Assessment and Exercise Interventions in Early and Middle Childhood Development

Original Editor - Jess Bell based on the course by Tracy Prowse
Top Contributors - Jess Bell, Wanda van Niekerk, Tarina van der Stockt, Kim Jackson, Aminat Abolade, Cindy John-Chu and Olajumoke Ogunleye

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Introduction

There are a range of assessment tools to both quickly screen and assess children in more detail. These assessments will highlight if a child has a specific developmental difficulty that may affect their school and sports readiness.

PhysiFun Checklist

The PhysiFun checklist has been developed to highlight to the teacher / therapist if a particular student needs help with any activity. It is also a useful feedback tool for parents:

• Class list check (teacher) - this takes approximately 10 minutes
• Grade 0 - 1 the parent and teacher can check – this takes approximately 5 minutes
• Quick tests - checked each term (see Table 1)
• Specific assessment for delayed child  - always refer to 1-1 physio first if severely delayed

Table 1. Quick Tests

Skill	4 years	5 years	6 years
Stand on 1 leg (seconds)	7	10	15
Walk heel to toe on a line (steps)	4	5	6
Knee push up in 30 secs (repetitions)	3 to 5	6 to 10	11 to 15

Specific Tests

The following balance, strength and activity tests can be used to quickly identify any deficit a child might have:

Standing on one leg:

• Children aged 4 years tend to be able to hold this position for 7 seconds
• Children aged 5 years, 10 seconds
• Children aged 6 years, 15 seconds

Walking heel to toe on a line:

• Children aged 4 years tend to be able to take 4 steps
• Children aged 5 years, 5 steps
• Children aged 6 years, 6 steps

Number of knee push ups in 30 seconds:

• Children aged 4 years, tend to be able to do 3 to 5 repetitions
• Children aged 5 years, 6 to 10 repetitions
• Children aged 6 years, 11 to 15 repetitions

The plank test can also be used for torso strength for children aged 8 to 12 years:

• Children aged 8 to 10 years can typically hold this position for 69 to 108 seconds
• Children aged 11 to 12 years can typically hold this position for 86 to 127 seconds

Taking a daily step count using a pedometer can also be used as a measure of physical activity:

• Children aged 6 to 19 years average around 12,000 steps
• It is important to note that there is a difference in genders:
  • Girls average 11,000 to 12,000 steps
  • Boys average 13,000 to 15,000 steps

Supine flexion (i.e. lie on back and bring knees to chest and lift head up):

• Children aged 3 should be able to hold this position for around 15 seconds
• Children aged 4 hold for around 17 seconds
• Children aged 5 hold for around 27 seconds
• Children aged 6 hold for around 53 seconds

Prone extension test (i.e. lifting arms, head and legs off floor):

• Children aged 4 years should be able to hold this for around 18 seconds
• Children aged 6 should be able to hold this position for around 29 seconds
• Children aged over 8 should be able to hold this position for over 30 seconds

Push ups:

• Children aged 5 and 6 should be able to complete 3 repetitions
• Children aged 7 should be able to complete 4 repetitions
• Children aged 8 should be able to complete 5 repetitions

Curl up (i.e. a sit up with legs straight):

• Children aged 5 and 6 should be able to do 2 repetitions
• Children aged 7 should do 4 repetitions
• Children aged 8 should do 6 repetitions

Monitoring Effectiveness

It is important to consider your aims when monitoring the effectiveness of an intervention. The above tests can be repeated every few months in order to measure changes following an intervention. There are also a range of outcome measures that can assess specific areas.

For increasing physical activity, literacy and fitness:

• Canadian Assessment of Physical Literacy
• Progressive Aerobic Cardiovascular Endurance (PACER) Run (similar to a beep test)
• PANIC Physical Activity Questionnaire

These measures can all be used as both an assessment and outcome tool.

For assessing motor coordination skills (i.e for Developmental Coordination Disorder):

• Movement ABC and Movement ABC Checklist
• Bruininks Oseretsky Test (BOT) and BOT2

These tests can also all be used as assessment tools and outcome measures.

For improving concentration, self regulation, social participation:

• The Strength and Difficulties Questionnaire is a freely available self-report assessment tool

For improving the experience of the child in all aspects of life (i.e. an ecological intervention), it is important to use intervention outcomes (that look at the environment, task and child). Examples include:

• School Function Assessment
• Goal Attainment Scaling (GAS)

Key Benefits of Classroom Integration

There is a need for interventions that are:

• Cost effective
• Easy to implement during school hours
• Address gross motor difficulties, postural problems, poor physical activity participation levels and concentration difficulties during school hours.
• “Little and often”

Physical Activity Guidelines

The following guidelines are based on recommendations by the World Health Organisation:

• Children aged 5 to 18 years should engage in:
  • Moderate (5-6/10) to vigorous activity (8/10) of exercise 60 minutes per day
  • Screen time should be less than 2 hours

• Children aged 3 to 5 years old should aim for:
  • 3 hours of exercise per day
  • Screen time should be less than 1 hour

• Children’s physical activity should include a variety of aerobic activities, including some vigorous intensity activity
• On at least 3 days per week, children should engage in activities that strengthen muscle and bone
• To achieve additional health benefits, children should engage in more activity – up to several hours per day

The programme should address all the key areas of a child's development. Recent research supports the idea that exercises should include a variety of methods and skills. REF