Review of the Bruininks-Oseretsky Test of Motor Proficiency,Second Edition (BOT-2)

The Bruininks-Oseretsky Test of Motor Proficiency (Bruininks, 1978) is a standardized, norm-referenced measure used by physical therapists and occupational therapists in clinic and school practice settings. This test recently was revised and published as the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2; Bruininks & Bruininks, 2005). The BOT-2 is an individually administered measure of fine and gross motor skills of children and youth, 4 through 21 years of age. It is intended for use by practitioners and researchers as a discriminative and evaluative measure to characterize motor performance, specifically in the areas of fine manual control, manual coordination, body coordination, and strength and agility. The BOT-2 has both a Complete Form and a Short Form. This review of the BOT-2 describes its development and psychometric properties; appraises strengths and limitations; and discusses implications for use by physical therapists and occupational therapists.     

Review of the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2)

The Bruininks-Oseretsky Test of Motor Proficiency (Bruininks, 1978) is a standardized, norm-referenced measure used by physical therapists and occupational therapists in clinic and school practice settings. This test recently was revised and published as the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2; Bruininks & Bruininks, 2005). The BOT-2 is an individually administered measure of fine and gross motor skills of children and youth, 4 through 21 years of age. It is intended for use by practitioners and researchers as a discriminative and evaluative measure to characterize motor performance, specifically in the areas of fine manual control, manual coordination, body coordination, and strength and agility. The BOT-2 has both a Complete Form and a Short Form. This review of the BOT-2 describes its development and psychometric properties; appraises strengths and limitations; and discusses implications for use by physical therapists and occupational therapists.     

Sensory Motor and Functional Skills of Dizygotic Twins: One with Smith–Magenis Syndrome and a Twin Control

Smith–Magenis syndrome (SMS), the result of an interstitial deletion within chromosome 17p11.2, is a disorder that may include minor dysmorphic features, brachydactyly, short stature, hypotonia, speech delays, cognitive deficits, signs of peripheral neuropathy, scoliosis, and neurobehavioral problems including sleep disturbances and maladaptive repetitive and self-injurious behaviors. Physical and occupational therapists provide services for children who have the syndrome, whose genetic disorder is frequently not identified or diagnosed before 1 year of age. A comprehensive physical and occupational therapy evaluation was completed in nonidentical twins with one having SMS, using the Sensory Profile; Brief Assessment of Motor Function (BAMF); Peabody Developmental Motor Scales, Second Edition (PDMS-2); and Pediatric Evaluation of Disability Inventory (PEDI). This provides a framework for conducting assessments to enhance early detection and interdisciplinary management with this specialized population.     

中文版脑瘫儿童粗大运动功能分级系统的信度和效度研究

目的 确定中文版脑瘫儿童粗大运动功能分级系统（Gross Motor Function Classification System ,GMFCS）的信度和效度。方法 共有来自上海三家康复机构的91名0-12岁脑瘫儿童参加了此项研究，选择35名脑瘫儿童测定GMFCS的重测信度；以66名脑瘫儿童为对象测定GMFCS的评价者间信度；分别以88名脑瘫儿童的粗大运动功能评估量表（GMFM）和54例脑瘫儿童的Peabody粗大运动发育量表（PDMS-GM）的各项测试结果为效标确定GMFCS的平行效度；对88例同时接受GMFCS和GMFM评价的儿童的测试结果进行结构效度检测，以GMFCS为应变量，GMFM五个功能区的百分比为自变量进行多重逐步回归分析，判断粗大运动中五个分区功能对GMFCS的影响程度。结果 GMFCS具有良好的重测信度（ICC值为0.99），同时具有良好的评估者间信度（ICC为0.95-0.98）；GMFCS与GMFM和PDMS-GM各项分值之间有良好的平行效度，Spearman相关系数在-0.57到-0.84在之间；粗大运动功能中的坐位能力和行走能力是影响GMFCS的主要因素，校正决定系数为0.709（p<0.001）。 结论 中文版脑瘫儿童粗大运动功能分级系统的具有良好的信度和效度，适用于国内对脑瘫儿童进行功能分级。     

