Adapted Physical Activity Quarterly, 2021, 38, 95–108

https://doi.org/10.1123/apaq.2020-0047
© 2021 Human Kinetics, Inc. ORIGINAL RESEARCH

The Instructional Sensitivity of the Test

of Gross Motor Development-3 to Detect
Changes in Performance for Young
Children With and Without Down Syndrome
Kerri L. Staples E. Andrew Pitchford
University of Michigan Iowa State University

Dale A. Ulrich
University of Michigan

The Test of Gross Motor Development is among the most commonly used
measures of gross motor competency in children. An important attribute of any
developmental assessment is its sensitivity to detect change. The purpose of this
study was to examine the instructional sensitivity of the Test of Gross Motor
Development—third edition (TGMD-3) performance criteria to changes in
performance for 48 children (age 4–7 years) with and without Down syndrome
following 10 weeks of physical education. Paired t tests identified significant
improvements for all children on locomotor (p < .01) and ball skills (p < .01).
These significant differences were associated with moderate to large effect sizes.
SEM was low relative to the maximum raw score for each subtest, indicating
high confidence in the scores. These findings provide evidence that the TGMD-3
is sensitive to change in performance for children with and without Down
syndrome.

Keywords: assessment/measurement of motor skills, motor skill assessment,

measurement

Fundamental motor skills have long been viewed as the building blocks of
advanced, sport-specific skills (Clarke & Metcalfe, 2002). When children are able
to perform a variety of fundamental motor skills with competence, they are better
prepared for successful participation in a greater variety of sports and physical
activity (PA) experiences (Logan, Webster, Getchell, Pfeiffer, & Robinson, 2015).
In early childhood, participation in PA provides additional opportunities to practice
and improve those skills (Stodden et al., 2008), while also developing competence

Staples and Ulrich are with the School of Kinesiology, University of Michigan, Ann Arbor, MI, USA.
Pitchford is with the Dept. of Kinesiology, Iowa State University, Ames, IA, USA. Staples (skerri@
umich.edu) is corresponding author.

95
96 Staples, Pitchford, and Ulrich

in a larger repertoire of fundamental motor skills (Robinson et al., 2015). In

comparison, children with low levels of motor skill competence are less likely to
participate in PA pursuits (Cairney, Hay, Veldhuizen, Missiuna, & Faught, 2010;
Fong et al., 2011; Jarus, Lourie-Gelberg, Engel-Yeger, & Bart, 2011), which limits
further opportunities for practice and skill improvement. The relationships between
PA, motor skill competence, and physical fitness strengthen across childhood and
with development (Robinson et al., 2015; Stodden et al., 2008), with recent reviews
demonstrating that motor skill competency also has an impact on health, including
cardiovascular fitness and weight status (Bremer & Cairney, 2018; Lubans,
Morgan, Cliff, Barnett, & Okely, 2010). Motor skill competence plays a central
role in promoting positive trajectories of PA and health, ultimately, preparing a
child to be active across their lifespan.
The Test of Gross Motor Development (TGMD) is one of the most common
measures used to evaluate motor skill competence for children between the ages of
3 and 10 years (Ulrich, 1985, 2000, 2019). The TGMD was strategically designed
to match the fundamental motor skills targeted in an elementary school physical
education (PE) curriculum (Ulrich, 1985) and includes both locomotor and ball
skills. It uses a developmental framework to examine changes in motor compe-
tency that are associated with increasing age and experience, making it a widely
used assessment in both research and practice. The TGMD is also used by adapted
physical educators and pediatric physical therapists as a measure of motor skill
competence for children with and without disabilities to detect possible motor
delays, determine a child’s eligibility to receive required services, and evaluate a
child’s progress toward increasing levels of competence (Ulrich, 2017). To do this
effectively, practitioners need to feel confident that the measure they are using is
reliable, precise, and capable of detecting improvements.
An important psychometric property of a developmental test, whether it is
used for education practice or research-based interventions, is instructional sensi-
tivity. This property of a test or test item is that “an instructionally sensitive test
should be able to detect differences in instruction received by students” (Polikoff,
2010, p. 3). Stated broadly, instructional sensitivity is the “tendency for an item to
vary in difficulty as a form of instruction” (Haladyna & Roid, 1981, p. 40). In order
for the TGMD to be effectively used, it must be instructionally sensitive enough to
detect changes in response to direct instruction in fundamental motor skills.
Given the developmental framework on which the TGMD is based, improved
performance is expected. The Test of Gross Motor Development—third edition
(TGMD-3) norms establish average scores across 3- and 6-month intervals for the
age equivalence and normative comparisons, respectively (Ulrich, 2019). Cur-
rently, there is no published evidence to provide a basis regarding the amount of
progress that can be expected over any given time frame for children who are
participating in PE as part of their school curriculum. However, Ulrich and Ulrich
(1984) directly examined the instructional sensitivity of the original version of the
TGMD and found that significant changes in test scores could be attributed to 10
weeks of direct instruction. Furthermore, numerous research studies examining
interventions to improve fundamental motor skills have used all versions of the
TGMD to measure changes among children without disabilities (e.g., Brian,
Goodway, Logan, & Sutherland, 2017; Burns, Fu, Fang, Hannon, & Brusseau,
2017; Deli, Bakle, & Zachopoulou, 2006; Goodway, Crowe, & Ward, 2003;

