Motor competency is defined as one’s ability to perform fundamental movement skills consistently and proficiently (Rudd et al., 2015). Motor proficiency is defined as one’s performance of fine motor precision; fine motor integration (visual motor integration); manual dexterity; upper limb coordination; bilateral coordination; and terms usually associated with health-related fitness, such as balance, speed and agility, and strength (Bruininks & Bruininks, 2010). Children in the United States are consistently presenting progressively lower performance in terms of motor competency (Brian et al., 2019) and proficiency (Arnould et al., 2015). Motor competency and proficiency affects children’s healthy development during the early years (Haga, 2008; Lubans et al., 2010; Stodden et al., 2013, 2014). Children with lower levels of motor competency are at a higher risk for hypokinetic diseases (e.g., Type 2 diabetes and obesity) and decreased levels of participation in physical activity later in adolescence (Robinson et al., 2015; Stodden et al., 2008).
Children with disabilities are particularly at-risk for delays in motor competency (Bishop & Pangelinan, 2018; Wrotniak et al., 2006). In recent years, many scholars have examined the effects of interventions to improve components of motor competency and proficiency in young children both with and without disabilities (Case-Smith et al., 2013; Lai et al., 2014; Logan et al., 2012). Given children spend most of their waking hours in the school environment (Federal Interagency Forum on Child, & Family Studies [US], 2017), school can be an ideal location to intervene on young children’s competency and proficiency (Cortina et al., 2008).
School-based interventions with a purpose to improve only gross motor skills, associated with motor competency, are quite prevalent (Logan et al., 2012). Gross motor skill intervention studies generate powerful effects for children without disabilities in school-based settings (η2 = .61 [Brian et al., 2017a, 2017b]; η2 = .67 [Taunton et al., 2017]; η2 = .73 [Robinson & Goodway, 2009]). However, to our knowledge, few researchers have examined the effects of gross motor skill interventions in children both with and without disabilities in school-based settings (Taunton et al., 2017; Valentini & Rudisill, 2004a, 2004b). Within these few interventions, only Taunton et al. reported the effect size of the intervention, η2 = .67. However, potential outcomes of these interventions are promising given the results yielded similar effects including children both with and without disabilities to other gross motor skill interventions on children without disabilities.
Similar to gross motor interventions, health-related fitness interventions often do not include within- and between-group analysis of children both with and without disabilities together in the same intervention (Adair et al., 2015; Lai et al., 2014). Young children globally are exhibiting poor health-related fitness; this is exacerbated in children with disabilities. Health-related fitness is important for all children due to the associations with motor skills, physical activity, quality of life, and psychological well-being (Pereira et al., 2011; Vieira et al., 2013). Yet, despite its importance and inclusion within physical education curricula, health-related fitness studies are typically conducted outside of school-based settings (e.g., after school programs, sports context, or community-based environments; Adair et al., 2015). Thus, health-related fitness should be considered with any school-based movement intervention program.
Likewise to health-related fitness, interventions targeting solely fine motor skills exist but rarely occur in school-based settings (Case-Smith et al., 2013; Feder & Majnemer, 2007; Pless & Carlsson, 2000). Due to the constraints of a school-based environment (e.g., lack of time, resources, funding, and scheduling), it is often difficult to allot specific time for the development of the of specific motor competency and proficiency skills simultaneously (Gooze et al., 2010). Lack of targeted fine motor interventions is concerning as all aspects of children’s motor competency and proficiency (e.g., gross motor, fine motor, and health-related fitness skills) are important for whole child development during the early years. Thus, an integrative approach to intervention for children with and without disabilities which combines multiple components of motor competency and proficiency (e.g., gross motor, fine motor, and health-related fitness skills) may be warranted with a curricular framework that meets the needs of today’s diverse student population.
