball skill subtests, and total skill scores (p < 0.05) compared to the control group. Specifically, the results of the three locomotor skills (running, horizontal jump, & slide) and three ball skills (two-hand strike, dribble, & kick) significantly improved in scoring accuracy. The results of this study can evidence that a TGMD-3 rater training program for pre-service APE teachers enhances the scoring accuracy of FMS among children with DD.

Relationship Among Motor Behavior, Motor Development, and Motor Performance in Children Aged 7-8 Years in China

For children aged 7-8 years in China, "immobility" is a key problem hindering their physical and mental development in recent years. It is widely accepted that motor performance development in children is accompanied by physical and mental growth and development. However, few studies have clarified the relationship among motor behavior, motor development and motor performance. To bridge this knowledge gap, an empirical analysis of children aged 7-8 years in China was conducted. This study developed scales for testing motor performance, motor behavior and motor performance, respectively, and collected data of these tests on children aged 7-8 years in China. Canonical correlation analysis was used to analyze the correlations among motor performance, motor behavior and motor performance, and partial least squares regression was used to evaluate the relationship between dependent and independent variables. It was found that, for the children aged 7-8 years in China, there were significant positive correlations among the motor performance, motor behavior, and motor development. The three tests were closely related and could be applied to promote children's sports performance through improved training activities for targeting specific indicators. The study found there was no significant differences in the application of the three tests for children with different age and gender. This finding lays a foundation for further testing in older children and meets the measurement requirements of modern medicine's "bio-psycho-social model of health promotion". Additionally, the theoretical motional quotient model of "The Bio-Behavior-Task" is constructed as a comprehensive motor performance evaluation system, aligning with students' physical and mental development standards.

A Feasibility Trial for Virtual Administration of the Test of Gross Motor Development-3 for Children With Autism Spectrum Disorders During the COVID-19 Pandemic

The Test of Gross Motor Development-3 is one of the most popular assessment tools in physical education and physical activity settings. It is a valid assessment originally designed to administer in-person, but the virtual administration of the assessment has yet to be deemed feasible. Thus, the purpose of this study was to explore the trial feasibility of virtual data collection using the Test of Gross Motor Development-3 to assess the fundamental motor skills of children with autism spectrum disorder. Most specifically, we report on the design and feasibility of the online assessment process. A total of 22 families of children with autism spectrum disorder participated in the online data collection.

Motor Competence in Individuals with Down Syndrome: Is an Improvement Still Possible in Adulthood?

In children, motor competence (MC) and the amount of physical activity are tightly interconnected. In adults with Down syndrome (DS), MC has been poorly addressed, resulting in a limited understanding of the possibility to improve MC over time. Here, we aim to: (1) investigate MC in adults with DS by comparing them with a group of typically developed peers and (2) verify the effect of an adapted karate program on MC. Adults with DS (DSG; n = 57) and typically developed adults (TDG; n = 21) performed the Test of Gross Motor Development version 3 (TGMD-3). The total TGMD-3 score (^TOTTGMD-3), the locomotor (^LOCTGMD-3), and object control (^OBJTGMD-3) scores were computed. After a 40 week adapted karate program, DSG (n = 37) underwent the post-training TGMD-3 assessment. Compared to TDG, DSG showed lower ^TOTTGMD-3 (DSG: 45.5 ± 17.3; TDG: 77.3 ± 9.5), ^LOCTGMD-3 (DSG: 22.2 ± 10.0; TDG: 36.2 ± 7.6) and ^OBJTGMD-3 (DSG: 23.3 ± 10.9; TDG: 41.1 ± 5.6). After the training, ^TOTTGMD-3, ^LOCTGMD-3 and ^OBJTGMD-3 increased by 35.6%, 30.0% and 40.7%, respectively. Our results suggest that MC acquisition does not evolve into a mature form in adulthood in individuals with DS. Moreover, a brief exposure to an adapted karate program induces an increase in motor competence in DS, even in adulthood.

