Motor profile of portuguese children on the peabody developmental motor scales-2

Motor profile of portuguese children on the peabody developmental motor scales-2

RESUMEN COMUNICACIÓN/PÓSTER

The Peabody Motor Developmental Scale-Second Edition (PDMS-2) (Folio & Fewell, 2000) is one of the most widely used instruments for evaluating infants and children. The instrument was developed in the United States for the evaluation of children’s motor development (0-to-71 months of age), and translated and adapted for Portugal (Saraiva & Rodrigues, 2006). This study was designed to examine the cultural sensitivity (regional relevance) of the PDMS-2 for Portuguese preschool children aged 36 to 71 months. A total of 540 children (255 males and 285 females) from 15 public preschools of Viana do Castelo, Portugal, were assessed according to the guidelines provided in the manual. Examining children’s proficiency, Portuguese preschoolers performed above US norms on grasping (p? .0002), visual-motor integration (p? .0001), and stationary (p? .0018) subtests, and bellow on the locomotion (p? .0024), and object manipulation subtest (p? .0001). Overall, Portuguese children showed better results on the Fine Motor Quotient comparing to the Gross Motor Quotient. These results suggest that Portuguese and US children have different motor development profile, probably as the result of cultural, environmental, and educational factors that require further investigation.

Introduction

The Peabody Developmental Motor Scales-2 (PDMS-2) (Folio & Fewell, 2000) is one of the most widely used instruments to assess fine and gross motor skills of children from birth through 71 months of age. This norm-referenced test can be used by occupational therapists, diagnosticians, early interventions specialists, adapted physical education teachers, psychologists, and others who are interested in assessing motor abilities of young children.
According to Folio and Fewell (2000), the PDMS-2 provide five principal uses: to estimate a child’s motor competence relative to his or her peers; to identify relative differences within gross and fine motor development; to establish individual goals and objectives for therapy or educational intervention; to monitor the child’s individual progress; and to be used as a research tool.
The PDMS-2 is composed of six motor subtests: reflexes, stationary, locomotion, object manipulation, grasping, and visual-motor integration. Three global indexes of motor performance called composites can be estimated: Fine Motor Quotient (FMQ), Gross Motor Quotient (GMQ) and Total Motor Quotient (TMQ).
The second edition of PDMS shows several improvements with respect to the normative sample and psychometric proprieties. Norms of PDMS-2 were developed from a sample of 2003 children residing in 46 states of USA and its stratification was based on age, gender, family income, parent education level, ethnic background, race, geographical area, and disability status. 
Concerning the psychometric proprieties of PDMS-2, the manual test (Folio & Fewell, 2000) reported a good internal consistency for each subtest (? = .89 to .95) and for each motor quotient (0.96 a 0.97); acceptable test-retest reliability (r=0.73 to 0.96 depending on the age group); and a high inter-rater reliability varying between 0.97 and 0.99 for each subtest and between 0.96 and 0.98 for the motor quotients. As far as criterion validity, the PDMS-2 has a high correlation with the original version (r=0.84 and 0.91 respectively for GMQ and FMQ) and with the Mullen Scales of Early Learning (r=0.86 e 0.80 respectively for GMQ and FMQ). Regarding its construct validity, Folio and Fewell (2000) examined two confirmatory factor analysis on two sub-samples of the north american normative data (children from birth to 11 months and 12 to 72 months) and established two-factor model of the PDMS-2: Fine and Gross Motor abilities, defined respectively by two fine motor subtests (Visual-Motor Integration, Grasping) and three gross motor subtests (Stationary, Locomotion and Object manipulation, or Reflexes – for children birth through 11 months). The sensitivity of the PDMS-2 was also confirmed in different groups of individuals (males, females, European Americans, African Americans, Hispanic Americans, children with mental retardation, children with physical disorders).
Despite these psychometric proprieties, some authors (Crowe, Mcclain & Provost, 1999; Provost et al., 2004; Tripathi, Joshua, Kotian, & Tedla, 2008; Van Hartingsveldt, Cup & Oostendorp, 2005) warn that the application of the PDMS-2 and particularly the interpretation of standard scores with children from a different cultural background of the normative sample should be performed with caution. It is possible that the North American norms are reasonably different for populations that are culturally and geographically distant. Hence, the use of the PDMS-2 scale outside the U.S. demands checking for cross-cultural and regional relevance. This study was designed to examine the cultural sensitivity (regional relevance) of the PDMS-2 for Portuguese preschool children aged 36 to 71 months.

