Current Approaches to Motor Competence Assessment in School-Age Children

INTRODUCTION

Health is a state of complete physical, mental and social well-being [1]. According to World Health Organization (WHO), 60% of related factors to individual health and quality of life are correlated to lifestyle. Regular physical activity (PA) contributes to maintaining and improving health and is important for human development throughout a person's entire lifespan. Normal psychomotor development accompanied by an adequate amount of PA in infancy and early childhood is crucial for the development of mental and physiological health [2].

The concept of Physical Literacy (PL) has been created to encourage the development of health through an active lifestyle. This concept focuses not only on the facilitation of health-related fitness but also focuses on areas such as motivation, confidence, motor competence (MC), knowledge, and understanding to value and take responsibility for engagement in PA [3]. Thus, the concept of PL incorporates four interrelated domains, namely physical, psychosocial, social, and cognitive domains.

The understanding of causality among particular domains included in the concept of PL is not entirely clear. Schmutz et al. [3] point in early childhood to the independent development of MC and PA. A positive relationship exists between MC and PA across childhood, according to Robinson et al. [4]. Stodden et al. [5] have proposed a theoretical model, which assigns an important role to the age of a child when examining the relationship between PA and MC. According to this model, it is assumed that the association between PA and MC is more significant and reciprocal during the stages of middle and late childhood.

Different theories of motivated behavior applied to understanding and predicting PA participation (e.g., competence motivation theory, self-efficacy theory) highlight perceived competence as one of the most consistent predictors of PA [6].

MC, which is the main topic in this article, is defined as the level of development of fundamental motor skills (FMS), including locomotor, manipulative, and balance skills appropriate to the stage of ontogenetic development. MC is a person’s proficiency to execute motor skills as well as the underlying mechanisms, including motor coordination and control [7].

The evolution of terms within motor development has created ambiguity in terminology within the literature and across the various disciplines and sub-disciplines of human movement. There remain a variety of terms used to describe levels of movement skill. Contemporary use of the term MC reflects various terminologies that have been used in previous literature (i.e., motor proficiency, motor performance, fundamental movement/motor skills, motor ability, and motor coordination) [7] .

In fact, socioeconomic status (professional occupation and education levels of mother and father), house living space (the type of housing; existence near the house of a courtyard, terrace, garden, or yard where the child can play), the child’s interaction with peers (age of preferred playmates, sex of preferred playmates, interaction with peers out of school), and the educational practices within the family (geographical limit of child’s play in relation to household, type of toys, relative time spent by each parent with the child), are significantly associated with children’s MC [8].

Appropriate development of FMS is an essential prerequisite for an active lifestyle and overall well-being. Children who display an adequate level of FMS are more likely to be physically active throughout their life and possess the well-developed aerobic capacity, and are less likely to become overweight or obese [9]. Active lifestyle positively influences parameters associated with physiological health and health-related fitness and aspects of psychosocial health such as cognitive function and social and emotional development [10].

Although motor development is a lifelong process, the essential stage for FMS learning and development is childhood, which is also a critical period for MC development. FMS acquired during early childhood are the basis for learning more complex and specific motor skills in later stages of life. Moreover, FMS developed during early childhood create a foundation for motor skills associated with everyday life [4].

Children who fail to acquire an appropriate level of FMS struggle with learning more complex motor skills. In addition, these children often attempt to avoid PA which require a higher level of motor skills and therefore represent a higher risk of failure. Thus, these children tend to be unwilling to participate in PA both in childhood and later in adulthood, contributing to all negative consequences of a sedentary lifestyle [10]. Most complications related to a low level of MC are demonstrated in primary school-aged children because the school readiness is being assessed, and these children are being evaluated in a school setting.