Crosstalk between Gross and Fine Motor Domains during Late Childhood: The Influence of Gross Motor Training on Fine Motor Performances in Primary School Children

Gross and fine motor competence have a close relationship during development and are shown to correlate to some extent. However, the study of the interaction between these domains still requires further insights. In this study, we investigated the developmental changes in overall motor skills as well as the effects of gross motor training programs on fine motor skills in children (aged 6–11, n = 240). Fine motor skills were assessed before and after gross motor intervention using the Box and Block Test. The gross motor intervention was based on the Test of Gross Motor Development—3rd Edition. Results showed that gross and fine motor skills correlate across all years of primary school, both significantly improving with age. Finally, the gross motor intervention appeared to not influence fine motor skills. Our findings show that during primary school age, overall motor development is continuous, but non-linear. From age nine onward, there seems to be a major step-up in overall motor competence, of which teachers/educators should be aware of in order to design motor educational programs accordingly. While gross and fine motor domains might be functionally integrated to enhance children’s motor performances, further research is needed to clarify the effect of gross motor practice on fine motor performances.

The influence of visual supports and motivation on motor performance of the MABC-2 for Chinese school-aged children with autism spectrum disorder

The influences of including visual supports and strategies to increase motivation for children with autism spectrum disorder (ASD) in motor assessments were examined. 97 children with ASD and 117 age-matched typically developing (TD) children performed the Movement Assessment Battery for Children, Second Edition (MABC-2) under traditional, visual support, motivation, and visual support plus motivation protocols. Results showed that children with ASD elicited lower MABC-2 scores than TD children. Moreover, in children with ASD, the visual support protocol, but not the motivation protocol, produced higher scores on ball and balance skills than the traditional protocol. These findings indicated that children with ASD were developmentally delayed in motor skills; however, their performance may be improved by including visual supports in motor assessments.

Examining the Antecedent Role of Movement Proficiency in Child Development: Study Protocol

Background: Decades of research, largely from associational studies, show that the relationships of movement proficiency with the cognitive and social aspects of development are particularly strong in early childhood. Children who move proficiently tend to have better cognitive skills and social behaviors. However, the mechanisms that underpin these relationships remain unclear and research that explores causation is necessary. This study will explore the antecedent role of movement proficiency in the cognitive and social domains of child development, by examining whether a targeted movement skills training program facilitates improvements in cognitive and social skills.

Methods: A group-randomized controlled trial will be conducted, implementing a fundamental movement skills training program in Hong Kong kindergartens. Participants will consist of children aged 3–5 years (N = 158) who will be randomly allocated by class to either a training or active control condition. The training program (10 weeks × 2 bouts) will be informed by an error-reduced approach to skills learning, which will involve careful design and manipulation of equipment and training environment to minimize practice errors. The active control condition will consist of typical movement activities implemented in the kindergartens in the context of the local curriculum guide. Outcomes will be measured using standardized tests of gross motor skills proficiency, executive functioning, and social skills. Measurements will occur at baseline, mid-training, post-training, and follow-up. Latent variable longitudinal modeling will be used to analyze changes in the outcomes, with covariates that include sex, body composition, fine motor skills, and physical activity.

Expected Results: The findings will subsequently be reported consistent with the Consolidated Standards of Reporting Trials (CONSORT) statement. Contributions to knowledge and understanding of child development are expected, through evidence of causal mechanisms surrounding the relationship of motor with cognitive and social development. The findings will also inform policy and practice related to early childhood development and education.