A framework that meets the needs of many learners with and without disabilities in inclusive settings is Universal Design for Learning (UDL; Center for Applied Special Technology, 2011). The UDL originated in the field of special education (Rose, 2000) and is emergent in fields, such as adapted physical education (Lieberman & Houston-Wilson, 2018). The foundation of UDL is rooted in a conceptual framework in which teachers account for children’s abilities, preferences, learning styles, languages, and individual needs in the design phase of curriculum and lesson planning (Rose, 2000). The UDL contrasts with curricula that makes modifications during the lesson for specific disabilities, learning styles, or preferences that are separate from the main lesson designed for the “average” learner within the class environment (Hitchcock et al., 2002; Lieberman et al., 2008). The UDL accounts for the diversity of all learners by creating genuinely inclusive physical education experiences through unified activities and games to maximize learning (Lieberman et. al, 2008). Teachers provide the foundational components of UDL (multiple means of representation, action, expression, and engagement) to all children within each lesson throughout the intervention (Center for Applied Special Technology, 2011).
Universally designed interventions are effective when solely targeting gross motor skills in school-based settings (Taunton et al., 2017). However, to our knowledge, no studies have featured an integrative approach with multiple aspects of motor development (e.g., motor competency and proficiency, health-related fitness, and fine motor skills) using the foundational components of UDL (multiple means of representation, action, expression, and engagement) as framework for intervention with children both with and without disabilities. Therefore, the purpose of this study was to examine the effects of an integrative intervention on gross and fine motor competency and proficiency as well as health-related fitness for young children (aged 3–6 years) with and without disabilities in a school-based setting. Measuring outcomes of motor competency and proficiency using multiple assessments is necessary to appropriately measure the multifaceted programmatic effectiveness of an integrative intervention. We hypothesize the children in integrative intervention will perform significantly better than children in the control condition after 6 weeks of intervention on children’s motor competency and proficiency across both assessment measures (e.g., Bruininks–Oseretsky Test of Motor Proficiency—second edition brief form [BOT2-BF] and Test of Gross Motor Development—second edition [TGMD-2]). Moreover, there will be no differential effects of disabilities on children’s motor competency and proficiency within the intervention group at the posttest for both the BOT2-BF and TGMD-2 assessments.
Theory
We grounded this study in a translational interpretation of dynamical systems theory via Newell’s model of constraints (Newell, 1986). Newell’s model suggests that development occurs from the interdependent association of three constraints: the individual person, the task that the individual is performing, and the environment that surrounds the individual and the task (Newell, 1986). Practical translations of Newell’s constraints through our intervention include the following to increase children’s overall motor repertoire: (a) manipulating both functional (e.g., providing lower impact activity choices within each station) and structural (e.g., providing tactile, verbal, and visual prompts within each station activity) constraints of the individual; (b) controlling environmental constraints (e.g., manipulating group sizing and noise levels) during lessons; and (c) manipulating the task to provide affordances and rate limiters within the task (e.g., modifying equipment and distances within station activities) constraints (Newell, 1986; Pope et al., 2012).
Methods
Setting
The study featured a pretest/postest/control experimental design. The study took place at a public early childhood center within a rural school district in the Southeastern United States. The school district and center strived to provide the highest quality educational services to exceptional students by implementing research and standards-based interventions, instruction, and assessments as well as provide a personalized system of learning for all students, a common mission and vision for many school districts. The center contained 29 classrooms that included preschool (ages 3 and 4 years old) and kindergarten (ages 5 and 6 years old). In accordance with the school district policy, all children received 30 min of free play daily. Classroom teachers led and supervised all activities during recess. Given the setting, center’s mission, and structure of physical activity during early childhood results of the study could be replicated and generalizable to many early childhood centers.
Participants
Participants included preschool and kindergarten children (N = 111), aged 3–6 years (Mage = 5.15, SD = 0.82 years) enrolled at the public early childhood center in the Southeastern United States. The sample was diverse in age (3 years old = 10, 4 years old = 38; 5 years old = 37, and 6 years old = 26); sex (girls = 58, boys = 53); and ethnicity (African American = 24, Hispanic = 15, White = 70; other = 2). Overall, the sample included children with disabilities (n = 24) and without disabilities (n = 87). Disabilities presented included autism spectrum disorders (n = 2), developmental delay (n = 4), speech and language disorder (n = 17), and hearing impaired/hard of hearing (n = 1). Four children presented multiple mild to moderate disabilities (hearing impaired/hard of hearing and speech/language disorder = 1; speech/language disorder and developmental delay = 3). Children were randomly assigned an identification number prior to the start of the study. Children placed in general and inclusion classes by the center were randomly assigned to a condition (e.g., intervention or control) using a random number generator. Children within the control condition went to recess with the classroom teachers during the intervention sessions. Children must have attended 80% of all intervention sessions to be included in the intervention. All children included in the study met required attendance.
