9/21/15

Using the BOT-2 to Identify and

Support Students with Fine and
Gross Motor Difficulties !

Brett D. Bruininks, Ph.D.

September 21, 2015

Bruininks-Oseretsky
Test of Motor Proficiency,
2nd Edition

Nationally Standardized test:!

Examines behaviors or foundations that are

highly predictive in motor performance

Motor Control
of hands/fingers that requires precision

Individually administered Dexterity Skills

assessment that uses involved in reaching, grasping, object manipulation

engaging goal-directed
activities to measure a Movement Skills
wide array of motor skills in outdoor recreational activities and sports

in children ages 4 through

21 Balance
Strength

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Major Areas of Emphasis

Maintenance of Body Position is essential in acts of movement and
skilled performance (e.g. running, jumping, and striking objects)

Coordination of Visual Tracking with Movement of arms and

hands is needed for catching and throwing
Speed of Response is an important psychomotor ability

Integration of Visual-Perceptual responses with highly

controlled motor responses is required for successful reading and
writing

Precision and Speed of Fine Motor Movements are essential

components of skilled motor performance in vocational activities, play and
sports

The BOT-2

Provides practitioners:
Reliable and Valid
Affordable
Efficient measure of fine and gross motor
control skills in children and young adults

Professionals

Physical
OTs PTs
Rehabilitation

Adaptive &
Nurses Physical Neurologists
Educators

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Topics
A. Purpose & Application B. Features of the BOT-2

C. Testing Options: (1) Full Composite Test

(2) Short Form (3) Fine and Gross Motor

(4) BOT-2 Brief (5) Individual Subtests

D. Supporting Programs: R.T.I E. Tips for Administration

F. FAQs

A. Purpose & Application

Assessing Motor Development Making Placement Decisions

Developing & Evaluating Motor Support Diagnosis of Motor

Training Programs Impairment

Screening Research

B. Features of the BOT-2

Portability
Supportive Evidence
Administration Easel
Scoring

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BOT-2 & Supportive Evidence

Internal Test-Retest Inter-rater
Validity
Consistency Reliability Reliability

Statistically significant
*Scores obtained
Total Motor in supporting
across items within
Composite = High 90s diagnoses that involve
each subtest and
Mid-Upper 80s motor performance
composite
deficits (DCD, ASD)

Mean Subtest
Comp.= hi 80s to Has the statistical support for
evidence-based assessment
low 90s Short Form =
TMC = mid 90s Mid-Upper 80s
Short Form = mid Has the evidence-based support
80s that educational settings and
agencies for accommodation are
requiring

Administration Easel

Large (8.5 x 11) Content

Full Color Photos
Includes:

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Scoring Prompts

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Scoring Prompts

Scoring

Total motor composite: 4 motor area composites, 8

subtests
Gender-based norms/combined norms
Scale scores, standard scores, percentile rank,
descriptive levels
Graphical profiles
Pairwise comparisons

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Q-Global
Web-based
Allows you to quickly and easily score and report results.
Single Reports, Short Form Reports, 1, 3, 5-year subscriptions

The Q-Global includes:

Unlimited Scoring
Entry of either Item Raw Scores (IRS) or Subtests Total Point Scores (TPS)
Generation of derived scores and score profiles
Identification of examinees motor skill strengths and weaknesses
Gross Motor Composite (Q-Global Only)
Fine Motor Composite (Q-Global Only)
Generates Reports

The Complete Test Kit

Manual Administration Easel
Examinee Booklets (25) Record Forms (25)
Scoring Transparency Balance Beam
Blocks (15) and String (1) Sorting Cards (50)
Pegboard (1) and Pegs (30) Pennies (20) and Pad
Red Pencils (2) Shuttle Block
Target Box
Knee Pad Scissors
Tennis Ball Carrying Case
Note: you will need to provide: Stopwatch, tape measure and tape

C. Testing Options

Gross Motor &

Short Form
Fine Motor

Complete Form

Individual
BOT-2 Brief
Subtests

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(1) Total Motor Composite

A Four-Composite Structure
All 8 Subtests (53 Items)

Preferred option
Most comprehensive and reliable measure of overall motor
proficiency

Qualifying an individual for services

Supporting clinical diagnosis

Items: 53

Subtests: 8

Testing Time: 40-60* minutes (10-15 min set-up)