APAQ Vol. 38, No. 1, 2021

 TGMD-3 Sensitivity 97

Ignico, 1991; Johnson, Rudisill, Sassi, Wadsworth, & Hastie, 2017; Martin,
Rudisill, & Hastie, 2009; Palmer, Chinn, & Robinson, 2019; Robinson &
Goodway, 2009; Robinson, Veldman, Palmer, & Okely, 2017). There is no
evidence, at this time, that the TGMD-3 has sufficient instructional sensitivity
to detect progress, although practitioners and researchers assume that it has similar
instructional sensitivity as previous versions and is capable of detecting changes in
performance. For these reasons, it is necessary to validate the instructional
sensitivity of the TGMD-3 performance criteria to detect change in the context
and timeframe for which it is commonly used.
The TGMD is also a commonly used outcome measure to compare perfor-
mance between children with and without disabilities or sensory impairments
(e.g., Capio, Mak, Tse, & Masters, 2018; Haegle, Brian, & Goodway, 2015;
Harvey et al., 2007; Schott, Holfelder, & Mousouli, 2014; Staples & Reid, 2010). It
is also used to evaluate the effectiveness of different learning environments or
motor skill interventions for children with disabilities (e.g., Bremer & Lloyd, 2016;
Capio et al., 2018; Capio, Poolton, Sit, Eguia, & Masters, 2013; Ketcheson, Hauck,
& Ulrich, 2017; Valentini & Rudisill, 2004). As psychometric evidence for a test
based on the general population cannot be directly inferred upon populations with
disabilities, it is critical to address aspects of reliability and validity, including
instructional sensitivity, in both children with and without disabilities. This study
includes a sample of children with Down syndrome to examine the instructional
sensitivity of the TGMD-3 performance criteria to changes in performance among
children with and without disabilities.
In addition to updating the normative sample, the revisions in the TGMD-3
(Ulrich, 2019) have led several independent research studies to support the
assessment’s psychometric properties. Both construct and developmental valid-
ity have been established (Temple & Foley, 2017; Webster & Ulrich, 2017).
Research also supports the TGMD-3 as a reliable and valid measure for
evaluating the motor skill competence of children with mental and behavioral
disorders, including intellectual disability (Magistro et al., 2018; Simons &
Eyitayo, 2016). Strong test–retest reliability demonstrates the consistency of a
child’s performance on the total score and subtest scaled scores of the TGMD-3
(Webster & Ulrich, 2017), which lends support to the reliability of the adminis-
tration and scoring of the TGMD-3. Excellent interrater and intrarater reliability
for the total score, locomotor subtest, and ball skills subtest have also been
reported among experienced scorers, with the intraclass correlation coefficient
ranging from .92 to .96 (Maeng, Webster, Pitchford, & Ulrich, 2017). Finally,
strong clinical validity in differentiating performance between children with and
without disabilities has also been established with both raw and scaled scores
from the TGMD-3 (Pitchford & Webster, 2020; Ulrich, 2019).
High levels of reliability are essential for minimizing measurement error. The
SEM is a type of reliability that provides an estimate of how much the measured, or
observed, scores are spread around a “true” score. Statistically, the range in which a
child’s true score likely falls can be estimated. A lower SEM reflects a smaller
range of scores and, therefore, the more precision or reliability the measure has.
Lower SEM scores also provide a more sensitive measure to infer a child’s
progress. This level of precision is central to making informed decisions and
providing an accurate measure of performance and change across time. In the case

APAQ Vol. 38, No. 1, 2021

98 Staples, Pitchford, and Ulrich

of the TGMD, the SEM provides an indication of the extent to which the locomotor
and ball skills subtest scores reflect each child’s and group’s true level of
performance. This type of reliability is important because educators are required
to determine which students are eligible to receive specialized services and
demonstrate student progress across all curricular areas, including PE. The
TGMD-3 manual includes the SEM for scaled scores for each subtest and the
gross motor composite across the ages for which the TGMD-3 is standardized
(Ulrich, 2019, p. 40). This study extends our understanding of measurement error
by determining the SEM of the raw score for each subtest. Although it is inevitable
that some error is present in an observed score, we cannot assume that the SEM
will be the same across all ages or among children with and without disabilities
(Ulrich, 2017).
The primary objective of this study is to establish the instructional sensitivity
of the TGMD-3 to capture changes in fundamental motor skill performance among
samples of preschoolers with Down syndrome and elementary school children
without disabilities following 10 weeks of instruction in PE. Based on the
established instructional sensitivity of previous versions of the TGMD, our
hypothesis is that children will display significant increases in TGMD-3 scores
following instruction. Findings supporting this hypothesis would provide new
evidence of instructional sensitivity for the TGMD-3. A second objective of
this study is to demonstrate the SEM for the raw score of the locomotor and ball
skills subtests of the TGMD-3 for each group. Based on the normative data from
the TGMD-3, we expected that the SEM for each group would be within one
scaled score.