Over the past ten years, the research regarding MC and FMS has primarily focused on motor delays and deficits. Insufficient level of MC is generally associated with poor quality of movement, motor control, and coordination. In motor deficits assessment, also commonly known as MC assessment, it is prevalent for researchers to use terms such as low MC and developmental coordination disorder or dyspraxia (DCD) interchangeably. DCD is a neurodevelopmental motor disorder characterized by psychomotor delay and fine and gross motor development delay without obvious intellectual or medical causes [11]. DCD diagnostics is frequently used in a clinical setting, and low MC is one of the crucial indicators used when diagnosing DCD. When considering the application of appropriate intervention, it is essential to distinguish whether motor deficits have been developed through the insufficient amount of PA or whether these deficits result from a neurodevelopmental disorder.

The aim of this article is to establish an overview of diagnostic tools for an assessment of MC in primary school-aged children. In addition, this research article aims to shed light on motor deficits, improve understanding of MC assessment in the concept of PL, describe the correct application of particular assessment tools, and evaluate their applicability in a European setting.

MATERIAL AND METHODS

Many tools for MC evaluation are listed in the scientific literature. To analyze descriptive and psychometric characteristics, we selected test batteries according to the following criteria. The main criteria used for selecting assessment tools include assessing FMS level, MC, movement quotient, general MC, motor skills, motor coordination, and other variables describing the same phenomenon published in indexed journals in English or German. Studies that used tests to measure fine motor skills or specific sport-related skills exclusively or used only a single test item were not included.

Another selection criterion was the age category of primary-school-age children, i.e., the period from 6/7 years to 11/12 years. Due to the selected inclusion criteria, some frequently used assessment tools for preschool children have been excluded, such as Motoriktest für Vier- bis Sechsjährige Kinder - MOT 4-6 [12].

Assessment tools designed for neurotypical children have been included. On the other hand, assessment tools with the primary focus on specific populations with disabilities such as Gross Motor Function Measure (GMFM) to measure changes in gross motor function over time or with intervention in children with cerebral palsy have not been included [13].

Furthermore, some of the assessment tools that are not being used very frequently and include outdated normative data have been excluded, for example, Trampolin-Körperkoordinationstest published in 1963 [14].

The last criterion for selecting test batteries is the availability of basic psychometric parameters in the literature. When selecting a suitable assessment tool, it is crucial to consider the psychometric properties of a particular assessment tool. The most important criteria for choosing an assessment tool are content validity, validity criteria, construct validity, test-retest reliability, inter-rater reliability, and the internal consistency – Cronbach's alpha [15].

Methodology recommended in AERA/APA/NCME [16] has been used to evaluate the validity and reliability of the selected assessment tools. The overall score consisted of evaluating content validity, validity criteria, and construct validity. Similarly, the overall score for reliability has been calculated from test-retest reliability, inter-rater reliability, and the internal consistency – Cronbach's alpha. Each component of validity and reliability is evaluated by 0 or 1 based on the quality and availability of variables in published research articles. The overall psychometric score is expressed as the sum of validity and reliability scores.

An overview of the selected assessment tools used for an evaluation of MC in primary school-aged children, their description, and the authors is provided in Table 1.

RESULTS

We selected the final five test batteries for more detailed descriptive and psychometric characteristics. The manual in English or German and possibly normative criteria for the European geographical area are available for these batteries.

In the case of more versions of a particular assessment tool, only the latest version has been included. Moreover, screening questionnaires, which are intended for a school setting but do not meet the requirements of standardized assessment tools or are supposed to be primarily answered by parents or teachers, have been excluded.

Five final assessment tools are Movement Assessment Battery for Children 2 [17], Körperkoordinationstest für Kinder, 3. Aufgabe [18], Test of Gross Motor Development-Third Edition [19], Bruininks-Oseretsky Test of Motor Proficiency, Sec. Ed. [20], Test zur Erfassung motorischer Basiskompetenzen [21]. Assessment tools are described in detail in Table 2.