Fine Manual Fine Motor Precision (7 Items)

Control Fine Motor Integration (8 Items)
Gross Manual Manual Dexterity (5 Items)
Control Upper-Limb Coordination (7 Items)
Bilateral Coordination (7 Items)
Body Control
Balance (9 Items)
Running Speed & Agility (5 Items)
Strength & Agility
Strength (5 Items)

-Subtest 1-
Fine Motor Precision

Consists of activities that

require precise control of Untimed
finger and hand movement
5 drawing items
1 paper-folding item
Total # of
1 cutting Item Errors

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-Subtest 2-
Fine Motor Integration
Reproduce drawings of various
Precision

geometric shapes that range in

complexity and
Accuracy

Measures:
Precise control of finger and
Multi-

hand movement
Faceted
Ability to integrate visual stimuli

Scoring
with motor control (copying)

-Subtest 3-
Manual Dexterity
Goal directed activities that involve:
Reaching Accuracy Speed
Grasping
Bi-manual coordination with
small objects
Key: Total #
Timed
Timed Correct
Differentiates levels of dexterity

-Subtest 4-
Bilateral Coordination
Skills involved in playing
sports and many Precision & Accuracy
of Movement
recreational activities
# of consecutive correct
movements
Tasks require body control
as well as sequential and Repeat if Max isn't
reached on first trial
simultaneous coordination
of upper and lower limbs

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-Subtest 5-
Balance
Evaluates motor skills that are
integral for maintaining posture Use Running
Course

Measures:
Max Time &

Total # Correct
Stability of the trunk
Stasis and movement Repeat if Max
isn't reached on
Proprioception or use of first trial
visual cues

-Subtest 6-
Running Speed & Agility
Assesses running speed and agility using:
Use Running
Course
Shuttle Run

Hopping Tasks Time and Total #

Correct
Lateral Movement
Emphasis on form
and Speed
Key: Provides an opportunity to make
clinical observations about gait. We
sometimes forget that we can learn a lot
about an individualby observation. Take Provides a great opportunity to make
some notes. clinical observations about gate

-Subtest 7-
Upper-Limb Coordination
Designed to measure visual Eye-Hand Coordination
tracking with coordinated arm
and hand movements
Use a portion of running
course
4 Items require use of one hand

Total number (consecutive)

3 Items require coordination of 2
hands

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-Subtest 8-
Strength
Measures core (trunk) and upper Strength
and lower body strength

Standing long jump

Push-ups Good Form

Sit-ups
Wall Sit
Time and Total #
V-up

When to Use the Total Motor

A comprehensive and reliable measure of total motor

proficiency is needed.
The assessment may have a role in determining whether
an individual qualifies for special-education services.
Diagnostics are needed to confirm the presence of a
clinical condition.

(2) Short Form

All four Motor Composites

14 total Items
Items from each of the 8 Subsets

15-20 minutes

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Components of the Short Form

Subtest Item Item
Fine Motor Precision Drawing Lines-Crooked (3) Folding Paper (6)

Fine Motor Integration Copying a Square (2) Copying a Star (7)

Manual Dexterity Transferring Pennies (2)

Jumping in Place-Same-Side Tapping Feet and Fingers-Same

Bilateral Coordination Synchronized (3) Side Synchronized (6)
Standing on One Leg-Balance
Balance Walking Forward on a Line (2)
Beam Eyes open (7)

Running Speed & Agility One-Leg Stationary Hop (3)

Dropping and Catching a Ball- Dribbling a Ball-Alternate Hands

Upper Limb Coordination Both Hands (1) (6)

Strength Push-ups (2a/b) Sit-ups (3)

When to Use the Short Form

Screen for further evaluation/assessment.

A program re-evaluation is needed.
Use to obtain pre-referral information, as appropriate.
Only a single score of overall motor proficiency is
necessary.

(3) Fine and Gross Motor Test Kits

Test Kit is split into two areas: Fine and Gross

Designed to specifically look at one area
Yields: Fine Motor Composite and Gross Motor
Composite
Supplemental manual
Administration: 30-35 minutes

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Gross and Fine Motor

BOT-2 Fine Motor Form BOT-2 Gross Motor Form

Fine Motor Precision Bilateral Coordination

Fine Motor Integration Balance

Manual Dexterity Running Speed & Agility

Upper-Limb Coordination Strength

Provides scores on 4 subtests, 2 Provides scores on 4 subtests, 2

motor-area composites: Fine Manual motor-area composites: Body
Control and Manual Coordination = Fine Coordination and Strength & Agility =
Motor Composite Gross Motor Composite

(4) BOT-2 Brief

Developed to address the need for fewer manipulatives.

