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

Reliability of the Test of Gross Motor Development Third Edition Among Children with Developmental Coordination Disorder

AIM

The Test of Gross Motor Development Third Edition (TGMD-3) is used to assess the development of fundamental movement skills in children from 3 to 10 years old. This study aimed to evaluate the intra-rater, inter-rater, and test-retest reliability and to determine the minimal detectable change (MDC) value of the TGMD-3 in children with developmental coordination disorder (DCD).

METHODS

The TGMD-3 was administered to 20 children with DCD. The child's fundamental movement skills were recorded using a digital video camera. Reliability was assessed at two occasions by three raters using the generalizability theory.

RESULTS

The TGMD-3 demonstrates good inter-rater reliability for the locomotor skills subscale, the ball skills subscale, and the total score (φ = 0.77 - 0.91), while the intra-rater reliability was even higher (φ = 0.94 - 0.97). Test-retest reliability was also shown to be good (φ = 0.79-0.93). The MDC95 was determined to be 10 points.

CONCLUSION

This study provides evidence that the TGMD-3 is a reliable test when used to evaluate fundamental movement skills in children with DCD and suggests that an increase of 10 points represents a significant change in the motor function of a child with DCD.

Fundamental Stability Skills: Reliability Analysis Using the Alfamov Assessment Tool

Fundamental movement skills (FMS), considered as building blocks of movement, have received growing interest due to their significant impact on both present and future health. FMS are categorized into locomotor, object control and stability skills. While there has been extensive research on assessing the proficiency and reliability of locomotor and object control skills, stability skills have received comparatively less attention. For this reason, this study aimed to assess the test-retest, intrarater and interrater reliability of five stability skills included in the Alfamov app. The performance of eighty-four healthy primary school children (60.8% girls), aged 6 to 12 years (mean ± standard deviation of 8.7 ± 1.8 years), in five stability skills was evaluated and scored by four raters, including two experts and two novices. The Alfamov tool, integrating various process-oriented tests, was used for the assessment. Reliability analyses were conducted through the computation of the intraclass correlation coefficient (ICC) along with the corresponding 95% confidence intervals. Good-to-excellent intrarater reliability, excellent interrater reliability and moderate-to-good reliability in the test-retest were achieved. The results proved that Alfamov is a robust test for evaluating stability skills and can be suitable for use by different professionals with less experience in assessing children's motor competence.

Motor skill competence and moderate- and vigorous-intensity physical activity: a linear and non-linear cross-sectional analysis of eight pooled trials

BACKGROUND

Few studies have examined the relationship between motor skill competence and device-measured physical activity in large samples and none have used non-linear modelling. This study assessed the linear and non-linear associations between motor skill competence and physical activity in children using pooled data from eight studies.

METHODS

Cross-sectional ActiGraph accelerometer and motor skills competence data from 988 children (50.8% boys) aged 3-11 years were included. Total, object control and locomotor skill competence were assessed using the Test of Gross Motor Skill Development. Linear mixed models were fitted to examine linear associations between motor skill competence and physical activity. Then, restricted cubic splines models were used to assess potential non-linear relationships. Interactions by sex and age were assessed.

RESULTS

There was evidence of positive linear associations between total skill, and object control and locomotor skills, with moderate- and vigorous-intensity physical activity; however, the associations with total skill competence and object control better fitted a non-linear model. Non-linear models indicated associations were positive but relatively weak in the low to mid ranges of TGMD/object control scores but at high ranges (~ > 70 out of 100/ and ~ 35 out of 50) the association strength increased for both moderate- and vigorous-intensity physical activity. There were sex interactions for locomotor skills only, specifically for vigorous activity with boys having a stronger positive association than girls.

CONCLUSIONS

There appears to be a threshold for object control skill proficiency that children need to reach to enhance their physical activity levels which provides support for a motor skill "proficiency barrier". This provides a tangible benchmark for children to achieve in motor competence programs.

Differences between Novice and Expert Raters Assessing Trunk Control Using the Trunk Control Measurement Scale Spanish Version (TCMS-S) in Children with Cerebral Palsy

The Trunk Control Measurement Scale (TCMS) is a valid and reliable tool to assess static and dynamic trunk control in cerebral palsy. However, there is no evidence informing about differences between novice and expert raters. A cross-sectional study was conducted with participants between the ages of 6 and 18 years with a CP diagnosis. The TCMS Spanish version (TCMS-S) was administered in-person by an expert rater, and video recordings were taken for later scoring by the expert and three other raters with varying levels of clinical experience. The intraclass correlation coefficient (ICC) was used to evaluate reliability between raters for the total and subscales of the TCMS-S scores. Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) were also calculated. There was a high level of agreement between expert raters (ICC ≥ 0.93), while novice raters demonstrated good agreement (ICC > 0.72). Additionally, it was observed that novice raters had a slightly higher SEM and MDC than expert raters. The Selective Movement Control subscale exhibited slightly higher SEM and MDC values compared to the TCMS-S total and other subscales, irrespective of the rater's level of expertise. Overall, the study showed that the TCMS-S is a reliable tool for evaluating trunk control in the Spanish pediatric population with cerebral palsy, regardless of the rater's experience level.

Test of Gross Motor Development-3: Item Difficulty and Item Differential Functioning by Gender and Age with Rasch Analysis

The assessment of motor proficiency is essential across childhood to identify children’s strengths and difficulties and to provide adequate instruction and opportunities; assessment is a powerful tool to promote children’s development. This study aimed to investigate the hierarchal order of the Test of Gross Motor Development-Third Edition (TGMD-3) items regarding difficulty levels and the differential item functioning across gender and age group (3 to 5, 6 to 8, and 9 to 10 years old). Participants are 989 children (3 to 10.9 years; girls n = 491) who were assessed using TGMD-3. For locomotor skills, appropriate results reliability (alpha = 1.0), infit (M = 0.99; SD = 0.17), outfit (M = 1.18; SD = 0.64), and point-biserial correlations (rpb values from 0.14 to 0.58) were found; the trend was similar for ball skills: reliability (alpha = 1.0), infit (M = 0.99; SD = 0.13), outfit (M = 1.08; SD = 0.52); point-biserial correlations (rpb values from 0.06 to 0.59) were obtained. Two motor criteria: gallop, item-1, and one-hand forehand strike, item-4, were the most difficult items; in contrast, run, item-2, and two-hand catch, item-2, were the easiest items. Differential item functioning for age was observed in nine locomotor and ten ball skills items. These items were easier for older children compared to younger ones. The TGMD-3 has items with different difficulty levels capable of differential functioning across age groups.