H1: Conceptual framework 5
1.1 Basic principles of rehabilitation in mental health care 5
1.2 Basic principles of (motor) assessment 6
1.2.1 Testing versus assessment 6
1.2.2 Considerations in (early) childhood assessment 7
1.2.3 How to decide upon the right assessment method? 7
1.2.4 Purpose of assessment 8
1.2.5 How to measure/evaluate? 10
1.2.5.1 Quantitative versus qualitative 10
1.2.5.2 Norm-referenced versus criterion-referenced 10
1.2.5.3 Performance based instruments versus behaviour rating instruments 10
1.2.5.4 Formal versus informal 10
1.3 Basic measurement concepts 11
1.3.1 Psychometric properties 11
1.3.2 Norm-referenced instruments vs criterion-referenced instruments 12
1.3.3 Interpretation of test results 13
1.3.4 Reporting the results 13
1.4 Taxonomy of Burton & Miller 14
1.5 Relationship between motor ability and other developmental domains 15
1.5.1 Cognitive - motor 15
1.5.2 Motor - social affective 16
1.5.3 Motor performance and body weight 16
1.5.4 Motor performance and physical activity 17
1.5.5 Associations in clinical populations (developmental disabilities) 17
1.5.6 In conclusion 17
H2: General motor abilities - screening and wide-range assessments 18
2.1 General motor abilities 18
2.2 Movement assessment battery for children, 2e edition (MABC-2) 18
2.2.1 What? 18
2.2.2 Content 18
2.2.3 Use of the instrument 19
2.2.4 Psychometric properties 20
2.2.4.1 Test 20
2.2.4.2 Checklist 20
2.2.5 Checklist 20
2.2.6 Procedure 20
2.2.7 General guideline 21
2.2.8 Test items 21
2.2.9 Scoring and interpretation 22
2.2.9.1 Scoring 22
2.2.9.2 Interpretation 23
2.2.10 Advantages and disadvantages 23
2.3 Bruininks-Oseretsky test of motor proficiency, 2e edition (BOT-2) 24
1
, 2.3.1 What? 24
2.3.2 Content 25
2.3.3 Use of the BOT-2 25
2.3.4 Psychometric properties 25
2.3.5 General guidelines 25
2.3.6 Administration procedure 26
2.3.7 Test items 26
2.3.8 Scoring and interpretation 26
2.3.8.1 Scoring 26
2.3.8.2 Interpretation 27
2.3.9 Advantages and disadvantages 27
H3: Motor development 28
3.1 Bayley Scales of Infant and Toddler Development-3 28
3.1.1 What? 28
3.1.2 Use of the Bayley-III-NL 28
3.1.3 Content 28
3.1.4 Psychometric properties motor scale 29
3.2 Peabody Developmental Motor Scales-2 29
3.2.1 History 29
3.2.2 What? 30
3.2.3 Use of the PDMS-2 30
3.2.4 Content 30
3.2.4.1 Six subscales 30
3.2.4.2 Composites 31
3.2.5 Administration procedure 31
3.2.6 Psychometric properties 32
3.3 Test of Gross Motor Development-3 32
3.3.1. Background 32
3.3.2 What? 32
3.3.3 Use of the TGMD-3 33
3.3.4 Content 33
3.3.5 Administration procedure 33
3.3.6 Scoring 33
3.3.7 Psychometric properties 34
3.3.8 Advantages and disadvantages 34
H4: Body coordination 35
4.1 Body coordination 35
4.2 Körperkoordinationstest für Kinder (KTK-2-NL) 35
4.2.1 What? 35
4.2.2 Content 35
4.2.3 Administration procedure 36
4.2.3.1 Subtest 1 - backward balancing 36
4.2.3.2 Subtest 2 - platform transfer 37
4.2.3.3 Subtest 3 - jumping sideways 37
2
, 4.2.3.4 Subtest 4 - hopping over obstacle 37
4.2.4 Scoring and interpretation 38
4.2.4.1 Scoring 38
4.2.4.2 Interpretation 38
4.2.5 Psychometric properties 39
4.2.6 Advantages and disadvantages 39
4.3 DCD Daily (Van der Linden) revised 2018, Dutch instrument 39
4.4 Coordination disorders and child psychiatry 40
H5: Body scheme and spatial orientation 41
5.1 Body scheme 41
5.1.1 Definitions 41
5.1.2 Assessment 42
5.1.2.1 Showing and naming body parts 42
5.1.2.2 Physical self-description questionnaire (PSDQ, Marsch et al.) 42