Intra-Rater (Live vs. Video Assessment) and Inter-Rater (Expert vs. Novice) Reliability of the Test of Gross Motor Development-Third Edition

The Test of Gross Motor Development (TGMD) is one of the most common tools for assessing the fundamental movement skills (FMS) in children between 3 and 10 years. This study aimed to examine the intra-rater and inter-rater reliability of the TGMD—3rd Edition (TGMD-3) between expert and novice raters using live and video assessment. Five raters [2 experts and 3 novices (one of them BSc in Physical Education and Sport Science)] assessed and scored the performance of the TGMD-3 of 25 healthy children [Female: 60%; mean (standard deviation) age 9.16 (1.31)]. Schoolchildren were attending at one public elementary school during the academic year 2019–2020 from Santiago de Compostela (Spain). Raters scored each children performance through two viewing moods (live and slow-motion). The ICC (Intraclass Correlation Coefficient) was used to determine the agreement between raters. Our results showed moderate-to-excellent intra-rater reliability for overall score and locomotor and ball skills subscales; moderate-to-good inter-rater reliability for overall and ball skills; and poor-to-good for locomotor subscale. Higher intra-rater reliability was achieved by the expert raters and novice rater with physical education background compared to novice raters. However, the inter-rater reliability was more variable in all the raters regardless of their experience or background. No significant differences in reliability were found when comparing live and video assessments. For clinical practice, it would be recommended that raters reach an agreement before the assessment to avoid subjective interpretations that might distort the results.

Shared Features or Co-occurrence? Evaluating Symptoms of Developmental Coordination Disorder in Children and Adolescents with Autism Spectrum Disorder

Motor differences are common in Autism Spectrum Disorder (ASD), but rarely evaluated against diagnostic criteria for Developmental Coordination Disorder (DCD). We aimed to determine whether motor problems in ASD represent the possible co-occurrence of DCD. We retrospectively reviewed standardized assessments and parent-reports to evaluate motor ability in 43 individuals with ASD against diagnostic criteria for DCD, and compared to 18 individuals with DCD. Over 97% of cases in the ASD group scored below the 16th percentile in motor ability, with most below the 5th percentile. Over 90% of cases in the ASD group met criteria for co-occurring DCD. Motor challenges are a clinically-significant problem in ASD; systematically assessing the prevalence of co-occurring ASD + DCD is necessary to optimize assessment and intervention.

Clinical Validity of the Test of Gross Motor Development-3 in Children With Disabilities from the U.S. National Normative Sample

The Test of Gross Motor Development (TGMD) measures fundamental motor skills competency and is frequently used for eligibility determination of adapted physical education services in children with disabilities. The purpose of this study was to determine if the TGMD-3 is clinically sensitive to detect deficits in the fundamental motor skills of children with disabilities (i.e., intellectual disability, autism spectrum disorder, attention deficit hyperactivity disorder, language and articulation disorders). Eighty-five children with disabilities and 85 matched controls (i.e., typically developing, individually matched on age, sex, ethnicity, and race) completed the TGMD-3. Mann-Whitney U tests identified significant differences in the total TGMD-3 scores for children with intellectual disability (p < .001), autism spectrum disorder (p < .001), and attention deficit hyperactivity disorder (p = .032). No differences were identified for children with language and articulation disorders. Comparisons of subscales (i.e., locomotor and ball skills) differed across disability groups. This study provides evidence that the TGMD-3 is clinically sensitive to identify deficits in fundamental motor skills competency.

Evaluation of Overhand Throwing Among College Students With and Without Autism Spectrum Disorder

Children with autism spectrum disorder (ASD) typically demonstrate deficits in gross motor skills such as the overhand throw. It has not been determined whether such deficits persist into adulthood. Therefore, the purpose of this study was to examine the kinematics and developmental level of overhand throws among young adults with and without ASD. Three-dimensional motion-capture data were collected during overhand throwing trials performed by 20 college students (10 students with ASD). Individuals with ASD demonstrated similar throw duration, stride length, and step width but a longer acceleration phase and slower ball velocity than individuals without ASD. Young adults with ASD also performed the overhand throw with less developmental proficiency than those without ASD. Specifically, individuals with ASD exhibited developmental deficits in the backswing and composite throwing score. Motor skill interventions for individuals with ASD should address throwing skills, with a particular focus on the preparatory phase of the overhand throw.