复旦中文版神经肌肉疾病运动功能评估量表在儿童和青少年中的信度和效度研究

目的：验证复旦中文版神经肌肉疾病（NMD）运动功能评估量表（MFM）在中国儿童和青少年NMD中的信度和效度。 方法：2013年6月至2017年7月在复旦大学附属儿科医院（我院）神经科经基因检测或肌肉活检明确诊断为各类NMD、＞2岁且在我院康复科接受过复旦中文版MFM 20和MFM 32评估的患儿,排除1年内接受过手术、具有严重认知障碍和测试前3 d内从事过严重影响体力的活动患儿。2名物理治疗师同时进行MFM 20和MFM 32测试,检验不同测试者间的信度;同一评价者在第1次评价后间隔3~7d进行第2次评价,检测重测信度;以6 min步行距离（6MWT）和4项功能性计时测试为效度指标;通过分析MFM分值与之的相关性确定关联效度。通过分析纳入对象中杜氏进行性肌营养不良（DMD）患儿的MFM分值与北极星移动量表（NSAA）分值之间的相关性确定关联效度。 结果：372例患儿符合本文纳入排除标准,平均（6.5±2.7）岁,<7岁222例,男性338例,其中DMD 263例,重测信度（2~7岁16例,>7岁38例）和测试者间信度（2~7岁16例,＞7岁29例）检测结果显示,MFM 32和MFM 20的总分和各分区分值ICC=0.89~0.97。基于372例患儿,MFM 32和MFM 20的总分和D1区分值与6MWT和功能性计时测试结果具有中等和较强的相关性（r=0.48~0.73）,与D2和D3分区的分值相关性为中等和较弱。在263例DMD患儿中,MFM 32和MFM 20的总分和D1区分值与NSAA分值的相关性为强和极强相关性。 结论：复旦中文版MFM量表在儿童和青少年NMD患儿中具有很好的信度和效度,可以有效地测定NMD患儿的运动功能状态。     

Effect of Group-Task-Oriented Training on Gross and Fine Motor Function,and Activities of Daily Living in Children with Spastic Cerebral Palsy

Abstract

Aims: To determine the effects of group-task-oriented training (group-TOT) on gross and fine motor function, activities of daily living (ADL) and social function of children with spastic cerebral palsy (CP).

Methods: Eighteen children with spastic CP (4–7.5?years, gross motor function classification system level I–III) were randomly assigned to the Group-TOT (9 children received group-TOT for 1?hour, twice a week for 8?weeks) or the comparison group (9 children received individualized traditional physical and occupational therapy). The Gross Motor Function Measure (GMFM)-88, the Bruininks-Oseretsky Test of Motor Proficiency 2^nd edition (BOT-2), and the Pediatric Evaluation of Disability Inventory (PEDI) were administered before and after the intervention, and in the Group-TOT, 16?weeks after the intervention.

Results: Children in the Group-TOT showed significant improvements in the GMFM-88 standing and walking/running/jumping subscales, the BOT-2 manual dexterity subscale, and the PEDI social function subscale (p?<?0.05); changes were maintained 16?weeks after the intervention ended. In contrast, the comparison group improved in only the BOT-2 fine motor integration subscale (p?<?0.05).

Conclusions: The findings provide evidence of effectiveness of group-TOT in improving gross and fine motor function, and social function in children with CP.     

Relationships Between Fine-Motor,Visual-Motor,and Visual Perception Scores and Handwriting Legibility and Speed

ABSTRACT

Occupational therapists assess fine motor, visual motor, visual perception, and visual skill development, but knowledge of the relationships between scores on sensorimotor performance measures and handwriting legibility and speed is limited. Ninety-nine students in grades three to six with learning and/or behavior problems completed the Upper-Limb Speed and Dexterity Subtest of the Bruininks–Oseretsky Test of Motor Proficiency, the Beery–Buktenica Developmental Test of Visual-Motor Integration—5th Edition, the Test of Visual Perceptual Skills—Revised, the Visual Skills Appraisal, and a handwriting copying task. Correlations between sensorimotor performance scores and handwriting legibility varied from .07 to .38. Correlations between sensorimotor performance scores and handwriting speed varied from .04 to .42. Stepwise multiple regression analysis indicated that the variance in handwriting explained by these measures was ≤20% for legibility and ≤26% for speed. On the basis of multivariate analysis of variance only scores for the Developmental Test of Visual-Motor Integration differed between students classified as “skilled” and “unskilled” handwriters. The low magnitude of the correlations and variance explained by the sensorimotor performance measures supports the need for occupational therapists to consider additional factors that may impact handwriting of students with learning and/or behavior problems.     