DISCUSSION

A study of the scientific literature shows the inconsistency of terminology concerning the concept of MC. In the concept of HRF, there is a relative agreement in aspects and their causality to health. In the area of MC, there is no such agreement. This is already evident when comparing the variables measured on the selected five test batteries. From Table 2 it is evident that the output of the chosen test batteries is five different terms: the total score of motor proficiency, motor competence, gross motor composite, total motor composite, and basic motor competencies. For mutual comparison, it is important to analyze the individual test tasks and how they are evaluated.

Another relevant fact in this context is that test instruments based on different theoretical frameworks often use almost the same motor tasks as test items, with differences arising only in contextual details or scoring [25]. For example, the tasks “aiming and catching” or “one-leg balance” appears in quite similar forms in the MABC-2 and BOT-2, the task “throwing” in the MABC-2 and MOBAQ [21].

When choosing the preferred diagnostic device, the measurement target is essential. When diagnosing MC, the primary purpose is to identify a low level of MC, motor deficits, and delays in an individual in a clinical setting, specify the deficit and propose support.

When monitoring, which focuses on population group measurements, the objective is to screen the current status of the selected groups. The primary purpose of educational monitoring is to evaluate children's achievements, create support and design future educational policies.

The MOBAQ, KTK, TGMD-3 test batteries are designed for monitoring. For diagnostics, it is preferable to choose the complete form of BOT-2 and MABC-2, which are also intended for identifying children at risk of DCD. On their own, it is not possible to decide on the presence of DCD based on the results of these test batteries, but the test batteries are part of the complete diagnostic background.

The tests designed for monitoring contain fewer tasks and are aimed at children with deficits and above-average talents. The diagnostic tests in the full version have more items; they are more time-consuming. They are better at finding potential debilitations, but they are not sensitive to above-average results.

In terms of the number of individual tasks, the most extensive battery is BOT-2. It contains 53 test tasks and details the areas of potential deficits. However, its realization requires at least one hour as well as evaluation. It is balanced by the test's high sensitivity in the complete version. According to the results of Ghrahaei et al. [26], it seems that the BOT-2 has an appropriate validity and reliability as well as a high sensitivity and can be used to evaluate motor skills and diagnose children with DCD.

Time may limit BOT-2 to a more extensive application. For these reasons, a short version of BOT-2 has been developed, which can also be used in the area of monitoring. However, the short form does not provide substantial motor performance assessment and requires a revision [27].

All selected assessment tools meet the instruction, administration, and evaluation criteria. The test kits contain clear instructions for each test item, administration manuals, and a comprehensive scoring guidebook. A convenient set of scoring sheets exists for clinical tools BOT-2 and MABC-2, including qualitative evaluation as a part of the overall score. The qualitative evaluation might focus on details about understanding the tasks' results, quality of the movement, coexisting comorbidities, or laterality problems.

In terms of age, the most extensive is BOT-2. It is designed in the original version up to 21 [20]. The normative criteria for Austria, Germany, and Switzerland have been verified for children up to 14 [28]. The age range is similar for other test batteries.

Suppose we evaluate the most significant advantages and disadvantages of individual test batteries. In that case, the benefit of MABC-2 is the existence of normative criteria in several European countries and the cross-cultural validity [29]. The situation is similar for BOT-2, other tests adopt normative standards according to the land of origin, and only manual translations are used.

The main disadvantage of the MABC-2 is a relatively wide age range, which results in a loss of sensitivity [7]. For BOT-2, the factor structure of individual subtests is determined for specific age categories [27].

KTK lacks the evaluation of fine motor items, namely object manipulation skills. For this reason, the KTK-3+EHC assessment tool, which includes Faber's eye-hand coordination test, was created [30]. The disadvantages of the TGMD-3 test include the absence of fine motor skills and balance skills. For the TGMD-3, cross-cultural validity in the ball skills subtests, specifically, one-hand strike, two-hand strike, and overhand throw, is problematic. It makes the use of this assessment tool more complicated in European countries. The criterion validity indicates that the TGMD-3 may be measuring a slightly different construct to the other assessment tools included in this study. It has a poor agreement with the MABC-2, which has a good agreement with the BOT-2 [31].

