The Miller Function & Participation Scales (M-FUN)

The Miller Function & Participation Scales (M-FUN) Presented by: Sam Beaumont, Delilah Bolo, & Katrin Denda

M-FUN • • • •

Author: Lucy Jane Miller Publisher: Harcourt Assessment, Inc. Publishing date: 2006 Cost: – Miller Function and Participation Scales Complete Kit with Manipulatives- Includes Workbooks and Checklists $399.00 – Accessories: – Record Forms (Pkg. of 25) $59.00 – Workbooks (Pkg. of 25) $46.50 – Checklists (Pkg. of 25) $20.80

M-FUN • Purpose: – M-FUN helps determine how a child’s motor competency affects his/her ability to engage in home and school activities and to participate socially – M-FUN can be used to determine or identify: – Visual motor, fine motor, and/or gross motor delay – Eligibility for services – Motor abilities that may benefit from home and/or classroom adaptations and accommodations – Underlying neuromotor foundational issues (i.e., problems with hand functions, strength, and endurance) – Curriculum-relevant interventions – Child’s progress toward intervention goals

M-FUN • Type of assessment: • M-FUN is a developmental tool. It is a standardized assessment tool and includes a set of questionnaires – 40-60 min. to complete the standardized portion, and 5-10 min. for the caregiver, teacher, or examiner to complete each checklist

M-FUN • Population and age range: • Age range: 2 years 6 months to 7 years 11 months » older children with motor delays may be tested for progress, but no norms

• Children with mild, moderate, or severe motor delay could be tested

M-FUN • Domains and Subtests: – There is a performance component and participation component – With the tasks and checklists, administers will be able to obtain knowledge about: self-care, functional use of tools, functional mobility, purposeful hand-eye coordination, and participation in home and school activities – Frameworks: looking at play/leisure, education, ADLs

M-FUN • Domains and Subtests: – Performance Assessment: visual motor, fine motor, and gross motor scaled score. They could all be administered in one sitting or multiple. – 15-16 activities total, depending on age – neurological foundations are observed in each activity can be categorized into four areas: hand function, postural abilities, executive function and participation, and nonmotor visual perception

– Participation Assessment: Home, classroom, and test observation checklists – teachers, caregivers, or someone who routinely works with child should complete home and classroom observations

M-FUN • Qualifications to administer: – A variety of professionals may choose to use the M-FUN, including the fields of: OT, PT, special education, adaptive physical education, early childhood interventionists – Examiners should have experience in standardized test administration, scoring, and interpretation, and detailed knowledge of motor development and sensory processing in young children

Psychometric Properties • Reliability – Test-retest (after 0 to 21 days): • Moderately high reliability across time for all ages. The reliability coefficient ranged from .77 (Visual Motor and Gross Motor) to .82 (Fine Motor).

– Internal consistency: • For standardization sample: the average coefficients were good (.85 for the visual motor test) to excellent (.90 for the fine motor test and .92 for the gross motor test). • The average coefficients for the Home, Classroom, and Test Observations checklists were excellent, ranging from .95 to .96

– Inter-rater reliability (5 pairs of examiners; 29 children): • The correlation between raters’ scores was .91 for Visual Motor, .93 for Fine Motor, and .91 for Gross Motor. • There was a high degree of consistency between scorers’ interpretations: the average decision agreement (i.e. identifying the child as performing in the average range or as having a motor impairment) was 96% for Visual Motor, 97% for Fine Motor, and 93% for Gross Motor.

Psychometric Properties • Validity – Content Validity: • M-FUN content reflects the developmental progression of motor abilities in children 2 yrs 6 mo through 7 yrs 11 mo • M-FUN activities are assessed in the context of visual motor, fine motor, and gross motor „games“; in addition, M-FUN has three checklists (Home, Classroom, and Test Observations) that focus on activity completion and participation • Activities are constructed to be relevant to tasks leading to early school success – Internal Structure: • Moderate to high correlations among the 3 tests, ranging from .47 (Visual Motor and Gross Motor) to .58 (Fine Motor and Gross Motor). The correlation between Visual Motor and Fine Motor was .55 – Relationship to other variables: • Moderate to high correlation b/w the Miller Assessment of Preschoolers (MAP) and the M-FUN (from .47 to .83), suggesting the two tests yield different but complementary information about a child’s motor skills – Clinical validity statistics: • Clinical validation studies indicate that M-FUN is very sensitive to the motor difficulties of children identified as having motor delays and provide strong support for clinical utility.

