The Bruininks-Oseretsky Test of Motor Proficiency-Short Form is reliable in children living in remote Australian Aboriginal communities

Strength of relationship between body mass index and gross motor capacity in youth with intellectual disabilities

BACKGROUND

Adequate skill levels of gross motor capacity affect activities of daily living, participation in recreational activities and general physical activity levels of youths (7-21 years). Most studies of typically developing youths have reported significant negative relationships between gross motor capacity and body mass index. The latter findings are especially of concern for youths with intellectual disabilities in that it has been estimated that 61% of children and 66% of adolescents were classified as overweight/obese. Therefore, the purpose of this study was to determine the strength of the relationship between body mass index and gross motor capacity among youths with mild to moderate intellectual disability (ID).

METHODS

Components of the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) were used for designated aspects of gross motor capacity: six items for upper limb coordination (ULC); seven items for balance (BAL); six items for bilateral coordination (BLC); and one item for agility (A-2). Participants consisted of 654 youths (438 men), ages 8-21 years with ID. Participants were divided into pre-puberty and post-puberty men (post ≥12 years) and women (post ≥10 years of age). Body mass index (BMI, kg/m2) was determined by height and weight measurements on the day of testing. A Kendall's tau correlation coefficient (τ) was used to determine the strength of the relationship between body mass index and gross motor capacity (BOT-2 test scores).

RESULTS

The τ values for both pre-puberty and post-puberty for all BAL, BLC, A-2 tests and for three of the six ULC tests were negligible to very weak (τ = 0 to ±0.19). Higher τ values were seen for pre-puberty youths in three of the ULC tests, but they fell within the weak range (τ < 0.24). When combining all pre-puberty and post-puberty participants, τ values were in the negligible to very weak range for all tests.

CONCLUSION

The strength of relationship between body mass index and gross motor capacity as measured by the BOT-2 subtest item scores used in this study is very weak and suggests that they are not clinically relevant.

Motor Proficiency, Manual Dexterity, and Visual Perception in School-age Children With ADHD: Contribution of Different Comorbidities

Attention-deficit/hyperactivity disorder (ADHD) is often comorbid with a number of other psychiatric conditions. The goal of this study was to investigate whether motor skills, manual dexterity, and visual perception differ in the presence of ADHD and comorbid psychiatric conditions in school-age boys by comparing them to a group of children with typical development (TD). We evaluated 81 boys 6 to 10 years of age in 5 groups: ADHD only (n=18); ADHD+specific learning disorders (ADHD+SLDs) (n=17); ADHD+oppositional defiant disorder (n=16); ADHD+anxiety disorders (n=15); and TD (n=15). The participants with ADHD only and those with ADHD+comorbidity had significantly lower scores than the participants in the TD group in every area we evaluated. The lowest scores were observed in the ADHD+SLD group in all motor skills domains except for the fine motor precision field. Furthermore, the group with ADHD+SLD had statistically significantly lower scores than the 3 other groups with ADHD+comorbidity in 3 areas: balance, upper extremity coordination, and speed and agility. Motor problems in patients with ADHD and comorbid conditions may not be a focus of attention in clinics. However, especially in the case of comorbid conditions accompanying ADHD, it is important to consider problems in motor skills, manual dexterity, and visual perception in evaluation and treatment to increase these children's quality of life.

Association of muscular strength with total and central adiposity in adolescents with intellectual disability

BACKGROUND

It has been established that for youth without disabilities, muscular strength (MS) is negatively associated with total and central adiposity. However, this relationship has not been clearly established for youth with intellectual disability (ID). The purpose of this study was to examine the association of MS with total and central adiposity in adolescents with ID.

METHOD

Participants were 59 adolescents (40 males and 19 females: age 16.29 ± 1.66 years) with ID. Total and central adiposity were evaluated with dual-energy x-ray absorptiometry (DXA), body mass index (BMI), BMI z-score, waist circumference (WC), and conicity index (C-index). MS was evaluated with the score on the Bruininks-Oseretsky Test of Motor Proficiency (range, 0 to 42, with higher scores indicating better performance). Sex-specific maturity offset equations were used to evaluate somatic maturity. Spearman's correlation coefficients and sequential multiple regression were used to examine associations between MS and adiposity.

RESULTS

Muscular strength score was negatively associated with BMI (sr = -0.32; P < 0.05), percent body fat (%BF; total, trunk, android and gynoid regions) (sr = -0.51 to -0.58; P < 0.01), and android-to-gynoid fat ratio (sr = -0.29; P < 0.05). After control for somatic maturity and sex, regression analysis indicated that MS score explained 10%-17% of the variance in BMI, BMI z-score, %BF (total, trunk, android and gynoid regions), WC, C-index and android-to-gynoid fat ratio.

CONCLUSIONS

These findings suggest that MS is associated with DXA- and anthropometric-determined total and central adiposity among adolescents with ID.

