An initial referral for a child with a statement for
dyspraxia and attention difficulties in a primary
school
 Lack of assessment and intervention materials for
schools
 Small OT team and long wait for OT input
 Specialist teachers and EPs keen to develop
materials to address this need
 Education project group formed with consultation
from OT team
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Whole School approach comprising:
Primary school audit tool
Resources for classroom staff
A targeted motor skills (Wave 2) intervention
comprising
KS1 and KS2 assessment tools
An intervention planning booklet
Half day training for SENCo and TA pairs and
follow on practitioners workshops
The programme consists of:
 The MMSA assessment
 The MMSP targeted intervention
It is for:
 Children who show signs of gross motor, fine
motor or organisational difficulties
 Children with a medical diagnosis e.g CP only
included after discussion with an OT
 The teacher checklist is designed to help select
children to participate and actively involves
teachers in observation and assessment
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What do schools need? An assessment that focuses on relevant
skills, is quick to complete and informs intervention and
assessment of progress
What form should an assessment of children’s motor skills take?
Strongest evidence is for cognitive-motor approach to
assessment of motor skills (Wilson, 2005)
The best evidenced motor skill norms were used (Crawford et al
2001) where possible
Tools were developed and revised over a year with OTs, teachers
and TAs
Inter-rater reliability testing with 37 children in 11 schools found
high levels of agreement between researchers and TAs
(Bond, C., Cole, M., Crook, H., Fletcher, J., Lucanz, J. & Noble, J. (2007). The development of the Manchester
Motor Skills Assessment (MMSA) – An initial evaluation. Educational Psychology in Practice, 23(4), 363-379)
The process of drafting and re-drafting has lead to:
 KS1 and KS2 assessment tools focusing on functional
skills relevant to the school context (gross, fine motor
skills and organisational skills)
 The assessment is designed to be done before the child
takes part in a motor skills group and at the end
 Children are assessed individually on 10 tasks and
each assessment takes approximately 15 minutes
For each item the child is rated on a four point scale, which follows
a skill acquisition model
0 = Not able to complete task
1 = Early stage of skill acquisition
2 = Becoming more competent
3 = Fluent
 Scoring descriptors provide extra detail to enable accurate scoring
 The assessment helps to:
(a) show progress
(b) help with programme planning
 A DVD has been developed to support training
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Training DVD example
Maximum score is 30
 Generally 15-18 would be maximum score for a
child with global difficulties to participate in the
group
 Where a child has specific difficulties in one
area the score profile, teacher information and
knowledge of group profile used to decide
whether the child would benefit from being in
the group
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Use individual profiles and knowledge of the
children to identify who will work well together in
a group
 Use profiles to identify key areas for individual
children to work on
 Balance the range of activities in the session to
suit broad needs of the group e.g. more fine
motor or organisational tasks
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Developed in response to research and
school need for:
Intervention programmes with a built in
assessment component
Intervention that could be delivered by
school staff
Evidence based motor skills programmes
Programmes linked to theory of motor skill
learning and development
Ideally have 2 adults running sessions initially
 Group size: 4 children if 1 adult, or 6 if 2 adults
 Run sessions daily for 20 minutes 8 weeks or 3-4
sessions per week for 12 weeks
Structure (Ripley, 2001)
 Whole group warm up
 Paired activities 3x 2 minutes (mix of fine and gross with
individual target setting)
 Collaborative group cool down activity
 End of session – review, rewards
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Emphasis is upon the group being a positive, fun
experience to boost confidence
 A cooperative approach with frequent opportunities for
working together and building relationships
 Activities are repeated over 5 sessions to enable
children to build fluency
 Children’s target setting and tracking sheets enable
them to see their own progress
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Overall structure (Ripley, 2001)
Cognitive motor approach (Wright and Sugden,
1998; Sugden and Chambers, 2005)
Visualisation strategies (Wilson et al. 2002)
Mastery experiences (Bandura, 1994)
Active problem solving (Mandich, Polatajko,
Missiuna & Miller, 2001)
Frequent practise (Sugden & Chambers, 2005)
Praise and reward to boost performance (Crust,
2005)
Once children have completed a block of
sessions they are reassessed and a decision
made whether they would benefit from a further
block (some progress) or referral on (no or ltd
progress)
 Children given a break between blocks and
class teachers encouraged to work on some
specific areas in order to generalise skills
 Some schools have found it useful to run KS1
one term then KS2 the next
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Repeated measures design with 24 children
assessed using the MMSA
Pre -------------- T2 ------- T3 -------------- T4
6months
Intervention
6 months
Monthly
progress
3.0
2.5
2.0
1.5
T1
Effect sizes
T2
0.010
0.603
T3
T4
0.023
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Development project finished in 2008. All 39
schools that had been part of project surveyed
in 2009 with 59% response rate
60% continuing to deliver the motor skills
intervention
School level impact was variable
External support from the team was rated highly
More support requested re handwriting
interventions
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Training has been revised and continues to be
available to schools
Feedback has lead to shift of focus to
sustainability and whole school approach
Both the whole school and targeted elements
may be published as the Manchester Motor
Skills Assessment and Intervention Package
Continued research is needed to build the
evidence base in relation to the effectiveness of
the intervention, to develop the assessment tool
and develop a parent involvement element
Bandura, A. (1994). Self-efficacy. In Ramachaudran, V. S. (Ed.)
Encyclopedia of human behaviour (Vol. 4, 71-81). New York:
Academic Press.
Bond, C., Cole, M., Crook, H., Fletcher, J., Lucanz, J. & Noble, J.
(2007). The development of the Manchester Motor Skills
Assessment (MMSA) – An initial evaluation. Educational
Psychology in Practice, 23(4), 363-379.
Bond, C. (2011) Supporting children with motor skills difficulties:
An initial evaluation of the Manchester Motor Skills Programme.
Educational Psychology in Practice, 27(2), 143-153.
Bond, C. (in press) Developing provision for children with motor
skill difficulties: the role of EPs. Educational Psychology in
Practice.
Crawford et al (2001) Identifying Developmental Coordination
Disorder: Consistency between tests in Missiuna, C. (ed)
Children with developmental coordination disorder:strategies
for success. Hawthorn Press:London.
Crust, L. (2005). Imagery: Mental drills for physical people: how
recreating all-sensory experiences can profoundly affect your
performance. In Walker, I. (Ed.), Sports Psychology: the will to
win, 11-25. London: Peak Performance.
Mandich, A. D., Polatajko, H.J., Missiuna, C. & Miller, L.T. (2001).
Cognitive strategies and motor performance in children with
developemental coordination disorder. In Missiuna, C. (Ed.).
Children with Developmental Coordination Disorder: Strategies for
Success, 125-143. New York: Hawthorn Press.
Ripley, K. (2001). Inclusion for children with dyspraxia/DCD: A
handbook for teachers. London: David Fulton Publishers.
Sugden, D. & Chambers, M. (Eds.). (2005). Children with
developmental coordination disorder. London: Whurr.
Wilson, P. H (2005) Practitioner Review: Approaches to assessment
and treatment of children with DCD: an evaluative review. Journal
of Child Psychology and Psychiatry 46:8 pp 806-823.
Wright, H. & Sugden, D. E. (1998). School based intervention
programme for children with developmental coordination disorder.
European Journal of Physical Education, 3, 35-50