Pediatric Assessments PDF

Bruininks-Oseretsky Test, second edition (BOT-2/BOT-3) Description of the measure: The BOT-2 ,published in 2005, provides a comprehensive overview of fine and gross motor skills in children and young adults within school-age range. The BOT-3, published 2024....

Bruininks-Oseretsky Test, second edition (BOT-2/BOT-3) Description of the measure: The BOT-2 ,published in 2005, provides a comprehensive overview of fine and gross motor skills in children and young adults within school-age range. The BOT-3, published 2024. Program in Physical Therapy BOT Subtests BOT-2 BOT-3 Fine motor precision Fine Motor Precision Fine motor integration Fine Motor Integration Manual dexterity Manual Dexterity Upper limb coordination Upper Limb Coordination Bilateral coordination Bilateral Coordination Balance Balance Running speed, agility Strength Strength Dynamic Movement Program in Physical Therapy BOT (cont’d) Age and types of diagnoses: 4-21 years mild to moderate motor control deficits Criterion or norm-referenced: norm referenced Program in Physical Therapy Bruininks-Oseretsky Test (BOT) (con’t) Reliability: test retest.69-.83 inter-rater.98 Validity: excellent for gross motor portion Cost of test: test kit $770 (digital) $990 (print) test forms ($75/pk 25 forms) Online score calculation (after recording on print form) $4.25/child Time it takes to administer: BOT-2 Complete battery: 45-60 minutes, Short form: 15-20 minutes, Gross Motor or Fine Motor Sections: 25-30 minutes each BOT-3 Complete: 50-90 minutes, Gross Motor/Fine Motr 25-45 minutes each When/how often the test would be administered: Evaluation, testing intervals should be 3 or more months, may be dependent on setting Program in Physical Therapy Bruininks-Oseretsky Test (BOT-2) (con’t) Setting(s) in which this would be performed: outpatient, school, short form potentially could be used in a clinic or community setting as a screening tool Special Considerations/Clinical Applications: items in each subtest become progressively more difficult, it is recommended to complete them in order each subtest may be retested on its own based on child's areas of deficit this test is recommended for children with mild to moderate motor deficits, this test is not recommended for children who use assistive devices for all/most mobility test items are challenging even for many typically developing children this test covers a broad age range, it is not expected that a younger child will be able to complete all the items at the highest level Program in Physical Therapy Bruininks-Oseretsky Test (BOT-2) (con’t) BOT video BOT practice Program in Physical Therapy Denver II Description of the measure: The Denver Developmental Screening Test was introduced in 1967 to identify young children, up to age six, with developmental problems. A revised version, Denver II, was released in 1992 The purpose of the tests is to identify young children with developmental problems so that they can be referred for help. The areas screened in this test included four domains of child development: personal-social, fine motor-adaptive, language and gross motor. Age and types of diagnoses this test is used for: birth to six years of age Criterion or norm-referenced: norm-referenced Reliability: interobserver.99 test-retest:.90 Program in Physical Therapy Denver II (con’t) Validity: The authors of the Denver II indicate it is face valid because of the manner in which it was standardized. Cost of test: Free/minimal cost. This test no longer has support services- test kits are no longer available for purchase. The forms/training and scoring information may be obtained through the Denver website. Additional equipment needed: red yarn pom-pom 4" diameter, raisins (or O shaped cereal), rattle with narrow handle, 10- 1"square colored wooden blocks, small-clear glass bottle with a 5/8"opening, small bell, tennis ball, red pencil, small plastic doll with feeding bottle, plastic cup with handle, blank paper Time it takes to administer: 10-20 minutes Program in Physical Therapy Denver II (con’t) When/how often the test would be administered: Tests interpreted as "Suspect" or "Untestable" should be rescreened in 1-2 weeks. Normal tests could be rescreened at predetermined age intervals or if concerns arise Setting(s) in which this would be performed: pediatrician office(may occur at regular predetermined age intervals), developmental clinics, Parents As Teachers, other early child development programs such as Early Head Start, preschools. Additional Considerations: This is a screening tool used to make referrals for further