Interrater reliability assessment using the Test of Gross Motor Development-2

Objectives: The aim was to examine interrater reliability of the object control subtest from the Test of Gross Motor Development-2 by live observation in a school field setting. Design:: Reliability Study - cross sectional. Methods: Raters were rated on their ability to agree on (1) the raw total for the six object control skills; (2) each skill performance and (3) the skill components. Agreement for the object control subtest and the individual skills was assessed by an intraclass correlation (ICC) and a kappa statistic assessed for skill component agreement. Results: A total of 37 children (65% girls) aged 4-8 years (M= 6.2, SD=0.8) were assessed in six skills by two raters; equating to 222 skill tests. Interrater reliability was excellent for the object control subset (ICC= 0.93), and for individual skills, highest for the dribble (ICC= 0.94) followed by strike (ICC= 0.85), overhand throw (ICC= 0.84), underhand roll (ICC= 0.82), kick (ICC= 0.80) and the catch (ICC= 0.71). The strike and the throw had more components with less agreement. Conclusions: Even though the overall subtest score and individual skill agreement was good, some skill components had lower agreement, suggesting these may be more problematic to assess. This may mean some skill components need to be specified differently in order to improve component reliability.

The role of internal action representations in motor development

This research suggests that internal ‘neural’ action representations may subserve the development of important motor functions and, where impaired or delayed, may be associated with atypical function. This knowledge provides critical validation of current motor control theories and is central to our understanding of the neuro-cognitive basis of motor development.

Modelling the maturation of grip selection planning and action representation: insights from typical and atypical motor development

We investigated the purported association between developmental changes in grip selection planning and improvements in an individual’s capacity to represent action at an internal level (i.e., motor imagery). Participants were groups of healthy children aged 6-7 years and 8-12 years respectively, while a group of adolescents (13-17 years) and adults (18-34 years) allowed for consideration of childhood development in the broader context of motor maturation. A group of children aged 8-12 years with probable DCD (pDCD) was included as a reference group for atypical motor development. Participants’ proficiency to generate and/or engage internal action representations was inferred from performance on the hand rotation task, a well-validated measure of motor imagery. A grip selection task designed to elicit the end-state comfort (ESC) effect provided a window into the integrity of grip selection planning. Consistent with earlier accounts, the efficiency of grip selection planning followed a non-linear developmental progression in neurotypical individuals. As expected, analysis confirmed that these developmental improvements were predicted by an increased capacity to generate and/or engage internal action representations. The profile of this association remained stable throughout the (typical) developmental spectrum. These findings are consistent with computational accounts of action planning that argue that internal action representations are associated with the expression and development of grip selection planning across typical development. However, no such association was found for our sample of children with pDCD, suggesting that individuals with atypical motor skill may adopt an alternative, sub-optimal strategy to plan their grip selection compared to their same-age control peers.

Promoting gross motor skills and physical activity in childcare: a translational randomized controlled trial

OBJECTIVES: Educator-led programs for physical activity and motor skill development show potential but few have been implemented and evaluated using a randomized controlled design. Furthermore, few educator-led programs have evaluated both gross motor skills and physical activity. Therefore, the aim of this study was to evaluate a gross motor skill and physical activity program for preschool children which was facilitated solely by childcare educators. DESIGN: A six-month 2-arm randomized controlled trial was implemented between April and September 2012 in four early childhood centers in Tasmania, Australia. METHODS: Educators participated in ongoing professional development sessions and children participated in structured physical activity lessons and unstructured physical activity sessions. RESULTS: In total, 150 children were recruited from four centers which were randomized to intervention or wait-list control group. Six early childhood educators from the intervention centers were trained to deliver the intervention. Gross motor skills were assessed using the Test of Gross Motor Development (2nd edition) and physical activity was measured objectively using GT3X+ Actigraph accelerometers. No statistically significant differences were identified. However, small to medium effect sizes, in favor of the intervention group, were evident for four of the five gross motor skills and the total gross motor skill score and small to medium effect sizes were reported for all physical activity outcomes. CONCLUSIONS: This study highlights the potential of educator-led physical activity interventions and supports the need for further translational trials within the early childhood sector.

Objectively measured sedentary behaviour and health and development in children and adolescents: systematic review and meta-analysis

Sedentary behaviour has emerged as a unique determinant of health in adults. Studies in children and adolescents have been less consistent. We reviewed the evidence to determine if the total volume and patterns (i.e. breaks and bouts) of objectively measured sedentary behaviour were associated with adverse health outcomes in young people, independent of moderate-intensity to vigorous-intensity physical activity. Four electronic databases (EMBASE MEDLINE, Ovid EMBASE, PubMed and Scopus) were searched (up to 12 November 2015) to retrieve studies among 2- to 18-year-olds, which used cross-sectional, longitudinal or experimental designs, and examined associations with health outcomes (adiposity, cardio-metabolic, fitness, respiratory, bone/musculoskeletal, psychosocial, cognition/academic achievement, gross motor development and other outcomes). Based on 88 eligible observational studies, level of evidence grading and quantitative meta-analyses indicated that there is limited available evidence that the total volume or patterns of sedentary behaviour are associated with health in children and adolescents when accounting for moderate-intensity to vigorous-intensity physical activity or focusing on studies with low risk of bias. Quality evidence from studies with robust designs and methods, objective measures of sitting, examining associations for various health outcomes, is needed to better understand if the overall volume or patterns of sedentary behaviour are independent determinants of health in children and adolescents.