5.2 Spatial orientation 43
5.2.1 Definition and development 43
5.2.1.1 Definitions 43
5.2.1.2 Development of spatial orientation 44
5.2.2 Assessment 45
5.2.2.1 Test of Piaget-Head 45
5.2.2.2 Ayres Space Test 45
5.2.2.3 Spatial Orientation Memory Test 46
H6: Lateralization 47
6.1 Definitions 47
6.1.1 Lateralization and laterality 47
6.1.2 Handedness 47
6.1.2.1 Direction 47
6.1.2.2 Degree 47
6.1.2.3 Hand preference 48
6.1.2.4 Hand dominance or hand performance 48
6.2 Evidence, development and clinical importance 48
6.2.1 Scientific evidence 48
6.2.2 Right and left handedness and hand preference index 48
6.2.3 Predicting hand preference 49
6.2.4 Development of hand preference 49
6.2.5 Importance from clinical perspective 49
6.2.5.1 Possible problems in clinical practice 49
6.3 Assessment 50
6.3.1 Observations 50
6.3.1.1 Unstructured 50
6.3.1.2 Structured 50
6.3.2 Assessment instruments 51
6.3.2.1 Hand preference Test of Geuze (2009) 51
6.3.2.2 Hand Dominanz Test (HDT) 52
3
, 6.4 Conclusion 52
H7: Visual perception and visual motor integration 53
7.1 Definitions 53
7.1.1 Visual perception 53
7.1.2 Visual motor integration 53
7.2 Assessment 53
7.2.1 Test of Visual Perceptual Skills - 4th edition (TVPS-4) 53
7.2.2 Developmental Test of Visual Perception - 2 (DTVP-2) 54
7.2.3 Beery Buktenica Developmental Test of Visual Motor Integration - 6 55
7.2.3.1 Structure 56
1. Visuomotor integration (VMI) 56
2. Visual perception 56
3. Motor coordination 56
7.2.3.2 Psychometric properties 57
7.2.3.3 Advantages 57
H8: Handwriting 58
8.1 Definitions 58
8.1.1 What is writing? 58
8.1.2 Writing prerequisites 58
8.1.2.1 General conditions 58
8.1.2.2 Specific conditions 58
8.2 Development 58
8.2.1 Developmental stages 58
8.2.2 Pencil grip 59
8.2.2.1 Primitiv grips 59
8.2.2.2 Transition grips 59
8.2.2.3 Mature grips 59
8.2.3 Dynamic 3-point grip 60
8.2.4 Writing posture 60
8.3 Handwriting problems 60
8.4 Assessment 60
8.4.1 Systematische Opsporing Schrijfproblemen (SOS-2-VL) 61
8.4.2 Test of Handwriting Skills - revised (THS-R) 61
8.4.3 Detailed Assessment of Speed of Handwriting (DASH) 62
4
, Assessment in Mental Health Care
H1: Conceptual framework
1.1 Basic principles of rehabilitation in mental health care
Basic principle 1: Holistic vision, unity of body and mind: ‘psyche’ & ‘motor’
● There is no mental health without physical health
● There is no physical health without mental health
● Constant interaction between body and mind, impossible to separate
Basic principle 2: Development depends on the continuous, reciprocal and complex interaction
between different developmental/functional domains, including:
● Motor/physical aspects
● Psychological aspects
● Cognitive aspects
● Linguistic/communication aspects
● Social aspects
Basic principle 3: Reciprocal relationship between body - mind - context
● Relevance of where the child is growing up
○ If a child can’t ride a bike, it’s a problem in Belgium because it happens a lot here
○ In another country it is less problematic
○ Idem for good writing abilities
○ In Belgium very important, for refugees it is less important
● Not only an important relationship between the different domains of the development but
also the context f.e. the home situation
○ Context has a significant impact on the way to treat the child
○ Mismatch child factors and parent/context factors
■ Mismatch between context and child factors -> often end up in the mental
health care
■ Within children factors, one can affect another
○ Enough opportunities to develop?
