Early Child Development and Care

ISSN: 0300-4430 (Print) 1476-8275 (Online) Journal homepage: https://www.tandfonline.com/loi/gecd20

Fundamental motor skill among preschool

children in rural of Kuching, Sarawak

Hsien Liang Melvin Chung, Whye Lian Cheah & Helmy Hazmi

To cite this article: Hsien Liang Melvin Chung, Whye Lian Cheah & Helmy Hazmi (2019):
Fundamental motor skill among preschool children in rural of Kuching, Sarawak, Early Child
Development and Care, DOI: 10.1080/03004430.2019.1658088

To link to this article: https://doi.org/10.1080/03004430.2019.1658088

Published online: 29 Aug 2019.

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EARLY CHILD DEVELOPMENT AND CARE
https://doi.org/10.1080/03004430.2019.1658088

Fundamental motor skill among preschool children in rural

of Kuching, Sarawak
a,b
Hsien Liang Melvin Chung , Whye Lian Cheaha and Helmy Hazmia
a
Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti
Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia; bSarawak State Health Department, Kuching, Sarawak,
Malaysia

ABSTRACT ARTICLE HISTORY

Fundamental motor skill development is crucial in preventing preschool Received 11 July 2019
children from early adoption of obesogenic lifestyles. This study aims to Accepted 17 August 2019
determine the motor skill level in preschool children and its gender
KEYWORDS
differences in rural of Sarawak. This was a cross sectional study with a Fundamental motor skill;
total of 153 children from 9 kindergartens. Children in this study physical activity; preschool;
performed better for object control skills (14.7 ± 3.60) than loco-motor loco-motor skills; object
skills (13.2 ± 4.14). Girls achieved better in loco-motor skills (15.0 ± 3.79) control skills
such as run, gallop and hop; whereas boys produced better in object
control skills (15.5 ± 3.26) namely kick, throw, and roll. These findings
help to highlight the need to provide gender-separated games or sports,
so that both boys and girls can achieve equal level of motor skills for
participation in wider range of physical activities.

Introduction
Fundamental motor skills (FMS) development are crucial in preventing preschool children from early
adoption of obesogenic lifestyles. It is the key component to an active lifestyle, and thus promoting a
healthy active lifestyle in early childhood. FMS development is not anymore a new topic from the
stakeholder or policy marker down to the health educator professional as well as parents or guar-
dians. The basis for young children to acquire the FMS required to participate in a wide variety of
games and movement activities lies in part on being physically active. FMS also known by terms
such as motor proficiency, motor performance, motor competence, motor ability, and motor coordi-
nation, which are used in many literature. The term FMS refers to general motor coordinative
capacities required in every movement (eg. fluency, efficiency, stability), as well as to specific
motor skills (eg. running, jumping, throwing). It is often described as ‘a set of processes associated
with practice or experience leading to relatively permanent changes in the capability for movement’
(Schmidt & Lee, 2011). It consists of two major components which are the loco-motor skills (e.g.
running, jumping, skipping) and object control skills (e.g. throwing, catching, kicking). In other
words, FMS is generally the basic component for more complex and advanced motor skills, including
specific sport skills, or games that enable the children to continue participating in games, sports and
lifetime activities (Goodway, Robinson, & Crowe, 2010).
Despite many physical activity (PA) guideline and intervention programme were carried out, Hallal
et al. (2012), highlighted that many children as well as adolescents were still not fulfilled the rec-
ommended level of PA, which was reflected in the increasing trend of overweight and obese

CONTACT Hsien Liang Melvin Chung melvinchunghl@hotmail.com Department of Community Medicine and Public
Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300 Kota Samarahan, Sarawak, Malaysia Sarawak;
State Health Department, Lorong Diplomatik 3, Petra Jaya, Kuching 93050, Sarawak, Malaysia
© 2019 Informa UK Limited, trading as Taylor & Francis Group
2 H. L. MELVIN CHUNG ET AL.