Children's Involvement in Different Sport Types Differentiates Their Motor Competence but Not Their Executive Functions

Sports provide a context where important aspects of children’s health, such as motor skills and cognitive functions, can be enhanced. However, it is unknown which type of sport may be better for the development of motor competence (MC) and executive functions (EFs). This study investigated potential differences in MC and EFs in boys and girls, being involved in different types of sports (team, individual open skill, individual closed skill). A total of 115 children (49 boys), 8–12 years old (10.30 ± 1.19 years), participated in the study. Their MC was assessed with the Bruininks–Oseretsky Test of Motor Proficiency-2 Short Form, whereas for EFs, the Attention Network Test, the digits backwards test, and the how many–what number test were utilized. Significant MC differences among participants in different types of sports were revealed, favoring those from closed-skill sports; nevertheless, their EFs were at similar levels. Furthermore, no significant gender MC and EFs differences were detected. It seems that children’s participation in specific types of sports differentiates their motor skills but not their EFs, whereas boys and girls, when provided with the same opportunities, present similar levels of MC and EFs.

Bigiswun Kid Project: a longitudinal study of adolescents living with high rates of prenatal alcohol exposure, fetal alcohol spectrum disorder and early life trauma in remote Australian Aboriginal communities

INTRODUCTION

The Lililwan Project was the first Australian population-based prevalence study of fetal alcohol spectrum disorder (FASD) using active case ascertainment. Conducted in 2010-2011, the study included 95% of all eligible children aged 7-9 years living in the very remote Aboriginal communities of the Fitzroy Valley, Western Australia. Women from Marninwarntikura Women's Resource Centre, a local Aboriginal-led organisation, are concerned that some participants from the study are struggling in adolescence so partnered with researchers from the University of Sydney to follow up the Lililwan cohort in 2020-2022 at age 17-19 years.The overarching aim of the Bigiswun Kid Project is to identify adolescents' needs and build knowledge to inform services to improve the health and well-being of adolescents in remote Aboriginal communities. The specific aims are to: (1) provide a voice to adolescents and their families to understand the health and well-being status of the Lililwan cohort at 17-19 years. (2) Examine relationships between exposures during pregnancy, birth characteristics, and health and neurodevelopment at 7-9 years, and positive/adverse adolescent outcomes at 17-19 years. This information will identify prenatal and early life factors that predict good health and well-being in adolescence. (3) Determine whether management plans provided in the Lililwan Project were followed, and identify past and present service gaps, support needs and barriers to service use. (4) Determine if key physical characteristics of FASD change between childhood and adolescence in this Aboriginal population.

ETHICS AND DISSEMINATION

Approved by the Kimberley Aboriginal Health Planning Forum and relevant ethics committees.

Test of Gross Motor Development–3 Validity and Reliability: A Screening Form

Background: The Test of Gross Motor Development–3 (TGMD-3) is used to assess locomotor (LOCS) and ball (BS) skills in children. This test provides relevant information for evaluating learning and determining teaching efficacy. However, conducting and coding the test is time consuming. A screening form may improve its usage in specific settings and populations. Purpose: This study aimed to develop a screening form for the TGMD-3-SF and examine its validity and reliability. Method: We assessed 1,192 3-to-10-year-old children; 772 children completed the TGMD-3 and 420 the TGMD-3-SF; 114 children were retested for temporal stability and 300 for criterion validity. Results: We found appropriate results for the two-factors model, LOCS (gallop, hop, and skip) and BS (one-hand strike, kick, and overhand throw), RMSEA = .025, comparative-fit index = .99, and Tukey–Lewis index = .99; internal consistency (LOCS, α = .60; BS, α = .71); item validity (LOCS, r = .43, p < .001; BS, r = .47, p < .001); interrater (ICC = .86–.99), intrarater (ICC = .61–.92), test–retest (LOCS, ICC = .87; BS, ICC = .78) reliability, and concurrent validity (LOCS, r = .89, p < .01; BS, r = .90, p < .001). Conclusions: The TGMD-3-SF is valid and reliable for assessing children’s gross motor development.

The Test-Retest Reliability of the Bruininks-Oseretsky Test of Motor Proficiency-Short Form in Youth with Down Syndrome-A Pilot Study

Background: It is unclear whether assessments of motor proficiency are reliable for individuals with Down syndrome. The purpose of the study was to evaluate the test–retest reliability of the Bruininks–Oseretsky Test of Motor Proficiency-Short Form (BOT-2 SF) in youth with Down syndrome. Methods: Ten youth (ages 13.1–20.7 years) with Down syndrome completed the BOT-2 SF (14 items) plus a standing long jump on two separate occasions. Intraclass correlation coefficients (ICC), 95% confidence intervals (CIs), and standard error of measurement (SEM) were calculated to determine the test–retest reliability of the BOT-2 SF and the standing long jump. Results: The test–retest reliability of the BOT-2 SF overall scores and percentile rankings were considered excellent. The test–retest reliability of each of the subtests varied with classifications of poor (n = 5), fair to good (n = 6), and excellent (n = 4). Conclusion: Current evidence suggests that children with Down syndrome have reduced motor skills. However, there appears to be a lack of assessment tools that reliably evaluate the motor skills of this population. The results from this investigation suggest that the BOT-2-SF provides “excellent reliability” (≥0.75) to assess the motor skills in youth with Down syndrome.