The BOT-2 is the most complex assessment tool. It includes 53 test items, encompassing fine and gross motor skills. On the other hand, the most specific assessment tool is Körperkoordinationstest für Kinder, which comprises of 4 test items.

The evaluation of psychometric qualities of the selected assessment tools has been based on the previously published scientific articles.

The BOT-2, the MABC-2, and TGMD-3 have been considered to have the best psychometric qualities. The KTK assessment tool has shown low content validity and internal consistency. The MOBAK lacks some of the psychometric qualities, possibly because this assessment tool is relatively new and has not been frequently used so far.

CONCLUSION

This research article aimed to create a synthesis of descriptive and psychometric characteristics of 5 selected assessment tools designed to evaluate MC in primary school-aged children. These selected assessment tools included Movement Assessment Battery for Children-2, Körperkoordinationstest für Kinder, Test of Gross Motor Development-Third Edition, Bruininks-Oseretsky Test of Motor Proficiency, Sec. Edition, Test zur Erfassung motorischer Basiskompetenzen. Descriptive and psychometric characteristics can assist with selecting a suitable assessment tool based on fundamental properties, objectives of the assessment, conditions required for administration, recommended training for administers, and validity and reliability.

The objective of the investigation is crucial for the assessment of descriptive characteristics. An evaluation of MC might be conducted for several reasons, such as for educational purposes, identification of motor deficits and delays in a clinical setting, or designing a curriculum for students with special educational needs.

For purposes of monitoring in a school setting, the MOBAK, KTK, and the TGMD-3 are frequently used due to the ability of these assessment tools to evaluate both below-average performance and above-average performance. These assessment tools include sensitivity of MC results throughout the entire scale. These tools are also recommended for the measurement of large groups.

On the other hand, there are diagnostic tools primarily designed to identify motor deficits, such as MABC-2 and BOT-2. The primary function of the selected evaluation tools is the identification of motor deficites; therefore, the sensitivity of these evaluation tools to the identification of talent is low. They serve as a basis for individual DCD diagnosis, and they are not recommended for screening large groups.

The most detailed descriptive characteristics are provided by the BOT-2 test, which contains 53 test tasks. However, it is time-consuming and organizationally demanding. All these selected assessment tools meet the instruction, administration, and evaluation criteria. The test kits of these assessment tools contain clear instructions for each test item, administration manuals, and a comprehensive scoring guidebook. It is essential for more complex assessment tools like the BOT-2 and MABC-2. The possibilities of qualitative evaluation in both diagnostics test batteries might focus on details about the understanding of the tasks, quality of the movement, coexisting comorbidities, or laterality problems.

Another issue associated with the administration of assessment tools is the necessity of training related to the proper use of a particular assessment tool for administers and its availability and time requirements. In Europa, administration training is available for most of the assessment tools. In addition, it is possible to access training abroad or use available manuals to familiarize oneself with the administration and the evaluation.

Based on the results from the psychometric evaluation of the selected assessment tools, the BOT-2, the MABC-2, and the TGMD-3 have been evaluated with identical scores and have displayed better psychometric qualities than KTK and the MOBAK. KTK assessment tool has been shown to have low content validity and internal consistency. The MOBAK exhibits important curriculum validity, but it lacks some psychometric qualities because this assessment tool is relatively new and has not been frequently used yet. There is a lack of scientific research and practical implementation of the MOBAK to confirm its expected potential in motor skill assessment in a school setting.

Overall, with a joint assessment of descriptive and psychometric characteristics, BOT-2 is the most comprehensive diagnostic means of assessing MC, which includes monitoring fine and gross motor items.

ACKNOWLEDGMENTS

The study was financial supported by TA ČR ÉTA , TL03000221.