Instrumentation
Test of Gross Motor Development—Second Edition
To measure children’s gross motor skills, we used the TGMD-2 (Ulrich, 2000). The TGMD-2 measures children’s (aged 3–10 years 11 months) gross motor skill development. The assessments includes 12 skills divided into two subscales: locomotor skills and object control skills. Locomotor skills assessed in the TGMD-2 include running, galloping, hopping, jumping, sliding, and leaping. Object control skills assessed in the TGMD-2 include striking, dribbling, catching, kicking, throwing, and rolling. Following a demonstration of one of the 12 skills, the child gets a nonscored practice trial. The child then performs two additional trials of each skill which are retained for analysis.
The TGMD-2 is both a normative and criterion-referenced assessment. Each skill within the TGMD-2 has between three and five criteria for each skill trial. A rater records a “1” if the participant correctly performs the criterion of the skill. A rater records a “0” if the participant does not perform the criterion of the skill. A raw score for each skill ranging between 0 and 10, depending on the skill, is determined by summing the criterion total for each trial. Each raw skill score is summed with the other five skills within the subscale to determine a raw subscale score between 0 and 48. Each locomotor and object control subscale score can be summed to determine the total gross motor raw score, which can be converted into normative data based on age and sex of boys and girls.
Bruininks–Oseretsky Test of Motor Proficiency—Second Edition Brief Form
The BOT-2 brief form (BOT2-BF) is a valid and reliable assessment to measure motor proficiency in individuals with and without most disabilities (Bruininks & Bruininks, 2010). The BOT2-BF measures motor proficiency via 12 items representing eight subscales: fine motor precision, fine motor integration, manual dexterity, bilateral coordination, balance, speed and agility, upper limb coordination, and strength. As a result, the BOT2-BF is also considered a measure of health-related fitness. For each of the 12 items, the child read the directions using an optional teaching text in the administration manual and was given a demonstration by an administrator of the assessment and was also provided a picture of a child completing each skill.
Raw scores for each of the 12 BOT2-BF skills can be converted into a skill point score ranging from 0 to 10 depending on the specific skill. Each of the 12 BOT2-BF skill point scores is summed to determine a total BOT2-BF point score ranging from a minimum score of 0 to a maximum score of 72. Next, each of the eight BOT2-BF subscales point scores are converted into six composite scores: fine manual control, manual coordination, body coordination, strength and agility, total motor composite, gross motor composite, and fine motor composite using normative referencing based upon age and sex. A conversion of the six composite scores is indicative of a child’s total motor proficiency score.
Procedures
We obtained approval for the current study from the institutional board at the University of South Carolina. After receiving institutional board approval, all parents provided consent, and children provided verbal and written assent to participate in the study. We randomly selected six of the 29 classrooms at the center for participation. Within the six randomly selected classrooms, we randomly assigned children within each classroom to the experimental Integrative Successful Kinesthetic Instruction for Preschoolers (iSKIP) condition or control condition. We assessed the motor competency and proficiency of all children regardless of condition before the start of iSKIP using the TGMD-2 (Ulrich, 2000) and the BOT2-BF (Bruininks & Bruininks, 2010). We implemented both assessments by the standardized procedures in the respective administration manuals. After the pretest, children in the intervention condition participated in the intervention for 6 weeks, two times per week (360 min total), while children in the control condition participated in “business as usual” recess (30 min/day) 5 days per week. At the end of the intervention, all children were again assessed on the TGMD-2 and BOT2-BF using the same standardized procedures as used in the pretest.
We digitally recorded all TGMD-2 and BOT2-BF assessments and all intervention sessions to ensure coding and intervention integrity throughout the study. After the posttest, two independent raters were trained by a gold standard rater to code the TGMD-2 assessment for all participants. One lead rater coded the entire sample, while the second raters who were blinded to condition coded 30% each of randomly selected videos (60% of the total sample). The two raters established an interrater reliability of 92.6% with the gold standard. Four separate raters were trained to code the BOT2-BF assessment; all four raters were blinded to condition and established an interrater reliability of 88.3% across the randomly selected 30% sample.