Investigating the compatibility, interchangeability, and clinical usability of BOT2-BF and BOT2-SF in primary school-aged children with and without developmental dyslexia

The aim of our study was to determine the sensitivity and specificity levels of BOT2-BF and BOT2-SF tests applied to children with developmental dyslexia and to examine their clinical usability. This study was designed as a case-controlled study. 82 (study group 41, control group 41) 7-12 year children were included. The study occurred three stages. In the first place, the similarities and differences of BOT2-BF and BOT2-SF tests observed in clinical practices were examined by taking the feedback of experts and test correlations. In the second step, BOT2-BF and BOT2-SF tests were examined with reference to the Core Outcome Set (COS) evaluation criteria. In the last step, in order to examine the sensitivity and specificity levels of the tests, assessments were performed in two groups with 1-week intervals. According to the COS results, the BOT2-BF test was examined better than the BOT2-SF test under cross-cultural validity title. The sensitivity and specificity of BOT2-SF were 0.92 and 0.51, and for BOT2-BF were 0.92 and 0.41, respectively. This study will help clinicians working on children with developmental dyslexia to decide the type of test they will use to evaluate and easy access to materials motor proficiency.

Comparing Motor Competence of Sex- and Age-Matched Youth With Intellectual Disability From Brazil and the United States

Youth with intellectual disabilities (IDs) demonstrate below-criteria motor competence (MC) compared with typically developing (TD) youth. Whether differences in MC exist for youth with ID from different countries is unknown. This study examined the MC of youth with ID from Brazil (BR) and the United States (US) and compared it with norms for TD youth as established by the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2). The authors measured 19 BOT-2 test items for bilateral coordination, balance, and upper limb coordination of 502 youth (BR = 252, US = 250) with ID (6-21 years). Raw scores were converted to %ceiling (percentile of highest expected scores). For all test items, no significant differences were seen between BR and US participants in %ceiling scores. Participants from both countries demonstrated equivalent to slightly below BOT-2 norms in 14 of the 19 test items, with lowest scores seen in contralateral synchronizing bilateral coordination, balancing on one leg, and ball handling.

Field-Based Tests of Strength and Anaerobic Capacity Used in Children With Developmental Coordination Disorder: A Systematic Review

OBJECTIVE

Children with developmental coordination disorder (DCD) are reported to have lower levels of strength and anaerobic capacity. The purpose of this study was to (1) identify field-based tests for strength and anaerobic capacity used in studies comparing children with DCD and children who were typically developing (TD), (2) examine the methodological quality of studies reporting psychometric properties and rate the psychometric properties of the examined test, and (3) summarize available evidence by combining the methodological quality of the studies and the quality of the psychometric properties of the test.

METHODS

An electronic search was conducted in July 2019 in 4 electronic databases. For purpose 1, primary studies were included with no exclusion of study design in which children aged 4 to 18 years with DCD were compared with children who were TD on strength and/or anaerobic capacity measures. For purpose 2, primary studies were included with no exclusion of study design in which a psychometric property was investigated. The Consensus-Based Standards for Selection of Health Measurement Instruments (COSMIN) was used to evaluate the methodological quality of the 34 studies and rate the psychometric properties of the tests used.

RESULTS

Hand-held dynamometer, bent knee push-up, vertical jump, standing long-jump, functional strength measurement, fitness test, and test battery can be recommended for TD, and the shuttle run item of the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition and 10 m × 5 m sprints (straight and slalom) can be recommended for DCD.

CONCLUSION

Information regarding psychometric properties of field-based tests for strength and anaerobic capacity in children with DCD is lacking.

IMPACT

Information about the psychometric properties of field-based tests for strength and anaerobic capacity in children with DCD is lacking. More information is available on TD children, but it is also not complete; information regarding validity and responsiveness, especially, is missing. When using measures in children with DCD, it is important to keep in mind this lack of evidence for the validity and reliability of the outcomes for this target group.

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.

Validity and reliability evidence for motor competence assessments in children and adolescents: A systematic review

Valid and reliable tests of motor competence are necessary to allow researchers and practitioners to quantify levels of motor competence, identify skill deficiencies, and determine the effectiveness of motor skill interventions. The primary study aim was to systematically review the validity and reliability of scores derived from gross motor competence tests for typically developing child and adolescent populations. The secondary aim of this review was to identify the most prevalent motor skills assessed across all instruments. A search of seven electronic databases identified 57 different skill assessment tools from 107 studies. Construct validity was the most common measurement property examined (60 studies; 56%). Content validity (21 studies; 20%) was the least commonly explored measurement property. Scores derived from the Test of Gross Motor Development - second and third edition had the most support for validity and reliability. The most common skills included in these skill batteries were the overhand throw (n = 33), catch (n = 32), jump (n = 31) and hop (n = 26). Research efforts should focus on: (1) further investigation of measurement properties of existing tools rather than developing new assessments and (2) further investigation of existing tools and their measurement properties in adolescent populations.

