Motor Skills Information

Procedure

A line is marked 3m from a wall (or any solid structure that is taller than the child), using tape or chalk. Attach an A4 sheet of paper with a large target (circle or X) on it to the wall/structure at the child’s eye level. The child lies supine (on their back) with their feet(heels) on the line. On “go” the child is required to get up as quickly as possible, run and touch the target, and run back across the 3m line. The child has one practice and is then given two trials. Each trial should be automatically recorded. Press the ‘Now’ button to record the time at the start (START time) and at the end (END time) of each trial. The assessor should stop the timer as soon as the child’s torso crosses the line (like in a 100m sprint).

Procedure

The child should be tested in a clear space, away from obstacles. In this test, the child stands on their RIGHT leg first, with the arms held freely at the side of the body for up to 30 seconds. The child must keep the standing leg fixed but may keep the free leg in any position as long as it is off the floor. Hooking the free leg around the standing leg is not permitted. Swaying is allowed, and the arms may move from the sides but may not hold the free leg. Timing is started when the free leg leaves the floor. Timing is stopped if the child moves the standing leg or hooks the free leg around the other leg or touches the free leg with their hands. Begin the test by demonstrating the balance. Say out loud to the child what you are doing: For example, “See how I am:

Keeping my standing leg in one place while I am balancing.

Keeping my free leg off the floor; and

Using my arms to help me balance. ”

Allow the child to practice once on each leg for up to 15 seconds. Do not record these practice attempts. During these practice attempts, the data collector may help the child assume the balance position, holding one or both hands if necessary. If the child moves their standing leg or hooks their free leg round the other leg, or touches their free leg with their hands, give a reminder of the correct way to balance, or re–demonstrate. For the assessment, ask the child to balance on the right leg first. When the child is ready, say ”Go” and press the ‘Now’ button to record the time at the start (START time) and at the end (END time)of each trial. The child then performs the assessment on the left leg. If the child maintains balance on the right leg for 30 seconds stop the assessment and record these start and end times on the iPad. Apply the same discontinuation rule to the left leg.

Equipment

• Measuring tape
• Masking tape

 

Procedure

The assessor should provide the child with a correct demonstration of this task prior to the practice. The assessor should remember to place their feet in the correct starting position (with their toes behind the line; jump as far as they can and land on two feet. The assessor should explain to the child that they need to freeze in the spot that they land; this should help ensure that the children do not move their feet before measurements are taken.

Practice: The child is given at least one practice. During this practice, the assessor may help place the child’s feet in the correct starting position, jumping as far as they can, and landing on two feet. If the child starts with their feet in front of the line or doesn’t land with two feet give the child a reminder or re–demonstrate the correct procedure.

Formal trials: The child is given two trials. The assessor should measure the distance between the front of the line (tape) and the heel of the foot that is closest to the tape. Please record the distance to the nearest centimeter.

• Purpose

The NIH Toolbox 9-Hole Pegboard Test assesses fine motor dexterity or manipulation. Dexterity is a central component of hand function and relates to both the speed and accuracy of hand movements. The protocol includes one practice and one timed trial with each hand.

• Equipment

Jamar® (or Rolyan) 9-Hole Peg Test kit.

iPad (timer feature contained in the REDCap project for the task).

• Procedure

1. Place the pegboard on the table, positioning it in front and at the centre of the child’s body with the tray on the right-hand side. The child should be seated with the table at waist level.
2. The child should use the hand not being tested to stabilise the board. The assessor can also assist in stabilising the board by placing their hand over the child’s hand.
3. Make sure the hand being tested is flat on the table (palm down) until the assessor says “Go”.
4. Use a placemat or piece of rubber shelving to keep the pegboard from slipping on the table.

Instructions to say to child

Begin by saying: “In this activity we are going to see how fast you work with your hands. You are going to use your RIGHT hand first (point to hand if needed for understanding), and then you will do it again with your LEFT hand” (point to hand if needed).

Show the child the pegboard and say: “This is a pegboard, and these are the pegs. All the pegs are the same. Pick up the pegs one at a time using your RIGHT hand only (point to hand if needed). Put them in the holes one at a time until all 9 holes are filled. Then take them all out, one at a time, like this”.

The assessor demonstrates the task with their right hand and says as they are working: “The pegs can be put in the holes or taken out in any order. I have extra pegs, so if you drop a peg, don’t go after it. I’ll put in another one”.

Right Hand Practice:

Have the child start with his/her hand flat on table beside pegboard. Remind the child that the left hand should be used to stabilise board and continue: “Let’s practice with your RIGHT hand (point to hand if needed). You can use your other hand to hold the board in place”.

Say: “Are you ready? 3, 2, 1, Go!” Make sure to press the ‘START time’ as soon as you say “GO”.

As the child is placing the final peg, say: “And take them out”. Press the ‘Now’ button at the ‘END time’ to record the time as soon as the final peg is placed back in the cup.

Left Hand Practice:

Turn pegboard around so that the cup with the pegs is on the side of the LEFT hand.

 Say: “Now we are going to do the same thing with your other hand. Again, pick up the pegs one at a time using only your LEFT hand (point to hand if needed). Put them in the holes, one at a time, until all 9 holes are filled. Then take them all out, one at a time. The pegs can be put in the holes or taken out in any order”

 Have the child start with his/her left hand flat on table beside pegboard. Remind the child that their right hand can be used to stabilise the board and continue: “Let’s practice. Remember, you can use your other hand to hold the board in place”. Say: “Are you ready?

3, 2, 1, Go!” Make sure to press the ‘START time’ on the iPad as soon as you say “GO”. As the child is placing the final peg, say: “And take them out”. Press the ‘END time’ as soon as the final peg is placed back in the cup.

Purpose

The grip strength test is a measure of upper extremity strength. That is, the capacity of the hand and arm muscles to produce the tension and power necessary for maintaining posture, initiating movement, or controlling movement during conditions of loading the musculoskeletal system.

Equipment

Hand grip dynamometer

Procedure

Set-up:

The assessor turns the pulley gently in an anti-clockwise direction until the arrow indicator is pointed at zero.

The assessor should have the child holding the dynamometer in one hand and then adjust the grip range by turning the knob until the second joint of his/her forefinger is bent through 90 degrees. The child should stand upright and relaxed, extend his/her arms downward without touching the body.

 Practice:

Each child is given 2 practice trials. The assessor resets the dynamometer (by turning the pulley gently in an anti-clockwise direction until the arrow indicator is pointed at zero) and asks the child to practice with the RIGHT hand first. The assessor should have the child squeezing the grip continuously with full force for at least 3 seconds without letting his/her arms touch their body. The child should not swing the dynamometer during the measurement.  The second practice trial is with the LEFT hand.  After both practice trials, the assessor resets the dynamometer for the formal trials.

 Formal trials:

Each child is asked to perform two trials for each hand alternately, always starting with the RIGHT hand. During the testing, the assessor should encourage the child to grip harder and harder. After 3 seconds of each measurement, the assessor says: “Stop” and records the force in the kilogram’s unit (closest to 0.5 kg). The time between each trial is approximately 30 seconds. Record forces for the RIGHT and LEFT hand. The assessor turns off the dynamometer after completing the two trials.