among children in the last few years (Gupta, Goel, Shah, & Misra, 2012). According to González,
Fuentes, and Márquez (2017), children used to be very active and playful whenever they could,
however, recent studies had shown that children nowadays spent more time in sedentary, position
playing computer games or watching television, while time spent in moderate to vigorous physical
activity (MVPA) in a day was less than 5%. In addition to that, similar findings were also reported by
Crane, Naylor, and Temple (2018) that, 3–5-years-old children spend almost 80% of their free time in
sedentary activities. Reasons for this situation remained inconclusive. Many researchers started to
look into this matter and suggested that it could be the FMS that they were lacking, and it was
necessary to explore the relationship between FMS and level of PA (Bryant, 2015; Farmer, Belton,
& O’Brien, 2017; Kim & Lee, 2016). According to Kambas et al.(2012), there is a positive association
between PA with the level of FMS in children. Kambas and his colleague explained in their study
on the relationship between FMS and pedometer determined PA in 5–6-year-old children, that
young children with high levels of FMS were more active in contrast to their peers with lower
FMS. This finding adds to the growing body of literature that FMS serve as the building blocks for
future motor skilfulness and PA. In the mean time, a longitudinal cohort study on the relationship
between FMS in childhood and subsequent adolescent PA behaviour in Australia, suggested that
being able to perform motor skill competently in childhood is a significant factor in subsequent
engagement in adolescent PA, because these skills are often associated with PA experiences of a
moderate or vigorous intensity such as recreational or organized sports training (Barnett, van
Beurden, Morgan, Brooks, & Beard, 2009). With a higher level competence of motor skills, it results
in greater self-esteem related to these type of activities and increased enjoyment of them. This in
turn results in spontaneous and regular participation at later age (Barnett et al., 2009). Therefore, it
is important to look into the FMS competency which could be a potential mechanism to increase chil-
dren’s PA and improve their health.
Unfortunately, a general decrease in childhood PA had showed high and increasing rates of over-
weight and obesity among preschool children living in developing countries (de Onis & Blössner,
2000). According to the Third Health and Morbidity Survey (NHMS III) findings, it was reported that
the prevalence of obesity among children aged 7–13 years were 5.4% based on the CDC 2000 refer-
ence. A follow-up analysis was carried out on NHMS III using the International Obesity Task Force
(IOTF) references, reviewed that the figure was 19.9%, with boys higher than girls (21.7% vs
18.1%). Besides, in the urban areas, the prevalence was reported to be higher (22.6%) as compared
to rural areas (16.1%). From the ethnicity perspective, the Chinese have the highest prevalence
(26.6%), followed by Indian (26.1%) and Malay (18.1%) (Naidu et al., 2013). Furthermore, from the
findings of the Nutrition Survey of Malaysian Children (SEANUTS Malaysia), it was reported that
the prevalence of overweight (9.8%) and obesity (11.8%) was higher than that of thinness (5.4%)
and stunting (8.4%). Z-Score distribution curves for weight-for-age and height-for-age shows that
Malaysian children are skewed to the left of the WHO reference, both for boys and girls as well as
urban and rural (Poh et al., 2013). Even though numerous studies and surveys have been conducted
among Malaysian children on their Body mass index (BMI) status, it is still difficult to define the
pattern of obesity in general due to the inconsistency of the references used. However, it can be con-
cluded that the overall picture of childhood obesity rate in Malaysia was definitely at its worrying
state, therefore, evidences from these studies support the assertion that the level of FMS plays a
pivotal role in promoting a physically active lifestyle in preschool children.
As FMS competence is important for both the development and health benefits for the children,
there is a rationale to have a baseline for the level of the competence at these skills. This can be
measured either through the process or product of the movement. Product-based measures of
FMS are basically looking into the end product or outcome of a movement, which can be measured
quantitatively such as time, speed or distances achieved (Logan, Robinson, Wilson, & Lucas, 2011).
The product-based assessment provides little information concerning how a movement was per-
formed. On the other hand, process-based measured of FMS refers to the characteristic, patterns,
or steps involved to carry out a movement skill (Hardy, King, Farrell, Macniven, & Howlett, 2009).
 EARLY CHILD DEVELOPMENT AND CARE 3

Process-based measures provide more information on designing a more effective FMS programme as
this method can help to identify developmental skill level of the child. As far as concerned, no pre-
vious study has assessed the FMS competency in preschool children and sex differences in all the
major individual object control and loco-motor FMS using process-based measures, therefore, the
objective of this study was to determine the FMS level in preschool children and its gender differ-
ences using process-based measures in rural Sarawak.

Method
Participants and setting
This study was conducted in Bau district, Sarawak, situated 22 km away from the capital city of
Kuching and under the administration of Kuching Division. It was carried out in Bau district,
because it has a homogenous socio-demography characteristic in terms of ethnicity, household
income, and public facilities available for all the communities there. Besides, according to a cross-sec-
tional study carried out among primary school students aged 11–13 years in Kuching division, the
prevalence of overweight and obesity was reported at 18.2% and 15.2%, respectively. Among the stu-
dents, the Sarawak Bumiputra mainly the Iban and Bidayuh children had the highest prevalence of
obesity among the races (Lee, Cheah, Chang, & Siti Raudzah, 2012). Meanwhile, in the rural of
Sarawak, Chang, Lee, and Cheah (2012) reported the level of prevalence of overweight and
obesity among the young and middle-aged group adults were higher, which were 39.6% and
11.9%. In addition to that, looking from a different perspective, Cheah, Helmy, and Chang (2014)
revealed that the level of physical inactivity was reported high as well among the adolescent in
the rural of Sarawak, with a mean steps count of 6251.37 ± 3085.31, which did not reached the rec-
ommended step counts per day. While physical inactivity is a significant risk factor for obesity, there-
fore, child with physical inactivity were two times more likely to be obese as adults (Whitehead,
Maccallum, Tablot & Gopu, 2013). Apart from that, studies on the regarding issues among preschool
children in rural community are rather limited despite there is an indication that such a trend is slowly
seen in the rural communities, particularly areas closer to towns. Therefore, Bau district was a suitable
study area for this research.
The sampling frame for this study was all the government preschools or TABIKA KEMAS in Bau Dis-
trict. The TABIKA KEMAS were chosen as the sampling frame in this study because it is the first option
and priorities for the population in Bau to send their children for preschool education. Besides, TABIKA
KEMAS are convenient and available at almost all the villages in Bau district, making it the largest pre-
school centre for children aged 4–6 years old and it is the most strategic approach to reach the
majority of the children in the community. Hence, a total of 22 government kindergartens from
Bau District were recruited in this study. However, only those kindergartens that fulfilled the criteria
are considered for recruitment. The inclusion criteria for this study are kindergartens which have
access of an outdoor play area and equipment that supported the curriculum; preschool children
4–6 years of age; and children attendance at the childcare centre required at least 3 days per
week. Children with comorbid or disease that could interfere with practice of PA and those who
are participating in any other clinical trial or other health-oriented project are excluded from the
study. Permission to carry out this study was obtained from the Medical and Ethics Research Commit-
tee of Universiti Malaysia Sarawak and Ministry of Health Malaysia (NMRR-17-176-34353 IIR). Approval
was also obtained from Sarawak Community Development Department (Jabatan Kemajuan Masyar-
akat Negeri Sarawak), and Malaysia Ministry of Rural Development.