An Assessment of the Movement and Function of Children with Specific Learning Disabilities: A Review of Five Standardised Assessment Tools

Various standardised assessment tools have been used to evaluate children with disabilities. However, assessment tools that provide information on the movement and function of children with specific learning disabilities (SLD) are still limited. This article provides a narrative review of the characteristics of five movement and/or function assessment tools. The strengths and limitations of the tools will be highlighted. Empirical studies on the assessment tools used are reviewed based on three criteria: (i) standardised tools; (ii) assessment of movement and/or function; (iii) applicability to children with SLD ranging from 4-17 years of age and widely used in practice. The following instruments have been included as they have been found to fulfil the criteria: (i) the Bruininks-Oseretsky test of motor proficiency-2 (BOT-2); (ii) the movement assessment battery for children-2 (MABC-2); (iii) the pediatric balance scale (PBS); (iv) the Vineland adaptive behaviour scale-II (VABS-II) and (v) the pediatric evaluation of disability inventory-computerised adaptive test (PEDI-CAT). The article presents the characteristics, strengths and limitations of five standardised assessment tools that are currently in use, which measure the movement and/or function of children with SLD. This article concludes with a discussion of recommendations for the best approaches to evaluating the movement and functional abilities of children with SLD.

Movement difficulties in children with ADHD: Comparing the long- and short-form Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2)

AIMS

Up to 50% of children with attention deficit hyperactivity disorder (ADHD) also present with difficulties with motor proficiency. Several assessments of motor proficiency are available for occupational therapists, though the validity of these measures in an ADHD population requires further exploration. The aim of this paper was to evaluate the consistency of scores obtained using the long-form and short-form of the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2) in a school-age ADHD sample.

METHOD

The BOT-2 long-form was administered to 84 school-age children (78 males) with ADHD; short-form scores were extracted from the relevant long-form items.

RESULTS

Long-form and short-form total scores were highly correlated (r = .87), though the average short-form score was significantly higher. As a categorical measure, 52 children were classified as "at-risk" for movement difficulties by the long-form; but only 36 by the short-form, yielding a false-negative rate of 30.77%. The sensitivity of short-form could be improved by raising the cut-off thresholds of short-form scores as identified by receiver operating characteristic curve analysis but did not yield practical utility.

INTERPRETATION

As a continuous indicator (i.e. total scores), the short-form is comparable to the long-form. However, the short-form overestimates the child's motor proficiency relative to the long-form and yields an unacceptably high rate of false negatives as a categorical measure. The current revision of the short-form is therefore not recommended as a screening nor diagnostic instrument in an ADHD population. In the absence of ADHD-specific norms, use of the long-form provides greater opportunity for occupational therapists to identify those at-risk for movement difficulties. However, any assessment of motor proficiency should be accompanied by a broader comprehensive assessment to best understand a child's motor functioning.

A School-Based Screening Tool for Adolescents With Low Motor Coordination Abilities

This study sought to select the most relevant test items from the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOTMP-2) and from a selection of health-related fitness tests for identifying school teenagers with poor motor coordination. The 241 participants in this study (144 boys, 97 girls aged 13-14 years old) were tested on the short form of the BOTMP-2 and on the following additional fitness tests: (a) seated medicine ball test, (b) broad jump, (c) handgrip strength, (d) alternate hand ball wall toss, (e) 10 × 5-meter agility shuttle run, and (f) Chester step test. We performed a factor analysis of participant scores on these various tasks and BOTMP-2 test items to reduce them to the least number of meaningful and useful items. Four factors explained 45% of the data variance: gross motor skills and power (including broad jump, hand ball toss, shuttle run, and sit-ups tests); fine motor skills (including copying star, following the maze and paper folding); core strength and balance (including push-ups, hopping, and balance beam); and general body strength (including medicine ball throw and handgrip). We conclude that an efficient school-based battery of test items to screen 13-14 year old adolescents for fitness and coordination should assess these four factors and might especially rely upon the broad jump, copying a star shape, hopping handgrip strength, aerobic fitness, and wall ball toss.

Accuracy of motor assessment in the diagnosis of fetal alcohol spectrum disorder

Background

To evaluate the accuracy of motor assessment tools listed in Fetal alcohol spectrum disorder: a guideline for diagnosis across the lifespan (Canadian Guideline) for the purpose of fetal alcohol spectrum disorder (FASD) diagnosis. Specifically, we aimed to determine: 1) diagnostic accuracy of motor assessment tools and subtests; 2) accuracy of multiple subtests versus total scores; and 3) accuracy of alternate cut-offs.

Methods

Cross-sectional diagnostic study of 63 children aged 6–17 years. Diagnostic accuracy and alternate cut-offs were calculated for the Movement Assessment Battery for Children, 2nd edition (MABC-2), Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition Short Form (BOT-2SF) and Beery-Buktenica Developmental Test of Visual Motor Integration, 6th edition (BeeryVMI-6).