5
,Basic principle 4: Everything is related to development
● Take age into account when doing assessment, some things are typical for certain age-groups
● Important to know what typical development is
● In the early ages we have very wide ranges in what is normal f.e. first time walking can go
from 8 months to 15 months
Motor education versus motor therapy
● Are there any problems with the motor development? (therapists) -> therapy
● What is normal/typical development (scientist) -> education
● But before we know if there is a problem there needs to be diagnostics = focus of this course
1.2 Basic principles of (motor) assessment
1.2.1 Testing versus assessment
Assessment:
● ≠ synonym for testing, testing is a part of assessment
● = process of gathering information in order to increase understanding (learning,
development, functioning of the child)
● More broad than testing
● Including
○ Skills
○ Competences
○ Behaviours
○ Preferences f.e. how they get instructions (auditive, visual)
○ Interactions
6
, ● F.e.: a child can score bad on a motor test but the motor development may not be the cause,
it may be an intelligence problem
● Info for later therapy f.e. which cues to use in therapy
● Should include -> these are the bare minimum
○ Anamnesis
○ Questionnaires:
■ Broad or specific domain? -> depends on the setting
■ F.e. other speciality can already have info about some domains
○ Observation
○ Standardised motor assessment batteries
■ Reliable and valid
■ Age appropriate
■ Population appropriate: not easy f.e. in psychology -> IQ tests are not
developed for children with autism
1.2.2 Considerations in (early) childhood assessment
● Necessitates understanding of the (family) context
○ F.e. family and school
○ “How is the child growing up?”
○ Schedule the test moment on the right time vb. not while nap time
● Requirement for flexible procedures
○ Non-motor aspects will influence performance
○ F.e. To give instructions in another way or to give a break
● Gather only the data that you need
○ Not true that it is better to have more data
○ The child will get tired, there will be other factors influencing the results
● Ensure quality of gathered data
○ Some tests are really old
○ Be critical - is this test a real value to the assessment?
1.2.3 How to decide upon the right assessment method?
Knowledge on each of these aspects is essential to make a decision:
● Purpose (screening, evaluation, …)
○ Which tool do we need -> Screening? Evaluation?
7
, ○ Decide in advance -> what is my goal, why is there a need for help, why am I doing
this?
● Target population (age, disability, ...) -> will determine the kind of assessment
● Psychometric properties -> determine the value of your instrument (reliability and validity)
● Administrative properties (time, cost, user-friendly, ...)
○ Sometimes not the time or budget to choose the best instruments
○ Needs to be possible
1.2.4 Purpose of assessment
● Any motor assessment should start with the question ‘Why?’
○ Goal of motor assessment should be clearly specified a priori of the testing
○ Choice of assessment protocol depends on the goal -> screening vs assessment
■ Screening: quick, efficient
● Is there a possibility for a problem
● Do we need further assessment?
● Is there something going on?
● No distribution between small and big problems
■ Complete assessment: full info -> info on how big the problem is
● Motor assessment has a broad range of purposes
Purpose 1: Diagnostic assessment
● Classification / identification -> RIZIV
● Comprehensive procedure -> flowchart
● Careful and systematic procedure to diagnose problems in particular area of
development
● Individual level: always one on one -> never a group assessment in school f.e.
● Most common reason for assessment
● Eligibility for services
○ To start or not to start intervention
○ To continue or stop intervention -> should we try something else?
Purpose 2: Screening
● Screening instruments are designed to efficiently identify children who need a more detailed
assessment
● Advantage: brief and cost-effective
8
, ● Quality of screening instrument: largely depending on sensitivity and specificity
● Do not use beyond intended purpose
○ Do not use for diagnostics
○ Will not tell you which % the child is -> only tell if the child is at risk
Purpose 3: To plan treatment
● Setting a baseline for intervention
● Identification of the specific deficits: which skills?
● Identification of the details of the deficit
○ Example: George is not able to throw a ball
■ Standardised instrument usually provides information on the product
■ What is the cause? Which process criteria are not met?
● Identification of the context in which the deficits appear
○ Example: George can throw a large ball, but not a small one, or he is not able to do
so when someone is watching or there is time pressure (in a game)
● Identification of movement skill foundations: flexibility, motivation, muscular strength, ...
● Final goal = to develop a measurable treatment plan
Purpose 4: To evaluate change over time
● Measurement of developmental change: f.e. In at risk children or longitudinal studies
● Measuring the effectiveness of a program
● Measuring the individual’s progress after intervention
● Problems:
○ A ‘statistical’ significant progress might not be a functional one (ecological validity)
○ Development, maturation
Purpose 5: Providing feedback
● Sharing feedback with the child, parent, caregivers, teachers, ...