Method
Participants
This study includes 13 children with Down syndrome (seven boys and six girls)
and 35 children without (21 boys and 14 girls). Table 1 includes the distribution of
ages and sex for each group. The children with Down syndrome were between the
ages of 4 and 6 years (Mage = 5.10 ± 0.74 years). The school-aged children without
Down syndrome were grouped according to their grade level: 12 children in
Kindergarten (Mage = 5.59 ± 0.43 years), 12 children in Grade 1 (Mage = 6.69 ±
0.29 years), and 11 children in Grade 2 (Mage = 7.73 ± 0.28 years). There were no
sex differences in age for any of the groups. The majority of the children who

Table 1 Age (years) for Boys and Girls With and Without Down
Syndrome, M (SD)
Group Boys Girls Combined
Down syndrome (seven boys and six girls) 5.09 (0.68) 5.11 (0.86) 5.10 (0.74)
Kindergarten (six boys and six girls) 5.63 (0.33) 5.57 (0.54) 5.59 (0.43)
Grade 1 (nine boys and three girls) 6.71 (0.32) 6.65 (0.23) 6.69 (0.29)
Grade 2 (six boys and five girls) 7.73 (0.36) 7.74 (0.17) 7.73 (0.28)

APAQ Vol. 38, No. 1, 2021

 TGMD-3 Sensitivity 99

participated in this research were European American (n = 39). Six children with
Down syndrome were African American. Among the children without Down
syndrome, one child was Asian American, and two children were of mixed racial
backgrounds.

Measures
The TGMD-3 utilizes a developmental framework to measure performance on
13 fundamental motor skills. It is standardized for children aged 3–10 years. The
skills are divided into two subtests: locomotor and ball skills. The locomotor skills
subtest includes six skills: run, gallop, hop, skip, jump, and slide. The ball skills
subtest includes seven skills: two-handed strike, one-handed strike, catch, kick,
stationary dribble, overhand throw, and underhand throw. The TGMD-3 was
administered to each child following the standardized procedures that are outlined
in the test manual (Ulrich, 2019). Following a demonstration of each skill by a
trained administrator, children performed one practice trial and two trials that were
scored.
There are three to five performance criteria that reflect mastery of each skill.
Based on normative data, most children should demonstrate the majority of these
performance criteria by 10 years of age (Ulrich, 2019; Webster & Ulrich, 2017).
Scoring is based on the presence or absence of each performance criteria. When a
child demonstrates the performance criteria correctly, a score of 1 is recorded; if the
performance criteria are not demonstrated, they receive a score of 0. The scores are
summed across both trials and all skills to provide a raw score for each subtest. The
raw score for the locomotor and ball skills subtests can range from 0 to 46 and 0
to 54, respectively. A higher score indicates greater competence on the TGMD-3.
Although raw scores can be converted to scaled scores to afford normative
comparisons, raw scores were used in this study to compare each participant to
their previous test performance.
The length of motor skill interventions is often 6–12 weeks in length
(e.g., Bremer & Lloyd, 2016; Brian et al., 2017; Burns et al., 2017; Deli et al.,
2006; Goodway et al., 2003; Johnson et al., 2017; Ketcheson et al., 2017; Martin
et al., 2009; Robinson & Goodway, 2009; Robinson et al., 2017; Valentini &
Rudisill, 2004). To examine the instructional sensitivity of the TGMD-3 to capture
changes in performance associated with learning, the TGMD-3 was administered
to each participant twice, 10 weeks apart. In addition to being a common timeframe
for many motor skill interventions, this length of time was also chosen to reflect
approximately one quarter of a school year and the time between successive
report cards.

Procedures
All procedures in this study received approval from the Institutional Review
Boards of two universities. Prior to participation in this study, written informed
consent was obtained from the parent or legal guardian of each child. Permission to
video record the performance of the children with Down syndrome was included
in the informed consent. Child assent was also obtained prior to the administration
of the TGMD-3 on each day of testing.

APAQ Vol. 38, No. 1, 2021

100 Staples, Pitchford, and Ulrich

The children with Down syndrome attended a university-affiliated early

childhood program in Texas and received instruction in small classes of approxi-
mately 10 students, with one lead educator and two to three educator assistants
for each class. They participated in daily adapted PE for a total of 150 min per
week. A certified adapted physical educator provided instruction in PE, with the
assistance of the education team for each class. The children without Down
syndrome attended a school in Michigan. Each class consisted of approximately
20 students. PE was scheduled twice per week, for a total of 80 min. Instruction
was provided by a physical educator with specialized training in PE and health.
The research team did not try to influence the teaching methods used at either
school, assuming that both physical educators followed the national standards
and grade-level outcomes for K–12 PE (SHAPE America, 2014), where the focus
of pre-K to Grade 2 PE curriculum includes instruction to facilitate the acquisition
of fundamental motor skills, promote active participation (individually and in
group settings), and encourage movement in space using different speeds and
pathways.
Testing at each school was spread across a 2-week period. Each time the
TGMD-3 was administered, the children were tested in the same order to ensure
the same amount of time between assessments for all children. To minimize
measurement error associated with the administration of the TGMD-3, at each
school, the same individual administered the assessment at both time points. The
TGMD-3 performance of the children with Down syndrome was video recorded
for later scoring, whereas the performance of the children with typical develop-
ment was live scored. High intraclass correlation coefficients support interrater
and intrarater reliability between video and live scoring for the TGMD-3
(Pitchford, Palmer, Lu, Winkelseth, & Ulrich, 2018). To minimize measurement
error associated with scoring, the same person, who has several years of experi-
ence administering and scoring the TGMD-2 and TGMD-3, was the primary
scorer for all assessments at both schools. As a measure of interrater reliability,
approximately 30% (four of 13) of the assessments of the children with Down
syndrome were randomly selected at each time point and independently scored by
a second scorer. The percentage agreement on the individual performance
criterion for the locomotor skills subtest was 95.1% (range = 86.9–100%) and
for the ball skills subtest was 94.9% (range = 94.4–96.3%). Intraclass correlation
coefficients for absolute agreement of the locomotor and ball skills subtest scores
were .974 and .886, respectively.

