Physical Therapy Posts

the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2)

Understanding Physical Therapy Outcome Measurements: The Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2)

Previous physical therapy blogs have explained outcome measurements used to assess gross motor development in infants and children up to age 5, including the Peabody Developmental Motor Scale, second edition and the Alberta Infant Motor Scale. When children age out of either the PDMS-2 or the AIMS, one standardized assessment option physical therapists have is the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2). The BOT-2 can be used to evaluate a wide variety of fine and gross motor skills for children, teenagers and young adults 4-21 years of age. This is a test that can also be used by occupational therapists, psychologists, adaptive physical education teachers, special education teachers and educational diagnosticians.

The BOT-2 contains a total of 8 subtests that look at both fine and gross motor functioning. When certain subtests are combined, they can give more specific information regarding the child’s Fine Manual Control, Manual Coordination, Body Coordination, or Strength and Agility. Administering all 8 subtests can allow the physical therapist to obtain a Total Motor Composite looking at the child’s overall performance with fine and gross motor functioning.

Below is a description of the subtests most commonly used by physical therapists in BOT-2 testing:

  • Bilateral Coordination: This section of the BOT-2 looks at a child’s control with tasks requiring movement ofthe Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2) both sides of the body. Tasks in this section will require the child to move his arms and legs from the same and opposite sides of the body together, in sequence, or in opposition.
  • Balance: The balance subtest evaluates the child’s moving and stationary balance. Tasks are completed with a variety of challenges to the balance systems, such as while on one foot, on a balance beam, or with eyes closed.
  • Running Speed and Agility: This section of the test looks at a child’s maximum running speed, running and changing directions, as well as stationary and dynamic hopping and jumping skills.
  • Upper-Limb Coordination: This subtest is used to assess the child’s ability to coordinate arm and hand movements and visual tracking of the task. The child is required to demonstrate skills such as catching, throwing and dribbling a tennis ball with one or both hands.
  • Strength: In the strength section of testing, the child is required to perform tasks designed to evaluate strength in the core, arms and legs. Strength is assessed in both static positions as well as with dynamic movements.

Based on the child’s presenting concerns, a physical therapist may evaluate the child using just a few or all of these subtests. The child’s performance on the BOT-2 will allow the physical therapist to identify areas of strength and areas of need in regards to the child’s gross motor functioning, and can therefore help to guide treatment. Because the BOT-2 has both age and sex-specific normative data, this test will help the physical therapist determine how the child is performing compared to peers his age. The BOT-2 can be re-administered periodically in order to monitor progress in the child’s functioning and performance with gross motor skills.

If you have concerns with your child’s performance in any of the categories listed above, click here to get scheduled with one of our pediatric physical therapists!

References:
Bruininks, Robert H., and Brett D. Bruininks. Bruininks-Oseretsky Test Motor Proficiency. 2nd ed. Minneapolis: Pearson, 2005. Print.

Laughing baby with ball

Understanding Physical Therapy Outcome Measurements: The Peabody Developmental Motor Scale, Second Edition (PDMS-II)

 

 

 

In my previous blog about the Alberta Infant Motor Scale, I mentioned that as a baby ages, more age-appropriate developmental motor scales must be used to monitor achievement of skills.  The Peabody Developmental Motor Scale is a comprehensive and reliable tool used to measure both fine and gross motor activities early in life. It was designed to assess motor skills in children from birth to 5 years old.  A majority of physical therapists use this assessment to monitor toddler and preschooler development.

Laughing baby with ballThe PDMS-2 is not just limited to physical therapist use. It can be helpful to occupational therapists, diagnosticians, early intervention specialists, adapted physical education teachers, psychologists, and developmental pediatricians who are monitoring motor abilities of children younger than five.  The six subtests that make up the PDMS-2 can be used separately or can be combined to collectively describe a child’s gross motor skills (Gross Motor Quotient), fine motor skills (Fine Motor Quotient), or overall motor skills (Total Motor Quotient).

See below for a description of each subtest:

Reflexes: The 8-item Reflexes subtest measures aspects of a child’s ability to automatically react to environmental events.  Because reflexes typically become integrated and less obvious by the time a child is 12 months old, this subtest is given only to children from birth through 11 months of age.

Stationary:  The 30-item Stationary subtest measures a child’s ability to control his body within its center of gravity and retain equilibrium. Stationary skills include standing on one leg without falling, or standing on tiptoes.

Locomotion: The 89-item Locomotion subtest measures a child’s ability to move from one place to another.  The actions measured include crawling, walking, running, hopping, and jumping forward.

Object Manipulation: The 24-item Object Manipulation subtest measures a child’s ability to manipulate balls.  Examples of the actions measured include catching, throwing, and kicking.

Physical therapists mostly focus on the reflex, stationary, locomotion, and object manipulation portions of the PDMS-2.  Through these sections of the test, we can better assess 1) the maturation of a baby’s neuromuscular system, 2) his safety and stability when navigating his environment, 3) his ability to support and move his own weight, and 4) his ability to maintain his balance and control his trunk while moving objects outside his center of gravity. Overall, this tells us how well a child can use the large muscles in his body to stabilize and create movement.

The Peabody Developmental Motor Scale has been norm-referenced, and proven to be reliable and valid. It has been used to monitor children with and without developmental difficulties. It is relatively easy to administer and the information it provides can be used by medical professionals to tailor a child’s individualized education program (IEP).

Does your toddler have special needs? Or do you have questions about physical therapy screenings for your preschooler? Come to see one of our specialists!

Infant crawling

Understanding Physical Therapy Outcome Measurements: The Alberta Infant Motor Scale (AIMS)

Pediatric physical therapists use different methods and tools to monitor children at risk for motor delay. These measurement tools are often age-specific, reliable, valid, and easy to administer. The purpose of using standardized outcome measurements is that both typical and atypical development can be monitored across the lifespan.

Infant crawlingWhen a baby attends his first physical therapy session, he will most likely be evaluated using the Alberta Infant Motor Scale.  This scale assesses the motor development of babies birth to eighteen months of age. It breaks down the components of infant movements, up until independent walking is achieved.  Over the course of a baby’s first year of physical therapy, he will most likely be evaluated multiple times using this scale. Based on the child’s ability to perform gross motor milestones in 4 different positions: supine (lying on back), prone (lying on tummy), sitting, and standing, physical therapists and occupational therapists can determine his motor performance compared to his peers. Much like a height and weight scale used by pediatricians, the AIMS allows physical therapists to record infants’ developmental maturity as a percentile score, and to monitor his motor development over time. This way all health professionals involved in your baby’s care can track his growth over time, both compared to his peers, and compared to his previous performances.

There are a couple other standardized assessment tools we use to monitor gross motor development. Keep in mind that one-time screenings are not enough to rule out developmental delay. When using outcome measures to determine motor delay, physical therapists need to perform multiple assessments over time, using a variety of tests.  Once a baby outgrows the AIMS, we have other standardized tools ready to go for the toddler stage. Look for information on the Peabody Developmental Motor Scale in an upcoming blog.

Questions about physical therapy screenings for your baby? Please give us a call!