Data collection procedure

A letter of invitation was sent to all parents of children 3–5 years old at the selected kindergartens.
The researcher then organized a meeting to explain the objectives of the study to the parents or
4 H. L. MELVIN CHUNG ET AL.

guardians and to answer all questions raised. Informed consent and enrolment forms were obtained
from the parents or guardians on the day itself. Verbal assent was also obtained from each child by
asking the child if he or she would like to participate in a ‘exercise-time class’. Children who
responded in a positive manner by nodding their head or saying ‘yes’ indicating their assent to
the researcher, with the classroom teachers as a witness. Child’s medical card was also reviewed
to make sure that children with comorbid were not included in the study.

Measures
Fundamental movement skills
There are several validated tools available to measure FMS at the preschool age, namely Movement
Assessment Battery for Children (Movement- ABC), The Gross Motor Development-2 (TGMD-2),
Peabody Developmental Motor Scale – Second edition (PDSM-2), Körperkoordinationtest für
Kinder (KTK), Maastrichtse Motoriek Test (MMT), and Bruininks-Oseretsky Test of Motor Proficiency
(BOTMP – 2). In view of the variability of the tools selection, the right test to be used should in relation
to the condition or purpose of a study. For example, if a researcher is interested in stability skills
among the preschool children, the KTK test would be more appropriate. It mainly indicated for
children who had coordinative problems due to brain damage, behavioural and learning disturbance.
It is considered as a highly reliable and valid tool for its accuracy and standardization when
screening of stability skill. Vice versa, it only provides one-sided information on movement skills
development only.
Movement – ABC on the other hand focus on the study which determines the developmental
status of FMS, by identifying and describing the motor impairments of a child in their daily life.
Unlike other measurement tools, the Movement – ABC test is a norm-referenced test which is
limited to three major domains only: manual dexterity (3 tasks), ball skills (2 tasks) and balance
skills (3 tasks). Plus, because of the test items and scaling used in this tool are different between
age bands, this may bring difficulties for longitudinal study. Besides, in case of smaller sample size
and intention to study in depth of gross and fine motor skills, a more complex instrument such as
PDMS – 2 can be used, however, it is rather time-consuming to complete the whole assessment as
it involves 249 items in total. In addition to that, it discriminates motor developmental delayed
and disorder children from typically developing children.
Other than that, the MMT are used to assess the movement skills both quantitatively as well as
qualitatively. This test has a narrow age group, ranging from 5 to 6 years old only. One of the diag-
nostic value of this test is, it is able to screen for children who are at risk for Attention Deficit Hyper-
activity Disorder (ADHD) at an early age, however, it is limited by the narrow age range and absence
of loco-motor skill subtest. The BOT – 2 is used to identify the deficit in individual with light to mod-
erate motor coordination problems. Among the tools mentioned earlier, it has the widest range of
age group, from 4 years to 21 years old. BOT – 2 is commonly used as a screening tool for Autism
or Asperger’s disorder, developmental coordination disorder, and mild to moderate mental retar-
dation. The weakness of this test is its emphasis lies too much on detection of deficits, plus the
whole assessment process requires a rather long time duration for young children, and the score con-
version sheet is quite complicated.
Among all these tools, TGMD-2 (Ulrich & Sanford, 2000) was used in this study as it is specifically
designed and validated for use with children ages 3–10 years. It is a process and product-oriented
assessment. It incorporates qualitative aspects of movement behaviour in the assessment. It is
able to provide information on skill mastering and detailed steps in performing certain task skills.
It has a total of 12 items, 6 items for loco-motor components and 6 items for object control com-
ponents, respectively. The loco-motor skills consisted of running, skipping, hopping, leaping, gallop-
ing, horizontal jumping and sliding. The object control skills consisted of striking, dribbling, catching,
kicking, overhead throw and underhand roll. TGMD measures 12 FMS which include six loco-motor
and six object control standard scores as well as determine a gross motor quotient (GMQ). TGMD are
 EARLY CHILD DEVELOPMENT AND CARE 5

able to identify children whose FMS level are not according to their age development or whose FMS
level are delayed as compared with their peers. It can be used to help in planning a programme or
intervention for those children that shows delayed in their FMS and subsequently able to assess
changes after an intervention or programme.
Prior to data collection, the researcher must be well versed in administering the TGMD-2, through
in-situ observation. The test was carried out either at the kindergarten playground or activity hall,
depending on available facilities. Before the test, the examiner needs to determine the child’s pre-
ferred hand and foot. The children are tested individually by the researcher himself, and the children
were given a verbal description of the skill and single demonstration of the required skill. They were
given two test trials, and if the researcher was unsure about a child’s performance on certain skill, the
child was asked to repeat the skill. If the child displays the performance criteria correctly, score a ‘1’ in
the column from that trial. If they do not display the performance criterion correctly, score a ‘0’. The
performance criterion will be scored by summing the two trials and place in the column labelled
‘score’. Then, the researcher calculated the skill score, loco-motor and object control subtest score,
and raw score. Skill raw scores were tabulated with a possible range of 0–48 in each subset of
loco-motor and object control. Raw scores were then be calculated on the scoring sheet for each
trials. Standard scores were calculated for loco-motor and object controls skills based on the
TGMD-2 test procedures using age at the time of testing and sum of the six raw scores. The FMS
score was calculated using the sum of standard scores and an assigned value that is provided in
the test manual (Ulrich & Sanford, 2000).

