Movement Assessment Battery for Children


Original Editor - Romy Hageman
Top Contributors - Romy Hageman and Carina Therese Magtibay

Introduction[edit | edit source]

Early identification of mild to moderate motor impairments in children is essential for various reasons[1][2][3][4]. The most frequently used assessment in clinical practice across Europe for detecting mild motor disorders is the Movement Assessment Battery for Children (MABC)[5][6]. The MABC is a norm-referenced test where a child has to execute a set of motor tasks following specific guidelines[7]. The current version of the Movement Assessment Battery of Children is the second edition (MABC-2)[8].

The Movement Assessment Battery for Children consists of a checklist and a motor test, both designed to assess a child's motor skills in everyday activities. This assessment measures three key motor skill aspects: manual dexterity, ball skills, and balance[8][9].

  • Target audience: Children (aged 3-16 years old) with potential motor skill deviations.
  • Purpose: The MABC-2 is designed to identify deficits in motor development at an early stage, assess the motor skill level, and plan targeted therapeutic interventions.
  • The MABC is efficient and does not consume much time, making it likely that children will willingly participate in the test[10].

Clinical utility[edit | edit source]

Clinical utility of the MABC-2[11]:

  • Time to administer: 20-40 minutes
  • Test procedure: The therapist follows the items in a standardised order, but some flexibility is allowed.
  • Target examiner population: Physical therapists, Occupational therapists, Paediatricians, Research psychologists.
  • Training: not required.

Technique[edit | edit source]

There are three age groups (3;0 to 6;11 years, 7;0 to 10;11 years, and 11;0 to 16;11 years). For each age group, a separate test battery is available, with the level of difficulty increasing based on age:

  • Subtest age group 1 (3;0 to 6;11 years):
    • Manual dexterity 1: Coin insertion - The task is to pick up 6 or 12 plastic coins from the table and insert them through a narrow slot into a plastic box.
    • Manual dexterity 2: Bead threading - The task involves threading 6 or 12 plastic beads onto a string.
    • Manual dexterity 3: Tracing path - The task is to trace the route between two lines without exceeding the boundaries.
    • Ball skills 1: Catching a beanbag - The child is tasked with catching a beanbag.
    • Ball skills 2: Tossing a beanbag - The task is to throw the beanbag on the mat.
    • Balance skills 1: Single-leg balance - The task is to maintain balance on one leg.
    • Balance skills 2: Toe-walking - The child must walk along a line without letting the raised heel touch the ground.
    • Balance skills 3: Jumping on mats - The child must jump from a standing position with legs together from mat to mat.

In the following video you can see a demonstration of the assessment for subtest age group 1 (3;0 to 6;11 years):

[12]

  • Subtest age group 2 (7;0 to 10;11 years):
    • Manual dexterity 1: Placing pegs - The task is to insert small plastic pegs as quickly as possible into a board.
    • Manual dexterity 2: Threading a string - The task is to pull a string through the holes of a plastic board.
    • Manual dexterity 3: Tracing path - The task is to trace the route between two lines without exceeding the boundaries.
    • Ball Skills 1: Catching - The child must throw a tennis ball against the wall and catch it with both hands.
    • Ball skills 2: Throwing - The child must aim the beanbag into the red circle on a mat.
    • Balance skills 1: Single-board balance - The child must balance on one foot on the balance board.
    • Balance skills 2: Heel to toe - The child must walk along the line while the heel of one foot touches the toes of the other foot.
    • Balance skills 3: Hopscotch - The child must jump forward on one leg from mat to mat starting from a standing position.

In the following video you can see a demonstration for age group 2: go to 6:22 min.

[13]

  • Subtest age group 3 (11;0 to 16;11 years):
    • Manual dexterity 1: Turning plugs - The task is to flip small two-colored plastic plugs so that the other colors faces upward.
    • Manual dexterity 2: Building a triangle - The task is to assemble three plastics together with nuts and bolts to create a triangle.
    • Manual dexterity 3: Tracing path - The task is to trace the route between two lines without exceeding the boundaries.
    • Ball skills 1: Catching - The child must throw a tennis ball against the wall and then catch it with one hand.
    • Ball skills 2: Throwing - The task is to throw the tennis ball into a red circle on the wall.
    • Balance skills 1: Two-board balance - The child must balance on the balance board, ensuring that the heel of one foot and the toes of the other foot touch.
    • Balance skills 2: Walking backwards heel to toe - The child must walk backwards along a line, making sure that the toes of one foot touch the heel of the other.
    • Balance skills 3: Zigzag hopping - The task is to jump diagonally from one mat to another on one leg.