● Reimbursement agencies (health care agencies): feedback on the individual’s status relative
to functional or disability related outcomes or relative to TD peers
● Important for motivational processes
● Important to increase the understanding of the treatment
● Use of multiple methods and resources provides best information
● Focus on functional skills (criterion-referenced)
9
, Other purposes
● Research
○ Population norms
○ Effectiveness of intervention
○ Monitoring population trends
○ Relationships between motor competence and health outcomes
● Prognosis f.e. Comorbidity
● Prediction
○ Least common purpose of motor assessment in rehabilitation
○ Data can be used to predict neurodevelopmental outcomes at later age
○ Prediction of someone’s (future) achievement level (f.i. talent identification in sports)
1.2.5 How to measure/evaluate?
1.2.5.1 Quantitative versus qualitative
● Quantitative: measuring balance by performance on items (infer concept of balance) &
compare performance to TD/norm population
○ F.e. number of seconds a 3-year-old child can keep balance in unipedal stance
● Qualitative: describing motor behaviour in standardised environment; observation of quality
of movement
○ F.e. ask a 3-year-old child to make a bipedal jump & assess the quality of the
movement
1.2.5.2 Norm-referenced versus criterion-referenced
● Norm-referenced: comparison of individual performance to normative group (usually TD)
○ F.e. horizontal jump: measure how far a child jumped and compare the distance to
children of the same age (and gender)
● Criterion-referenced: comparison of individual performance to predetermined criteria
○ F.e. horizontal jump: observe how the child jumps, compare the performance on
different predetermined criteria, such as ‘does the child bent the knees before
jumping? Does the child raise the hands above the head?’
1.2.5.3 Performance based instruments versus behaviour rating instruments
● Performance based: based on actual performance on a certain item
● Behaviour rating: observation instruments, questionnaires, self-perception, ...
1.2.5.4 Formal versus informal
● Formal: instruments with standardised or uniform conditions and instructions, allow
comparisons across administrators or individuals, but no information on non-included items
● Informal: not standardised f.e. observations during play
10
1.1 Basic principles of rehabilitation in mental health care 5
1.2 Basic principles of (motor) assessment 6
1.2.1 Testing versus assessment 6
1.2.2 Considerations in (early) childhood assessment 7
1.2.3 How to decide upon the right assessment method? 7
1.2.4 Purpose of assessment 8
1.2.5 How to measure/evaluate? 10
1.2.5.1 Quantitative versus qualitative 10
1.2.5.2 Norm-referenced versus criterion-referenced 10
1.2.5.3 Performance based instruments versus behaviour rating instruments 10
1.2.5.4 Formal versus informal 10
1.3 Basic measurement concepts 11
1.3.1 Psychometric properties 11
1.3.2 Norm-referenced instruments vs criterion-referenced instruments 12
1.3.3 Interpretation of test results 13
1.3.4 Reporting the results 13
1.4 Taxonomy of Burton & Miller 14
1.5 Relationship between motor ability and other developmental domains 15
1.5.1 Cognitive - motor 15
1.5.2 Motor - social affective 16
1.5.3 Motor performance and body weight 16
1.5.4 Motor performance and physical activity 17
1.5.5 Associations in clinical populations (developmental disabilities) 17
1.5.6 In conclusion 17
H2: General motor abilities - screening and wide-range assessments 18
2.1 General motor abilities 18
2.2 Movement assessment battery for children, 2e edition (MABC-2) 18
2.2.1 What? 18
2.2.2 Content 18
2.2.3 Use of the instrument 19
2.2.4 Psychometric properties 20
2.2.4.1 Test 20
2.2.4.2 Checklist 20
2.2.5 Checklist 20
2.2.6 Procedure 20
2.2.7 General guideline 21
2.2.8 Test items 21
2.2.9 Scoring and interpretation 22
2.2.9.1 Scoring 22
2.2.9.2 Interpretation 23
2.2.10 Advantages and disadvantages 23
2.3 Bruininks-Oseretsky test of motor proficiency, 2e edition (BOT-2) 24
1
, 2.3.1 What? 24