Motor competence assessments for children with intellectual disabilities and/or autism: a systematic review

OBJECTIVE

Gross motor competence is essential for daily life functioning and participation in physical activities. Prevalence of gross motor competence in children with intellectual disabilities (ID) and/or autism is unclear. This systematic review aimed to identify appropriate assessments for children with ID and/or autism.

DESIGN & DATA SOURCES

An electronic literature search was conducted using the EBSCOhost platform searching MEDLINE, Education Research Complete, ERIC, CINAHL Plus and SPORTDiscus databases.

ELIGIBILITY CRITERIA

Included studies sampled children with ID and/or autism aged between 1 and 18 yrs, used field-based gross motor competence assessments, reported measurement properties, and were published in English. The utility of assessments were appraised for validity, reliability, responsiveness and feasibility.

RESULTS

The initial search produced 3182 results, with 291 full text articles screened. 13 articles including 10 assessments of motor competence were included in this systematic review. There was limited reporting across measurement properties, mostly for responsiveness and some aspects of validity. The Bruininks-Oseretsky Test of Motor Proficiency-2 followed by The Test of Gross Motor Development-2 demonstrated the greatest levels of evidence for validity and reliability. Feasibility results were varied, most instruments required little additional equipment (n=8) and were suitable for a school setting, but, additional training (n=7) was needed to score and interpret the results.

CONCLUSION

This review found the BOT-2 followed by the TGMD-2 to be the most psychometrically appropriate motor competency assessments for children with ID and/or autism in field-based settings. Motor competence assessment research is limited for these cohorts and more research is needed.

PROSPERO REGISTRATION NUMBER

CRD42019129464.

The validity and reliability of observational assessment tools available to measure fundamental movement skills in school-age children: A systematic review

BACKGROUND

Fundamental Movement Skills (FMS) play a critical role in ontogenesis. Many children have insufficient FMS, highlighting the need for universal screening in schools. There are many observational FMS assessment tools, but their psychometric properties are not readily accessible. A systematic review was therefore undertaken to compile evidence of the validity and reliability of observational FMS assessments, to evaluate their suitability for screening.

METHODS

A pre-search of 'fundamental movement skills' OR 'fundamental motor skills' in seven online databases (PubMed, Ovid MEDLINE, Ovid Embase, EBSCO CINAHL, EBSCO SPORTDiscus, Ovid PsycINFO and Web of Science) identified 24 assessment tools for school-aged children that: (i) assess FMS; (ii) measure actual motor competence and (iii) evaluate performance on a standard battery of tasks. Studies were subsequently identified that: (a) used these tools; (b) quantified validity or reliability and (c) sampled school-aged children. Study quality was assessed using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklists.

RESULTS

Ninety studies were included following the screening of 1863 articles. Twenty-one assessment tools had limited or no evidence to support their psychometric properties. The Test of Gross Motor Development (TGMD, n = 34) and the Movement Assessment Battery for Children (MABC, n = 37) were the most researched tools. Studies consistently reported good evidence for validity, reliability for the TGMD, whilst only 64% of studies reported similarly promising results for the MABC. Twelve studies found good evidence for the reliability and validity of the Bruininks-Oseretsky Test of Motor Proficiency but poor study quality appeared to inflate results. Considering all assessment tools, those with promising psychometric properties often measured limited aspects of validity/reliability, and/or had limited feasibility for large scale deployment in a school-setting.

CONCLUSION

There is insufficient evidence to justify the use of any observational FMS assessment tools for universal screening in schools, in their current form.

Reliability of the test of gross motor development: A systematic review

OBJECTIVE

To identify, synthesise and evaluate studies that investigated the reliability of the Test of Gross Motor Development (TGMD) variants.

METHODS

A systematic search was employed to identify studies that have investigated internal consistency, inter-rater, intra-rater and test-retest reliability of the TGMD variants through Scopus, Pubmed/MEDLINE, PsycINFO, Sport Discus and Web of Science databases.