In the following video you can see a demonstration for age group 3: go to 10:56 min.

[14]

Scoring[edit | edit source]

Scores are derived using specific forms, and the cumulative scores from each aspect contribute to an overall score. The norms are provided for the three age groups. The MABC incorporates a score interpretation aid known as the three-color ''Traffic Light'' system:[9]

  • A child scoring at or below the 5th percentile is classified as having a significant movement difficulty (red zone).
  • A child scoring between the 6th and 15th percentile is considered at risk (amber zone).
  • A child scoring above the 16th percentile is unlikely to have a movement difficulty (green zone).

Evidence[edit | edit source]

The MABC has demonstrated concurrent validity with other pediatric motor assessments[15] and is extensively utilized internationally[16][17][18][5][19][20]. The MABC is used across different European, Asia-Pasific, and South American countries [21], including Japan[22], China[23], Belgium[6], Croatia[24], The Netherlands[1], Brazil[25]and Thailand[26].

The MABC excels in identifying children with motor impairment issues compared to the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP)[27].

The MABC has been used in studies involving a range of different developmental conditions, such as:

Psychometric properties[edit | edit source]

The psychometric properties of the MABC-2 are[11]:

  • Intrarater reliability: ICC 0.88 (this suggest a strong level of agreement between scores given by the same rater across repeated measurements. This implies good reliability of the MABC-2 used by the same rater).
  • Inter-rater reliability: ICC 0.96-0.99 (this suggest an exceptionally strong agreement between scores assigned by different raters across repeated measurements. This implies excellent reliability of the MABC-2 when used by different raters.
  • Minimal detectable change (MDC): SEM 1.34 (95%CI)=3 ; 1.83 (95%CI); 1.83 (sensitivity 69.69%, specificity 52.10%)
    • Standard Error of Measurement (SEM): 1.34 (95% CI)=3 . This indicates that the measurement error, represented by the standard error of measurement, is 1.34, and there is 95% confidente that the true change in the score between measurements lies within the interval of 3 points.
    • MDC with a 95% confidence interval: 1.83 . This signifies the minimum detectable change in scores with 95% certainty. In other words, if an individual's scores differ by more than 1.83 points between two measurements, it can be considered a genuine change.
    • Sensitivity and specificity: 1.83 (sensitivity 69.69%, specificity 52.10%) . This indicated that the MDC of 1.83 points has a sensitivity of 69.69%, meaning it can detect real changes. The specificity of 52.10% indicates its ability to distinguish between genuine changes and measurement errors.
  • Minimal Clinically Important Difference (MCID): 1.39 (sensitivity 72.47%, specificity 46.18%). This signifies that a change of 1.39 points is considered clinically relevant. The sensitivity of 72.47% indicates its effectiveness in identifying genuinely important changes, while the specificity of 46.18% reflects its ability to distinguish between clinically relevant changes and random variations. Overall, an MCID of 1.39 points can be deemed as the minimum observed difference that holds clinical significance for the assessed aspect.

References[edit | edit source]