2.3.2 Content 25
2.3.3 Use of the BOT-2 25
2.3.4 Psychometric properties 25
2.3.5 General guidelines 25
2.3.6 Administration procedure 26
2.3.7 Test items 26
2.3.8 Scoring and interpretation 26
2.3.8.1 Scoring 26
2.3.8.2 Interpretation 27
2.3.9 Advantages and disadvantages 27
H3: Motor development 28
3.1 Bayley Scales of Infant and Toddler Development-3 28
3.1.1 What? 28
3.1.2 Use of the Bayley-III-NL 28
3.1.3 Content 28
3.1.4 Psychometric properties motor scale 29
3.2 Peabody Developmental Motor Scales-2 29
3.2.1 History 29
3.2.2 What? 30
3.2.3 Use of the PDMS-2 30
3.2.4 Content 30
3.2.4.1 Six subscales 30
3.2.4.2 Composites 31
3.2.5 Administration procedure 31
3.2.6 Psychometric properties 32
3.3 Test of Gross Motor Development-3 32
3.3.1. Background 32
3.3.2 What? 32
3.3.3 Use of the TGMD-3 33
3.3.4 Content 33
3.3.5 Administration procedure 33
3.3.6 Scoring 33
3.3.7 Psychometric properties 34
3.3.8 Advantages and disadvantages 34
H4: Body coordination 35
4.1 Body coordination 35
4.2 Körperkoordinationstest für Kinder (KTK-2-NL) 35
4.2.1 What? 35
4.2.2 Content 35
4.2.3 Administration procedure 36
4.2.3.1 Subtest 1 - backward balancing 36
4.2.3.2 Subtest 2 - platform transfer 37
4.2.3.3 Subtest 3 - jumping sideways 37
2
, 4.2.3.4 Subtest 4 - hopping over obstacle 37
4.2.4 Scoring and interpretation 38
4.2.4.1 Scoring 38
4.2.4.2 Interpretation 38
4.2.5 Psychometric properties 39
4.2.6 Advantages and disadvantages 39
4.3 DCD Daily (Van der Linden) revised 2018, Dutch instrument 39
4.4 Coordination disorders and child psychiatry 40
H5: Body scheme and spatial orientation 41
5.1 Body scheme 41
5.1.1 Definitions 41
5.1.2 Assessment 42
5.1.2.1 Showing and naming body parts 42
5.1.2.2 Physical self-description questionnaire (PSDQ, Marsch et al.) 42
5.2 Spatial orientation 43
5.2.1 Definition and development 43
5.2.1.1 Definitions 43
5.2.1.2 Development of spatial orientation 44
5.2.2 Assessment 45
5.2.2.1 Test of Piaget-Head 45
5.2.2.2 Ayres Space Test 45
5.2.2.3 Spatial Orientation Memory Test 46
H6: Lateralization 47
6.1 Definitions 47
6.1.1 Lateralization and laterality 47
6.1.2 Handedness 47
6.1.2.1 Direction 47
6.1.2.2 Degree 47
6.1.2.3 Hand preference 48
6.1.2.4 Hand dominance or hand performance 48
6.2 Evidence, development and clinical importance 48
6.2.1 Scientific evidence 48
6.2.2 Right and left handedness and hand preference index 48
6.2.3 Predicting hand preference 49
6.2.4 Development of hand preference 49
6.2.5 Importance from clinical perspective 49
6.2.5.1 Possible problems in clinical practice 49
6.3 Assessment 50
6.3.1 Observations 50
6.3.1.1 Unstructured 50
6.3.1.2 Structured 50
6.3.2 Assessment instruments 51
6.3.2.1 Hand preference Test of Geuze (2009) 51
6.3.2.2 Hand Dominanz Test (HDT) 52
3
, 6.4 Conclusion 52
H7: Visual perception and visual motor integration 53
7.1 Definitions 53
7.1.1 Visual perception 53
7.1.2 Visual motor integration 53
7.2 Assessment 53
7.2.1 Test of Visual Perceptual Skills - 4th edition (TVPS-4) 53
7.2.2 Developmental Test of Visual Perception - 2 (DTVP-2) 54
7.2.3 Beery Buktenica Developmental Test of Visual Motor Integration - 6 55
7.2.3.1 Structure 56
1. Visuomotor integration (VMI) 56
2. Visual perception 56
3. Motor coordination 56
7.2.3.2 Psychometric properties 57
7.2.3.3 Advantages 57
H8: Handwriting 58
8.1 Definitions 58
8.1.1 What is writing? 58
8.1.2 Writing prerequisites 58
8.1.2.1 General conditions 58
8.1.2.2 Specific conditions 58
8.2 Development 58
8.2.1 Developmental stages 58
8.2.2 Pencil grip 59
8.2.2.1 Primitiv grips 59
8.2.2.2 Transition grips 59
8.2.2.3 Mature grips 59
8.2.3 Dynamic 3-point grip 60
8.2.4 Writing posture 60
8.3 Handwriting problems 60
8.4 Assessment 60
8.4.1 Systematische Opsporing Schrijfproblemen (SOS-2-VL) 61
8.4.2 Test of Handwriting Skills - revised (THS-R) 61
8.4.3 Detailed Assessment of Speed of Handwriting (DASH) 62
4
, Assessment in Mental Health Care
H1: Conceptual framework
1.1 Basic principles of rehabilitation in mental health care
Basic principle 1: Holistic vision, unity of body and mind: ‘psyche’ & ‘motor’
