BOTMP
Terrence Brophy
Assigned T&M: BOTMP
Test and Measures Assignment
1) The title of the article I was assigned is Accuracy of motor assessment in the diagnosis of fetal alcohol spectrum disorder by Johnston et al. To begin, fetal alcohol spectrum disorder (FASD) is defined by the authors as a combination of neurodevelopmental impairments and physical characteristics that result from prenatal alcohol exposure (PAE). Our role as Physical Therapist within the health care team in managing FASD is to assess potential motor impairments. Therefore, the purpose of the article was to clarify diagnosis criteria regarding the motor impairments found in FASD.
The inclusion criteria for the study were for youth between ages 6 and 17 years old at the time of assessment who were confirmed to have a history of PAE. Based on the inclusion criteria, the authors included 63 children in their study. A diagnosis of FASD was made by “evidence of impairment in 3 or more of the following neuro-developmental domains in addition to confirmed PAE: motor skills; neuroanatomy/neurophysiology; cognition; language; academic achievement; memory; attention; executive function; affect regulation; adaptive behavior; social skills; or social communication” (D. Johnson et. al). The children included in the study had at least 3 non-motor impairments.
One of the motor assessment tools used in the study was the Bruininks Osterestsky Test of Motor Proficiency. The BOTMP assess fine motor precision, fine motor integration, manual dexterity, upper limb coordination, bilateral coordination, balance, running speed and agility, and strength (D. Johnson et. al). The study found that the sensitivity of the BOTMP was extremely low and it is not an accurate objective measure for evaluating the motor impairments secondary to FASD.
The study was a cross-sectional diagnostic study using historical data obtained by patient file review.
2) The authors were transparent with limitations within their study. One being that PAE was reported by mother’s retrospectively. Therefore, it is possible that the reports were inaccurate. Another limitation was that the clinicians knew that all of the children in the study had a history of PAE. This could lead to potential bias.
A strength of the article was that it also tested diagnostic accuracy of two other objective measures. One being the Movement Assessment Battery for Children, 2nd edition (MABC-2) and the Beery-Buktenica Developmental Test of Visual Motor Integration, 6th edition (BeeryVMI-6). This provided the reader with other objective measures to compare the BOTMP with.
3) The overall conclusion of the article is that the use of the BOTMP in measuring FASD should be reconsidered.
2 responses to “BOTMP”
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Hey Terrence, I liked how you began by providing an explanation of FAD to give context of what was to follow. I found it interesting that your article was discouraging the use of an outcome measure as commonly you see authors attempting to support their use. I would be interested to know if there were any other measures out there are being used with this population! Great job.
Hi Terrence. It sounds like the authors were trying to see if scores on the BOTMP correlated to FAS severity, and to me, the results are unsurprising. Symptoms of FAS can present in many different ways. I don’t think that there will ever be an OM that can detect every nuanced motor impairment caused by PAE. Thanks for the clear, concise summary. It’s nice that the authors were transparent and honest with their weaknesses. To me, this is just as valuable as touting the study’s strengths.