Bruininks-Oseretsky Test of Motor Proficiency (BOT2)

Developed by Robert H. Bruininks et al

(2005)

a) ICF level: Activitiesb) Attributes: Mobility (Changing and maintaining body

position, walking and moving, handling objects)c) Measures a single attributed) Purpose: Discriminate between problem versus no

problem, evaluative ( show change over time) e) Perspective: Service Providerf) Population designed for: Children and youth ages 4-

21Diagnosis: Useful for children with suspected motor delays to assess fine and gross motor skills.

g) Examination context: Rehabilitation Centre/Health Care Setting, Educational Setting. Test area must be without distraction.

a) Clarity – Excellentb) Format – Task Performance

Not physically invasive, patient actively involved, special equipment required: BOT-2 kit.

c) Time to complete assessment approx 1 hour, includes Short Form and Scoring.

Administration-EasyScoring- More ComplexInterpretation- Easy

d) Formal qualifications for administration and interpreting is recommended.

e) Cost- BOT-2 Test Kit- 795$ (includes manual 105$, 25 scoring sheets 44.50$) Pearson Education, 2009

a) Adequate – Excellent, included relevant characteristics of attribute based on comprehensive literature reviews.

b) Weighting – Yes, Implicit weighting is used. Each subgroup has a different numbers of items.

c) Level of measurement – Ordinal; Four different was to administer the BOT-2. (Complete Form, Short Form, Select Subsets, Select Composites)-Fine Manual Control 15 items: (Fine Motor Precision 7, Fine Motor Integration 8) -Manual Coordination 12 items: (Manual Dexterity 5, Upper-Limb Coordination 7) -Body Coordination 16 items: (Bilateral Coordination 7, Balance 9)-Strength and Agility 10 items: (Running Speed and Agility 5, Strength 5,(Push-ups: knee or full)

Long Form(LF)- 53 Items, Short Form (SF)- 14 items

Total 53 Items, Subscale scores are obtained, and can be administered alone

a)Manual: Excellent- published manual which outlines specific procedures for administration; scoring and interpretation; evidence of reliability and validity.

b) Norms Available- yes, children and youth ages 4-21 years old.

1) Size of Sample: 1520 children in 12 age groups

2) Population for which is normed:

-Stratification was based on age, gender, socioeconomic background as measured by parental education, ethnic background, geographical area, disability and educational placement. -Sample Group: 60.2% white, 15.1% African American, 18.4% Hispanic, and other (American Indian, Alaskan natives, and Asian Americans) were 6.3% of the sample groups

a) Adequate to Excellent Reliability –

b) Inter-rater reliability between 2 PT’s- Pearson Correlation >0.92 (excellent) for composite scores.

c) Inter-rater reliability between 2 PT’s- Pearson Correlation >0.90 (excellent) for complete form and subtests. With the exception of the Fine Motor Precision Subtest -Pearson Correlation 0.86, (excellent)

-Kopp at el, 2007, & Brunininks & Bruininks, 2005

Test-Retest Reliability -of cognitive, language and motor scales was assessed by testing 134 children twice by the same assessor over 7 to 42 days. Correlation scores varied depending upon the children’s ages. Fine manual control, manual coordination, and body coordination wee highly variable. 7 of 9 correlation <0.80 (excellent) for the composites and 16 of 18 correlations < 0.80 (excellent) for the subsets. Strength and agility (with knee push-ups and agility with full pushups) and related subsets were >0.80 (excellent). Small Practice effect noted in Manual coordination and Body coordination motor areas.

Internal Consistency1) > or = 0.93 (excellent) for the total Motor composite for all ages. 2) > or = 0.80 for the shore form, correlations between 0.60- 0.92

(Adequate to excellent) (Bruininks & Bruininks, 2005)

Internal Consistency of the BOT-2 total score was excellent (Cronbach’s alphas= 0.92). Coefficient alpha ranged from 0.81 to 0.88 for subtests, and 0.87-0.88 for the composites. This shows sufficient homogeneity of all the individual domains as well as the total test. In the Test-Retest analysis,(14 days vs 7-42 days) ICC varied between 0.88 and 0.99 for the subtests and composites, the ICC of the total score was 0.99 indicating excellent reliability. As expected SEM values for the subtests and composites all attained criterion ( SEM ≤ SD/2), suggesting an acceptable measurement precision of the BOT-2.