Comparison of performance on process- and product-oriented assessments of fundamental motor skills across childhood

Process-oriented motor competence (MC) assessments evaluate how a movement is performed. Product-oriented assessments evaluate the outcome of a movement. Determining the concurrent validity of process and product assessments is important to address the predictive utility of motor competence for health. The current study aimed to: (1) compare process and product assessments of the standing long jump, hop and throw across age groups and (2) determine the capacity of process assessments to classify levels of MC. Participants included 170 children classified into three age groups: 4–5, 7–8 and 10–11 years old. Participants’ skills were examined concurrently using three process assessments ((Test of Gross Motor Development-2nd edition [TGMD-2]), Get Skilled; Get Active, and developmental sequences) and one product measure (throw speed, jump and hop distance). Results indicate moderate to strong correlations between (1) process assessments across skills and age groups (r range = .37–70) and (2) process and product assessments across skills and age groups (r range = .26–.88). In general, sensitivity to detect advanced skill level is lowest for TGMD-2 and highest for developmental sequences for all three skills. The use of process and product assessments is suggested to comprehensively capture levels of MC in human movement.

A multidisciplinary perspective on motor impairment as an early behavioural marker in children with autism spectrum disorder

Objectives: There is no medical test for autism spectrum disorder (ASD), a heterogeneous condition currently defined in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) by dysfunction in social, communication, and behavioural dimensions. There is agreement in the literature that the motor profile of ASD may hold the key to improving clinical and diagnostic definition, with DSM-5 now referring to motor deficits, including “odd gait” (p. 55), as part of the ASD clinical description. This review describes the history of motor impairment in ASD, types of motor problems, and age-related motor findings and highlights evidence gaps and future research. Method: A narrative review is provided of the research literature describing motor impairment in ASD and its ability to differentiate between ASD versus non-ASD cohorts. Results: Findings show differences in motor development in children with ASD from infancy onwards, including difficulties across motor coordination, arm movements, gait, and postural stability. Motor disturbance may appear in young children with ASD prior to social and language difficulties becoming clinically apparent. However, challenges remain in defining and measuring the early motor profile that is specific to ASD. Despite well-established motor impairments in ASD, there is a lack of evidence regarding which motor-based interventions will be effective in this group. Conclusions: Motor impairment holds promise as an early diagnostic sign, a behavioural marker, and a means by which to improve identification and possibly phenotypic delineation in ASD. Further research is required to determine whether motor abnormalities can sensitively differentiate ASD from other developmental conditions and to establish evidenced-based interventions to reduce the associated impairment.

More active pre-school children have better motor competence at school starting age: an observational cohort study.

BACKGROUND: Almost half of young children do not achieve minimum recommendations of 60 daily minutes in physical activity. Physical activity is potentially an important determinant of the development of motor competence in children. This study is one of very few longitudinal studies in this area and the first to investigate early childhood physical activity as a predictor of subsequent motor skill competence. METHODS: Children were assessed as part of the Melbourne InFANT Program longitudinal cohort study at 19 months, 3.5 years and 5 years. Moderate-to-vigorous physical activity (MVPA) (accelerometry) was assessed at each time point. At age 5, children were also assessed in actual (Test of Gross Motor Development-2) and perceived motor competence (Pictorial Scale of Perceived Movement Skill Competence). General linear models were performed with all 12 skills (six object control and six locomotor skills), both actual and perceived, at age 5 as the respective outcome variables. Predictor variables alternated between MVPA at 19 months, 3.5 years and 5 years. RESULTS: Based on standardized TGMD-2 scores most children were average or below in their skill level at age 5. MVPA at 19 months was not a predictor of actual or perceived skill at age 5. MVPA at 3.5 years was associated with actual locomotor skill (B = 0.073, p = 0.033) and perceived total skill at 5 years of age (B = 0.059, p = 0.044). MVPA was not a predictor of actual or perceived object control skill at any age. CONCLUSION: Parents and preschool staff should be informed that more time in MVPA as a preschool child contributes to locomotor skill and to perceptions of skill ability in a child of school starting age. Understanding this relationship will assist in intervention development.