Results

The MABC-2 total motor score was more sensitive (0.30; 95% CI 0.17–0.46; p < 0.01) to motor impairment in the presence of FASD than the BOT-2SF (0.02; 95% CI 0.00–0.12) at the 2nd percentile (−2SD). The MABC-2 total motor score was more accurate than any combination of subtest scores. The Motor Coordination subtest of the BeeryVMI-6 (BeeryMC) at the 5th percentile (− 1.5SD) (sensitivity 0.68, specificity 0.90) was the most accurate subtest.

Conclusions

The BOT-2SF was an inaccurate assessment tool for FASD diagnosis. The MABC-2 total motor score was the most accurate using current guidelines, though its sensitivity was still low. Further investigation into inclusion of single subtests and/or using a less conservative cut-off in the Canadian Guideline is warranted.

Prenatal and childhood exposure to phthalates and motor skills at age 11 years

BACKGROUND

Previous reports suggest that prenatal phthalate exposure is associated with lower scores on measures of motor skills in infants and toddlers. Whether these associations persist into later childhood or preadolescence has not been studied.

METHODS

In a follow up study of 209 inner-city mothers and their children the concentrations of mono-n-butyl phthalate (MnBP), monobenzyl phthalate (MBzP), monoisobutyl phthalate (MiBP), monomethyl phthalate (MEP), mono-carboxy-isooctyl phthalate (MCOP), and four di-2-ethylhexyl phthalate metabolites (ΣDEHP) were measured in spot urine sample collected from the women in late pregnancy and from their children at ages 3, 5, and 7 years. The Bruininks-Oseretsky Test of Motor Proficiency short form (BOT-2) was administered at child age 11 to assess gross and fine motor skills.

RESULTS

The total number of children included in the study was 209. Of the 209 children, 116(55.5%) were girls and 93 were (45%) boys. Among girls, prenatal MnBP(b=-2.09; 95%CI: [-3.43, -0.75]), MBzP (b=-1.14; [95%CI: -2.13, -0.14]), and MiBP(b=-1.36; 95%CI: [-2.51, -0.21] and MEP(b=-1.23 [95%CI: -2.36, -0.11]) were associated with lower total BOT-2 composite score. MnBP (b= -1.43; 95% CI: [-2.44, -0.42]) was associated with lower fine motor scores and MiBP(b = -0.56; 95% CI: [-1.12, -0.01]) and MEP (b = -0.60; 95% CI: [-1.14, -0.06])was associated with lower gross motor scores. Among boys, prenatal MBzP (b = -0.79; 95% CI: [-1.40, -0.19]) was associated with lower fine motor composite score. The associations between MEP measured at age 3 and the BOT-2 gross motor, fine motor and total motor score differed by sex. In boys, there was an inverse association between ΣDEHP metabolites measured in childhood at ages 3 (b = -1.30; 95% CI: [-2.34, -0.26]) and 7 years (b = -0.96; 95% CI: [-1.79, -0.13]), and BOT-2 fine motor composite scores.

CONCLUSIONS

Higher prenatal exposure to specific phthalates was associated with lower motor function among 11- year old girls while higher postnatal exposure to ΣDEHP metabolites was associated with lower scores among boys. As lower scores on measures of motor development have been associated with more problems in cognitive, socioemotional functioning and behavior, the findings of this study have implications related to overall child development.

Structural validity of the Bruininks-Oseretsky test of motor proficiency - Second edition brief form (BOT-2-BF)

BACKGROUND

Practitioners often assess the motor skills of children presented with suspected developmental delays. It is essential that the tests used to assess children have strong measurement properties including validity.

AIM

The structural validity of the Bruininks-Oseretsky Test of Motor Proficiency - second edition Brief Form (BOT-2-BF) was investigated.

METHOD

123 healthy children (67 males & 56 females; M = 10 years, 2 months; SD = 1 year, 4 months) completed the BOT-2-BF. The Rasch Measurement Model (RMM) was used to assess the 14-item BOT-2-BF's dimensionality, hierarchical ordering, differential item functioning (DIF), and item and person separation reliability.

RESULTS

Nine BOT-2-BF misfit RMM requirements. A second RMM analysis of a five-item BOT-2-BF version was completed. The five-item version did meet the RMM requirements of item fit, dimensionality, hierarchical ordering, lack of DIF, and adequate item and person separation reliability.

IMPLICATIONS

The 14-item version of the BOT-2-BF is not recommended for use as a screening scale to assess children's motor skill performance. However, a revised five-item version of the BOT-2-BF did appear to meet RMM expectations. Further psychometric assessment of the revised five-item version of the BOT-2-BF is recommended.