Data Analysis
IBM SPSS Statistics (version 24.0; Armonk, NY) was used for all analyses.
Descriptive statistics were calculated for each age group and by sex. Due to the
small sample size and because the purpose of this study was to demonstrate the
instructional sensitivity of the TGMD-3 performance criteria to change and not to
examine the effectiveness of instruction, the scores of boys and girls for each group
were combined for the analyses. A series of paired-samples t tests were conducted
to evaluate the instructional sensitivity of the TGMD-3 performance criteria to 10
weeks of PE instruction. For all analyses, the statistics for equal variances are
reported.

APAQ Vol. 38, No. 1, 2021

 TGMD-3 Sensitivity 101

To support the statistical significance of these results, effect sizes were

calculated using G*Power (version 3.1.9.6; Faul, Erdfelder, Lang, & Buchner,
2007) and are reported as Cohen’s d. Differences of 0.2, 0.5, and 0.8 reflect small,
medium, and large effects, respectively (Cohen, 1988). Because we were evaluat-
ing the magnitude of change within one group (pre and post), the pooled SD was
used as the denominator to calculate the effect size. A second effect size calculation
was used to examine the sensitivity of the TGMD-3 performance criteria to detect
change over time. The standardized response mean (SRM) provides an estimate of
change that is standardized relative to the variability in change scores (Norman,
Wyrwich, & Patrick, 2007; Wright & Young, 1997). Although SRM is a preferred
method of evaluating the responsiveness of a measure, the interpretation of this
effect size is not straightforward, as it does not have specific reference points
(Middel & van Sonderen, 2002). However, a greater effect size is inferred the
farther the SRM differs from 0. The SRM is included to demonstrate the
instructional sensitivity of the TGMD-3 performance criteria to change following
10 weeks of PE. The equations used to calculate both effect sizes are included
below:

M1 − M2 M change
Cohen’s d = , SRM =
SDpooled SDchange

The SEM was calculated for each TGMD-3 subtest, for each group, at each time
point. The SEM was calculated in its original unit of measurement. Once the
SEM was calculated for each group, a confidence interval (CI) within which one
could be confident that a child’s true score would fall within could then be
determined. The following equation was used to calculate the CI for the 95
percentile:

95% CI = Observed score
ð1.96 × SEMÞ

Results
Instructional Sensitivity of the TGMD-3 Performance Criteria
to Changes in Performance
To examine the instructional sensitivity of the TGMD-3 to capture changes in
performance, the raw scores from the locomotor skills and ball skills subtests of
the TGMD-3 were compared before and after 10 weeks of PE instruction using a
series of paired-samples t tests. Tables 2 and 3 include the mean and SD of scores
before and after 10 weeks of instruction for boys and girls in each group. Looking
specifically at the locomotor skills subtest, the scores of children with Down
syndrome, t(12) = −4.28, p = .001, d = 0.37, and children without Down syn-
drome in Kindergarten, t(11) = −4.80, p = .001, d = 0.95, Grade 1, t(11) = −8.37,
p < .001, d = 0.90, and Grade 2, t(10) = −7.48, p < .001, d = 1.26, improved
significantly. Similar results were seen when looking at the ball skills subtest,
as the scores of children with Down syndrome, t(12) = −6.90, p < .001, d = 0.55,

APAQ Vol. 38, No. 1, 2021

 102 Staples, Pitchford, and Ulrich

Table 2 TGMD-3 Raw Scores for Locomotor Skills Before and After 10
Weeks of Physical Education for Boys and Girls With and Without Down
Syndrome
Locomotor skills (/46) Effect size
Group Pre Post Change d SRM
Down syndrome
Boys 6.71 (4.99) 8.71 (5.88) 2.00 (2.16)
Girls 11.67 (6.44) 14.17 (5.38) 2.50 (1.64)
Combined 9.00 (6.03)* 11.23 (6.11)* 2.23 (1.88) 0.367 1.187
SEM (95% CI) ±3.28 ±3.32
Kindergarten
Boys 19.17 (5.84) 26.50 (6.47) 7.33 (5.05)
Girls 23.00 (7.24) 28.00 (6.75) 5.00 (3.85)
Combined 21.08 (6.59)* 27.25 (6.36)* 6.17 (2.55) 0.952 1.387
SEM (95% CI) ±3.73 ±3.60
Grade 1
Boys 23.67 (7.09) 29.89 (6.21) 6.22 (2.68)
Girls 22.67 (9.29) 28.67 (8.51) 6.00 (2.65)
Combined 23.42 (7.24)** 29.58 (6.45)** 6.17 (2.55) 0.895 2.418
SEM (95% CI) ±4.10 ±3.65
Grade 2
Boys 28.50 (2.59) 31.83 (2.48) 3.33 (1.21)
Girls 29.60 (4.56) 34.60 (2.97) 5.00 (2.12)
Combined 29.0 (3.46)** 33.09 (2.95)** 4.09 (1.81) 1.26 2.255
SEM (95% CI) ±2.05 ±1.74
Note. Scores are reported as M (SD). TGMD-3 = Test of Gross Motor Development—third edition; d = Cohen’s d;
SRM = standardized response mean; CI = confidence interval; 95% CI = observed score ± (1.96 × SEM).
*p < .01. **p < .001.

and children without Down syndrome in Kindergarten, t(11) = −4.88, p < .001,
d = 0.85, Grade 1, t(11) = −3.62, p = .004, d = 0.59, and Grade 2, t(10) = −5.64,
p < .001, d = 0.63, improved significantly. Performance differences following
10 weeks of instruction in PE were supported for each group, with the effect sizes
ranging from small (d = 0.37) to large (d = 1.26) and the SRM ranging from 1.044
to 2.418.