Successful Kinesthetic Instruction for Preschoolers Intervention
One gross motor skill intervention that has a history of strong success in school-based settings is the Successful Kinesthetic Instruction for Preschoolers (SKIP) program (Altunsöz & Goodway, 2016; Brian & Taunton, 2018; Brian et al., 2017a, 2017b; Goodway & Branta, 2003). Taunton et al. (2017) applied the UDL principles with the existing SKIP intervention to create a universally designed motor skill intervention (SKIP-UDL) for children with and without mild disabilities. SKIP-UDL was deemed highly effective (η2 = .67) in increasing gross motor skills of children with and without disabilities in an inclusive school-based setting (Taunton et al., 2017). Although the SKIP and SKIP-UDL programs are effective, the program is designed to target only gross motor skill development. Currently, there is a significant knowledge gap on the additive effects of an integrative intervention addressing multiple components of young children’s motor competency and proficiency during early childhood.
Integrative Successful Kinesthetic Instruction for Preschoolers Condition
The iSKIP intervention featured a station-style structure. Groups of children went to a station for 7 min, then rotated to the next station on the group’s picture schedule. After the group completed all three skill stations (e.g., object control, locomotor, and health-related fitness), all groups went to a fine motor station together. The children then transitioned into a brief review of the day’s activities at the end of the intervention. We implemented the iSKIP intervention in two general and one inclusion early childhood classes. Inclusion classes consisted of classrooms in which at least 10% of the class had a documented disability, had an individualized educational plan, and received special education services within the school district. During nonintervention days (i.e., 3 days/week), children in the iSKIP participated in regularly scheduled recess time along with children in the control condition.
A certified physical education teacher holding a bachelor’s and master’s degree in physical education with 6 years of experience leading motor skill interventions in early childhood centers led the iSKIP intervention. The teacher also had extensive experience in teaching children with and without disabilities in general and inclusive settings. Each class also had two assistant teachers co-leading the intervention to maintain the school’s teacher-to-student ratio of 1:9 to 1:11 during physical education and recess. The assistant teachers were currently obtaining degrees in physical education and had previous experience delivering motor skill interventions and working with children with disabilities.
During the iSKIP intervention, we first accounted for the needs of all children based on the present level of performance at the pretest; diagnosed disability; sex; and learning style (e.g., auditory, kinesthetic, and visual). We then designed each lesson with activities that included multiple within-skill variations. We created lessons to be child-centered rather than teacher-centered approach, meaning many options within stations were available to all children, but each child chose their preferred skill variation. Within three skill stations, we then provided (a) multiple means of instruction (e.g., visual task cards, picture schedules, short video clips, physical demonstrations, and verbal cues); (b) multiple within-task variations (e.g., variety of equipment, distances, size targets, and single or partnered activities); and (c) providing a least-to-most prompting hierarchy (e.g., visual, verbal, partial physical, and full physical prompts) as needed. We always offered every component of the prompting hierarchy during the intervention; children could choose which level of prompting they needed determining within-station task completion by a set time (e.g., 2 min) rather than a set number (e.g., 10 trials). The intervention provided universally designed, flexible, and adaptable options for all children in both the general and inclusive physical education classes. The structured support of universal designed for learning targeted whole group station and activities rather than individual modifications for each station/activity. We promoted children’s decision making by allowing children a choice in the supports, types of instruction, goals, and equipment they needed to learn and participate in each station/activity.
Intervention Fidelity
In order to measure intervention fidelity, we modified a version of the T-SKIP fidelity check sheet from Brian et al. in 2017. We established a check sheet with the core principles and pedagogies of the SKIP program, with the foundational components of UDL (multiple means of representation, action, expression, and engagement) to establish intervention fidelity. The fidelity check sheet was rooted in recommendations for establishing intervention fidelity (Kaderavek & Justice, 2010). We trained two independent raters to code 100% of intervention sessions. One rater coded 100% of the total sample, while the second rater coded a random sample of 30% of overall intervention sessions. Each rater scored the lesson using a 1 (present), 0 (not present), or (−) not available scoring system. Overall, iSKIP fidelity was 95.7% across all lessons and classes. We established an interobserver agreement of 93.1% between the two independent coders across the random 30% sample. Given the intervention took place in one center, we conducted a weekly observation of the free play control condition to ensure tenants of the intervention did not bleed over to control conditions (site contamination) did not occur within participating classrooms. Upon nine random observations (e.g., six on intervention days and three on nonintervention days), we established no contamination occurred.