Anthropometry
Height and weight were measured at the baseline and at the end of the intervention. Weight was
measured to the nearest 0.1 kg and height was measured to the nearest 0.1 cm using SECA portable
weighing scale and stadiometer. Participants were asked to remove either shoe before measurement.
Participants were asked to stand upright with the heels and occiput against the stadiometer, look
straight ahead, making sure their line of vision was perpendicular to the body and the plane of
the head was horizontal (in the Frankfurt plane). BMI was calculated as weight in kilograms
divided by the square of height in metres. For the classification of gender-specific BMI-for-age,
WHO reference 2007 was used as this is the acceptable classification for Asian population including
Malaysia.

Statistical analysis
Data analysis were performed using Statistical Package for Social Sciences (SPSS) version 22.0. All data
were cleaned and checked for normality prior to analysis. Descriptive and inferential statistics were
carried out with p < 0.05 significance. Chi-square and independent T-test were used to determine
the proportion of skill components performed according to gender.

Results
Twenty-two kindergartens were invited to the study and 9 fulfilled and agreed to be involved. From
the eligible kindergartens, a total of 153 children participated in this study with the mean age of 4.5
years ± 0.50 as depicted in Table 1. The overall weight for these children is 19.1 kg ± 6.28 with an
overall BMI of 17.0 ± 4.05. Besides, the study also reported that the overall FMS mean score was
104.4 ± 16.75, where boys mean score was higher than girls (105.9 ± 16.56 vs 102.6 ± 16.93)
(Table 2). Majority of the children’s FMS score concentrated at 80–120. Looking into the two main
components of FMS, the girls showed significantly higher loco-motor skills score (15.0 ± 3.79) than
boys (11.6 ± 3.79). In contrast, boys significantly higher score in object control compared to girls
(15.5 ± 3.26 vs 13.9 ± 3.82).
For loco-motor skills, girls scored significantly higher than boys in the run, gallop, and hop
(Table 3). For object-control skills, boys were significantly higher than girls in the kick, throw, and
6 H. L. MELVIN CHUNG ET AL.

Table 1. Nutritional profile of boys and girls (N = 153).

Mean (SD)
Characteristic n (%) Overall Boy Girl
Gender
Male 83 (54.2)
Female 70 (45.8)
Age (years)
4 75 (49.0) 4.5 (0.50) 4.5 (0.50) 4.4 (0.50)
5 78 (51.0)
Height (cm)
< 100 31 (20.3) 104.9 (6.68) 105.3 (6.85) 104.4 (6.50)
100–119 116 (75.8)
>=120 4 (2.6)
Weight (kg)
< 16 54 (35.3) 19.1 (6.28) 19.5 (6.37) 18.6 (6.19)
16–30 79 (51.6)
>30 14 (9.2)

Table 2. Fundamental motor skill scores of preschool children (n = 153).

Mean (SD)
Characteristic n (%) Overall Boy Girl p-value
FMS Scorea
< 70 (Very poor) 0 104.4 (16.75) 105.9 (16.56) 102.6 (16.93)
70–79 (Poor) 8 (5.2)
80–89 (Below average) 32 (20.9)
90–110 (Average) 56 (36.6)
111–120 (Above average) 32 (20.9)
121–130 (Superior) 14 (9.2)
>130 (Very superior) 11 (7.2)
Loco-motor score 13.2 (4.14) 11.6 (3.79) 15.0 (3.79) <0.001
Object – control score 14.8 (3.60) 15.5 (3.26) 13.9 (3.82) 0.007
a
FMS score by TGMD-2, Ulrich & Sanford, 2000.

the roll. Other than that, both the boys and girls scored almost equals both the rest of the skills. In
order to further understand the competency for both the boys and girls in each of the process-
based measures, it was necessary to look into each of the skill components (Table 4). For loco-
motor, significant sex differences were found in girls in all the skill components for run in terms of

Table 3. Mean (SD) for loco-motor score and object-control score of boys and girls demonstrating
competency of skill components.
Mean (SD) p-value
Skills Boys (n = 83) Girls (n = 70)
Locomotor
Run 2.5 (0.98) 3.6 (0.73) <0.001
Gallop 2.3 (1.12) 3.3 (0.99) <0.001
Hop 3.3 (1.18) 4.3 (1.36) <0.001
Leap 1.9 (1.00) 1.9 (1.05) 0.870
Jump 3.2 (0.97) 3.5 (0.74) 0.088
Slide 3.1 (1.29) 3.2 (1.31) 0.793
Object control
Striking 3.6 (1.40) 3.2 (1.82) 0.169
Dribble 2.9 (0.97) 3.0 (0.91) 0.612
Catch 2.5 (0.69) 2.6 (0.59) 0.245
Kick 3.8 (0.57) 2.8 (1.01) <0.001
Throw 3.8 (0.47) 2.8 (1.10) <0.001
Roll 3.8 (0.51) 2.9 (1.13) <0.001
Note: Italic values significant at p<0.005
 EARLY CHILD DEVELOPMENT AND CARE 7

Table 4. Proportion of skill components performed according to gender.