Standard Error of Measurement

The SEM was calculated to provide a CI or range around the obtained score for
each group. Tables 2 and 3 include the SEM calculated for the 95% CI for children
with and without Down syndrome at each time point. The SEM (95% CI) ranged
from 1.7 to 4.1 (M = 3.1) for the locomotor subtest and from 1.9 to 5.8 (M = 4.3) for
the ball skills subtest.

APAQ Vol. 38, No. 1, 2021

 TGMD-3 Sensitivity 103

Table 3 TGMD-3 Raw Scores for Ball Skills Before and After 10 Weeks of
Physical Education for Boys and Girls With and Without Down Syndrome
Ball skills (/54) Effect size
Group Pre Post Change d SRM
Down syndrome
Boys 9.14 (5.46) 11.29 (4.15) 2.14 (1.46)
Girls 10.67 (2.73) 13.00 (3.03) 2.33 (0.82)
Combined 9.85 (4.32)** 12.08 (3.64)** 2.23 (1.67) 0.554 1.913
SEM (95% CI) ±2.35 ±1.98
Kindergarten
Boys 20.83 (10.36) 17.67 (6.12) 6.50 (3.33)
Girls 27.33 (7.84) 25.83 (10.65) 8.17 (6.85)
Combined 19.25 (8.28)** 26.58 (8.95)** 7.33 (5.21) 0.849 1.407
SEM (95% CI) ±4.68 ±5.06
Grade 1
Boys 36.78 (5.47) 41.11 (4.26) 4.33 (5.50)
Girls 17.67 (7.77) 26.67 (5.13) 9.00 (2.65)
Combined 32.00 (10.37)* 26.58 (8.95)** 5.50 (5.27) 0.588 1.044
SEM (95% CI) ±5.86 ±4.41
Grade 2
Boys 38.00 (9.21) 42.17 (8.75) 4.17 (3.31)
Girls 27.00 (4.69) 34.00 (3.94) 7.00 (2.55)
Combined 33.00 (9.18)** 38.45 (7.92)** 5.45 (3.21) 0.632 1.700
SEM (95% CI) ±5.42 ±4.68
Note. Scores are reported as M (SD). TGMD-3 = Test of Gross Motor Development—third edition; d = Cohen’s d;
SRM = standardized response mean; CI = confidence interval; 95% CI = observed score ± (1.96 × SEM).
*p < .01. **p < .001.

Discussion
The TGMD-3 is a measure of gross motor skill competence that is used widely in
both practice and research for examining levels of motor skill relative to curricular
objectives or to determine the effectiveness of a motor skills program or interven-
tion. Repeated assessment and monitoring of development over time depends on
the use of reliable instruments. Therefore, the purpose of this study was to validate
the instructional sensitivity of the TGMD-3 performance criteria relative to the
timeframes for which the assessment is commonly used. This was conducted in
samples of preschool-aged children with Down syndrome and elementary-school-
aged children without disabilities to establish instructional sensitivity in multiple
populations.
Children with and without Down syndrome made statistically significant
improvements on both subtests of the TGMD-3. Therefore, the results of this study

APAQ Vol. 38, No. 1, 2021

104 Staples, Pitchford, and Ulrich

validate the TGMD-3 performance criteria as being instructionally sensitive to

detect changes in motor skill competence following 10 weeks of instruction in
PE. The findings on statistical significance are strong, considering that the sample
sizes in each group were small, ranging from 11 to 13 children. The statistical
significance is further supported by small to large effect sizes (d), ranging from
0.367 to 1.26, and SRM values ranging from 1.187 to 2.418. Collectively, these
effect sizes support the performance criteria as being sufficiently sensitive to detect
improved scores that are also meaningful and practically significant (Sutlive &
Ulrich, 1998). Although small, the improvements made among the children with
Down syndrome were statistically significant and were supported with small to
medium effect sizes. These results validate the TGMD-3 for use with children with
and without Down syndrome, where the performance criteria are sufficiently
sensitive to capture even small improvements following 10 weeks of instruction.
The SEM scores found in this study mean that users of the TGMD-3 can be
confident in the subtest scores for each child that has been assessed. In addition to
the reliability on the administration and scoring of the TGMD-3, two additional
factors influence the SEM: sample size and the SD of the observed scores. Each
group in this study was composed of 11–13 participants; therefore, it is likely
that the SEM scores would decrease if the size of each sample were increased.
The second factor to influence the SEM scores is the variability or SD of scores.
Because the experience of individuals who administer and score the TGMD-3 is
likely to influence the variability among scores, it is essential to include the SEM
as part of the results (Ulrich, 2017). Based on the normative data published in the
TGMD-3 manual (Ulrich, 2019, p. 62), the greatest variability in performance is
between the ages of 4 and 7 years. It is expected that, with increasing age and
experience, performance will become less variable within and between children,
and SEM scores will become smaller.
Because observed or measured scores include some measurement error, they
should be considered an estimate of a child’s true score. Given the weight that is
often attached to a child’s score, it is important to consider the measurement error
that may influence that score. Teachers and researchers should therefore consider
using a CI to provide a range of scores that reflects a child’s performance, rather
than relying on a single score. This becomes particularly important when deter-
mining whether a student qualifies to receive additional services or when testing in
PE to determine whether progress is being made.