RESULTS

Of the 265 studies identified, 23 were included. Internal consistency, evaluated in 14 studies, confirming good-to-excellent consistency for the overall score and general motor quotient (GMQ), and acceptable-to-excellent levels in both subscales (locomotor and ball skills). Inter-rater reliability, evaluated in 19 studies, showing good-to-excellent intra-class correlation coefficient (ICC) values in locomotor skills score, ball skills score, overall score, and GMQ. Intra-rater reliability, evaluated in 13 studies, displaying excellent ICC values in overall score and GMQ, and good-to-excellent ICC values in locomotor skills score and ball skills score. Test-retest reliability was evaluated in 15 studies with 100% of the statistics reported above the threshold of acceptable reliability when ICC was not used. Studies with ICC statistic showed good-to-excellent values in ball skills score, overall score, and GMQ; and moderate-to-excellent values in locomotor skills score.

CONCLUSIONS

Overall, the results of this systematic review indicate that, regardless of the variant of the test, the TMGD has moderate-to-excellent internal consistency, good-to-excellent inter-rater reliability, good-to-excellent intra-rater reliability, and moderate-to-excellent test-retest reliability. Considering the few high-quality studies in terms of internal consistency, it would be recommend to carry out further studies in this field to improve their quality. Since there is no gold standard for assessing FMS, TGMD variants could be appropriate when opting for a psychometrical robust test. However, standardized training protocols for coding TGMD variants seem to be necessary both for researchers and practitioners in order to ensure acceptable reliability.

Gross motor function and health fitness in adults with autistic spectrum disorder and intellectual disability: single-blind retrospective trial

This study aimed at providing an exercise program for each type of disability after analyzing the exercise program performed by adults with intellectual disability (ID) or autistic spectrum disorder (ASD). Twenty-nine male adults voluntarily took part in this study, whose age ranged from 19 to 28 years and with an average body mass index of 23.98± 4.02 kg/m². The sample was divided into two groups as follows: ASD group (ASDG; n=15) and ID group (IDG, n=14). The selected tests used to measure gross motor function (GMF, locomotion and object control skills) and health fitness (body composition, flexibility, strength, muscle endurance, and cardiopulmonary endurance) were also used in previous studies. The GMF and health fitness between ASDG and IDG showed no significant differences. This study indicates that exercise programs could provide similar effects, even with other disorder types having similar symptoms.

How Much Instructional Time Is Necessary? Mid-intervention Results of Fundamental Movement Skills Training Within ABA Early Intervention Centers

Background: The purpose of this study was to explore the question of the minimal amount of instructional time needed to still be effective by assessing the efficacy at mid-intervention of an early fundamental movement skill (FMS) intervention for preschoolers with Autism Spectrum Disorder (ASD).

Method: Fourteen preschoolers participated in this randomized controlled trial daily over 10 weeks (10 h total at mid-intervention). A two-factor mixed MANOVA tested the significance of group*time interactions for two dependent variables: object control and locomotor raw scores on the Test of Gross Motor Development—III.

Results: Group*time interactions approached significance with large effect sizes on the vector of both dependent variables and in a univariate fashion on object control scores, but not locomotor scores.

Conclusions: These findings hold relevance for physical educators working with young children with ASD, indicating that 10 h of FMS instruction, at least in this form, is not adequate to improve FMS.