● There is no mental health without physical health
● There is no physical health without mental health
● Constant interaction between body and mind, impossible to separate
Basic principle 2: Development depends on the continuous, reciprocal and complex interaction
between different developmental/functional domains, including:
● Motor/physical aspects
● Psychological aspects
● Cognitive aspects
● Linguistic/communication aspects
● Social aspects
Basic principle 3: Reciprocal relationship between body - mind - context
● Relevance of where the child is growing up
○ If a child can’t ride a bike, it’s a problem in Belgium because it happens a lot here
○ In another country it is less problematic
○ Idem for good writing abilities
○ In Belgium very important, for refugees it is less important
● Not only an important relationship between the different domains of the development but
also the context f.e. the home situation
○ Context has a significant impact on the way to treat the child
○ Mismatch child factors and parent/context factors
■ Mismatch between context and child factors -> often end up in the mental
health care
■ Within children factors, one can affect another
○ Enough opportunities to develop?
5
,Basic principle 4: Everything is related to development
● Take age into account when doing assessment, some things are typical for certain age-groups
● Important to know what typical development is
● In the early ages we have very wide ranges in what is normal f.e. first time walking can go
from 8 months to 15 months
Motor education versus motor therapy
● Are there any problems with the motor development? (therapists) -> therapy
● What is normal/typical development (scientist) -> education
● But before we know if there is a problem there needs to be diagnostics = focus of this course
1.2 Basic principles of (motor) assessment
1.2.1 Testing versus assessment
Assessment:
● ≠ synonym for testing, testing is a part of assessment
● = process of gathering information in order to increase understanding (learning,
development, functioning of the child)
● More broad than testing
● Including
○ Skills
○ Competences
○ Behaviours
○ Preferences f.e. how they get instructions (auditive, visual)
○ Interactions
6
, ● F.e.: a child can score bad on a motor test but the motor development may not be the cause,
it may be an intelligence problem
● Info for later therapy f.e. which cues to use in therapy
● Should include -> these are the bare minimum
○ Anamnesis
○ Questionnaires:
■ Broad or specific domain? -> depends on the setting
■ F.e. other speciality can already have info about some domains
○ Observation
○ Standardised motor assessment batteries
■ Reliable and valid
■ Age appropriate
■ Population appropriate: not easy f.e. in psychology -> IQ tests are not
developed for children with autism
1.2.2 Considerations in (early) childhood assessment
● Necessitates understanding of the (family) context
○ F.e. family and school
○ “How is the child growing up?”
○ Schedule the test moment on the right time vb. not while nap time
● Requirement for flexible procedures
○ Non-motor aspects will influence performance
○ F.e. To give instructions in another way or to give a break
● Gather only the data that you need
○ Not true that it is better to have more data
○ The child will get tired, there will be other factors influencing the results
● Ensure quality of gathered data
○ Some tests are really old
○ Be critical - is this test a real value to the assessment?
1.2.3 How to decide upon the right assessment method?
Knowledge on each of these aspects is essential to make a decision:
● Purpose (screening, evaluation, …)
○ Which tool do we need -> Screening? Evaluation?
7
, ○ Decide in advance -> what is my goal, why is there a need for help, why am I doing
this?
● Target population (age, disability, ...) -> will determine the kind of assessment
● Psychometric properties -> determine the value of your instrument (reliability and validity)
● Administrative properties (time, cost, user-friendly, ...)
