Concurrent Validity of the Beery–Buktenica Developmental Test of Visual–Motor Integration and the Bruininks–Oseretsky Test of Motor Proficiency in the Assessment of Children Ages 5 to 12 Years Referred for Occupational Therapy

PURPOSE: The purpose of the study is to provide evidence-based clinicians with a comparative analysis of the psychometric property of concurrent validity of two commonly used tests of motor proficiency, the Beery–Buktenica Developmental Test of Visual–Motor Integration, sixth edition (Beery–VMI), and the Bruininks–Oseretsky Test of Motor Proficiency (BOT–2) in children referred for occupational therapy ages 5–12 yr. Hypothesis 1 (H1): Scores on the BOT–2 Fine Manual Control (FMC) scale and scores on the Beery–VMI Visual–Motor Integration (VMI) and Visual Perception (VP) scales and on the BOT–2 Manual Coordination (MaC) scale and the Beery–VMI Motor Coordination (MoC) scale are positively correlated. Hypothesis 2 (H2): The degree and ratio of the classification agreement of the BOT–2 FMC and Beery–VMI VMI and VP and BOT–2 MaC and Beery–VMI MoC are high. Testing these hypotheses is timely not only due to the frequent clinical use of these tests, but also to inform evidence-based clinicians administering both tests whether they are essential, are optional, or can be used as alternative assessment methods.

DESIGN AND METHOD: This is a quantitative (hypothesis-driven), nonexperimental (ex post facto), and sectional (a cohort of children ages 5–12) study. A convenience sample of 84 records of children ages 5–12 yr referred for occupational therapy (OT; M age = 7.41 yr, SD = 1.4) were reviewed, and the standardized scores on the Beery–VMI VMI, VP, and MoC and the BOT–2 FMC and MaC were recorded in an IBM SPSS Statistics file. The sample of records was drawn from a school in a middle-class school district in one county on Long Island, New York. After receiving parent or guardian written consent, each participant was individually administered the Beery–VMI and the BOT–2. Administration and scoring of the tests were done by the first author. Descriptive statistics were used to examine measures of central tendency of the standardized scores of the five outcome measures.

H1 required the computation of Pearson correlations to assess the relationship among scores on the BOT–2 FMC and MaC and scores on the Beery–VMI VMI, VP, and MoC. H2 required the use of Cohen’s kappa (quadratic weighted κ statistic) to assess the degree and rate of agreement on performance classification between the BOT–2 FMC and MaC and the Beery–VMI VMI, VP, and MoC. A score of ±1 SD is within normal performance, –2 SD is borderline, and –3 SD below the standardized mean is defined as developmental delay. Level of significance was established at p < .05 (two-tailed).

RESULTS: H1: Only two of the three expected correlations were observed between VMI and FMC (r = .654, p < .001, two-tailed) and VP and FMC (r = .367, p < .001, two-tailed). No significant (p < .05) correlation was observed between MaC and MoC. H2: Classification between VMI and VP yielded low degree and ratio of agreement between FMC (45%, κ = .130, and 40%, κ = .114, respectively) and between MaC and MoC (28%, κ = .091).

CONCLUSION: The findings do not support a compatible use of the two tests. As the number of children being referred to OT increases, it is important that the children who need services are accurately identified. Future research is needed to replicate the study with larger samples and with typically developing children to further validate these findings.

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