  1. ↑ 1.0 1.1 Smits-Engelsman BCM, Niemeijer AS, & van Waelvelde H. Is the Movement Assessment Battery for Children-2nd edition a reliable instrument to measure motor performance in 3 year old children? Research in Developmental Disabilities. 2011;32(4):1370–1377.
  2. ↑ Jongmans MJ. Early identification of children with Developmental Coordination Disorder. In: Sugden DA, Chambers M, editors. Children with Developmental Coordination Disorder. London: Whurr; 2005. p. 155-167.
  3. ↑ Missiuna C, Rivard L, Bartlett D. Early Identification and Risk Management of Children with Developmental Coordination Disorder. Pediatric Physical Therapy. 2003;15(1), 32–38.
  4. ↑ Coxon ML, Hoyt CR, Smith AE, Hadders-Algra M. Going Beyond Conventional Assessment of Developmental Motor Disorders: Exploring Video Methods for Early Identification Among Children 0 to 3 Years. Advances in Rehabilitation Science and Practice. 2023;12.
  5. ↑ 5.0 5.1 Geuze RH, Jongmans MJ, Schoemaker MM, & Smits-Engelsman BCM. Clinical and research diagnostic criteria for developmental coordination disorder: A review and discussion. Human Movement Science. 2001;20:7– 47.
  6. ↑ 6.0 6.1 Schoemaker MM, Niemeijer AS, Flapper BCT, et al. Validity and reliability of the Movement Assessment Battery for Children-2 Checklist for children with and without motor impairments. Dev Med Child Neurol. 2012;54(4):368–375.
  7. ↑ Huang CY, Huang TY, Koh CL, Yu YT, Chen KL. The Movement Assessment Battery for Children Second Edition in Ages 3 to 6 Years: A Cross-Cultural Comparison for Children in Taiwan, Physical Therapy. 2023.
  8. ↑ 8.0 8.1 Henderson SE, Sugden DA, Barnett AL. Movement assessment battery for children-2 second edition [Movement ABC-2]. London, UK: The Psychological Corporation; 2007.
  9. ↑ 9.0 9.1 Brown T, Lalor A. The Movement Assessment Battery for Children—Second Edition (MABC-2): A Review and Critique. Physical & Occupational Therapy In Pediatrics. 2009; 29(1): 86–103.
  10. ↑ Van Waelvelde H, De Weerdt W, De Cock P, Smits-Engelsman BC. Aspects of the validity of the Movement Assessment Battery for Children. Human Movement Science. 2004; 23(1), 49–60.
  11. ↑ 11.0 11.1 Griffiths A, Toovey R, Morgan PE, Spittle AJ.Psychometric properties of gross motor assessment tools for children: a systematic review. BMJ Open. 2018; 8(10), e021734.
  12. ↑ Riane Wubbenhorst. Movement Assessment Battery for Children 2nd Edition. Available from: https://www.youtube.com/watch?v=_FucZyMY_ug [last accessed 27-11-2023]
  13. ↑ CR. ABC assessment. Available from: https://www.youtube.com/watch?v=4oq9SBoVDD0 [last accessed 27-11-2023]
  14. ↑ CR. ABC assessment. Available from: https://www.youtube.com/watch?v=4oq9SBoVDD0 [last accessed 27-11-2023]
  15. ↑ Missiuna C, Rivard L, Bartlett D. Exploring assessment tools and the target intervention for children with Developmental Coordination Disorder. Physical & Occupational Therapy in Pediatrics. 2006; 26(1/2), 71–89.
  16. ↑ Chow SMK, Henderson SE. Brief report—Interrater and test-retest reliability of the movement assessment battery for Chinese preschool children. American Journal of Occupational Therapy. 2003; 57(5): 574–577.
  17. ↑ Chow S, Hsu Y, Henderson S, Barnett A, Lo S. The Movement ABC: A cross-cultural comparison of preschool children from Hong Kong, Taiwan and the USA. Adapted Physical Activity Quarterly. 2006; 23(3): 31–48.
  18. ↑ Croce RV, Horvat M, McCarthy E. Reliability and concurrent validity of the Movement Assessment Battery for Children. Perceptual and Motor Skills. 2001; 93: 275–280.
  19. ↑ Tan SW, Parker HE, Larkin D. Concurrent validity of motor tests used to identify children with motor impairment. Adapted Physical Activity Quarterly. 2001; 18: 168–182.
  20. ↑ Wiart L, Darrah J. Review of four tests of gross motor development. Developmental Medicine & Child Neurology. 2001; 43: 279–285.
  21. ↑ Wu O, Brown T, Yu M-L, Wilson C, Joshua N, Campbell H. Test-Retest Reliability and Convergent Validity of the Movement Assessment Battery for Children - Third Edition with Australian 3-6-Year-Olds and Their Parents. Journal of Occupational therapy, Schools, & Early Intervention. 2023; pp. 1941-1243.
  22. ↑ Hirata S, Kita Y, Yasunaga M, Suzuki K, Okumura Y, Okuzumi H, Hosobuchi T, Kokubun M, Inagaki M, Nakai A. Applicability of the Movement Assessment Battery for Children–second edition (MABC-2) for Japanese children aged 3–6 years: A preliminary investigation emphasizing internal consistency and factorial validity. Frontiers in Psychology. 2018; 9