Limitations and Future Direction

The TGMD-3 is standardized for use with children aged 3–10 years. The results of
this study are limited by the small sample size, limited racial representation,
unequal distribution of boys and girls across age groups, and the inclusion of only
children with and without Down syndrome between the ages of 4 and 7 years.
Although we can assume, based on the results of this study, that the performance
criteria are sufficiently sensitive to capture changes in performance for children
younger and older than those assessed in this study, future research will need to
examine the responsiveness of the TGMD-3 with children spanning the full age
range for which it is standardized. Although the results of this study suggest that

APAQ Vol. 38, No. 1, 2021

 TGMD-3 Sensitivity 105

both boys and girls have similar gains in motor skill competence over a 10-week
period, future research should continue to examine the differences between boys
and girls and their response to instruction and/or intervention. Future research
should also examine the instructional sensitivity of the TGMD-3 performance
criteria for children with disabilities other than Down syndrome (e.g., autism,
intellectual disability, visual impairment).
The primary scorer for all TGMD-3 assessments was not blind to the purpose
of this study, and there may have been some learning of the TGMD-3, as the
participants were assessed on two separate occasions. However, the 10-week
period between successive TGMD-3 assessments for each group far exceeded the
average 2-week timeframe (range 7–25 days) on which the test–retest reliability of
the TGMD-3 was established (Webster & Ulrich, 2017). It is unlikely that the
scorer or the children would recall how they performed on the test 10 weeks prior.
The purpose of this study was to examine the instructional sensitivity of the
TGMD-3 performance criteria as a result of regular participation in PE to support
its use as an outcome measure in research and practice. To examine the effective-
ness of instruction in PE or motor skill intervention, future research will require
detailed information about the intervention protocol or curriculum that was
followed.

Conclusions
The importance of fundamental motor skills in children’s health and develop-
ment has been established (Bremer & Cairney, 2018; Lubans et al., 2010;
Robinson et al., 2015). It is critical that teachers, therapists, and researchers
have access to reliable and accurate measurements. Given the studies that have
already been done to support the psychometric properties of the TGMD-3
(Temple & Foley, 2017; Webster & Ulrich, 2017), this study adds additional
support regarding the instructional sensitivity of the TGMD-3 and the utility of
the test to track changes in fundamental motor skills for young children with and
without Down syndrome. Significant improvements in the TGMD-3 scores were
observed for all age and disability groups following 10 weeks of PE instruction.
Teachers and researchers can be confident that children should demonstrate
improved performance after receiving 10 weeks of curricular instruction. The
results of this study extend the findings of Webster and Ulrich (2017) and Temple
and Foley (2017) with respect to establishing developmental and construct
validity of the TGMD-3 for young children with and without Down syndrome,
thereby contributing to the body of research that establishes the psychometric
properties of the TGMD-3 to support the many ways in which the assessment is
used in both research and practice.

References
Bremer, E., & Cairney, J. (2018). Fundamental movement skills and health-related out-
comes: A narrative review of longitudinal and intervention studies targeting typically
developing children. American Journal of Lifestyle Medicine, 12(2), 148–159. PubMed
ID: 30202387 doi:10.1177/1559827616640196

APAQ Vol. 38, No. 1, 2021

106 Staples, Pitchford, and Ulrich

Bremer, E., & Lloyd, M. (2016). School-based fundamental motor skill intervention for
children with autism-like characteristics: An exploratory study. Adapted Physical Activity
Quarterly, 33(1), 66–88. PubMed ID: 26785501 doi:10.1123/APAQ.2015-0009
Brian, A., Goodway, J.D., Logan, J.A., & Sutherland, S. (2017). SKIPing with teachers: An
early years motor skill intervention. Physical Education and Sport Pedagogy, 22(3),
270–282. doi:10.1080/17408989.2016.1176133
Burns, R.D., Fu, Y., Fang, Y., Hannon, J.C., & Brusseau, T.A. (2017). Effect of a 12-week
physical activity program on gross motor skills in children. Perceptual and Motor
Skills, 124(6), 1121–1133. PubMed ID: 28728459 doi:10.1177/0031512517720566
Cairney, J., Hay, J.A., Veldhuizen, S., Missiuna, C., & Faught, B.E. (2010). Developmental
coordination disorder, sex, and activity deficit over time: A longitudinal analysis of
participation trajectories in children with and without coordination difficulties. Devel-
opmental Medicine and Child Neurology, 52(3), e67–e72. PubMed ID: 20015253
doi:10.1111/j.1469-8749.2009.03520.x
Capio, C.M., Mak, T.C.T., Tse, M.A., & Masters, R.S.W. (2018). Fundamental movement
skills and balance of children with Down syndrome. Journal of Intellectual Disability
Research, 62(3), 225–236. PubMed ID: 29205624 doi:10.1111/jir.12458
Capio, C.M., Poolton, J.M., Sit, C.H.P., Eguia, K.F., & Masters, R.S.W. (2013). Reduction
of errors during practice facilitates fundamental movement skill learning in children
with intellectual disabilities. Journal of Intellectual Disability Research, 57(4),
295–305. PubMed ID: 22369034 doi:10.1111/j.1365-2788.2012.01535.x
Clarke, J.E., & Metcalfe, J.S. (2002). The mountain of motor development: A metaphor. In
J. E. Clarke & J. Humphrey (Eds.), Motor development: research and reviews (Vol. 2,
pp. 163–190). Reston, VA: NASPE Publications.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences. New York, NY:
Routledge Academic.
Deli, E., Bakle, I., & Zachopoulou, E. (2006). Implementing intervention movement
programs for kindergarten children. Journal of Early Childhood Research, 4(1),
5–18. doi:10.1177/1476718X06059785
Faul, F., Erdfelder, E., Lang, A.G., & Buchner, A.. (2007). G*Power 3: A flexible statistical
power analysis for the social, behavioral, and biomedical sciences. Behavior Research
Methods, 39(2), 175–191. doi:10.3758/BF03193146
Fong, S.S.M., Lee, V.Y.L., Chan, N.N.C., Chan, R.S.H., Chak, W.K., & Pang, M.Y.C.
(2011). Motor ability and weight status are determinants of out-of-school activity
participation for children with developmental coordination disorder. Research in
Developmental Disabilities, 32(6), 2614–2623. PubMed ID: 21767931 doi:10.1016/
j.ridd.2011.06.013
Goodway, J.D., Crowe, H., & Ward, P. (2003). Effects of motor skill instruction on
fundamental motor skill development. Adapted Physical Activity Quarterly, 20(3),
298–314. doi:10.1123/apaq.20.3.298
Haegle, J.A., Brian, A., & Goodway, J. (2015). Fundamental motor skills and school-aged
individuals with visual impairments: A review. Review Journal of Autism and
Developmental Disorders, 2, 320–327. doi:10.1007/s40489-015-0055-8
Haladyna, T., & Roid, G. (1981). The role of instructional sensitivity in the empirical review
of criterion-referenced test items. Journal of Educational Measurement, 18(1), 39–53.
doi:10.1111/j.1745-3984.1981.tb00841.x
Harvey, W.J., Reid, G., Grizenko, N., Mbekou, V., Ter-Stepanian, M., & Joober, R. (2007).
Fundamental movement skills and children with attention-deficit hyperactivity disor-
der: Peer comparisons and stimulant effects. Journal of Abnormal Child Psychology,
35(5), 871–882. PubMed ID: 17503174 doi:10.1007/s10802-007-9140-5
Ignico, A.A. (1991). Physical education for Head Start children: A field-based study. Early
Child Development and Care, 77(1), 77–82. doi:10.1080/0300443910770107

