Miller Function & Participation Scales: M-FUN Lucy Jane Miller, 2006 PURPOSE: To assess childrens visual motor,

fine motor, and gross motor skills, in order to identify delays, determine eligibility for services, need for intervention and classroom adaptations, or need for further assessment of neuromotor status. Performance component of the test is norm-referenced Participation component of the test is criterion-referenced POPULATION: For children ages 2 years 6 months to 7 years 11 months Can also be used for older children to direct treatment or as an outcome measure (but dont use norms) ICF DOMAIN: M-FUN incorporates elements of body function, activities and participation domains TEST MATERIALS: Examiners Manual Administration Directions Record forms (2 yrs 6 mo 3 yrs 11 mo & 4 yrs to 7 years 11 mo) o Form includes Test Observations Checklist and Neurological Foundations Profile Workbooks (same age categories) Home observations checklist Classroom observations checklist Objects & toys needed for assessment Environment: quiet area, distractions minimized, enough room for all activities, solid or carpeted surface, adequate lighting, good shoes or barefoot, child-size table and 2 chairs TIME TO ADMINISTER: 40 to 60 minutes for performance components, 5-10 minutes for participation component TEST COMPONENTS: Performance component: o workbook activities & play activities o visual motor, fine motor, & gross motor games o Age 2:6 5:11: 15 activities; age 6 7:11: 16 activities o Norm-referenced

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Participation component: o Home observation checklist, classroom observation checklist, test observations checklist o Criterion-referenced

ADMINISTRATION: Warm-up activity to get acquainted Then do activities: natural, fun games that are typical of childrens daily leisure and school activities. Use standard instructions: bolded in admin section of manual Keep other materials out of sight to ensure focus Administer items in order except for children who are more challenging and need adaptation (note changes on record form): 1st Visual motor, 2nd Fine motor, 3rd Gross motor Score sheet indicates equipment needed and time limits (if applicable) for each item. Answers are also noted on the score sheet. Scoring is multifaceted. The child receives points for different aspects of the motor skill he or she is demonstrating Do teaching and practice of item first (up to 60 sec.), then do actual test item. Complete Behavior Ratings after each section of the test Complete Test Observations Checklist (p. 4 of the score sheet) during or after the test STRENGTHS: Neurological Foundations Profile is very useful clinically, particularly for newer therapists Kids love it: skills are tested in a game format You can do and score sections independently For each activity, the examiners manual goes over the objectives of the activity, information that you obtain about the childs motor skills, what the performance results mean in relation to a childs home or school environment, and an item analysis that indicates the neurological foundations for each task and the corresponding items. (p. 23 36) The manual is very thorough, and relatively easy to follow. LIMITATIONS: Limited age range for SAP Recording all of the components and following the standardized instructions can be difficult (a lot to do and watch for at once). Suggestion: 2 assessors when starting to use this assessment. The snack section means a bit more preparation - having crackers and a water bottle on hand. Reliability for Visual Motor section is fairly low for 7:0-7:11 age band (0.67)

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STANDARDIZATION: Normative sample: 414 children in the USA, distributed throughout age bands, gender, geographic areas of USA, parent education (measure of socio-economic status), and ethnicity; 2004-2005. Normative data in 6 month age bands except 5:0 7:11 (1 year) Sample sizes for each age group ranged from 45-60 kids 6.8% of the children received some type of school service or were identified as having a specific condition requiring PT or OT VALIDITY: Test content: Reflects developmental progression of motor abilities in children aged 2:6 to 7:11. Assesses VM, FM and GM skills relevant to tasks leading to early school success. The Neurological Foundations Profile (P.110-111) summarizes the areas of motor ability covered in each M-FUN test. Checklists also evaluate social participation in the home, classroom, and during testing; this is a key construct of the WHO-ICF. Response processes for the activities have excellent face validity because they are very functional activities. Internal structure: Moderate correlations (0.47 to 0.58) between FM, VM, and GM scaled scores: supports the concept that these are indexes of different aspects of motor abilities Relationship to other variables: Correlations between M-FUN scores and MAP (Miller Assessment of Preschoolers) ranged from moderate to high (0.47-0.83) Clinical validity statistics: Excellent sensitivity (the probability that someone who has the condition will test positive for it) and good specificity (the probability that someone who does not have the condition will test negative) at 1 and 1.5 standard deviations below the mean when clinicians are testing a referral population. RELIABILITY: Test-retest reliability: corrected reliability coefficients ranged from .77 (Visual Motor and Gross Motor) to .82 (Fine Motor): Moderately high Internal consistency: implies that the items in the domain tested are measuring one construct. o For the standardization sample: The average reliability coefficients were good (0.85 for VM) to excellent (0.90 for FM and 0.92 for GM). Reliabilities were high for VM and FM for ages 2:6-5:11 (0.82 and 0.91). Reliabilities for VM were lower for ages 6:0-6:11 (0.76) and 7:0-7:11 (0.67). Reliabilities for FM were lower for ages 6:0-6:11 (0.79) and 7:0-7:11 (0.85).

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GM reliabilities were 0.91-0.93 for all ages except 2:6-2:11 (0.88) Average reliability coefficients for the checklists were excellent, ranging from 0.95-0.96. When examined by age, coefficients ranged from very good (0.87) to excellent (0.98) o For a clinical group: Similar to above, therefore equally reliable for measuring skills of children from the general population and children who are at risk for motor impairment Inter-rater reliability: Correlation between raters scores was 0.91 for VM, 0.93 for FM, and 0.91 for GM. (High degree of consistency.) Standard error of measurement: related to reliability coefficients and variability of test scores. Can be used to place a confidence interval around the childs score (the range of scores within which the childs true score is likely to be).

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