Boys Girls
(n = 83) (n = 70)
Skills n (%) n (%) p-value
Locomotor
Run
R1. Arms move in opposition to legs, elbows bent. 56 (67.5) 64 (91.4) <0.001
R2. Brief period of suspension (both feet off the ground). 50 (60.2) 65 (92.9) <0.001
R3. Narrow foot placement; lands on heel or toe. 49 (59.0) 59 (84.3) <0.001
R4. Non-support leg bent approximately 90 degree. 49 (59.0) 62 (88.6) <0.001
Gallop
G1. Arms bent and lifted to waist level at take-off. 52 (62.7) 60 (85.7) 0.001
G2. A step forward with the lead foot followed by a step with the trailing 43 (51.8) 63 (90.0) <0.001
foot to a position adjacent to or behind the lead foot. 48 (57.8) 57 (81.4) 0.002
G3. Brief period when both feet are off the floor. 44 (53.0) 49 (70.0) 0.032
G4. Maintains a rhythmic pattern for four consecutive gallops.
Hop
H1. Non-support leg swings forward in pendular fashion to produce force. 63 (75.9) 63 (90.0) 0.023
H2. Foot of non-support leg remains behind body. 52 (62.7) 57 (81.4) 0.011
H3. Arms flexed and swing forward to produce force. 54 (65.1) 60 (85.7) 0.003
H4. Takes off and lands three consecutive times on preferred foot. 49 (59.0) 60 (85.7) <0.001
H5. Takes off and lands three consecutive times on non-Preferred foot. 53 (63.9) 59 (84.3) 0.004
Leap
L1. Take off on one foot and land on the opposite foot. 69 (83.1) 55 (78.6) 0.473
L2. A period where both feet are off the ground longer than running. 40 (48.2) 39 (55.7) 0.354
L3. Forward reach with the arm opposite the lead foot. 50 (60.2) 42 (60.0) 0.976
Jump
J1. Preparatory movement includes flexion of both knees with arms extended behind body. 79 (84.3) 63 (90.0) 0.301
J2. Arms extend forcefully forward and upward reaching full extension above the head. 68 (81.9) 61 (87.1) 0.377
J3. Take off and land on both feet simultaneously. 70 (84.3) 63 (90.0) 0.301
J4. Arms are thrust downward during landing. 60 (72.3) 56 (80.0) 0.267
Slide
S1. Body turned slide ways so shoulders are aligned with the line on the floor. 73 (88.0) 59 (84.3) 0.511
S2. A step sideways with lead foot followed by a slide of the trailing foot to a point next to the 61 (73.5) 58 (82.9) 0.165
lead foot. 61 (73.5) 54 (77.1) 0.603
S3. A minimum of four continuous step-slide cycles to the right. 66 (79.5) 53 (75.7) 0.573
S4. A minimum of four continuous step-slide cycles to the left.
Object Control
Striking
ST1. Dominant hand grips bat above non-dominant hand. 65 (78.3) 50 (71.4) 0.326
ST2. Non-preferred side of body faces the imaginary tosser with feet parallel. 59 (71.1) 44 (62.9) 0.280
ST3. Hip and shoulder rotation during swing. 60 (72.3) 46 (65.7) 0.380
ST4. Transfer body weight to front foot. 53 (63.9) 40 (57.1) 0.397
ST5. Bat contacts ball. 62 (74.7) 47 (67.1) 0.304
Dribble
D1. Contacts ball with one hand at about belt level. 72 (86.7) 60 (85.7) 0.853
D2. Pushes ball with fingertips (not a slap). 59 (71.1) 56 (80.0) 0.204
D3. Ball contacts surface in front of or to the outside of foot on the preferred side. 67 (80.7) 56 (80.0) 0.911
D4. Maintains control of ball for four consecutive bounces without having to move the feet to 41 (49.4) 35 (50.0) 0.941
retrieve it.
Catch
C1. Preparation phase where hands are in front of the body and elbows are flexed. 71 (85.5) 64 (91.4) 0.260
C2. Arms extend while reaching for the ball as it arrives. 65 (78.3) 55 (78.6) 0.969
C3. Ball is caught by hands only. 72 (86.7) 65 (92.9) 0.219
Kick
K1. Rapid continuous approach to the ball. 81 (97.6) 50 (71.4) <0.001
K2. An elongated stride or leap immediately prior to ball contact. 74 (89.2) 39 (55.7) <0.001
K3. Non-kicking foot placed even with or slightly in back of the ball. 81 (97.6) 48 (68.6) <0.001
K4. Kicks ball with instep of preferred foot or toe. 81 (97.6) 57 (81.4) 0.001

(Continued)
8 H. L. MELVIN CHUNG ET AL.

