Additional KNES370 terms

developmental variability

different individuals develop differently

motor development is?

• individual

• development is age-related not age-determined

what type of developments exist?

typical and atypical (cerebral palsy) development

what are some consequences of development variability?

• different individuals achieve the same motor milestone

• similar ages exhibit a range of different motor behaviors

• difference in motor milestone achievement sequence

what are some differences in development?

sensory, nervous, and muscular interact with environmental and task constraints

validity

• more difficult to achieve

• a measure is valid if it measures the concept that one claims it (reliable)

what are the types of validity?

• face validity

• content validity

• criterion validity

• predictive validity

• construct validity

content validity

• must reflect both static and dynamic balance

• if it covers the full range of the concept’s meaning

criterion validity

matches results from a more direct/already validated measure of same concept

construct validity

• most complicated to assess

• whether a test, assessment, or measure actually evaluates the theoretical concept (construct) it is supposed to measure.

face validity

if “on its face” it is related to the concept being measured more than to other concepts

predictive validity

• commonly used to assess fall risk in older adults

• different versions

• balance & gait section → add up scores

• ex: Tinetti Test (aka Tinetti Balance Test, aka Performance

  Oriented Mobility Assessment)

what was the sensitivity and specificity test?

Consider some condition

▪ Some people have condition

▪ Others do not

looking for the people who test positive for condition

• Some are true positives

▪ Others are false positives

Of the people who test negative for

condition

▪ Some are true negatives

▪ Others are false negatives

sensitivity

• true positive rate

• of all the people who have the condition, proportion correctly identified:

• number of true positive/number of people w/condition

• doesn’t equal: number of true positives/number of people assessed

specificity

• of all the people who do not have the condition, the proportion correctly identified:

• number of true negatives/number of people w/o condition

• false positive rate: 1 - specificity

• doesn’t equal: number of false positives/number of people assessed

reliability

measure that is not a valid measure all the time (only if reliable)

if it yields consistent scores (assuming the concept being measured doesn’t change) evaluated using correlation coefficient

what are the types of reliability?

• test-retest and interrater

• Both definitions assume that measured concept is not changing

• Both types of reliability are evaluated based on results from a (large) group of individuals

test-retest reliability

measure assessed for same individual at two different times yields similar scores both time

interrater reliability

measure assessed for same individual by two different testers yields similar scores from both testers

consider whether the length of time a child can stand on one foot is a valid measure of balance. What type of validity does this measure?

face validity

suppose that a test has high sensitivity and high specificity. Does this guarantee that there will be more true positives than false positives?

no

can a measure be reliable without being valid?

yes

norm-referenced tests

• yields a quantitative measure that compares an individual to other individuals from the same group

• groups are based on factors such as age and sex

• comparisons often based on percentiles

what was the Movement Assessment Battery for Children (Movement ABC), version 2

norm-referenced test

Assesses motor development in children ages 3-17

▪ Items in three categories

• Manual dexterity

• Ball skills

• Static and dynamic balance

A test of balance is valid if?

the assessment of the individual yields a score that actually reflects the individual’s balance

For a measure of balance to have content validity, it must reflect what?

static and dynamic balance

The study of Raîche et al. (2000) we discussed in class found that using the Tinetti test to assess fall risk has?

some predictive validity

Suppose that a test for some condition has very high specificity. This guarantees what?

Most individuals who do not have the condition will be correctly identified by the test as not having the condition.

uppose you are using a device to measure changes in children's muscle strength during development. The device breaks and starts to always give the same value for muscle strength every time it is used. This means that your assessment of muscle strength is?

reliable but not valid

Why is the Movement Assessment Battery for Children referred to as a norm-referenced assessment tool?

It yields a percentile score that compares the child being tested to other children of the same age.

developmental coordination disorder

• heterogeneous group of children who have difficulty in their movement control and coordination

• not easy to diagnose

• motor milestones sometimes, but not always delayed

• more common in males

• about 1 out of every 16 children

• lack of awareness and therapy

said to have:

 Developmental dyspraxia

 Sensorimotor integration problems

 Motor planning problems

DCD symptoms tested for posture and balance

 Balancing on one leg

 Walking balance beam

DCD symptoms tested for fundamental motor skills

 Catching, throwing, etc.