assessment. As a caution, some feel that the tool may over identify and lead to unnecessary referrals. Program in Physical Therapy Denver II Program in Physical Therapy Test of Infant Motor Performance (TIMP) Description: This test assesses postural and selective motor control of functional performance Age and types of diagnoses this test is used for: 34 weeks gestational age to 4 months (adjusted age) Criterion or norm-referenced: norm referenced Reliability: test-retest.89 inter rater.85 Validity: excellent correlation of the TIMP to the AIMS Program in Physical Therapy Test of Infant Motor Performance (TIMP) (con’t) Cost of test: Starter Kit: $189 (TIMP test manual, age calculator, TIMP score sheets). Score Sheets (25) $68 Training: Online course: $379 Additional items NOT in starter kit: red ball, rattle, soft cloth Time it takes to administer: 20-40 minutes When/how often the test would be administered: Neonatal Intensive Care Unit(NICU): occasionally at time of initial evaluation pending infant gestational age and medical status, before discharge for therapy/follow-up planning, set time for readministering test based on facility guidelines, within age frame at follow up visits-possibly within 1 month of first administration Program in Physical Therapy Test of Infant Motor Performance (TIMP) (con’t) Setting(s) in which this would be performed: NICU , developmental clinics Special Considerations: Consider age of infant and longevity of follow up/additional testing Only should be used by therapists trained to handle infants who are fragile Program in Physical Therapy The Peabody Developmental Motor Scale Description of the measure : Early childhood motor development program contains six subtests that assess the motor skills of children. PDMS-2 PDMS-3 published late 2023 Program in Physical Therapy Focus Area PDMS-2 PDMS-3 Reflexes Body Control Stationary Body Transport Locomotion Object Control Object Manipulation Hand Manipulation Grasping Eye-Hand Coordination Visual-Motor Integration Supplemental Subtest Physical Fitness Program in Physical Therapy The Peabody Developmental Motor Scale (con’t) This test is well known, has been studied/researched often and while the test kit and forms are expensive, it is common in the outpatient pediatric setting. Age and types of diagnoses this test is used for: birth to under 6 years. developmental delay, some coordination disorders, cerebral palsy. Criterion or norm-referenced: norm referenced Reliability: test-retest. for total motor quotients.89-.96 inter-rater.96-.99 Validity: excellent correlation with AIMS Program in Physical Therapy The Peabody Developmental Motor Scale (con’t) Cost of test: Test Kit: $820 PDMS-2 test books $107/25 books PDMS-3 test books $159/25 books (comes with code for online scoring), $45/25 fitness score sheets Time it takes to administer: 45-60 minutes for the entire test; 20-30 minutes for either the fine or gross motor section. Less time may be needed for a younger child. When/how often the test would be administered: time of initial evaluation, progress testing may be 3-6-12 months depending on setting, needs and progress Program in Physical Therapy The Peabody Developmental Motor Scale (con’t) Setting(s) in which this would be performed: outpatient, early childhood, sometimes inpatient (although not usually as part of the initial inpatient evaluation) Additional Considerations: for very young infants who have a medical diagnosis associated with a risk for developmental delay, this test may not show a delay early in life. In clinical practice, clinicians sometimes make modifications to how the test is administered, this may impact test results and intra-rater reliability Detailed information on populations and research: https://www.sralab.org/rehabilitation-measures/peabody-developmental-motor- scales-second-edition Program in Physical Therapy The Peabody Developmental Motor Scale (con’t) PDMS Practice Scoring Program in Physical Therapy WeeFIM The WeeFIM is an adaptation of the Functional Independence Measure (FIM) used in adults. Age Range: months to 18 years Assessment Areas: self-care (eight items) mobility (five items) cognition (five items) Higher WeeFIM scores on admission were associated with shorter length of stay and higher discharge scores. Similarly, a shorter time from injury to rehabilitation admission was associated with shorter stay and higher discharge scores. Program in Physical Therapy WeeFIM (con’t) Setting: Inpatient rehab, may be used in select other inpatient settings Training: Formal training, certification testing required to administer. Site