12 items consisting of at least one item from each BOT-2
subtest.
Quick and easyyields an overall picture of motor
proficiency.
Administration Time: 12-15 minutes

The BOT-2 Brief

Subtest Item Item
Fine Motor Precision Filling in a Star Drawing a Line Through a Path

Fine Motor Integration Copying Overlapping Circles Copying a Diamond

Manual Dexterity Stringing Blocks

Touching Nose with Index

Bilateral Coordination Fingers-Eyes Closed
Pivoting Thumbs & Index Fingers

Walking Forward Heel-to-Toe on

Balance a Line

Running Speed & Agility One-Legged Side-hop

Upper Limb Coordination Catching a Tossed Ball-1-Hand Dribbling a Ball-Alternate Hands

Strength Push-ups (2a/b)

Kit includes: Manual/Administration Easel, Record Forms (25), Red Pencil, Blocks and String, Knee Pad, Tennis Ball

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When to Use the BOT-2 Brief

Used to determine the need for further assessment.

Note: Can be used as part of a comprehensive battery
designed to compliment cognitive and academic
assessments.

(5) Individual Subtests

Select only those subtests/composites relevant to an

individuals needs.
When to use: Plan a motor training program and/or
evaluate progress.
Important Note: Separate composites/subtests alone
are not as statistically strong as the complete test.
Should be limited to situations in which you have prior
knowledge of the examinees abilities.

D. Purpose & Application

Assessing Motor Development Making Placement Decisions

Developing & Evaluating Motor Support Diagnosis of Motor

Training Programs Impairment

Screening Research

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Motor-Related Disabilities
Disability Prevalence
2.8 million children

Motor Coordination Deficits

Estimated: 6-10+% of the population (WHO, 2008)

Coordination Deficits commonly found in individuals with:

Autism Spectrum Disorders (~1 in 68)

Cognitive Disabilities

Physical Disabilities

ADHD (5% of children)

TBI (473,000+, children ages 0-14 treated)

Obesity (17%, ages 2-19) [CDC, 2015].

Moderate Coordination Problems

Associated with poor academic achievement and socialization issues

Health issues

D. Supporting Needs: RTI

Before a child is deemed eligible for special education services under
IDEA, the child must be evaluated to determine his or her disability status
and educational needs.

Past: Designed to offer an alternative

Present: Overarching eligibility means to qualify children for special
framework. Overall integrated education under a specific disability
system of service delivery

Multi-tiered systems of support

Resource allocation model

Matched to student need
Response to Intervention
Problem solving model
Data-based decision making
Early intervention

BOT-2 and RTI

Tier 3: Students need supplemental
and individualized intervention

Tier 2: Students need

supplemental intervention

Tier 1: Majority of students

will not require assessment
or additional intervention

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Role of BOT-2 in Problem Solving

Problem Use the BOT-2 to determine if there is/are

Identification motor skill deficit(s)

Use the BOT-2 to identify specific motor skills

Problem Analysis
needs and areas for intervention

Select and implement supplemental

Plan Implementation interventions based on identified student
needs

Use the BOT-2 to assess the impact of the

Plan Evalaution
implemented intervention(s) [Benchmarking]

BOT-2 Within the RTI Model

The BOT-2 is primarily relevant for Tiers 2 & 3 assessment
and intervention.
Its primary uses are for:
Identification of motor deficits
Specific deficits needing intervention
Targeted intervention selection
Provide data for writing specific IEP goals
Evaluating individual response to intervention
BOT-2 Normative data will help set individual goals

Case Study
Name: MK90045
Gender: Male
Age: 12-years, 10 months
Special notes: Male has recognized attention, motor,
and social difficulties.
Examinee has been tested using the BOT-2 Full Motor
Composite
NOTE: Subtests were pulled out to show deficits

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Professional Reports
Below average manual dexterity and ability to coordinate his body in a
quick and controlled manner