 Skipping

 Bumping into people or tripping while walking

DCD symptoms tested for prehension

 Tying shoes

 Zipping coat

 Buttoning buttons

 Handwriting

 Using scissors

why conduct interventions?

• to improve health and well-being of individuals

• to provide eveidence of causation, rather than just association

DCD diagnostic criteria

• Learning and execution of coordinated motor skills below expected level for age, given opportunity for skill learning

• Motor skill difficulties significantly interfere with activities of daily living and impact academic productivity, etc.

• Onset early during development

• Not better explained by intellectual delay, visual impairment or neurological condition

what do children with DCD have problems with?

• Fine motor skills (e.g., handwriting)

• Balance

• Visuomotor skills (e.g., ball skills)

• In two or all of the above areas

what other conditions could children with DCD have?

 Attention deficit hyperactivity disorder (ADHD)

 Autism spectrum disorder

 Specific language impairment (SLI)

• About one third of children with SLI also have DCD (Flapper &

Schoemaker 2013)

 Anxiety

 Depression

sensory reweighting

• the ability to adaptively change our

• Based on how reliably different senses indicate self-motionreliance on different sensory modalities

ex: If visual scene starts to move, we:

• Reduce our reliance on vision

• Increase our reliance on vestibular sensation & somatosensation

which curve represents children w/DCD?

black squares

typical developing children show ____ sensory reweighting

more

Reliability of somatosensation increases or reliability of vision decreases → Reliance on vision decreases → Visual gain decreases

DCD children show ____ sensory reweighting

less

• Less ability to adapt to changing conditions

norm-referenced tests of children w/DCD

• diagnosis from physician

• Movement ABC score < 5th percentile

norm-referenced tests of typically developing children

• Movement ABC score > 20th percentile

suppose that children with greater motor competence also tend to have higher levels of physical activity. What can we conclude?

doesn’t mean that increasing motor competence increases physical activity and vice versa

what does the P in PICO framework stand for?

population

The group of individuals the study is designed to draw conclusions

about

• Study selects participants from this population

Consider an intervention study designed to answer the following research question: Can virtual reality balance exercises improve balance in older adults with a risk of falling? What is the P in the PICO framework for this study?

older adults with a risk of falling

who were the participants (population) for the virtual reality exercise intervention?

older adults with a risk of falling

• Permission of doctor at nursing home

• No acute or chronic diseases or other issues that might hinder exercising

• No participation in exercises similar to the intervention

• No unmodified hearing and visual limitations

• No vestibular or cerebellar balance disorders

what was the intervention for the virtual reality exercise intervention?

• Six weeks of virtual reality balance exercises

 Xbox Kinect games Ski, Penalty and Goalkeeper, Darts

 30 of 60 participants randomly assigned to treatment group

 Two 30−60 min sessions a week

what was the comparison/control for the virtual reality exercise intervention?

Routine activity programs of nursing home, including indoor jogging, table tennis, artistic activities

• 30 of 60 participants randomly assigned to control group

what were the outcomes for the virtual reality exercise intervention?

Timed Up and Go (TUG)

• Tested before and after intervention

• Decreased significantly in treatment but not control group

• Decrease significantly larger in treatment group

Berg Balance Scale, an assessment of balance in older adults

Falling Efficacy Scale, an assessment of fear of falling

what does the I in PICO framework stand for?

intervention

• The treatment, training or experience the study provides to some participants (the treatment group) in order to learn about the treatment’s effects

what does the C in PICO framework stand for?

comparison/control

• The alternative treatment, training or experience the study provides to other participants (the control group) to allow comparisons between treatment and control groups that strengthen conclusions about the treatment’s effects

what does the O in PICO framework stand for?

outcomes

• The outcome measures assessed in participants (at various time points) and compared between treatment and control groups in order to draw conclusions about the treatment’s effects