(Wuang and Sue , 2009)

a) Rigor of standardization – Excellent Validity- compared to other motor skills tests ( Kopp et al, 2007)

b) Content validity was excellent: Judgmental and statistical (Rasch & Factor analysis) were used to examine the subtest structure. (Kopp et al, 2007)

Construct validity-Excellent compared to other tests.

Strength of Association: •Comparison of BOT-2 total composite score with the Peabody

Developmental Motor Scale (PDMS2) (Folio & Fewell, 2000) , and the Test of Visual Motor Skill-Revised (TVMS-R) in children with intellectual disabilities.

• Measured by comparing scores of children in a non-clinical group and comparing the scores of children having diagnoses associated with motor performance deficits (children with mild to moderate mental retardation, children with developmental coordination disorder, and children with high functioning autism or Asperger’s disorder). In each study children in the non- clinical group were matched with children in there age group in the clinical group. In all 3 studies each clinical group had significantly lower scores (p<.001), then its none clinical comparison. This supports the ability of the BOT-2 to distinguish between non- clinical groups and specific clinical groups.

( Kopp et al 2007)

•BOTMP-BOT-2: High correlation for Total Motor Composite (TMC) and Battery Composite (BC) 0.80

•PDMS-2- BOT-2: (TMC) and Total Motor Quotient (TMQ) strongly correlate (0.73); subtest and composite correlations are moderate to high (0.35- 0.75).

•TVMS-R –BOT-2: Correlation of Fine Motor Integration subtest is strong (0.74)

This is Adequate to Excellent evidence of concurrent validity ( Bruininks & Bruninks, 2005)

Task difficulty has caused a floor effect, constituting a threat to the validity of the preschoolers’ motor assessment. Data analysis was done using both ANOVA and MANOVA with the total battery score in the short form and the 14 items scores’ being the dependent variables. A modification of the battery is suggested, so that the BOT-SF(short form) will give a valid result for children 4-6 years old.

(Venetsanou et al, 2009)

• Excellent- more then 2 well designed studies showing strong hypothesized relationships between changes of the measure and other measures of change on the same attribute.

• It would be nice to modify the total battery score in children 4-6 years old for each of the 14 items in the short form and test its responsiveness.

-Excellent

1)Strengths- Administration Easel with photos that minimizes language demands

and gives cues to support standardized and efficient test administration and scoring

- Face Validity; items in the test reflect typical childhood motor activities ( ball skills, movement, paper/pencil activities)

- The Construct Validity of this test, as well as Inter-rater and test-retest reliabilities of some subsets for BOT-2 and BOT-SF are also strengths.

2) Weaknesses- Weak test-retest reliability for some subsets- Scoring requires lots of time and is tedious; can be confusing,

adding mistakes and errors in scoring- Some items (total battery composite/SF) are difficult for 4yr olds

and children with developmental delays.

You most validly would use this to test patients under 21 years old to diagnose the childs motor performance in the areas of fine manual control, manual coordination, body coordination, strength, and agility. The scores can then be compared to normative values of other children.

This test has been should to be descimitative and evaluative ( change over time)

Bruininks RH, Bruininks BD. The Bruininks- Oseretsky Test of Motor Proficiency, 2nd Ed: Manual. Circle Pines, MN: AGS Publishing; 2005.

Kopp K, Kartin D, Deitz JC. Review of the Bruininks-Oseretsky Test of Motor Proficiency, 2nd Ed (BOT-2).Physical & Occupational Therapy in Pediatrics. 2007; 27 (4)

Venetsanou F, Kambas A, Aggeloussis N, Fatouros I, Taxildaris K. Motor assessment of preschool aged children: A preliminary investigation of the validity of the Bruininks-Oseretsky test of motor proficiency-Short Form. Human Movement Science. 2009;28: 543-550

Waung YP, Su CY. Reliability and responsiveness of the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition in children with intellectual disability. Research in Developmental Disabilities. 2009; 30: 847-855.