APAQ Vol. 38, No. 1, 2021

 TGMD-3 Sensitivity 107

Jarus, T., Lourie-Gelberg, Y., Engel-Yeger, B., & Bart, O. (2011). Participation patterns of
school-aged children with and without DCD. Research in Developmental Disabilities,
32(4), 1323–1331. PubMed ID: 21324639 doi:10.1016/j.ridd.2011.01.033
Johnson, J.L., Rudisill, M.E., Sassi, J., Wadsworth, D., & Hastie, P. (2017). Instruction
matters: Influence of instruction on motor skill learning across different mastery
motivational climate conditions. European Journal of Physical Education and Sport
Science, 3(9), 24–33. doi:10.5281/zenodo.1066398
Ketcheson, L., Hauck, J., & Ulrich, D. (2017). The effects of an early motor skill
intervention on motor skills, levels of physical activity, and socialization in young
children with autism spectrum disorder: A pilot study. Autism, 21(4), 481–492.
PubMed ID: 27354429 doi:10.1177/1362361316650611
Logan, S.W., Webster, E.K., Getchell, N., Pfeiffer, K.A., & Robinson, L.E. (2015).
Relationship between fundamental motor skill competence and physical activity during
childhood and adolescence: A systematic review. Kinesiology Review, 4(4), 416–426.
doi:10.1123/kr.2013-0012
Lubans, D.R., Morgan, P.J., Cliff, D.P., Barnett, L.M., & Okely, A.D. (2010). Fundamental
movement skills in children and adolescents: Review of associated health benefits.
Sports Medicine, 40(12), 1019–1035. PubMed ID: 21058749 doi:10.2165/11536850-
000000000-00000
Maeng, H., Webster, E.K., Pitchford, E.A., & Ulrich, D.A. (2017). Inter- and intrarater
reliabilities of the Test of Gross Motor Development—Third edition among experi-
enced TGMD-2 raters. Adapted Physical Activity Quarterly, 34(4), 442–455. PubMed
ID: 29035576 doi:10.1123/apaq.2016-0026
Magistro, D., Puiumatti, G., Carlevaro, F., Sherar, L.B., Eslinger, D.W., Bardaglio, G., : : :
Musella, G. (2018). Measurement invariance of TGMD-3 in children with and without
mental and behavioral disorders. Psychological Assessment, 30(11), 1421–1429.
doi:10.1037/pas0000587
Martin, E.H., Rudisill, M.E., & Hastie, P. (2009). The effectiveness of a mastery motivational
climate motor skill intervention in a naturalistic physical education setting. Physical
Education and Sport Pedagogy, 14(3), 227–240. doi:10.1080/17408980801974952
Middel, B., & van Sonderen, E. (2002). Statistical significant change versus relevant or
important change in (quasi) experimental design: Some conceptual and methodological
problems in estimating magnitude of intervention-related change in health services
research. International Journal of Integrated Care, 2(4), e15. doi:10.5334/ijic.65
Norman, G.R., Wyrwich, K.W., & Patrick, D.L. (2007). The mathematical relationship
among different forms of responsiveness coefficients. Quality Life Research, 16(5),
815–822. PubMed ID: 17351823 doi:10.1007/s11136-007-9180-x
Palmer, K.K., Chinn, K.M., & Robinson, L.E. (2019). The effect of the CHAMP
intervention on fundamental motor skills and outdoor physical activity in preschoolers.
Journal of Sport and Health Science, 8(2), 98–105. doi:10.1016/j.jshs.2018.12.003
Pitchford, E.A., Palmer, K.K., Lu, Y., Winkelseth, K., & Ulrich, D.A. (2018). Inter- and
intra-rater reliability during live- and video-coding of the TGMD-3. Journal of
Sport & Exercise Psychology, 40(S1), S34. doi:10.1123/jsep.2018-0169
Pitchford, E.A., & Webster, E.K. (2021). Clinical validity of the Test of Gross Motor
Development-3 in children with disabilities from the U.S. national normative sample.
Adapted Physical Activity Quarterly, 38(1). doi:10.1123/apaq.2020-0023
Polikoff, M.S. (2010). Instructional sensitivity as a psychometric property of assessments.
Educational Measurement: Issues and Practice, 29(4), 3–14. doi:10.1111/j.1745-3992.
2010.00189.x
Robinson, L.E., & Goodway, J.D. (2009). Instructional climates in preschool children who
are at-risk. Part I: Object-control skill development. Research Quarterly for Exercise
and Sport, 80(3), 533–542. doi:10.1080/02701367.2009.10599591