Control Condition
The control condition involved children both with and without disabilities participating in the early childhood center’s gross motor curriculum known as “business as usual” recess. Children received 30 min of unstructured play supervised by classroom teachers. Children could freely select activities and games to play during this time without any formal instruction from classroom teachers.
Data Analyses
We first conducted descriptive analyses of the sample (e.g., age, sex, and ethnicity). Due to compliance issues with some children on both the BOT2-BF and TGMD assessments, we retained only 91 children within the study to complete the BOT-BF, and 109 children completed the TGMD-2. Afterward, we conducted Shapiro–Wilk tests, box plots, and QQ plots to test for normality. We then conducted an independent-samples t test to determine sex differences in BOT2-BF and TGMD-2 locomotor and object control scores. We calculated effect sizes using Cohen’s d measuring small (0.02), moderate (0.05), and large (0.07) (Cohen, 1988). Furthermore, after the independent-samples t test revealed sex differences for TGMD-2 scores, we conducted a Pearson product moment correlation between locomotor and object control scores to support the use of the multivariate analysis of covariance (MANCOVA) controlling for sex. To determine the effects of the iSKIP intervention on children’s with and without disabilities motor competency, we conducted a 2 Condition (iSKIP/control) × 2 Time (pretest/posttest) × 2 Ability (disability/no disability) repeated-measures MANCOVA using raw scores of the TGMD. To interpret effect sizes, we calculated eta squared and defined degree of effects in the following way small (.01), moderate (.03), and large (.05) (Cohen, 1988).
First, for BOT2-BF scores, we screened the data for outliers and removed one participant due to compliance issues on multiple subscales of the BOT2-BF. To determine the effects of the iSKIP intervention on children’s with and without disabilities motor proficiency, we conducted a 2 Condition (iSKIP/control) × 2 Ability (disability/no disability) × 2 Time (pretest/posttest) repeated-measures analysis of variance.
Results
Descriptive results of raw mean scores for both the BOT2-BF and TGMD-2 are presented in Table 1. Results from the Shapiro–Wilk test included p values greater than .05. Given the nonsignificant Shapiro–Wilk test and through visual interpretations of all plots, we deemed all data normally distributed. Results from an independent-samples t test yielded no significant differences in pretest scores between sex for BOT2-BF, t(109) = 1.24, p = .217, d = 0.24 but for TGMD-2; locomotor, t(109) = 2.03, p = .045, d = 0.39; and object control skills, t(109) = 4.29, p < .001, d = 0.80. Moreover, results from the Pearson product moment supported a moderate correlation between TGMD-2 locomotor and object control skills pretest (r = .51, p < .001) and posttest (r = .59, p < .001). The association of both locomotor and object control skills justified using the repeated-measures MANCOVA for TGMD-2.
Descriptive Statistics by Sex for TGMD-2 and BOT2-BF Raw Scores
| Assessment | N | Mean | SD |
|---|---|---|---|
| TGMD-2 locomotor | |||
| Boys | 53 | 21.11 | 6.81 |
| Girls | 58 | 18.58 | 6.29 |
| TGMD-2 object control | |||
| Boys | 53 | 20.67 | 7.32 |
| Girls | 58 | 15.55 | 5.15 |
| BOT2-BF | |||
| Boys | 53 | 20.71 | 14.49 |
| Girls | 58 | 75.55 | 12.19 |
Note. TGMD-2 = Test of Gross Motor Development—second edition; BOT2-BF = Bruininks–Oseretsky Test of Motor Proficiency—second edition brief form.