Methods

Sample

A total of 540 children (255 males and 285 females) were recruited from 15 public preschools located in urban, rural and suburban areas of Viana do Castelo, Portugal. Children who met the following criteria were included in the study: 1) Children aged between 36 and 71 months; 2) Portuguese nationality; and 3) absence of any known intellectual, physical or emotional disabilities, as well as without special educational needs as proven by an evaluation from special education professionals. The data was divided into three age groups: three-year-olds (36 to 47 months, n=162), four-year-olds (48 to 59 months, n=189) and five-year-olds (60 to 71 months, n=189). Socio-demographic characteristics of the sample by age group are summarised in Table 1.
Table 1. Socio-demographic characteristics of 540 Portuguese children

Table 1. Motor profile of portuguese children on the peabody developmental motor scales-2

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Instrument

The original PDMS-2 was previously translated into the Portuguese language, and its construct validity and reliability was confirmed for Portuguese preschoolers (Saraiva, Rodrigues, & Barreiros, 2011). All PDMS-2 subtests showed good internal consistency (? = .76 to .95) and good test-retest reliability (ICC = .85 to .95). The results of the confirmatory factor analysis support that the Portuguese version displays the same construct and number of items as the original PDMS-2 version.
This instrument is composed of six subtests: Reflexes (ability to automatically react to environmental events in children from birth to 11 months – 8 items), Stationary (ability to sustain control of the body within its center of gravity- 30 items), Locomotion (ability to move from one place to another – 89 items), Object manipulation (ability to manipulate balls by children with 12 months of age or older – 24 items), Grasping (ability to use hands – 24 items), and Visual-motor integration (ability to use visual perceptual skills to perform complex eye-hand coordination tasks – 72 items). Each motor subtest item is scored using a three-point rating scale (0, 1, or 2). The sum of the individual items within each subtest (raw score) can be converted to age equivalent, percentile and standard scores. Standard scores of each subtest can then be summed and converted into three global indexes of motor performance (composites): Fine, Gross and Total Motor Quotients. The reflexes, object manipulation, stationary and locomotion subtests add to the Gross Motor Quotient (GMQ), while the grasping and visual-motor integration subtests contribute to the Fine Motor quotient (FMQ). The Total Motor Quotient (TMQ) is determined by a combination of the gross and fine motor subtests results. The PDMS-2 has established the mean value of 10 points (± 3) for each subtest and the mean value of 100 points (± 15) for each motor quotient. The standardized values can also be converted into qualitative classification of seven categories (between “Very Superior” and “Very Poor”).

Data collection procedures

Prior to data collection, informed consent was obtained from the school administration and classroom educators. The parents or legal guardians of the preschool children were informed about testing procedures, and corresponding written consent was obtained.
The PDMS-2 was administered according to manual guidelines (Folio and Fewell, 2000) by two researchers, who were specifically trained, and achieved an inter-rater agreement for the item scores of 90% before data collection. Each child was individually tested in a quiet area of the school. Depending on the child’s age, the assessment duration ranged from 30 to 45 minutes. The data collection was videotaped for later observation and scoring. The standard scores were calculated for Grasping; Visual-motor integration, Stationary, Locomotion and Object manipulation subtests and then were converted to GMQ, FMQ, and TMQ, based on normative data of children USA.
The procedures employed were in accordance with Helsinki’s Declaration of Human Ethical guidelines (1975). The study protocol was approved by the Faculty of Human Kinetics (Technical University of Lisbon, Portugal) Ethics Committee.

Date Analyses
Descriptive statistics (mean and standard deviation) were calculated for all motor subtests and quotients (GMQ, FMQ, TMQ) by age groups and sex. The Student’s t-test (normal distribution variables) or the Mann-Whitney test (non-normal distribution variables) was used to analyze the differences between boys and girls. The standard scores of all subtests and quotients were converted to Z-scores according to the PDMS manual and used for a t-test comparison with the normative data of the US sample reported in the manual. 

Results
Table 2 presents the descriptive results of each PDMS-2 subtest and quotient by age group and sex.

Table 2.  Means and standard deviations (SD) for PDMS-2 subtests and quotients by age group and sex

Table 2. Motor profile of portuguese children on the peabody developmental motor scales-2

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Note: Significant differences between boys and girls in bold

The results presented in table 2 indicate that the Portuguese sample had better performance on grasping and visual motor integration subtests comparing to the locomotion and object manipulation subtests. A lower performance on object manipulation subtest can be found for all age groups. The findings showed higher scores on FMQ comparing to GMQ.
Significant differences were found between girls’ and boys’ performance in object manipulation (p < 0.001), Grasping (p ? 0.011), Visual-motor integration (p ? 0.028), and Locomotion (p = 0.024) subtests. Boys showed higher scores on the object manipulation in all age groups, and Locomotion subtest in the three-year-old age group. Girls presented a better performance in the Grasping and Visual-motor integration subtests in all age groups. These sex differences also appear on GMQ (p ? 0.043) and FMQ (p ? 0.008) scores.
The following figures 1 and 2 show the comparison of motor performance between the Portuguese sample and PDMS-2 normative sample, using Z-scores.

Figure 1. Motor profile of portuguese children on the peabody developmental motor scales-2

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Figure 1. Comparison of motor performance between the Portuguese sample and PDMS-2 normative sample on all motor subtests

Figure 2. Motor profile of portuguese children on the peabody developmental motor scales-2

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Figure 2. Comparison of motor performance between the Portuguese sample and PDMS-2 normative sample on all motor quotients.