APAQ Vol. 38, No. 1, 2021

108 Staples, Pitchford, and Ulrich

Robinson, L.E., Stodden, D.F., Barnett, L.M., Lopes, V.P., Logan, S.W., Rodrigues, L.P., &
D’Hondt, E. (2015). Motor competence and its effect on positive developmental
trajectories of health. Sports Medicine, 45(9), 1273–1284. PubMed ID: 26201678
doi:10.1007/s40279-015-0351-6
Robinson, L.E., Veldman, S.L.C., Palmer, K.K., & Okely, A.D. (2017). A ball skills
intervention in preschoolers: The CHAMP randomized controlled trial. Medicine and
Science in Sports and Exercise, 49(11), 2234–2239. PubMed ID: 29045324 doi:
10.1249/MSS.0000000000001339
Schott, N., Holfelder, B., & Mousouli, O. (2014). Motor skill assessment in children with
Down syndrome: Relationship between performance-based and teacher-report mea-
sures. Research in Developmental Disabilities, 35(12), 3299–3312. doi:10.1016/j.ridd.
2014.08.001
SHAPE America. (2014). National standards and grade-level outcomes for K-12 physical
education. Reston, VA: Author.
Simons, J., & Eyitayo, G.B. (2016). Aspects of reliability and validity of the TGMD-3 in
7–10 year old children with intellectual disability in Belgium. European Psychomo-
tricity Journal, 8(1), 3–16.
Staples, K., & Reid, G. (2010). Fundamental movement skills and autism spectrum
disorders. Journal of Autism and Developmental Disorders, 40(2), 209–217. PubMed
ID: 19685284 doi:10.1007/s10803-009-0854-9
Stodden, D.F., Goodway, J.D., Langendorfer, S.J., Roberton, M.A., Rudisill, M.E., Garcia,
C., & Garcia, L.E. (2008). A developmental perspective on the role of motor skill
competence in physical activity: An emergent relationship. Quest, 60(2), 290–306.
doi:10.1080/00336297.2008.10483582
Sutlive, V.H., & Ulrich, D.A. (1998). Interpreting statistical significance and meaningful-
ness in adapted physical activity research. Adapted Physical Activity Quarterly, 15(2),
103–118. doi:10.1123/apaq.15.2.103
Temple, V.A., & Foley, J.T. (2017). A peek at the development validity of the test of gross
motor development-3. Journal of Motor Learning and Development, 5(1), 5–14. doi:
doi.org/10.1123/jmld.2016-0005
Ulrich, D.A. (1985). Test of gross motor development. Austin, TX: Pro-Ed.
Ulrich, D.A. (2000). Test of gross motor development (2nd ed.). Austin, TX: Pro-Ed.
Ulrich, D.A. (2017). Introduction to the special section: Evaluation of the psychometric
properties of the TGMD-3. Journal of Motor Learning and Development, 5(1), 1–4.
doi:10.1123/jmld.2017-0020
Ulrich, D.A. (2019). Test of gross motor development (3rd ed.). Austin, TX: Pro-Ed.
Ulrich, D.A., & Ulrich, B.D. (1984). The objectives-based motor-skill assessment instru-
ment: Validation of instructional sensitivity. Perceptual and Motor Skills, 59(1),
175–179. doi:doi.org/10.2466/pms.1984.59.1.175
Valentini, N.C., & Rudisill, M.E. (2004). An inclusive mastery climate intervention and the
motor skill development of children with and without disabilities. Adapted Physical
Activity Quarterly, 21(4), 330–347. doi:10.1123/apaq.21.4.330
Webster, E.K., & Ulrich, D.A. (2017). Evaluation of the psychometric properties of the
Test of Gross Motor Development—3rd edition. Journal of Motor Learning and
Development, 5(1), 45–58. doi:10.1123/jmld.2016-0003
Wright, J.G., & Young, N.L. (1997). A comparison of different indices of responsiveness.
Journal of Clinical Epidemiology, 50(3), 239–246. doi:10.1016/S0895-4356(96)
00373-3

APAQ Vol. 38, No. 1, 2021

Copyright of Adapted Physical Activity Quarterly is the property of Human Kinetics
Publishers, Inc. and its content may not be copied or emailed to multiple sites or posted to a
listserv without the copyright holder's express written permission. However, users may print,
download, or email articles for individual use.