Below average balance, especially eyes closed

Toe Walking

Overall poor motor skill resulting in avoidance of group sports

Decreased attention to task

Fidgeting and impulsivity which required medical management in order

to participate in academic tasks

Decreased social skills, lack of participation in conversation

Decreased verbal expression of ideas and opinions

Motor Subtests Results

Subtest Score(s) Comments

Below Average Examinee presented issues with

Manual Dexterity grasping
(Age Equivalent: 8:3-8:5)

Upper Limb Below Average Examinee exhibited object

Coordination (Age Equivalent: 8:3-8:5) tracking and gasping issues

Bilateral Average: Examinee presented issues with

Coordination (Age Equivalent: 10:9-10:10) synchronization (opposite)

Examinee presented issues

Below Average:
Balance with posture, toe walking and
(Age Equivalent: 5:10-5:11)
focus

Note: Examinee was given the TMC. Subtests were chosen to show deficits

Motor Intervention Focus

Improve his physical activity

Improve overall body coordination
Address areas of weakness and develop precise and
measurable IEP goals related to his skill deficits.
Increase in motor skills may positively impact social
skills, confidence, participation, self-efficacy, and
academic performance.

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Set-up Instructions

Prepare testing area

Room: 60 feet long/12 feet wide
Table and 2 chairs (Feet must be able to touch the
floor
Tape off Running Course
Affix Target
Prepare Record Forms

E. Tips for Administration

Read and Follow all

Familiarize yourself Pay Attention to the
Directions and Rules
with the test Testing Environment
within the Test

Manual Easel Validity Reliability Room Lighting

=
Temp Furniture
Set-up Scoring Reduction in subtest
transition time =
Reduces overall
Practice Examinee Comfort
testing time

Make sure the

Keep testing area free
examinee is wearing Meet the needs of your
of all testing equipment
appropriate testing examinee
not in use
attire

Hungry Thirsty Assistive

Athletic Comfortable Restroom Devices
Attention Safety clothing
Shoes

Make sure your

examinee understands Establish Rapport
the directions

Demonstrate Easel Open and

Respect
Honest
Flexibility

Teaching Text Proper Form

Make it fun!

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Properly schedule Administer every item

Maintain rapport each examination and in each subtest and
throughout the testing adjust testing time score everything
accordingly objectively

Eye Smooth
2 Sessions?
Contact Transitions Validity Reliability

Encourage

F. Frequently Asked Questions

What Version of the Test is

Preferred?

The Total Motor Composite option is

preferred. Its the most comprehensive and
reliable measure of overall motor proficiency and
should certainly be used when:
Qualifying an individual for services
Supporting clinical diagnosis

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Can I Change Up the Order of the

Subtests/Items?

No. It is for the benefit of the examinee

and the results that you stay with the
order designated by that subtest.
Subtest items were ordered to allow
maximum performance.

Can I Split Testing Sessions?

Certainly. Many factors go into testing

performance and you can decide to administer the
test by splitting into two sessions. Key: if you are
administering a subtest and need to stop the test,
complete that subtest.

How Much Time Between Testing

Dates to Minimize the Testing
Eect?
Its general practice to wait 90 days until the next
administration (can be used for Benchmarking). This
will ensure minimal (if any) testing effects and
determine the impact of the intervention(s). However,
depending on your child or young adult, you can
administer the BOT-2 and its subtests somewhat more
frequently (~60 days). Note: the latter is typically used
for pre/postest scenarios.

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How Do I Make Sure I have the

Preferred Foot/Hand?

Although some children do like to stand/lean on their

preferred foot/leg, for testing purposes, the BOT-2
designates the preferred foot as the one he/she uses to
kick the ball.
The preferred hand is the one in which he or she reaches
for the ball in the preliminary assessment.

When Should I Administer a

Second Trial?

If the examinee doesn't achieve a maximum score of

the item, in some of the BOT-2 items, a second trial is
allowable. Check the Administration Easel for the
specifics. Note: when scoring, take the higher score of
the two trials.

Can I Get a Discount on

Products?

Some products offered by Pearson qualify for

discounts:
Research Assistance Plan
Training Partner Programtraining needs of
college and university faculty and training directors

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Special Thanks

Sherry Lokken
Shelley Hughes
Michelle Samlaska
Cynthia P. Conner

Thank You

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