Test of Motor Proficiency Second Edition (BOT-2): Compatibility of the Complete and Short Form and Its Usefulness for Middle-Age School Children

Background: The Bruininks-Oseretsky Test of Motor Proficiency Second Edition (BOT-2) assesses the psychomotor development. It is available in two forms. According to several studies the BOT-2 short form (SF) provides significantly higher results than the BOT-2 complete form (CF). This might be due to the use of an inadequate type of scores when comparing results of the SF and the CF. Objective: To verify whether the degree of psychomotor development assessed by the BOT-2 SF is comparable to the results of the BOT-2 CF in middle-age school children when using standard scores considering age and sex. Methods: The research sample consisted of n = 153 neurotypical children (n = 69 girls, n = 84 boys) from 8 to 11 years (9.53 ± 0.85). The degree of psychomotor development was determined by the standard scores of the BOT-2 CF and BOT-2 SF-both considering sex and age. The conformity in results between the CF and the SF, the sensitivity and specificity of the BOT-2 SF and the relations between the results of each sub-test within the BOT-2 CF and the BOT-2 SF were analyzed. Results: The BOT-2 SF provided a statistically significantly lower standard score x = 45.87 (±5.41) compared to the BOT-2 CF x = 47.57 (±8.29) p < 0.05 with middle effect size value, Hays ω² = 0.09. The ROC analysis showed that the BOT-2 SF obtains sufficient sensitivity (84%) but poor specificity (42.9%) and AUC = 0.484 CI95% (0.31-0.62). Moreover, only 57% of total variance of the BOT-2 CF is explained by the relation between the results of the CF and the SF. Conclusion: The BOT-2 SF does not provide practically significant different results compared to the BOT-2 CF when using a proper scale for comparing both versions. In addition, poor specificity of the BOT-SF suggests that the BOT-2 SF might be a useful tool to reveal mainly psychomotorically delayed but not above average (psychomotorically advanced) children. Further, due to the weak portion of a shared common factor, it remains still unclear whether the BOT-2 CF and the BOT-2 SF measure the same behavioral domain.

Postural stability and visual impairment: Assessing balance in children with strabismus and amblyopia

Background

Vision plays an important role in controlling posture and balance in children. Reduced postural control has been reported in children with strabismus, but little has been reported specifically in amblyopia.

Objective

To investigate whether children with amblyopia have reduced balance compared to both children with strabismus without amblyopia and healthy controls.

Study design and methods

In this cross-sectional study, a total of 56 patients and healthy controls were recruited from the Ophthalmology and Otolaryngology Clinics at The Hospital for Sick Children, Toronto. Participants were divided into three groups: (1) 18 with unilateral amblyopia (strabismic amblyopia or mixed mechanism); (2) 16 with strabismus only without amblyopia; and (3) 22 visually-normal controls. The primary outcome was the balance performance as measured by the balance subtest of the Bruininks-Oseretsky Test of Motor Proficiency 2 [BOT2].

Results

The age and gender-adjusted BOT2 balance scores were significantly reduced in the amblyopia group (mean score 9.0 ± 3.1 SD) and the strabismus without amblyopia group (mean score 8.6 ± 2.4 SD) compared to visually normal controls (mean score 18.9 ± 4.2) (p<0.0001), but no statistical difference was demonstrated between the two patient groups (p = 0.907). Further subgroup analysis of the strabismus only group did not reveal a statistically significant difference in performance on BOT2 balance score between strabismus only patients with good stereopsis 60 sec or better (BOT2 mean score 9.8±3.0 SD) to patients with 3000 sec or no stereopsis (BOT2 mean score 7.9±1.7) (p = 0.144).

Conclusion

Our findings suggest that normal vision plays an important role in the development and maintenance of balance control. When normal binocular vision is disrupted in childhood in strabismus and/or amblyopia, not only is the vision affected, but balance is also reduced. Our results indicate that the presence of even mild binocular discordance/dysfunction (patients with intermittent strabismus and good stereopsis) may lead to postural instability.

The effect of SPARK on social and motor skills of children with autism

BACKGROUND

This study aimed to evaluate the effectiveness of a selected group exercise known as Sports, Play and Active Recreation for Kids (SPARK) on the motor and behavioral skills of children with autism spectrum disorder (ASD) using a quasi-experimental design with repeated measures.

METHODS

Twenty-eight children with ASD (age range of 5e12 years) participated in this study. The participants were examined at baseline, pre-test, and post-test using Bruininks-Oseretsky Test of Motor Proficiency (BOTMP), Autism treatment evaluation checklist (ATEC), and Gilliam Autism Rating Scale-second edition (GARS-2).

RESULTS

The results showed that the SPARK program significantly improved balance (static and dynamic), bilateral coordination and social interaction (p < 0.05) in children with ASD.

CONCLUSION

The results of this study suggest that the SPARK's training can be considered as a therapeutic option not only for motor enhancement but also for improving social skills in children with ASD.