Quantitative Gait Analysis in Duplication 15q Syndrome and Nonsyndromic ASD

Motor impairments occur frequently in genetic syndromes highly penetrant for autism spectrum disorder (syndromic ASD) and in individuals with ASD without a genetic diagnosis (nonsyndromic ASD). In particular, abnormalities in gait in ASD have been linked to language delay, ASD severity, and likelihood of having a genetic disorder. Quantitative measures of motor function can improve our ability to evaluate motor differences in individuals with syndromic and nonsyndromic ASD with varying levels of intellectual disability and adaptive skills. To evaluate this methodology, we chose to use quantitative gait analysis to study duplication 15q syndrome (dup15q syndrome), a genetic disorder highly penetrant for motor delays, intellectual disability, and ASD. We evaluated quantitative gait variables in individuals with dup15q syndrome (n = 39) and nonsyndromic ASD (n = 21) and compared these data to a reference typically developing cohort. We found a gait pattern of slow pace, poor postural control, and large gait variability in dup15q syndrome. Our findings improve characterization of motor function in dup15q syndrome and nonsyndromic ASD. Quantitative gait analysis can be used as a translational method and can improve our identification of clinical endpoints to be used in treatment trials for these syndromes. Autism Res 2020, 13: 1102-1110. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Motor impairments, particularly abnormalities in walking, occur frequently in genetic syndromes highly penetrant for autism spectrum disorder (syndromic ASD). Here, using quantitative gait analysis, we find that individuals with duplication 15q syndrome have an atypical gait pattern that differentiates them from typically developing and nonsyndromic ASD individuals. Our findings improve motor characterization in dup15q syndrome and nonsyndromic ASD.

Comparability of the Test of Gross Motor Development–Second Edition and the Test of Gross Motor Development–Third Edition

When a test is revised, it is important that test users are made aware of the comparability of scores of the new and the original test. We examined how scores on the Test of Gross Motor Development–Second Edition (TGMD-2) and Test of Gross Motor Development–Third Edition (TGMD-3) compared among children in middle childhood. Participants were 270 children recruited in grade 3 (54% female; Mage = 8 years 6 months) and followed through grade 5. Participants completed the skills of both tests. Subtest scores were converted into percent of maximum possible (POMP) scores to facilitate comparison. Although similar, uniformly the TGMD-3 POMP scores were slightly lower. Repeated measures analyses of variance revealed that locomotor subtest scores derived from both tests improved from grade 3 to grade 5, as did TGMD-3 assessed ball skills. However, there was no difference in TGMD-2 assessed object control skills over time. It appears that under-contribution by the underhand roll suppressed the trajectory of improvement of TGMD-2 assessed object control skills. This finding supports the exclusion of the roll from the TGMD-3. The consistent pattern of sex-based differences in TGMD-2 object control skill and TGMD-3 ball skills reinforces the need for male and female norm-reference data for ball skills.

Psychometric proprieties of the Test of Gross Motor Development-Third Edition in a large sample of Italian children

OBJECTIVES

The Test of Gross Motor Development-3 (TGMD-3) evaluates fundamental gross motor skills across two domains: locomotor and ball skills. This study aimed to perform a full psychometric assessment of this test in a large sample of Italian pre- and primary school children.

DESIGN

Cross-sectional and test-retest study design.

METHOD

Children N = 5210; mean age years = 8.38, SD = 1.97; % females = 48 completed three trials, including one practice. Only the scores of the two latter 'formal' trials were recorded for the evaluation. Factorial validity and measurement invariance of TGMD-3 across age and gender groups and test-retest reliability for the overtime measure consistency were tested. Item response theory analysis further tested single items' performances.

RESULTS

Explorative and confirmatory factor analyses confirmed the two-factor structure of the TGMD-3. Multi-group confirmatory factor analyses indicated that there were no significant reductions in model adjustments between the configural, metric and structural invariance solutions for gender and age groups. Test-retest results ranged between 0.967 and 0.990 for both skill sets across age groups. Item response theory analysis using a graded response model showed low standard error and high-test information levels covering a wide spectrum range of both locomotor and ball skills.

CONCLUSIONS

These results highlight the strong construct validity and reliability of the TGMD-3 to measure gross motor skills in children across gender and age groups. Item response theory analysis evidenced how the performance criteria included in this test cover a wide range of gross the motor skills spectrum. The use of TGMD-3 may inform motor development programs and support curricular decisions in schools.