Table 4. Continued.
Boys Girls
(n = 83) (n = 70)
Skills n (%) n (%) p-value
Throw
T1. Windup is initiated with downward movement of hand/arm. 82 (98.8) 53 (75.7) <0.001
T2. Rotates hip and shoulders to a point where the non-throwing side faces the wall. 79 (95.2) 42 (60.0) <0.001
T3. Weight is transferred by stepping with the foot opposite the throwing hand. 77 (92.8) 42 (60.0) <0.001
T4. Follow-through beyond ball release diagonally across the body toward the non-preferred 79 (95.2) 58 (82.9) 0.013
side.
Roll
R1. Preferred hand swings down and back, reaching behind the trunk while chest faces cones. 81 (97.6) 52 (74.3) <0.001
R2. Strides forward with foot opposite the preferred hand toward the cones. 81 (97.6) 50 (71.4) <0.001
R3. Bends knees to lower body. 75 (90.4) 51 (72.9) 0.005
R4. Release ball close to the floor so ball does not bounce more than 4 inches high. 79 (95.2) 51 (72.9) <0.001
Note: Italic values significant at p<0.005

position and arms movement in opposition to legs, elbows bent as well as position and foot place-
ment landing on heel or toe (R1–R4), with competency levels ranging between 84.3% and 92.9% as
compared to boys. Besides, the girls were also more competent in gallop with their arms bent and
lifted to waist level at take-off (G1), position of the lead foot followed by a step with trailing foot
to a position adjacent to or behind the lead foot (G2) in a rhythmic pattern for consecutive
gallops (G3–G4). More than 80% of the girls achieved higher competence than boys in all the skill
components for hop in terms of non-support leg swings forward in pendulum fashion to produce
force (H1), foot of non-support leg remained behind body (H2), arms flexed and swing forward to
produce force (H3), took off and landed three consecutive times on preferred foot (H4) and took
off and landed three consecutive times on non-preferred foot (H5). While on the other hand, aver-
agely about 59–75.9% of the boys could perform these five skill components.
From the six skill components in object-control, only three components showed that the boys
scored higher than the girls, namely kick, throw and roll, while striking, dribble and catch were
almost equally same. Most of the boys could perform the kick skill component better than the
girls, with more than 80% of the boys were continuously rapid in approaching to the ball (K1),
with an elongated stride or leap immediately prior to the ball contact (K2), had non-kicking foot
placed even with or slightly in back of the ball (K3), as well as kicked the ball with instep of preferred
foot (K3). On the other hand, not more than 75.7% of the girls were able to perform these kick skill
components correctly, with the lowest skill component K2 at 55.7% only. For throw skill components,
almost all the boys (>90%) had higher competency level in all the components such as initiating
windup with downward movement of hand/arm (T1), rotated hip and shoulders to a point where
the non-throwing side faces the wall (T2), transferred the weight by stepping with the foot opposite
the throwing hand (T3) and follow-through beyond ball release diagonally across the body toward
the non-preferred side (T4). In terms of roll skill components, about 97.6% of the boys used their pre-
ferred hand swings down and back, reaching behind the trunk while chest faces cones (R1), and stride
forward with the foot opposite the preferred hand toward the cones (R2). Ninety percent of the boys
bent their knee to lower their body (R3) and released the ball close to the floor so ball did not bounce
back high (R4). Averagely, about 70% of the girls performed these components correctly.

Discussion
The present study revealed that about 80% of the children had FMS more than 90, with an overall
mean score of 104.4 ± 16.75. According to Bürgi et al. (2011), having high FMS level, it has a transfer
effect to specialized sports skills. This means that children with more developed FMS find it easier to
learn some complicated sports skills, and subsequently be more physically active and involved in
wider range of PA compared to those children with lower FMS. Similarly, Barnett et al.(2012)
 EARLY CHILD DEVELOPMENT AND CARE 9

