Operationalising the fine motor construct: an evaluation of assessment tools

Background: Fine motor skills have been linked to a wide range of negative physical, social, educational, and emotional health consequences. However, there is a lack of consensus on which methods should be used to measure these skills and several different assessment tools exist. Five such assessment tools include: (i) the Beery-Bucktenica Visual-Motor Integration test; (ii) the Developmental Coordination Disorder Questionnaire; (iii) the Clinical Kinematic Assessment Tool; (iv) the Movement Assessment Battery for Children; and (v) the Detailed Assessment of Speed of Handwriting. These tools measure different aspects of the complex ‘fine motor skill’ construct (from quantitative assessment of underlying sensorimotor processes to qualitative observations of function). This study investigated the degree to which these tools operationalise an ‘umbrella’ latent construct of fine motor skill given its multifaceted nature. Methods: Data were collected from four different groups: sample (i) - children from a Primary school in Bradford (n= 318); sample (ii) - children with teacher-identified handwriting difficulties from sample (i) (n= 91); sample (iii) - children from ten Primary schools across Bradford with teacher-identified handwriting difficulties (n= 172); and sample (iv) - a clinical sample of children referred to an occupational therapist for ‘Developmental Coordination Disorder’ assessments (n= 33). Correlation, linear regression, and principal component analysis were used to assess the relationships between the measures within each of these samples. Results: Analyses found limited agreement between the measures across the four samples, with regression models accounting for only 4–27% of the variance. Conclusion: The different tools available to assess ‘fine motor skills’ measure specific facets of sensorimotor ability that are only weakly related and/or predictive of each other. The lack of a consensus around which tools should be used to operationalise which aspect of sensorimotor ability can help explain why there are challenges in assessing and supporting children with sensorimotor difficulties.