Research in Developmental Disabilities 33 (2012) 1626–1632

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Research in Developmental Disabilities

The Motor-Proficiency-Test for children between 4 and 6 years of age

(MOT 4–6): An investigation of its suitability in Greece
A. Kambas a,d,*, F. Venetsanou b,d, D. Giannakidou a,d, I.G. Fatouros a, A. Avloniti a,
A. Chatzinikolaou a, D. Draganidis a, R. Zimmer c,d
a
Department of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece
b
Department of Physical Education and Sport Science, National Kapodestrian University of Athens, Greece
c
University of Osnabrueck, Germany
d
Active Children Active Schools-Research Group, Germany

A R T I C L E I N F O A B S T R A C T

Article history: Given the negative influence of motor difficulties on people’s quality of life their early
Received 28 February 2012 identification seems to be crucial and consequently the information provided by a sound
Accepted 3 April 2012 assessment tool is of great importance. The aim of this study was to examine the suitability
Available online 27 April 2012 of the MOT 4–6 (Zimmer & Volkamer, 1987) for use with preschoolers in Greece. Seven
hundred and seventy-eight Greek children aged 48–71 months participated in the study.
Keywords: The two-way ANOVA used on total MOT performance revealed significant differences
Motor assessment among the age groups formed in preschool age within Greeks, while boys’ and girls’ scores
Psychometric properties
were quite similar. From the comparisons of Greeks’ scores with the German
Preschool children
standardization sample’s ones, statistically significant differences were found in two
age groups. However according to the Cohen’s d effect size they were not of great
importance. The distribution of Greeks’ scores according to the test cut-offs, revealed that
the MOT can differentiate all levels of performance, although a slight deviation from the
distribution of Germans’ scores was noticed. Finally, both the test–retest reliability and
internal consistency of the test were found to be excellent. The MOT 4–6 seems to be a
valuable motor assessment tool for Greek preschoolers. Regarding its norms, despite the
minor differences that were noticed between the motor development of Greek and
German preschoolers, their adjustment was thought to be unnecessary. Instead of
lowering the norms, efforts for preventing the motor performance decline should be
enhanced.
ß 2012 Elsevier Ltd. All rights reserved.

1. Introduction

It is well known that motor difficulties that children face result in multiple negative consequences not only on their
psychomotor development (Bouffard, Watkinson, Thompson, Causgrove Dunn, & Romanow, 1996; Cantell, Smyth, &
Ahonen, 1994; O’Beirne, Larkin, & Cable, 1994), but also on the cognitive (Geuze & Börger, 1993; Losse, Henderson, Eiman,
Knight, & Engmans, 1991) and social – affective one (Bouffard et al., 1996; Hay & Missiuna, 1998; Schoemaker & Kalverboer,
1994). Children who display exceptional difficulties with tasks requiring motor co-ordination develop a life style that puts at

* Corresponding author at: Department of Physical Education and Sport Science, Democritus University of Thrace, University Campus, 69100 Komotini,
Greece. Tel.: +30 2531039643; fax: +30 2531039623.
E-mail address: akampas@phyed.duth.gr (A. Kambas).

0891-4222/$ – see front matter ß 2012 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.ridd.2012.04.002
 A. Kambas et al. / Research in Developmental Disabilities 33 (2012) 1626–1632 1627