Overall Portuguese preschoolers performed significantly better than their US peers on grasping (p? 0.0002), visual-motor integration (p? 0.0001), and stationary (p? 0.0018) subtests, except for grasping subtest in the five-year-old age group. They performed significantly lower on locomotion (p? 0.0024), and object manipulation subtest (p? .0001). Portuguese children showed significantly higher scores on the FMQ (p? .0001); significantly lower scores on the GMQ (p? .003), but no differences on the TMQ at all ages.

Discussion

The main intent of the present study was to examine the cultural sensitivity (regional relevance) of the PDMS-2 for Portuguese preschool children aged 36 to 71 months. The results of our study suggest that Portuguese and US children have different motor development profiles. Significant differences in all subtests were found, except for the grasping subtest in the five-year-old age group. Overall, Portuguese children performed above US norms in FMQ and below in GMQ.

These findings are consistent with previous studies (Adolph, K., Karasik, & Tamis-LeMonda, 2010; Cintas, 1995; Chow, Henderson, & Barnett, 2001; Crowe, McClain, & Provost, 1999; Manyson, Harris, & Bachman, 2007; McClain, Provost, & Crowe, 2000; Tripathi, et al., 2008) which point differences in motor development among infants and children from various cultural backgrounds. For example, Crowe, et al. (1999) found that Native American children scored significantly lower than the normative sample in the Peabody Fine Motor Developmental, and when gender was taken into consideration, older girls (30 to 35 months) had significantly lower scores. In another study, Tripathi, et al. (2008) administered the PDMS-2 to 300 children from Indian (birth and 60 months of age), and concluded overall that Indian children scored better on gross motor subsection of the scale than on fine motor.

Depending on the motor subtest and age group, significant differences were also found between Indian children and the PDMS-2 normative sample. Several biological and environment factors may help explain the differences in motor development among children from different cultures/countries, such as child’s characteristics (e.g., gender, age, race, ethnic, somatic characteristics), family background, child-rearing practices, parental/social expectations (Cintas, 1995), as well as quality and quantity of stimulation provide in family (Hamadani, et al., 2010; Rodrigues, 2005; Varzin, Naidu, Vidyasagar, 1998) and school environments (Anme & Segal, 2003; Barros, Fragoso, Oliveira, Cabral-Filho, Castro, 2003; Mulligan, Specker, Buckley, O’Connor, Ho, 1998; Santos, et al., 2009; Stipek, Daniels, Calluzzo, Milburn, 1992).

Within this bio-ecological framework, we can speculate that American children have more opportunities for gross motor experiences which promote mainly object manipulation (e.g., throwing, catching) and locomotion skills. Furthermore, and for reasons academic and educational, Portuguese preschoolers appear more oriented to fine motor tasks (e.g., painting, cutting). In our study, differences between Portuguese girls and boys were also found. Boys performed better in object manipulation skills, while the girls had superior performance in fine motor skills.

This is consistent with the findings of previous studies which reported sex differences in specific motor skills for preschoolers. This study revealed boys showing to be more proficient in object manipulation skills (Chow, et al., 2001; Engel-Yeger, et al., 2010; Düger, Bumin, Uyanik, Aki, & Kayihan, 1999; Giagazoglou, et al., 2011; Hardy, King, Farrell, Macniven, & Howlett, 2010; Ikeda & Aoyagi, 2008; Kroes, et al., 2004; Livesey, Coleman & Piek, 2007; Loovis & Butterfield, 2003; Oja & Jürimäe, 1997; Shala, 2009; Thomas & French, 1985; Toriola & Igbokwe, 1986; Vandaele, Cools, de Decker, & de Martelaer, 2011); while girls tending to exhibit superior performance in manual dexterity (Chow et al., 2001; Düger et al., 1999; Kroes, et al., 2004; Lejarraga et al., 2002; Livesey, et al., 2007; Sigmundsson & Rostoft, 2003).

Some standardized tools reflect these different in its norms (e.g., Koöper Koördinationstest für Kinder, Test of Gross Motor Development, Bruinink-Oseretsky Test of Motor proficiency), but PDMS-2 does not provide separate norms for boys and girls. Hence, future normative studies with the Portuguese population should take into account sex differentiation. In conclusion, our study suggests that Portuguese and US children have different motor development profiles, probably as the result of cultural, environmental, and educational factors that require further investigation. Future study should be conducted with a representative Portuguese sample to confirm these findings and to establish norms for the Portuguese population.

Acknowledgements

This research was sponsored by the Portuguese Foundation for Science and Technology (individual doctoral grant ref. SFRH/BD/36479/2007), by the Polytechnic Institute of Viana do Castelo (PROTEC grant ref. SFRH/BD/50019/2009) and by PRO-ED who granted the support material.

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