suggested in a longitudinal assessment study looking into the relationship between childhood motor
proficiency and adolescent PA, and concluded that children with a well-developed FMS will results in
a higher PA level in their later years. Some studies even suggested a reciprocal relationship between
PA and FMS. It is suggested that people who are more physically active tend to learn and developed
FMS more easily and on the other hand, those with a higher performance of FMS will usually have a
higher PA level (Bürgi et al., 2011; Jaakkola & Washington, 2013). Based on the present findings, it is
insufficient to determine the linear relationship between FMS and PA, however, these results
suggested that two components are closely related to one another. Therefore, it is necessary to
explore further the FMS components in depth, respectively locomotor and object control skills in
relates to PA level over a period of duration to determine its relationship.
Looking at the FMS components, the children in this study scored better for object control skills
with a higher mean score than loco-motor skills. Despite methodological and cultural differences
between the current study and other international studies, the low competence level in loco-
motor skill was also reported in previous research (Vlahov, Baghurst, & Mwavita, 2014). This could
be explained by, the children in the study were more well versed and enjoyed playing with games
and sports such as balloons kick, ball chase, circle jump relay and others and all these games
usually involved object control skills while the loco-motor skills is a by-product of the development
of object control skills. This is supported by Foulkes et al.(2015), that object control skills such as
playing badminton, it actually indirectly incorporated the loco-motor skills like short shuffling
steps, pivot step, jab step or lateral move in it. Therefore, object control skills were found to have
a higher predictive value than loco-motor skills on vigorous activity participation at later age
because this skill is basis to the involvement of more complex activities (Vlahov et al., 2014). Further-
more, Barnett et al.(2012) also reported that children in their study who mastered object control skills
like catching, throwing and kicking were found to be spent more time in PA participation. When they
explore further, this is because having high level of FMS, a child may have more confidence and self-
esteem to wider range of PA and this will increase their enjoyment, and subsequently result in greater
and regular participation.
In terms of gender differences, girls achieved a higher score in loco-motor skills, whereas boys
were doing better in object control skills. These findings are consistent with previous research by
Goodway et al. (2010), that among the 469 pre-schoolers, the boys performed better than girls at
object control skill. In addition to that, in Brazil, a study that involved 1248 children aged 3–10
years old, using TGMD-2 to gain a contemporary view of gender performance in the context of
FMS performance, revealed that the boys demonstrated superior scores for object control skills
across different age groups (Spessato, Gabbard, Valentini, & Rudisill, 2013). Similarly, McKenzie
et al. (2002), provided further evidence to support our findings that, young girls were better in
loco-motor skills such as jumping and balancing, while young boys were better at catching. These
findings were also been observed in later childhood and adolescence of various research (Hardy,
King, Espinel, Cosgrove, & Bauman, 2010; O’ Brien, Issartel, & Belton, 2013). Gabbard (2012) explained
that these differences are most likely due to environmental factor as there was no reason for girls to
be less feasible with object control skills compared to boys, in view that both the boys and girls had
similar physical characteristic until they reach their puberty years apart from the differences in BMI. In
other words, physiological differences are unlikely to influence the FMS competency of both boys
and girls. Besides, Gutierrez and García-López (2012), reported in a qualitative study on gender differ-
ences in the game behaviour in terms of participation, that boys participated more in offensive play
with the ball and achieving the goal, while the girls displayed more-off-the-task or spectator-player
behaviours. They further explained that the girls may felt insecure, nervous, or embarrassed with their
performance of motor skills in front of their peers, as they did not felt competent in the skills.
However, this required further research to study the factors why boys and girls have different
levels of FMS, may it be environmental factors, psychosocial factors, lack of skills or simply
because the girls do not prefer the activities that the boys participated in.
10 H. L. MELVIN CHUNG ET AL.

Looking into each of the individual skill components respectively, the boys scored better at kick,
throw and roll, while girls were more competent at the run, gallop and hop. There were no much
differences between the boys and girls for FMS skills such as leap, jump, slide, striking, dribble and
catch. These patterns were consistent with the findings in a study by Hardy et al. (2010). From this
findings, it can be seen that the boys were more feasible in activities that involve coordination of
limbs and trunk movement, and the girls were more proficient at activities that required legs move-
ment with correct feet placement and rhythm. This explained why when the boys entered their ado-
lescence or young adulthood, they prefer moderate to vigorous intensity sport games like football,
basketball and badminton. This is an important findings as it gives us a rough idea not only which
type of module that is suitable for different age group but also which components of skill that are
lacking or deficient and need to be emphasized in the physical exercise (PE) lesson, free play
session or even in planning a PA programme. For example, more attention should be focus on
instructional activities or sports such as striking a ball or dribble for the girls to improve their
object control skills and more loco-motor skill-based activities such as running or hopping for the
boys, so that the children can achieve appropriate levels of FMS level according to their age.
However, Wee (2014) reported that there was no proper structured syllabus module in the PE
subject or free play session and very often, the teachers teach sport skills that are not found in the
syllabus and did not prepare the lessons beforehand. Besides, this study triggered the thought of
when is the best and appropriate timing for the PE lesson or free play session to be conducted,
because most of these lessons were either conducted or postponed to later morning or even
replaced by other more important examination subject. Malaysia, with hot weather all year
around, the heat might be unbearable, the children might felt uncomfortable to continue their
class after the session, and therefore, losing interest towards PA. Therefore, there is a need to
review the content of the PE syllabus and how the lesson to be conducted.
In addition, all preschool centres or schools in Malaysia should have at least the basic sport or
game facilities or standardized play area for PA. Lack of focus of the school on girl’s PA and facilities
that were more readily accessed or desirable to boys were commonly observed in most of the school
making the girls felt less confidence in PA and subsequently become less active than boys. Therefore,
it is important to consider the gender factor so that it provides equal opportunities for both boys and
girls to engage in more vigorous PA. Apart from the school setting, in a wider picture, this study also
suggests that future development plans should also consider the availability and the accessibility of
public facilities. The local governments should build more public facilities such as community park,
walking tracks, bicycle paths and also ensure that these places are safe and attractive for the
public. They also have to make sure that all these places are kept clean and well-lit. The zoning
and land use regulation should also be emphasized so that these areas are away from the industrial
zone which are free from air or noise pollution.
The FMS assessment tool used in this study also revealed flaws in the monitoring of the PA in
Malaysia. Looking into Malaysia Active Healthy Kids (MAHK) assessment, which was firstly introduced
in 2016, with the objective to provide a comprehensive, evidence-based evaluation of PA indicators
at various levels based on the socio-ecological model among Malaysia children and adolescents aged
from 5 to 17 years old. The MAHK assessment is a tool and platform for researchers and policymakers
to share the findings and knowledge to develop a more effective strategies to promote active healthy
lifestyles in the population. However, from the report, the majority of the findings were from the
primary school children aged 6–17 years old, which did not reflect much on preschool years. On
the other hand, the MAHK has a total of 11 indicators relating to PA in children such as, (i) Overall
Physical Activity; (ii) Organized Sport and Physical Activity Participation; (iii) Active Play; (iv) Active
Transportation; (v) Sedentary Behaviour; (vi) School; (vii) Physical Education and Physical Activity Par-
ticipation; (viii) Family and Peer Influence; (ix) Community and the Built Environment; (x) Government
Strategies and Investments and (xi) Diet. These indicators were based on the few national surveys and
reports carried out in Malaysia, such as, Global School-based Health Survey-Malaysia (GSHS-Malaysia)
which contributed to indicator (i); Nutritional Survey of Malaysian Children (SEANUTS Malaysia)-
 EARLY CHILD DEVELOPMENT AND CARE 11