Motor performance checklist for 5-year-olds: a tool for identifying children at risk of developmental co-ordination disorder

OBJECTIVE: The aim of this study was to further evaluate the 'Motor Performance Checklist for 5-year-olds', an instrument which had been piloted with some success and reported via this journal in 1996. METHOD: Both validity and reliability in identifying children in most need of paediatric occupational therapy services was assessed. The Motor Performance Checklist was compared against a chosen 'gold standard' test, The Bruininks-Oseretsky test of Motor Proficiency, in a group of 141 5-year-old children. RESULTS: Correlations of 0.72 and 0.85 were found between the tests. The checklist was found to have a sensitivity of 83% and a specificity of 98%. Positive predictive validity was found to be 72% and negative predictive validity 99%. Interrater reliability ranged between 0.79 and 0.99 and intrarater reliability was 0.77. CONCLUSIONS: These results indicate that the Motor Performance Checklist has the potential to assist in identifying children in most need of referral to community occupational therapy services.     

Brief assessment of motor function: content validity and reliability of the fine motor scale.

PURPOSE: The Brief Assessment of Motor Function Fine Motor Scale (FMS) allows rapid assessment, independent of age. This study was done to establish content validity of the FMS and to demonstrate FMS reliability. METHODS: A standard questionnaire ("Disagree" to "Agree," 1-4) was emailed to 28 expert panel members. Ten children with diagnoses including Proteus, Sheldon-Freeman, Smith-Lemli-Opitz, and Smith-Magenis syndromes were videotaped for reliability trials. RESULTS: Expert panel members agreed that all 28 items should be included (means, 3.43-3.89); were functionally relevant (means, 2.93-3.82), were clearly worded (means, 2.71-3.61), and were easily discriminated (means, 3.32-4.0). Kappa values for interrater and intrarater reliability were 0.978 and 0.993, respectively. CONCLUSIONS: Feedback from an expert Panel supported content validity of the Brief Assessment of Motor Function FMS. Kappa values for interrater and intrarater reliability suggest this is a reliable instrument for rapid, objective fine motor assessment.     

The Association of Motor Skills and Adaptive Functioning in XXY/Klinefelter and XXYY Syndromes

Aims: Klinefelter (XXY) and XXYY syndromes are genetic disorders in males characterized by additional sex chromosomes compared to the typical male karyotype of 46, XY. Both conditions have been previously associated with motor delays and motor skills deficits. We aimed to describe and compare motor skills in males with XXY and XXYY syndromes, and to analyze associations with age, cognitive abilities, and adaptive functioning. Methods: Sixty-four males with XXY and 46 males with XXYY, ages 4–20 were evaluated using the Beery Test of Visual Motor Integration and the Bruininks-Oseretsky Test of Motor Proficiency – 2nd Edition assessments, Vineland–2 adaptive scales, and cognitive testing. Results: Motor coordination impairments were found in 39% of the males with XXY and 73% of the males with XXYY. Both groups showed strengths in visual perceptual skills. Males with XXYY had lower mean scores compared to males with XXY across all assessments. Fine motor dexterity and coordination deficits were common. There was a positive correlation between VMI scores and adaptive functioning. Conclusion: Occupational and physical therapists should be aware of the motor phenotype in XXY and XXYY both to aid in diagnosis of unidentified cases and to guide intervention.     

Comparison of 15-Month Motor and 18-Month Neurological Outcomes of Term Infants with and without Motor Delays at 10-Months-of-Age

Fifteen-month motor outcomes and 18-month neurological outcomes of term infants with (Group 1, n + 18) and without (Group 2, n + 18) low scores on the Alberta Infant Motor Scale (AIMS) at 10-months-of-age were compared. Their scores on the AIMS did not differ at 15-months. Infants in Group 1, however, obtained significantly lower scores on the locomotor skill area of the Peabody Developmental Motor Scales at 15 months and walked an average of 2 months later than infants in Group 2. Nevertheless, infants in both groups were functioning within the range of normal at 15 months and had neurologically normal 18-month outcomes, as assessed by a pediatrician using the Neurological Examination of the Collaborative Perinatal Project, except for one child in Group 1 who was identified as “suspicious” because he was not yet walking. The results suggest that motor delays detected at 10-months will not necessarily persist. Pediatric therapists are encouraged to consider normal variations in both rate and pattern of early motor development when making judgements about the results of norm-referenced tests. Instituting a practice of serial assessments, rather than relying on the results of one assessment, will improve the accuracy of identification of infants who exhibit persistent motor delay.     