Test of Gross Motor Development—Second Edition
The results of the 2 Condition (iSKIP/control) × 2 Time (pretest/posttest) × 2 Ability (disability/no disability) repeated-measures MANCOVA included a significant main effect for iSKIP, F(1, 109) = 8.81, p < .001, η2 = .14, Time, F(1, 109) = 51.86, p < .001, η2 = .49, but no main effect for Ability, F(1, 109) = 0.98, p = .375, η2 = .01. Moreover, results yielded a significant iSKIP × Time interaction, F(1, 109) = 23.87, p < .001, η2 = .31. However, no interaction was reported for iSKIP × Ability, F(1, 109) = 0.14, p = .86, η2 = .00, or Ability × Time, F(1, 109) = 3.09, p = .05, η2 = .05. Descriptive statistics for TGMD-2 by ability are reported in Table 2.
Descriptive Statistics by Condition and Ability From Pretest to Posttest Raw Scores
| Assessment | N | Pretest, M (SD) | Posttest, M (SD) |
|---|---|---|---|
| TGMD-2 locomotor | |||
| iSKIP | |||
| No disability | 27 | 21.11 (5.98) | 31.13 (7.60) |
| Disability | 26 | 20.11 (6.73) | 31.77 (6.09) |
| Control | |||
| No disability | 23 | 20.65 (6.47) | 22.52 (7.55) |
| Disability | 35 | 17.97 (7.02) | 22.34 (8.86) |
| TGMD-2 object control | |||
| iSKIP | |||
| No disability | 27 | 19.25 (5.99) | 29.85 (7.10) |
| Disability | 26 | 18.03 (7.71) | 26.15 (9.35) |
| Control | |||
| No disability | 23 | 17.82 (8.00) | 23.17 (7.35) |
| Disability | 35 | 17.11 (5.77) | 19.28 (5.62) |
| BOT2-BF | |||
| iSKIP | |||
| No disability | 27 | 20.35 (10.66) | 29.80 (15.67) |
| Disability | 25 | 21.29 (16.81) | 28.41 (19.88) |
| Control | |||
| No disability | 23 | 17.28 (12.84) | 16.60 (11.37) |
| Disability | 35 | 17.17 (13.16) | 22.06 (12.34) |
Note. TGMD-2 = Test of Gross Motor Development—second edition; BOT2-BF = Bruininks–Oseretsky Test of Motor Proficiency—second edition brief form; iSKIP = Integrative Successful Kinesthetic Instruction for Preschoolers.
Bruininks–Oseretsky Test of Motor Proficiency—Second Edition Brief Form
Results from the Shapiro–Wilk test included p values greater than .05. Given the nonsignificant Shapiro–Wilk test and through visual interpretations of all plots, we deemed all data normally distributed. The 2 Condition (iSKIP/control) × 2 Ability (disability/no disability) × 2 Time (pretest/posttest) repeated-measures analysis of variance resulted with a significant main effect for Time, F(1, 109) = 29.46, p < .001, η2 = .23, and also for iSKIP, F(1, 96) = 5.86, p = .017, η2 = .06. There was also a significant Time × iSKIP interaction, F(1, 109) = 10.87, p = .001, η2 = .10. However, there was no significant interaction for Time × Ability, F(1, 109) = 0.80, p = .37, η2 = .00. Descriptive statistics for BOT2-BF by ability are reported in Table 2.
Discussion
The purpose of this study was to examine the effects of an integrative, universally-designed, intervention, iSKIP, on the motor competency and proficiency (which included health-related fitness) of young children with and without disabilities. A secondary purpose was to examine differential effects based upon possessing a disability or not. To our knowledge, few have examined multiple facets of young children’s motor competency and proficiency in school-based interventions that include children with and without disabilities (Taunton et al., 2017) assessed in multiple ways. These significant gaps were directly addressed within this study through two primary aims.