The role of zinc supplementation on the metallothionein system in children with autism spectrum disorder

The present research was carried out to elucidate the role of zinc (Zn) supplementation on the plasma concentration and gene expression, as well as the effects on cognitive-motor performance, in a cohort of children with autism spectrum disorder (ASD). The study was performed on a cohort of 30 pediatric subjects with ASD, encompassing an age range of 3-8 years. The impact of Zn supplementation was investigated in 3 months (or 12 weeks) on the ASD children. Each daily dosage of Zn was calculated as being equal to the body weight in kg plus 15-20 mg. The effect of Zn was also evaluated on the serum level of metallothionein 1 (MT-1A), and the severity of autism via scores on the Childhood Autism Rating Scale. The effect of Zn was investigated on the gene expression of MT1-A before and after Zn supplementation. The data of the present study showed an increase in cognitive-motor performance and an increased serum metallothionein concentration, as well as a significant lowering in the circulating serum levels of copper (Cu) following Zn supplementation. In the cohort of ASD patients, the genetic expression of MT-1 was higher after Zn therapy than before the treatment. In conclusion, Zn supplementation might be an important factor in the treatment of children with ASD.

A multiple-method review of accommodations to gross motor assessments commonly used with children and adolescents on the autism spectrum

The purpose of this study is to understand the common accommodations used during standardized motor assessment of children on the autism spectrum. This study was completed in three parts: (1) a narrative review of the literature; (2) an open-ended survey sent to the first authors of the identified articles; and (3) a descriptive analysis of responses. Results revealed that 56.7% of the identified articles did not report enough information of assessment procedures, 18.9% followed the assessment manual, 16.9% provided accommodations on a needs basis, and 7.5% used a consistent modified protocol. Individual responses showed that extra demonstrations (n = 5) were the most frequent accommodation, followed by extra breaks (n = 3), picture cards (n = 2), and hand-over-hand assistance (n = 1); some respondents stated that they did not provide accommodations. The findings indicate that a clear set of accommodation for motor skill assessments does not exist, though some commonalities were reported. Further research is necessary to understand the impact of accommodations in the assessment process, as well as which accommodations are needed and/or effective.

Analysis for reliability and validity of gross motor function and health fitness tests for children with developmental disabilities

The aim of this study was to determine the reliability and validity of gross motor function and health fitness assessment tests for children with developmental disabilities. All 35 participants who took part in this study on a voluntary basis were male children (age, 10.31±1.25 years). All selected tests for gross motor function and health fitness assessments were used in previous studies to measure basic physical health and motor abilities, which include strength (grip strength test), muscular endurance (modified sit-ups test), flexibility (sit and reach test), and cardiopulmonary endurance (15-m shuttle run test). Reliability was analyzed using intraclass correlation coefficients in the pretest-posttest and Bland-Altman graphs study. Pearson correlation was used to analyze convergent validity and analysis of variance was used to analyze variations among age groups. Lastly, a correlation analysis was conducted between the tests in gross motor function and health fitness assessments. This study indicates that gross motor function and health fitness assessments have obtained adequate reliability parameters and are able to determine differences in children from 9 to 12 years of age. The tests performed were simple to use, safe, and suitable for children with developmental disabilities.

The Effect of Different Intervention Approaches on Gross Motor Outcomes of Children With Autism Spectrum Disorder: A Meta-Analysis

Despite the rising interest in intervention for children with autism spectrum disorder, the extent to which interventions are effective on gross motor outcomes is currently unknown. The purpose of this study was to analyze the effect of different intervention approaches on gross motor outcomes among children with autism spectrum disorder using meta-analysis. A total of 18 studies met the inclusion criteria for quantitative analysis. Pre- and posttest means and SDs were extracted to calculate effect sizes. Potential moderator variables were chosen based on important intervention characteristics. The results suggest that interventions have a large effect on gross motor outcomes among children with autism spectrum disorder (δ = 0.99, SE = 0.19, p < .001, 95% confidence interval [0.62, 1.36]). The interventions that were 16 total hours or longer had a significantly larger effect than those less than 16 hr. In addition, the interventions in experimental settings had significantly larger effects than the interventions in practical settings. Future interventions should consider intensity, including not only the duration of the intervention but also the intensity in which specific intervention goals are targeted.