○ Sometimes not the time or budget to choose the best instruments
○ Needs to be possible
1.2.4 Purpose of assessment
● Any motor assessment should start with the question ‘Why?’
○ Goal of motor assessment should be clearly specified a priori of the testing
○ Choice of assessment protocol depends on the goal -> screening vs assessment
■ Screening: quick, efficient
● Is there a possibility for a problem
● Do we need further assessment?
● Is there something going on?
● No distribution between small and big problems
■ Complete assessment: full info -> info on how big the problem is
● Motor assessment has a broad range of purposes
Purpose 1: Diagnostic assessment
● Classification / identification -> RIZIV
● Comprehensive procedure -> flowchart
● Careful and systematic procedure to diagnose problems in particular area of
development
● Individual level: always one on one -> never a group assessment in school f.e.
● Most common reason for assessment
● Eligibility for services
○ To start or not to start intervention
○ To continue or stop intervention -> should we try something else?
Purpose 2: Screening
● Screening instruments are designed to efficiently identify children who need a more detailed
assessment
● Advantage: brief and cost-effective
8
, ● Quality of screening instrument: largely depending on sensitivity and specificity
● Do not use beyond intended purpose
○ Do not use for diagnostics
○ Will not tell you which % the child is -> only tell if the child is at risk
Purpose 3: To plan treatment
● Setting a baseline for intervention
● Identification of the specific deficits: which skills?
● Identification of the details of the deficit
○ Example: George is not able to throw a ball
■ Standardised instrument usually provides information on the product
■ What is the cause? Which process criteria are not met?
● Identification of the context in which the deficits appear
○ Example: George can throw a large ball, but not a small one, or he is not able to do
so when someone is watching or there is time pressure (in a game)
● Identification of movement skill foundations: flexibility, motivation, muscular strength, ...
● Final goal = to develop a measurable treatment plan
Purpose 4: To evaluate change over time
● Measurement of developmental change: f.e. In at risk children or longitudinal studies
● Measuring the effectiveness of a program
● Measuring the individual’s progress after intervention
● Problems:
○ A ‘statistical’ significant progress might not be a functional one (ecological validity)
○ Development, maturation
Purpose 5: Providing feedback
● Sharing feedback with the child, parent, caregivers, teachers, ...
● Reimbursement agencies (health care agencies): feedback on the individual’s status relative
to functional or disability related outcomes or relative to TD peers
● Important for motivational processes
● Important to increase the understanding of the treatment
● Use of multiple methods and resources provides best information
● Focus on functional skills (criterion-referenced)
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, Other purposes
● Research
○ Population norms
○ Effectiveness of intervention
○ Monitoring population trends
○ Relationships between motor competence and health outcomes
● Prognosis f.e. Comorbidity
● Prediction
○ Least common purpose of motor assessment in rehabilitation
○ Data can be used to predict neurodevelopmental outcomes at later age
○ Prediction of someone’s (future) achievement level (f.i. talent identification in sports)
1.2.5 How to measure/evaluate?
1.2.5.1 Quantitative versus qualitative
● Quantitative: measuring balance by performance on items (infer concept of balance) &
compare performance to TD/norm population
○ F.e. number of seconds a 3-year-old child can keep balance in unipedal stance
● Qualitative: describing motor behaviour in standardised environment; observation of quality
of movement
○ F.e. ask a 3-year-old child to make a bipedal jump & assess the quality of the
movement
1.2.5.2 Norm-referenced versus criterion-referenced
● Norm-referenced: comparison of individual performance to normative group (usually TD)
○ F.e. horizontal jump: measure how far a child jumped and compare the distance to
children of the same age (and gender)
● Criterion-referenced: comparison of individual performance to predetermined criteria
○ F.e. horizontal jump: observe how the child jumps, compare the performance on
different predetermined criteria, such as ‘does the child bent the knees before
jumping? Does the child raise the hands above the head?’
1.2.5.3 Performance based instruments versus behaviour rating instruments
● Performance based: based on actual performance on a certain item
● Behaviour rating: observation instruments, questionnaires, self-perception, ...
1.2.5.4 Formal versus informal
● Formal: instruments with standardised or uniform conditions and instructions, allow
comparisons across administrators or individuals, but no information on non-included items
● Informal: not standardised f.e. observations during play
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