Effects of iSKIP on Targeted Outcomes
In the present study, children in iSKIP demonstrated significantly greater gains in all three target outcomes compared with children in the control group. The overall effect sizes of iSKIP for gross motor skills as reported by the TGMD-2 (η2 = .31) were not as robust as previous SKIP studies (η2 = .61 to .73) (Altunsöz & Goodway, 2016; Brian et al., 2017a, 2017b; Goodway & Branta, 2003). However, when considering only 180 min of the reported 360-min iSKIP intervention were allotted for gross motor skill development, our effect sizes are on pace with many 6-week, 360-min SKIP interventions if they were proportionally at half dosage (Brian et al., 2017a, 2017b; Taunton et al., 2017). In addition, children within iSKIP included those with and without disabilities. Taking into consideration that historically there are differential effects of SKIP based upon disability, our results are ahead of the pace previously set (e.g., Taunton et al., 2018; η2 = .42). Thus, these findings suggest that both SKIP and iSKIP may be universally effective for children with and without disabilities in inclusive and general education settings. If our dosage would have been 360 min of only gross motor, we may have had similar effect sizes as studies without children with disabilities (bettering the pace of Taunton et al., 2017).
Regarding fine motor skills, the results of the iSKIP intervention included substantially higher effect sizes than the previous literature (iSKIP η2 = .03 to .50 vs. previous literature η2 = −.02 to .05; Barton et al., 2015; Pless & Carlsson, 2000). Indeed, our effect sizes for fine motor were almost 10 times greater than previous studies with half the dosage (iSKIP dosage = 6 weeks vs. previous interventions = 12 weeks or greater). The focus of previous interventions was specific toward physical activity and health-related fitness skills (Pan et al., 2017; Sallis et al., 1997), while the primary purpose of iSKIP was motor development. In addition, children with disabilities were not included in previous studies (Kriemler et al., 2011; Lai et al., 2014). Thus, our effect sizes were larger despite a shorter dosage and the wide variety of learners in the universally designed intervention speaking to our design actually being universal.
The results included smaller effect sizes for BOT2-BF scores for fine motor, gross motor, and health-related fitness skills for the iSKIP intervention. These effects may be due to the BOT2-BF being a product-oriented assessment as opposed to a process-oriented assessment. In fact, it is suggested that an extended period of practice or intervention time is required to change the product of a child’s motor skill competency or proficiency over the process of their actual movement patterns (Stodden & Rudisill, 2006).
Within-Group Differences of iSKIP
A secondary research question was to determine if there were differential effects of iSKIP based upon children with or without disabilities. Overall, there were no significant differences in both TGMD-2 and BOT2-BF scores between children with disabilities or without disabilities; likewise, there were differential effects of disability across time in the iSKIP intervention. A lack of differential effects based upon disability is not surprising given the curriculum framework used in the iSKIP intervention. The UDL has often been cited as an effective curricular framework to create equal learning opportunities to increase competencies in children with and without disabilities (Center for Applied Special Technology, 2011). However, in inclusive movement settings, UDL has only been used in practical settings (i.e., in many physical education classrooms without a research evidence base of effectiveness; Lieberman et. al, 2008). The UDL lacks a substantial evidence base to be deemed an evidence-based strategy to increase learning and competencies for inclusive movement settings (e.g., physical education; Taunton et al., 2017). The current study is one of only two studies to provide empirical support for the effectiveness of UDL in inclusive movement settings (Taunton et al., 2017).
Effectiveness of iSKIP Using Multiple Assessments
Typically, researchers who have examined young children’s motor skills, particularly in school-based settings, used only one assessment to measure children’s motor competency and proficiency. Recently, many have called for the use of multiple assessments (e.g., process and product measures) to better examine to address many facets of children’s motor skills (Logan et al., 2017). Therefore, another purpose of this study was to examine the effectiveness of iSKIP on children’s motor competency and motor proficiency in children with and without disabilities using multiple measures. Results at the posttest yielded no significant differences in posttest TGMD-2 and BOT2-BF scores between children with and without disabilities.
Therefore, by implementing both process and product assessments of motor skills, we can further examine extent of delays in motor skill development, avoid “ceiling and floor” effects of certain motor skill assessments if applicable, or identify certain domains of motor competency and proficiency where children demonstrate strengths and weaknesses. This can be beneficial for teachers during physical education or adapted physical education not only for placement but instructional planning. For example, some children may not perform as well on certain motor assessments by demonstrating a “floor effect” in some categories of motor skills (e.g., BOT2-BF product-oriented assessments and health-related fitness or fine motor). While in other facets (e.g., gross motor skills), children may score higher on more process-oriented assessments, such as the TGMD-2. Teachers and practitioners can now use information from both assessments to provide appropriate placement and supports within physical education or adapted physical education, as well as targeted instructional planning to remediate certain delays an increase children’s competency and proficiency in motor skills.