Concurrent Validity of Two Standardized Measures of Gross Motor Function in Young Children with Autism Spectrum Disorder

AIMS

This study provides information on how two standardized measures based on different theoretical frameworks can be used in collecting information on motor development and performance in 4- and 5-year-olds with autism spectrum disorder (ASD). The purpose of the study was to determine the concurrent validity of the Miller Function and Participation Scales (M-FUN) with the Peabody Developmental Motor Scales, Second Edition (PDMS-2) in young children with ASD.

METHODS

The gross motor sections of the PDMS-2 and the M-FUN were administered to 22 children with ASD between the ages of 48 and 71 months. Concurrent validity between overall motor scores and agreement in identification of motor delay were assessed.

RESULTS

A very strong correlation (Pearson's r =.851) was found between the M-FUN scale scores and the PDMS-2 gross motor quotients (GMQs). Strong agreement in identification of children with average motor skills and delayed motor skills at 1.5 standard deviations below the mean was also found.

CONCLUSIONS

This study supports the concurrent validity of the M-FUN with the PDMS-2 for young children with ASD. While both tests provide information regarding motor delay, the M-FUN may provide additional information regarding the neurological profile of the child.

What's missing in autism spectrum disorder motor assessments?

BACKGROUND

Motor delays and impairments in autism spectrum disorders (ASD) are extremely common and often herald the emergence of pervasive atypical development. Clinical accounts of ASD and standardized measures of motor function have identified deficits in multiple motor domains. However, literature describing frequently used standardized motor assessments in children with ASD, their test properties, and their limitations are sparse.

METHODS

We systematically reviewed the literature to identify the most frequently used standardized motor assessments used to evaluate children with ASD from infancy to early childhood. All assessments included were required to possess reference norms, evaluate more than one motor domain, and have undergone some degree of validation.

RESULTS

We identified six frequently used standardized measures of motor function per our inclusion and exclusion criteria. We investigated and described in detail the psychometric properties of these assessments, their utility for use with children with ASD, and their individual and overall strengths and limitations. The global strengths of these assessments are the ability to identify early development delays and differences in fine and gross motor function in children with ASD. Global limitations of these studies are lack of validation in individuals with ASD and scoring systems that often miss specific and subtle abnormalities.

CONCLUSIONS

Standardized assessments of motor function have provided valuable information on motor impairments in ASD. However, significant limitations remain in the use of these measures in children with ASD. Moving forward, it is imperative that standardized measures of motor function receive greater validation testing in children with ASD to assess their potential application given the clinical heterogeneity of this condition. In addition, utilizing quantitative measures of motor function should allow for evaluation and comparison of individuals with ASD across the lifespan with varying cognitive and behavioral abilities.

Motor development and delay: advances in assessment of motor skills in autism spectrum disorders

PURPOSE OF REVIEW

Motor impairments in neurodevelopmental disorders, specifically autism spectrum disorder (ASD), are prevalent and pervasive. Moreover, motor impairments may be the first sign of atypical development in ASD and likely contribute to abnormalities in social communication. However, measurement of motor function in ASD has lagged behind other behavioral phenotyping. Quantitative and neurodiagnostic measures of motor function can help identify specific motor impairments in ASD and the underlying neural mechanisms that might be implicated. These findings can serve as markers of early diagnosis, clinical stratification, and treatment targets.

RECENT FINDINGS

Here, we briefly review recent studies on the importance of motor function to other developmental domains in ASD. We then highlight studies that have applied quantitative and neurodiagnostic measures to better measure motor impairments in ASD and the neural mechanisms that may contribute to these abnormalities.

SUMMARY

Information from advanced quantitative and neurodiagnostic methods of motor function contribute to a better understanding of the specific and subtle motor impairments in ASD, and the relationship of motor function to language and social development. Greater utilization of these methods can assist with early diagnosis and development of targeted interventions. However, there remains a need to utilize these approaches in children with neurodevelopmental disorders across a developmental trajectory and with varying levels of cognitive function.