indicator (iv), (v), (xi); Report on School Sports Infrastructure and Programmes Survey (i-KePS Report) –
indicator (vi); and Annual Report of Ministry of Health 2012- indicator (x). All these indicators are
effective in measuring the children’s PA level, however the FMS components were not been empha-
sized despite its impact in active lifestyle.
One of the strength of this study is the use of a validated process-based measure for FMS, which
allows a thorough analysis of all the 12 skill components, respectively. Besides, it is the first study to
determine the prevalence of FMS as well as gender differences at each of the skill components level
in Sarawak. This in return can provide a better guideline in designing and planning a community-
based or school interventions programme that targets FMS as a strategy to promote long-term
activity. However, this study is not without its limitation that allows for future research opportunities.
This study was limited to a suburban area of Kuching division and may not be applicable to other
areas of the state. Therefore, future studies should consider other areas including urban locations
and other states. A further limitation is that the study design was cross-sectional, so the direction
of associations cannot be determined. It is suggested that a longitudinal design, which starts from
the preschool years, will reveal more findings in determining the causal association between FMS
and PA among the children in the future.

Conclusion
As from our findings, preschool years are an important developmental phase for the acquisition and
development of FMS, which have the potential to influence the children to participate in games and
sports at their later life, therefore, our findings on gender differences in FMS and low level of loco-
motor skills, highlights the need to provide gender-separated games or sports, so that both boys
and girls can have equal level of FMS developed accordingly, before starting primary school.
Besides, preschool teachers need professional training and practice on the development of FMS in
order to plan an organized and structural activities or games that help the children to participate
in a wider range of physical activities with greater confidence and enjoyment, and lead to skill
mastery. Once learned, the skills are retained for life and able to help to prevent declines in physical
activity (Holfelder & Schott, 2014).

Acknowledgements
We also thank the Sarawak Community Development Department (Jabatan Kemajuan Masyarakat Negeri Sarawak),
Malaysia Ministry of Rural Development, and all the preschool teachers for assisting us in the assessments.

Disclosure statement
No potential conflict of interest was reported by the authors.

Funding
This research is sponsored by the Sarawak Heart Foundation [grant number SHF/8.1/1].

Notes on contributors
Dr Melvin Chung is a Public Health Medicine Specialist of Ministry of Health Malaysia. He completed his medical degree
from Volgograd State Medical University (VSMU), Russia. He had his early training as medical doctor in Sarawak General
Hospital in 2012, and was posted to Betong district hospital for compulsory services after that. In 2013, Dr Melvin hold the
responsibility as Betong District Hospital Director. He was then continued gaining experience in Bau District Health Office
as District Health Officer in 2014. Dr Melvin completed his Master in Public Health as well as Doctor of Public Health
(DrPH) in Universiti Malaysia Sarawak (UNIMAS) in 2019. His research interest is concerned with the physical inactivity,
sedentary behaviour, fundamental motor skills, childhood obesity and physical activity intervention among the children.
12 H. L. MELVIN CHUNG ET AL.

He also completed research projects on family health, specifically into the role performance of community health volun-
teers in Kuching.
Dr Cheah Whye Lian is an associate professor in the Department of Community Medicine and Public Health, Faculty of
Medicine and Health Sciences. She has her degree in Nutrition, Master in Public Health and Ph.D. in Community Nutrition.
Her research focused on the issues on assessment of nutritional status from children to adulthood, specialized at the
community level. She has knowledge in conducting quantitative, qualitative and mixed-methods research. Her work
also involves studies among the indigenous groups of Sarawak, looking at the interaction between cultural and
health behaviours, particularly among the Iban and Bidayuh communities. She was the principal investigator of
several projects focusing on non-communicable disease among adolescents in Sarawak intervention study on preschool
children. She also had completed projects on rural health, children and adolescent health, community-based
intervention.
Dr Helmy Hazmi is a Public Health Physician currently working in Universiti Malaysia Sarawak (UNIMAS). He received his
early training as a medical doctor in UNIMAS and subsequently in Public Health Medicine in Universiti Sains Malaysia
(USM), Kelantan, with a major in Epidemiology and Bio-statistics. Besides being active in teaching the undergraduates
and the postgraduates, where he is currently the MPH Programme Coordinator. He is also a reviewer for journals and
a member of the Malaysian One Health University Network (MyOHUN). As a columnist, he is actively writing health
articles for the public through the Malaysian Medical Gazette outlet. Dr Helmy is also a member of the Academy of Medi-
cine, Malaysia. His research interest is varied and is concerned with matters that elevate the health and well-being of the
public. He has interest in both Non-Communicable (NCDs) and Communicable Diseases (CDs), clinical epidemiology,
medical sociology, mental health, medical technology, the use of IoT in medicine and lately in the scholarship of Teach-
ing and Learning in medical education.

ORCID
Hsien Liang Melvin Chung http://orcid.org/0000-0002-8723-9465

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