Recess and Free Play in Early Childhood Centers
In the present study, children in iSKIP demonstrated significantly greater gains in all three target outcomes of motor skills as compared with the control group. This is not surprising as historically, children who only receive free play or recess are often at risk for developmental delay, and the risk becomes greater for children with disabilities (Brian et al., 2017a, 2017b; Goodway & Branta, 2003; Taunton et al., 2017). Furthermore, children with and without disabilities who receive as little as 30 min of structured motor time twice per week in addition to free play score as high as 50 percentile points higher on motor assessments than peers who only receive free play (Taunton et al., 2017).
Simply providing “recess” and “free play” during designated gross motor time may not lend itself to significant development of critical motor skills necessary for healthy growth and development during the early years of childhood. Our results are in alignment with the notion of a “proficiency barrier” in which children need not only minimally practice for rudimentary levels, but a considerable amount of practice to reach a more advanced level of motor skill proficiency for healthy growth and development (Brian et al., 2020; Langendorfer & Roberton, 2002). However, in order to truly break through the “proficiency barrier,” children need to be provided instruction along with practice as motor skills do not emerge naturally (Brian et al., 2020; Langendorfer & Roberton, 2002). The concept of the “proficiency barrier” now has empirical support. Therefore, children in the iSKIP condition significantly increased their motor competency and proficiency after 6 weeks of instruction as compared with control children (who did not change at all) that only received recess or free play.
Importance of an Integrative Intervention
Implementing interventions that target vital areas of child development is needed but often poses many challenges for implementation in school-based settings. Initial findings from the pretest represent a significant need for a more integrative approach to developing motor competency and proficiency during the early years (Diamond, 2010). Furthermore, the approach of taking existing designated time (e.g., recess) and implementing a structured integrative intervention, with an appropriate curricular framework, targeting multiple outcomes of children’s development is supported by these data. This approach can be supplementative in increasing children’s overall motor repertoire regardless of current ability or disability. School district leaders should consider creating structured intervention times throughout the school week in addition to providing opportunities for free play. Moreover, in designing an integrative intervention, school district leaders should consult with multiple specialists within the school (e.g., occupational therapists, physical therapists, classroom teachers, physical education teachers, and special education teachers). Collaboration across multiple disciplines can aid in effective curriculum development and provide optimal training for classroom teachers, special education teachers, or physical education teachers who are tasked with administering an integrative intervention (Sato & Haegele, 2017).
Limitations and Future Research
While this study has many strengths, it is not without limitations. While the study included children with and without disabilities across both general and inclusion classes the sample size within these groups were small. Therefore, the generalizability of the iSKIP curriculum should be taken with caution until further examinations implement the iSKIP intervention with larger sample size. However, results of the current iSKIP intervention showed significant increases in children’s motor competency and proficiency with moderate effect sizes. However, even with a short intervention dosage during children’s existing gross motor time (e.g., 360 min), any aspects of motor development can be improved. Thus, future researchers should examine the effects of a longer iSKIP intervention dosage (e.g., >12 weeks) and also the retention effects (e.g., 6 months to a year) of a short-term (e.g., 6 weeks) and long-term (e.g., 12 weeks) iSKIP intervention on children’s motor competency and proficiency.
Conclusion
Presently, children with and without disabilities are demonstrating significant delays in many facets of overall motor development. Children with and without disabilities demonstrated significant delays in motor competency and proficiency. However, regardless of disability status, children who participated in an integrative intervention (e.g., iSKIP) twice per week during regularly scheduled gross motor time at an early childhood center for 6 weeks demonstrated significant gains in motor competency and proficiency compared with children who only received recess. In addition, young children with and without disabilities can benefit from an integrative intervention targeting multiple facets of motor development when using an appropriate curriculum framework, such as UDL. Further examination of the effects of longer intervention dosages and retention effects of integrative interventions, such as iSKIP on motor competency and proficiency for children with and without disabilities is needed.
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