license required use Time to Administer: 10-20 minutes, often administered by a multidisciplinary team Scoresheet Categories: Categories: Self-Care--assessed by OT, Transfers and Locomotion--assessed by PT, Sphincter Control- assessed by RN, Communication and Social Cognition--assessed by SLP. Program in Physical Therapy WeeFIM (con’t) Self-care tasks Item number Task Description 1 eating using proper utensils to bring food to the mouth as well as chewing and swallowing 2 grooming aspects of personal grooming, including hair brushing, teeth cleaning, washing the face, and shaving 3 bathing washing, rinsing, and drying oneself in a tub or shower 4 upper body dressing oneself above the waist, and can also include dressing putting on or removing a prosthesis 5 lower body dressing oneself from the waist down, and like category dressing 4, can also include putting on or removing a prosthesis 6 toileting properly cleaning up and adjusting clothing after using the toilet Program in Physical Therapy WeeFIM (con’t) Sphincter control tasks Item number Task Description 7 Bladder management controlling the bladder 8 Bowel management controlling bowel movements Transfer tasks Item number Task Description 9 Bed to chair transfer transferring from lying down in a bed to a chair, wheelchair, or a standing position 10 Toilet transfer getting on and off of a toilet 11 Tub or shower transfer getting into and out of a tub or shower Program in Physical Therapy WeeFIM (con’t) Locomotion tasks Item number Task Description 12 walk or wheelchair walking or using a wheelchair 13 stairs going up and down one flight of stairs indoors Communication tasks Item number Task Description 14 understanding of language as well as written comprehension and verbal communication 15 expression ability to express oneself clearly both verbally and nonverbally Program in Physical Therapy WeeFIM (con’t) Social cognition tasks Item number Task Description 16 social interaction getting along and interacting with others in social or therapeutic situations 17 problem-solving solving problems and making responsible decisions associated with day-to-day activities 18 remembering information associated with performing memory daily activities Program in Physical Therapy WeeFIM (con’t) Items are scored as follows: NO HELPER 7 Complete Independence (Timely, Safely) 6 Modified Independence (Device) HELPER – Modified Dependence 5 Supervision 4 Minimal assistance (subject = 75% or more) 3 Moderate assistance (subject = 50% or more) Helper – Complete Dependence 2 Maximal assistance (subject = 25% - 49%) 1 Total assistance (subject = 0% - 24%) Program in Physical Therapy School Function Assessment (SFA) Developed by: Wendy Coster, PhD, OTR/L, Theresa Deeney, EdD, Jane Haltiwanger, PhD, Stephen Haley, PhD, PT The School Function Assessment (SFA) measures student performance of functional tasks that affect the academic and social aspects of an elementary school program. SFA facilitates collaborative program planning for students with various disabling conditions. Age range: Kindergarten through grade 6 Publication date: 1998 Program in Physical Therapy School Function Assessment (SFA) (con’t) Administration: Individual scales can be completed in as little as 5 to 10 minutes Cost: Kit: $304 , test forms (25) $124.80 Norms: Criterion-Referenced ratings Program in Physical Therapy School Function Assessment (cont’d) Part I Participation: Regular/ Special Ed Calssroom Playground/Recess Transportation to/from school Bathroom/Toileting Transitions to/from class Mealtime/Snacktime Program in Physical Therapy School Function Assessment (cont’d) Part II Task Supports Assistance Adaptations Part III Activity Performance Moving around the classroom/school Using school materials Interacting with others Following school rules Communicating needs Program in Physical Therapy HINE (Hammersmith Infant Neurologic Examination) The HINE consists of 26 items that assess different aspects of neurological function: cranial nerve function, movements, reflexes and protective reactions and behavior, as well as some age-dependent items that reflect the development of gross and fine motor function. Age Range: infants between 3 and 24 months of age. Training: encouraged, training videos are offered on the HINE website with paid membership Website: Hammersmith Neurological Exam Program in Physical Therapy  Scores greater than 64 were predictive of independent walking Scores less than 52 were highly predictive of cerebral palsy and severe motor impairments. This assessment is not to make any medical diagnoses and not to be used