Motor skill and mobility recovery outcomes of children and youth with traumatic brain injury

Traumatic brain injury (TBI) is a major cause of disability in children. Along with other neurological clinical sequelae, children often exhibit motor skill impairment and limitations in functional mobility following TBI. The purpose of this annotated bibliography is to: (1) familiarize therapists with the literature available regarding motor skill and mobility recovery outcomes for children and adolescents with TBI; (2) assist therapists in the selection of motor skill and mobility outcome assessments for use in clinical practice; and (3) provide therapists with comparisons of outcomes for external benchmarking. A number of reports document motor and mobility recovery outcomes as well as recovery in other domains. Studies vary, however, in design, sample size, number and type of outcome assessments used, time since injury at assessment(s), and the consideration of correlating factors such as age at time of injury and injury severity. Further research is needed to describe clinical, satisfaction and resource utilization outcomes, determine outcome predictors, and provide evidence for therapeutic intervention effectiveness.     

Test-Retest Reliability of the Gross Motor Function Measure in Children with Cerebral Palsy

The purpose of this study was to describe the test-retest reliability of the Gross Motor Function Measure (GMFM) in children with cerebral palsy. The GMFM was administered twice, within a one-week time period, to twenty-one children with cerebral palsy. The time of day, therapists, and evaluation setting were held constant. Intra-class correlations ranged from .76 to 1.00. The data suggest that the GMFM is consistent in the measurement of gross motor skills and that children with cerebral palsy exhibit stable gross motor skills during repeat measurement. This information will be helpful in future analysis of treatment efficacy using the GMFM as an outcome measure.     

Pediatric Oral Motor Feeding Assessments: A Systematic Review

Aim: To describe the clinical properties and psychometric soundness of pediatric oral motor feeding assessments. Methods: A systematic search was conducted using Medline, CINAHL, EMBASE, PsycInfo, and HAPI databases. Assessments were analyzed for their clinical and psychometric characteristics. Results: 12 assessment tools were identified to meet the inclusion/exclusion criteria. Clinical properties varied from assessments evaluating oral-motor deficits, screening to identify feeding problems, and monitoring feeding progress. Most assessments were designed for children with developmental disabilities or cerebral palsy. Eleven assessments had psychometric evidence, of these nine had reliability and validity testing (Ability for Basic Feeding and Swallowing Scale for Children, Behavioral Assessment Scale of Oral Functions in Feeding, Dysphagia Disorder Survey, Functional Feeding Assessment–modified, Gisel Video Assessment, Montreal Children's Hospital Feeding Scale, Oral Motor Assessment Scale, Schedule for Oral Motor Assessment, and Screening Tool of Feeding Problems Applied to Children). The Brief Assessment of Motor Function–Oral Motor Deglutition and the Pediatric Assessment Scale for Severe Feeding Problems had reliability testing only. The Slurp Test was not tested for any psychometric properties. Overall, psychometric evidence was inconsistent and inadequate for the evaluative tools.     

Critical Review of the Test of Gross Motor Development

The Test of Gross Motor Development (TGMD) is designed to be both a norm-referenced and criterion-referenced assessment of gross motor skills in 3-to 10- year-old children, normal to moderately handicapped. Whether the TGMD thoroughly covers the total domain of gross motor function with its two subtests of locomotor and object control is questioned. The TGMD appears promising as a test the is easily learned and administered by a wide variety of professionals. Studies are reviewed that address the issues if the TGMD's reliability and validity. As with any formal assessment, testers need to be aware of the TGMD's strengths and weaknesses in interpreting test scores.     

Identifying Developmental Coordination Disorder

Summary

In the absence of a gold standard to identify the presence of developmental coordination disorder in children, it is useful to examine the consistency of different tests used in physical and occupational therapy. This study examined three measures of motor skills to determine whether they consistently identified the same children. In total, 379 children participated in this study. The final matched samples consisted of 202 children ranging in age from 8 to 17 years: 101 met criteria for DCD and 101 children did not show any evidence of DCD. The results indicated that the overall agreement between the Bruininks Oseretsky Test of Motor Proficiency (BOT), the Movement Assessment Battery for Children (M-ABC) and the Developmental Coordination Disorder Questionnaire (DCDQ) was less than 80%. The difference in structure and style of administration between the BOT and the M-ABC appears to contribute to their tendency to identify different children. This studyemphasizes the need for therapists to use clinical reasoning to examine multiple sources of information about a child's abilities.