  23. ↑ Hua J, Gu G, Meng W, Wu Z. Age band 1 of the Movement Assessment Battery for Children–second edition: Exploring its usefulness in Mainland China. Research in Developmental Disabilities. 2013; 34(2): 801–808.
  24. ↑ Serbetar I, Loftesnes JM, Mamen A. Reliability and structural validity of the Movement Assessment Battery for Children-2 in Croatian preschool children. Sports. 2019; 7(12): 248
  25. ↑ Nazario PF, Ferreira L, Caruzzo NM, Aparecida V, dos Santos VAP, Vieira JLL. Psychometric properties of the Movement Assessment Battery for Children (MABC-2): an analysis based on the Item Response Theory. Journal of Human Growth and Development. 2022; 32(1): 136–144.
  26. ↑ Jaikaew R, Satiansukpong N, Wang Z. Movement performance and movement difficulties in typical school-aged children. PLoS ONE. 2021; 16(4): e0249401.
  27. ↑ Dewey D, Wilson BN. Developmental coordination disorder: What is it? Physical & Occupational Therapy in Pediatrics. 2001; 20: 5–27.
  28. ↑ Harvey WJ, Reid G. A review of fundamental movement skill performance and physical fitness of children with ADHD. Adapted Physical Activity Quarterly. 2003; 20: 1–25.
  29. ↑ Miyahara M, Piek J, Barrett N. Accuracy of drawing in a dual-task and resistance-to-distraction study: motor or attention deficit. Human Movement Science. 2006; 25: 100–109.
  30. ↑ Yiling S, Yuanchun R, Biyao F, Li Y, FANG W, Lei F. The relationship between fine motor skills and executive function in boys with attention deficit hyperactivity disorder. Chinese Journal of School Health. 2023; 44(10): 1522-1526
  31. ↑ Green D, Baird G, Barnett AL, Henderson L, Huber J, Henderson SE. The severity and nature of motor impairment in Asperger’s Syndrome: A comparison with specific developmental disorder of motor function. Journal of Child Psychology and Psychiatry. 2002; 43(4): 655–688.
  32. ↑ Smith IM. Motor problems in children with Autistic Spectrum Disorders. In D. Dewey & D. E. Tupper (Eds. ), Developmental Motor Disorders: A neuropsychological perspective (pp. 152–169). New York: The Guildford Press. 2004
  33. ↑ Liu T, Tongish M, Li Y, et al. Executive and motor function in children with autism spectrum disorder. Cogn Process. 2023; 24: 537–547.
  34. ↑ Hill EL. Non-specific nature of specific language impairment: A review of the literature with regard to concomitant motor impairments. International Journal of Language & Communication Disorders. 2001; 36: 149–171.
  35. ↑ Tseng YT, Hsu HJ. Not only motor skill performance but als haptic function is impaired in children with developmental language disorder. Research in Developmental Disabilities. 2023; 0891-4222.
  36. ↑ Niemeijer AS, Schoemaker MM, Smits-Engelsman BCM. Are teaching principles associated with improved motor performance in children with developmental coordination disorder? A pilot study. Physical Therapy. 2006; 86: 1221– 1230.
  37. ↑ Wilson BN, Kaplan BJ, Crawford SG, Dewey D. Inter-rater reliability of the Bruininks-Oseretsky test of motor proficiency-long form. Adapted Physical Activity Quarterly. 2000; 17: 95–110
  38. ↑ Wuang YP, Su JH, Su CY. Reliability and responsiveness of the Movement Assessment Battery for Children-Second Edition Test in children with developmental coordination disorder. Developmental Medicine & Child Neurology. 2012; 54(2): 160–165.
  39. ↑ Rodrigues P, Barros R, Lopes S, Ribeiro M, Moreira A, Vasconcelos O. Is gender a risk factor for developmental coordination disorder? Advances in Psychology Research (Vol. 127, pp. 85-104). New York, NY: Nova Science Publishers, Incorporated. 2017.
  40. ↑ Nobusako S, Wen W, Osumi M, et al. Action-outcome Regularity Perceptual Sensitivity in Children with Developmental Coordination Disorder. J Autism Dev Disorder; 2023.
  41. ↑ Jongmans MJ, Smits-Engelsman BCM, Schoemaker MM. Consequences of comorbidity of developmental coordination disorders and learning disabilities for severity and pattern of perceptual-motor dysfunction. Journal of Learning Disabilities. 2003; 36(6): 528–537.
  42. ↑ Kooistra L, Schellekens JMH, Schoemaker MM, Vulsma T, van der Meere JJ. Motor problems in early treated congenital hypothyroidism: A matter of failing cerebellar control? Human Movement Science. 1998; 17: 609–629.
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  47. ↑ Mercuri E, Jongmans M, Bouza H, Haataja L, Rutherford M, Henderson S, et al. Congenital hemiplegia in children at school age: Assessment of hand function in the non-hemiplegic hand and correlation with MRI. Neuropediatrics. 1999; 30: 8–13.
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