in isolation. Program in Physical Therapy Prechtl’s General Movements Assessment Purpose :From birth to 20 weeks post term, typically developing infants have a spontaneous movement repertoire. Newborns whose general movements are abnormal or absent are at risk of having neurological conditions such as cerebral palsy. How: General Movements are observed and determined with the awake newborn lying on their back when they are alert and calm. The newborn baby should not have pacifiers or toys, and parents should not interact with their baby during recording. The baby’s movements are recorded for 3-5 minutes, and the General Assessments are scored from this video. Cost: Training- required- $990 Program in Physical Therapy Prechtl’s General Movements Assessment Frequency/timing of assessment: Preterm: 2-3 times Term/Early Post Term: 1-2 times 9-15 weeks: at least 1-2 times. Time: less than 10 minutes Program in Physical Therapy Prechtl’s General Movements Assessment Preterm : 32 weeks corrected age- type and variety of movements Term: type and variety of movements Around 4 months- fidgety movements Program in Physical Therapy Prechtl’s General Movements Assessment Predictive Value: early detection of cerebral palsy The Pooled Diagnostic Accuracy of Neuroimaging, General Movements, and Neurological Examination for Diagnosing Cerebral Palsy Early in High-Risk Infants: A Case Control Study - PMC (nih.gov) Program in Physical Therapy Pediatric Balance Scale This assessment is similar to the Berg Balance Scale. Age Range: 2 years to at least school age (around 7 years) Cost: free Time: less than 20 minutes Special Considerations: ceiling effect Find more detailed information here (Links to an external site.) including age- normed cut off scores and validity and reliability Program in Physical Therapy M-CHAT-R (Modified Checklist for Autism in Toddlers, Revised) The M-CHAT-R is valid for screening toddlers between 16 and 30 months of age, to assess risk for autism spectrum disorder (ASD). It utilizes parent report with follow up interview questions for areas of concern. Once a parent has completed the M-CHAT-R, score the instrument according to the instructions. If the child screens positive, select the Follow-Up items based on which items the child failed on the M-CHAT-R; only those items that were originally failed need to be administered for a complete interview. Cost: Free to download for clinical, research, and educational purposes Training: None required Program in Physical Therapy M-CHAT-R (Modified Checklist for Autism in Toddlers, Revised) (con’t) Scoring Algorithm: For all items except 2, 5, and 12, the response “NO” indicates ASD risk; for items 2, 5, and 12, “YES” indicates ASD risk. The following algorithm maximizes psychometric properties of the M-CHAT-R: LOW-RISK: Total Score is 0-2; if child is younger than 24 months, screen again after second birthday. No further action required unless surveillance indicates risk for ASD. Program in Physical Therapy M-CHAT-R (Modified Checklist for Autism in Toddlers, Revised) (con’t) Scoring Algorithm continued: MEDIUM-RISK: Total Score is 3-7; Administer the Follow-Up (second stage of M-CHAT-R/F) to get additional information about at-risk responses. If M-CHAT-R/F score remains at 2 or higher, the child has screened positive. Action required: refer child for diagnostic evaluation and eligibility evaluation for early intervention. If score on Follow-Up is 0-1, child has screened negative. No further action required unless surveillance indicates risk for ASD. Child should be rescreened at future well-child visits. HIGH-RISK: Total Score is 8-20; It is acceptable to bypass the Follow-Up and refer immediately for diagnostic evaluation and eligibility evaluation for early intervention. Program in Physical Therapy M-CHAT-R (Modified Checklist for Autism in Toddlers, Revised) (con’t) Please note: Users should be aware that even with the Follow-Up interview, a significant number of the children who fail the M- CHAT-R will not be diagnosed with ASD; however, these children are at risk for other developmental disorders or delays, and therefore, follow-up is warranted for any child who screens positive. For more information, go here. Program in Physical Therapy M-CHAT-R (Modified Checklist for Autism in Toddlers, Revised) (con’t) Program in Physical Therapy  Developmental Checklists Special Situations https://pathways.org/wp- content/uploads/2021/03/MilestonesChecklist_English_8.5x1 1_2020.pdf Program in Physical Therapy Developmental Checklists CDC’s Developmental Milestones | CDC Program in Physical Therapy