Developmental outcomes of children exposed to antidepressants in pregnancy

Objective: To examine the developmental outcomes in children exposed to antidepressants in utero and compare those to children not exposed to these medications
Method: A prospective case-controlled study of children exposed to antidepressants in pregnancy assessed 22 exposed and 19 not exposed children using the Bayley Scales of Infant Development, third edition. The control group was measured at a mean age of 23.09 (SD 3.82) months and the medicated group at 28.53 months (SD 6.22). Maternal variables were assessed using a purpose-designed questionnaire and the Beck Depression Inventory (II) in pregnancy and at three assessments in the postpartum.
Results: Children exposed to antidepressant medication in pregnancy scored lower on motor subscales in particular on fine motor scores than non-exposed children with a moderate effect size of Cohen ’ s d = 0.47 fi ne motor and Cohen ’ s d = 0.43 for gross motor. Due to lack of power these findings did not reach conventional criteria for statistical significance. There was no association found between maternal depression and neurodevelopment.
Conclusions: This finding of a possible effect from antidepressant exposure in pregnancy on children ’ s motor development is similar to the findings from a previous study. Future research is needed which assesses children at an older age using specific assessments of motor development.

Use of electronic games by young children and fundamental movement skills?

This study investigated associations between pre-school children's time spent playing electronic games and their fundamental movement skills. In 2009, 53 children had physical activity (Actigraph accelerometer counts per minute), parent proxy-report of child's time in interactive and non-interactive electronic games (min./week), and movement skill (Test of Gross Motor Development–2) assessed. Hierarchical linear regression, adjusting for age (range = 3–6 years), sex (Step 1), and physical activity (cpm; M = 687, SD = 175.42; Step 2), examined the relationship between time in (a) non-interactive and (b) interactive electronic games and locomotor and object control skill. More than half (59%, n = 31) of the children were female. Adjusted time in interactive game use was associated with object control but not locomotor skill. Adjusted time in non-interactive game use had no association with object control or locomotor skill. Greater time spent playing interactive electronic games is associated with higher object control skill proficiency in these young children. Longitudinal and experimental research is required to determine if playing these games improves object control skills or if children with greater object control skill proficiency prefer and play these games.

Three year follow-up of an early childhood intervention : is movement skill sustained?

Background
Movement skill competence (e.g. the ability to throw, run and kick) is a potentially important physical activity determinant. However, little is known about the long-term impact of interventions to improve movement skills in early childhood. This study aimed to determine whether intervention preschool children were still more skill proficient than controls three years after a 10 month movement skill focused intervention: ‘Tooty Fruity Vegie in Preschools’.

Methods
Children from 18 intervention and 13 control preschools in NSW, Australia were assessed at ages four (Time1), five (T2) and eight years (T3) for locomotor (run, gallop, hop, leap, horizontal jump, slide) and object control proficiency (strike, bounce, catch, kick, overhand throw, underhand roll) using the Test of Gross Motor Development-2. Multi-level object control and locomotor regression models were fitted with variables time, intervention (yes/no) and a time*intervention interaction. Both models added sex of child and retained if significant, in which case interactions of sex of child with other variables were modelled and retained. SPSS (Version 17.0) was used.

Results
Overall follow-up rate was 29% (163/560). Of the 137 students used in the regression models, 53% were female (n = 73). Intervention girls maintained their object control skill advantage in comparison to controls at T3 (p = .002), but intervention boys did not (p = .591). At T3, there were no longer intervention/control differences in locomotor skill (p = .801).

Conclusion
Early childhood settings should implement movement skill interventions and more intensively target girls and object control skills.

Associations between young children's perceived and actual ball skill competence and physical activity

Objectives: The relationship between actual and perceived object control competence (ball skills) and the contribution to young children’s physical activity is not known.
Design: Cross sectional study.
Methods: The Test Gross Motor Development-2 assessed actual object control competence and a modified version of the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children assessed perceived object control competence. Moderate- to vigorous-intensity physical activity was measured via accelerometry. Three mixed regression models were performed: (i) object control competence as the predictor and the outcome as perceived object control, (ii) perceived object control competence as the predictor and the outcome moderate to vigorous physical activity and (iii) actual object control as the predictor and the outcome moderate to vigorous physical activity. Models adjusted for school clustering, monitor wear time, sex and age. Interactions between respective predictor variables and sex were performed if warranted. A total of 102 children (56% boys, 44% girls) aged 4–8 years (M 6.3, SD 0.92) completed assessments.
Results: Girls had lower perceived and actual object control competence and were less active than boys. Actual object control competence was positively associated with perceived object control competence (B = 0.11, t(96) = 2.25, p < 0.001, p = 0.027) and this relationship did not differ by sex (p = 0.449); however, neither actual (p = 0.092) nor perceived object control competence (p = 0.827) were associated with moderate to vigorous physical activity.
Discussion: Young children’s perceived ball skill abilities appear to relate to actual competence; however, these measures were not associated with physical activity. In older children, object control skill is associated with physical activity so targeting young children’s object control skills is an intervention priority.