Administration • Scheduling Testing – Child should be well-rested and ready to give “best performance” – Adequate time to administer the test (40-60 min. to complete the standardized portion, and 5-10 min. for the caregiver, teacher, or examiner to complete each checklist) • Testing Materials – M-FUN Administration Directions – Record form (for ages 2:6-3:11 or ages 4:0-7:11) – Workbook (for ages 2:6-3:11 or ages 4:0-7:11) – Manipulatives (some are included in test kit; others have to be purchased)

Administration (cont‘d) • Testing Environment – M-FUN can be administered anywhere (i.e. school, office, clinic, sheltered area of home) as long as it is quiet and there are no distractions – Testing area should be well lit, ventilated, and large enough to perform all activities – Because some of the gross motor activities require the child to have good balance and traction, tester should be aware of testing area’s flooring and child’s shoes >> if necessary, remove child’s shoes / socks for gross motor activities – Tester and child should sit in child-sized chairs if available – Child should be properly supported to not lose balance during testing activities

Administration (cont‘d) • Establishing rapport with child and testing the items – Allow caregivers to be present – begin the session by putting child at ease – Do a warm-up activity when testing 2 and 3 year old children – Know the administration directions (activities should be administered in order according to the Manual: start with Visual Motor; then Fine Motor; have a snack; finally Gross Motor) – however, there is flexibility if child is slow to warm up – Keep stimulus materials out of child‘s sight until needed for test (to avoid distractions) – Be enthusiastic – Give sufficient verbal reinforcement to maintain child‘s interest in test (i.e. ok to say „Good job!“ – but don‘t tell child if s/he answered an item correctly) – Use motivators (i.e. ok to use stickes, etc.)

Administration (cont‘d) • Testing items – Follow Administration Directions – All M-FUN games begin w/ a teaching and practice item during which tester can provide as many cues as necessary for child to understand the task (>>only on practice items) • Possible to reword directions • Explain why correct answer is correct • Explain what the child needs to pay attention to in pictures in order to get practice item correct • Giving physical cues (including guiding a child‘s hand for VM or FM, or placing the child in the correct position for GM)

– when testing the item, CANNOT change wording of directions or cue the child • Can repeat the directions or repeat a stimulus one time

Scoring

Scoring • Record form for two different age groups: – 2 years 6 months- 3 years 11 months – 4 years – 7 years 11 months

• Participation Assessment (Checklists) – Add all “1”s in each column – Multiply by number stated on form – Add all multiplied scores together for total

•Transfer to Scores Summary: Participation Scores

•See Appendix F to determine if child is Average, Below Average, or Far Below Average for each observation area.

Scoring • Performance Assessment – Each item has specific criteria for scoring, usually from 0-3 – Each item is broken down into multiple components – Obtain a total score for each item – Test all activities and items within activities with a few exceptions

•Transfer totals to Performance and Participation Skills Analysis: Performance Raw Scores Total

•Add total Raw Scores for Visual Motor, Fine Motor, Gross Motor

Scoring • Norm-Referenced Performance Scores – Scaled Score (Appendix B) – Confidence level and corresponding Scaled Score Points +/- (Appendix B) – Convert Scaled Score to Percentile Rank (Appendix C) – Percentile Rank Confidence Interval (Appendix C) – Determine Age Equivalent (Appendix D)

Scoring • Performance Score Differences – Can determine differences in scores of: • VM and FM • VM and GM • FM and GM

– Can determine if these differences are significant (.15 or .05) – Helps identify areas of strength and weakness

Scoring • Performance Score Chart – Mark with an “X” the scaled score – Mark with an “— ” the confidence interval

Scoring • Progress Scores – Compares Raw Scores in Fine Motor and Gross Motor across 3 tests – Compares Progress Score in FM and GM across 3 tests (Appendix E) – Can also graph this info

Scoring • Neurological Foundations Profile – Circle item numbers for which the child scored “0” or “1” point – May want to use different colors to differentiate if item was “0” or “1” – Able to identify areas that did not receive full credit – These areas may become a focus for interventions and/or making recommendations to parents

Interpretation • Can determine areas of strength and weakness • Can identify significant differences in skills • Can determine if child is at, above, or below his age group • Can identify the child’s percentile rank and relationship to mean (standard deviation) • How the child performs in different environments • Can track progress

Advantages • Fun, age-appropriate games • Opportunity for practice / teaching by giving cues to ensure child understands task • Simple administration • Straightforward scoring criteria w/ sample scoring • Multiple ways to interpret data (age equivalent, track progress, confidence interval, Neurological Profile, etc) • Considers multiple skill areas in items • Checklists from various perspectives • Helps determine eligibility for services

Disadvantages • Scoring can be time consuming • Be familiar w/ scoring components before administration • Administrator has to be extremely observant of child‘s performance (b/c of behavior rating throughout test) • Need parent and teacher involvement

References Miller, L. J. (2006). Miller Function & Participation Scales: Examiner’s Manual. San Antonio, TX: Harcourt Assessment, Inc.

Pearson Education. (2011). Miller Function & Participation Scales. Retrieved from http://www.pearsonassessments.com/HAIWEB/C ultures/en-us/Productdetail.htm?Pid=015-8015886&Mode=summary