Balance and Coordination Proficiency of Age-Matched Male and Female Children and Adolescents With Intellectual Disabilities

Male youth (8-18 years) with intellectual disability (ID) demonstrate motor proficiency below age-related competence capacities for typically developing youth. Whether below-criteria motor proficiency also exists for females with ID is not known. The purpose of this study was to determine if sex-specific differences exist in motor proficiency for youth with ID. The Bruininks-Oseretsky Test of Motor Proficiency was used to measure motor proficiency: six items for upper limb coordination, seven items for balance, and six items for bilateral coordination. One hundred and seventy-two (172) males and 85 females with ID but without Down syndrome were divided into five age groups for comparative purposes: 8-10, 11-12, 13-14, 15-16, and 17-21 years. Males scored sufficiently higher than females to suggest that sex data should not be combined to established Bruininks-Oseretsky Test of Motor Proficiency standards for upper limb coordination, balance, and bilateral coordination subtests.

Physical fitness characteristics of Omani primary school children according to body mass index

BACKGROUND

There is evidence that children with high cardiorespiratory fitness and normal body mass index (BMI) have less risk of non-communicable diseases (NCDs), however limited research was undertaken in Omani children. Therefore the aims of the present study were to describe body composition and physical fitness of a large cohort of Omani school children of both genders, and to investigate the effects of weight status on physical fitness.

METHODS

Three hundred and fourteen Omani school children aged 9 to 10 years old took part in anthropometric assessments, body composition and fitness tests, including handgrip strength, the basketball chest pass, broad jump, 20-m sprint, four 10-m shuttle agility, 30-s sit-up, and multistage fitness test (MSFT).

RESULTS

Obese boys and girls performed worse than normal-weight children in sprint, agility and endurance. In addition, fitness measures in the overweight group and underweight groups were not significantly different from other groups, except a better handgrip strength and poorer MSFT in overweight compared to normal weight girls, and poorer agility performance in underweight girls compared to the three other groups.

CONCLUSIONS

Most fitness measures are lower in obese Omani children, which suggests that they will be more at risk of developing NCDs later in life.

Fine motor skills in a population of children in remote Australia with high levels of prenatal alcohol exposure and Fetal Alcohol Spectrum Disorder

BACKGROUND

Many children in the remote Fitzroy Valley region of Western Australia have prenatal alcohol exposure (PAE). Individuals with PAE can have neurodevelopmental impairments and be diagnosed with one of several types of Fetal Alcohol Spectrum Disorder (FASD). Fine motor skills can be impaired by PAE, but no studies have developed a comprehensive profile of fine motor skills in a population-based cohort of children with FASD. We aimed to develop a comprehensive profile of fine motor skills in a cohort of Western Australian children; determine whether these differed in children with PAE or FASD; and establish the prevalence of impairment.

METHODS

Children (n = 108, 7 to 9 years) were participants in a population-prevalence study of FASD in Western Australia. Fine motor skills were assessed using the Bruininks-Oseretsky Test of Motor Proficiency, which provided a Fine Motor Composite score, and evaluated Fine Manual Control (Fine Motor Precision; Fine Motor Integration) and Manual Coordination (Manual Dexterity; Upper-Limb Coordination). Descriptive statistics were reported for the overall cohort; and comparisons made between children with and without PAE and/or FASD. The prevalence of severe (≤ 2nd percentile) and moderate (≤16th percentile) impairments was determined.

RESULTS

Overall, Fine Motor Composite scores were 'average' (M = 48.6 ± 7.4), as were Manual Coordination (M = 55.7 ± 7.9) and Fine Manual Control scores (M = 42.5 ± 6.2). Children with FASD had significantly lower Fine Motor Composite (M = 45.2 ± 7.7 p = 0.046) and Manual Coordination scores (M = 51.8 ± 7.3, p = 0.027) than children without PAE (Fine Motor Composite M = 49.8 ± 7.2; Manual Coordination M = 57.0 ± 7.7). Few children had severe impairment, but rates of moderate impairment were very high.

CONCLUSIONS

Different types of fine motor skills should be evaluated in children with PAE or FASD. The high prevalence of fine motor impairment in our cohort, even in children without PAE, highlights the need for therapeutic intervention for many children in remote communities.

Prevalence and profile of Neurodevelopment and Fetal Alcohol Spectrum Disorder (FASD) amongst Australian Aboriginal children living in remote communities

BACKGROUND

Despite multiple risk factors for neurodevelopmental vulnerability, few studies have assessed neurodevelopmental performance of Australian Aboriginal children. An important risk factor for neurodevelopmental vulnerability is prenatal alcohol exposure (PAE), which places children at risk for Fetal Alcohol Spectrum Disorder (FASD).

AIMS

This study assesses neurodevelopment outcomes in a population of Australian Aboriginal children with and without PAE.

METHODS AND PROCEDURES

Children born in 2002/2003, and living in the Fitzroy Valley, Western Australia between April 2010 and November 2011, were eligible (N=134). Sociodemographic and antenatal data, including PAE, were collected by interview with 127/134 (95%) consenting parents/caregivers. Maternal/child medical records were reviewed. Neurodevelopment was assessed by clinicians blinded to PAE in 108/134 (81%) children and diagnoses on the FASD spectrum were assigned.

OUTCOMES AND RESULTS

Neurodevelopmental disorder was documented in 34/108 children (314.8 per 1000). Any diagnosis on the FASD spectrum was made in 21/108 (194.4 per 1000) children (95% CI=131.0-279.0).

CONCLUSIONS AND IMPLICATIONS

Neurodevelopmental impairment with or without PAE is highly prevalent among children in the Fitzroy Valley. Rates of diagnoses on the FASD spectrum are among the highest worldwide. Early intervention services are needed to support developmentally vulnerable children in remote communities.

Change in functional balance after an exercise program with Nintendo Wii in Latino patients with cerebral palsy: a case series

[Purpose] This study aimed to explore the possibility of improving functional balance using an exercise program with Nintendo and the Balance Board peripheral in subjects with cerebral palsy. [Subjects and Methods] This study included 4 male outpatients of a neurological center. All participants received an exercise program based on the use of Nintendo with the Balance Board peripheral. Training consisted of three 25-min sessions per week for 6 weeks. Each session was guided by a physical therapist. Timed up-and-go and one-leg standing tests were conducted before and after the intervention. [Results] All subjects showed significant improvements in the results of the timed up-and-go test. However, there were no significant changes in the results of the one-leg standing test. [Conclusion] The exercise protocol involving Nintendo with the Balance Board peripheral appears to improve functional dynamic balance in patients with cerebral palsy. However, static functional balance does not improve after 6 weeks of training.

Gross motor performance in children prenatally exposed to alcohol and living in remote Australia

AIM

This study aimed to determine the gross motor (GM) performance of Aboriginal children living in remote Australia. The relationship between GM skills, prenatal alcohol exposure (PAE) and fetal alcohol spectrum disorders (FASD) was explored.

METHODS

A population-based observation study was conducted in 2011 to assess motor performance in children living in the Fitzroy Valley, Western Australia, using the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2). BOT-2 data were retrospectively analysed using recently developed software enabling separation of fine and GM outcomes.

RESULTS

A total of 108 children (98.1% Aboriginal; 53% male, mean age: 8.7 years) were assessed. Half (52.2%) were exposed to at least 'risky' levels of PAE, and 21 (19%) were diagnosed with an FASD. The mean GM composite score of the cohort (47.0 ± 8.4) approached the BOT-2 normative mean (50.0 ± 10) and was similar between children with and without PAE (P = 0.27). This mean score, however, was significantly lower in children with FASD than without (mean difference: -5.5 ± 20.6; P = 0.006). Compared with children without FASD, children with FASD had significant impairment in subtests for running speed and agility (mean difference ± standard deviation (SD): -2.4 ± 8.1; P = 0.003) and strength (mean difference ± SD:-2.8 ± 9.9; P = 0.004) and (ii) a higher proportion than expected had overall GM impairment (≤2 SD: 9.5%; ≤1 SD: 23.8%). In groups with PAE, no PAE and no FASD, GM function approached expected population norms.

CONCLUSIONS

A higher than expected proportion of children with FASD had GM scores that indicated impairment and need for therapy. Evaluation of GM performance should routinely be included in FASD assessment to determine strategies to optimise child development.

Prevalence of fetal alcohol syndrome in a population-based sample of children living in remote Australia: the Lililwan Project

AIM

Aboriginal leaders concerned about high rates of alcohol use in pregnancy invited researchers to determine the prevalence of fetal alcohol syndrome (FAS) and partial fetal alcohol syndrome (pFAS) in their communities.

METHODS

Population-based prevalence study using active case ascertainment in children born in 2002/2003 and living in the Fitzroy Valley, in Western Australia (April 2010-November 2011) (n = 134). Socio-demographic and antenatal data, including alcohol use in pregnancy, were collected by interview with 127/134 (95%) consenting parents/care givers. Maternal/child medical records were reviewed. Interdisciplinary assessments were conducted for 108/134 (81%) children. FAS/pFAS prevalence was determined using modified Canadian diagnostic guidelines.

RESULTS

In 127 pregnancies, alcohol was used in 55%. FAS or pFAS was diagnosed in 13/108 children, a prevalence of 120 per 1000 (95% confidence interval 70-196). Prenatal alcohol exposure was confirmed for all children with FAS/pFAS, 80% in the first trimester and 50% throughout pregnancy. Ten of 13 mothers had Alcohol Use Disorders Identification Test scores and all drank at a high-risk level. Of children with FAS/pFAS, 69% had microcephaly, 85% had weight deficiency and all had facial dysmorphology and central nervous system abnormality/impairment in three to eight domains.

CONCLUSIONS

The population prevalence of FAS/pFAS in remote Aboriginal communities of the Fitzroy Valley is the highest reported in Australia and similar to that reported in high-risk populations internationally. Results are likely to be generalisable to other age groups in the Fitzroy Valley and other remote Australian communities with high-risk alcohol use during pregnancy. Prevention of FAS/pFAS is an urgent public health challenge.