risk the development of their skills, their social relationships and their health (Bouffard et al., 1996). Additionally, in several
follow-up studies, it was revealed that the majority of children identified as having coordination problems in preschool age
never grown up of them (Gillberg & Gillberg, 1989; Gillberg, Gillberg, & Groth, 1989; Hellgren, Gillberg, Gillberg, & Enerskog,
1993; Losse et al., 1991). It is obvious that in preschool age, a period that is vital for the development of fundamental motor
skills (Gallahue, 1996), even the minimum motor difficulties should be identified so as the adequate intervention to be
implemented and several of the secondary problems to be avoided (Missiuna, 1999).
Many instruments, published and unpublished ones, have been designed for the identification of children’s motor
difficulties. The Bruininks–Oseretsky test of Motor Proficiency (Bruininks, 1978) and the Movement Assessment Battery for
Children (Henderson & Sugden, 1992) are among the most used ones (Geuze, Jongmans, Schoemaker, & Smits-Engelsman,
2001). However, questions about the validity of the information the aforementioned tests provide have been raised
(Venetsanou, Kambas, Aggeloussis, Serbezis, & Taxildaris, 2007; Venetsanou et al., 2011), so further investigation for
assessment tools that could be sufficient for that purpose should be conducted.
Moreover, during the selection of an assessment tool, especially if that is for preschoolers, the fact that those particular
children require a different pedagogical approach during their motor assessment (Zimmer & Volkamer, 1987) should be
accounted of. A tool exclusively designed for preschool aged children, aiming to (a) the identification of motor disorders and
(b) the assessment of motor development, is the ‘‘Motorik Test fuer 4–6 jaehrige Kinder’’ (Motor Proficiency Test for Children
between 4 and 6 years of age, MOT 4–6) (Zimmer & Volkamer, 1987). It is a norm referenced test recommended for
educational research purposes because of its specific age range (Vallaey & Vandroemme, 1999). However, due to the absence
of an English translation of its manual, the MOT 4–6 has been used in studies conducted mainly in German speaking
countries (Cools, De Martelaer, Vandaele, Samaey, & Andries, 2010; Kuhtz-Bushbeck, Boczek-Funcke, Illert, Joehnk, & Stolze,
1999; VanRossum & Vermeer, 1990).
Regarding the MOT 4–6’s psychometric characteristics, information is provided in the test manual. Specifically, the scores
of normal children are differentiated from those of children with behavioral problems, Attention Deficit/Hyperactivity
Disorder and problems in oral speech. Battery’s concurrent validity was examined with the Koerper Koordinationtest fuer
Kinder (KTK) (Kiphard & Schilling, 1974) resulting to a r = 0.78. Moreover, high values are reported for the MOT 4–6 test–
retest reliability (r = 0.85), split-half reliability (a = 0.80), as well as internal consistency (a = 0.81) and inter-rater reliability
(r = 0.88). Apart from the test manual, Cools et al. (2010) examined the convergent validity between the MOT 4–6 and the M-
ABC (Henderson & Sugden, 1992) and found a high classification agreement between those tests (90%) and a moderately
strong support for convergent validity (Kappa coefficient = 0.67) while less agreement (58%) was shown in the identification
of motor difficulties.
According to the aforementioned, the evidence for MOT 4–6’s technical adequacy seems sound. However, the assumption
that the norms from any test standardized in one country are valid in another has obvious weaknesses. Motor development is
known to be somewhat variable throughout the world and it can to some extent be shaped by cultural demands and the kind
of activities children engage in (see Venetsanou & Kambas, 2010 for a recent review). Thus, the standardization of a test is
needed to be reconsidered even when a single frontier is crossed (Miyahara et al., 1998). In view of the possible differences
between Greek and German children, the aim of the present study was to critically evaluate the suitability of the MOT 4–6 for
the motor assessment of Greek preschool aged children.

2. Method

2.1. Participants

Seven hundred and seventy eight (413 boys and 365 girls) stratified selected Greek children aged 48–71 months with
normal neurological examination and history participated in the study. Representativeness of the sample was obtained by
randomized Kindergarten selection in urban and rural areas of all the 13 Greek districts. The children were divided in four
age-groups [48–54 months (n = 162), 54–59 months (n = 161), 60–65 months (n = 231) and 66–71 months (n = 224)].
Permission for this study was granted by the Ethics Committee of the Department of Physical Education and Sport
Science, Democritus University of Thrace, Greece. Written informed consent was obtained from the parents of the children.

2.2. Measures

The MOT (Zimmer & Volkamer, 1987) consists of the following 18 items, Forward jump in a hoop (this item is introductive
and thus is not assessed), Walking forward (WF), Making dots on a sheet (MD), Grasping a tissue with toes (GT), Jumping
sideways (JS), Catching a dropped stick (CS), Carrying balls from box to box (BB), Walking in backward direction (WB),
Throwing a ball to a target (TT), Collecting matches (CM), Passing through a hoop (PH), Jumping in a hoop on one foot
standing on one leg (JF), Catching a ring (CR), Jumping Jacks (JJ), Jumping over a cord (JC), Rolling around the length axe of the
body (RB), Standing up holding a ball on the head (SH), Jumping and turning in a hoop (JT). The administration of the battery
takes approximately 15–20 min.
Performance in each task on the MOT 4–6 can be scored in several ways. Raw scores, such as the number of jumps made,
the seconds taken to complete a task, etc. are noted and then are converted into a three-level ranking scale. In that way, a
child’s item score ranges from 0 (skill not mastered) to 2 (skill mastered). The scores of all seventeen tasks are then added and
1628 A. Kambas et al. / Research in Developmental Disabilities 33 (2012) 1626–1632

their sum constitutes the child’s total raw motor score (TRS), ranging between ‘‘0’’ and ‘‘34’’. Finally a normalized motor score
(motor quotient – MQ), determined for each age level and based on normative data of 548 German children is provided.

2.3. Procedure

All assessments were conducted during the daily program from 09.00 to 15.00 o’clock from Monday to Friday, between
the years 2003 and 2009. Each child was individually and barefooted tested, according to the test guidelines (Zimmer &
Volkamer, 1987).
For the needs of the study, a group of 23 trained examiners of the Department of Physical Education and Sport Sciences,
Democritus University of Thrace was used. Intra-rater and inter-rater reliability was examined was found to be high.
Specifically, the value of ICC for intra-rater reliability ranged between .79 and .87, while for inter-rater reliability ranged
between .81 and .89. Moreover, sixty children randomly selected from the four age groups of the participants were tested
twice with an interval of a week between the two measurements, in order the test–retest reliability of the battery in Greek
preschoolers to be tested.

2.4. Statistical analyses

A 2 (sex)  4 (age) ANOVA design was carried out to test the effect of sex and age on MOT-TRS. Post hoc comparisons were
performed using the Bonferroni test, with the alpha level set at .05. Effect size measured by Eta Squared (h2) values, was also
computed for data interpretation. According to Cohen, only h2 > .14 can be considered sufficiently large to be of any
consequence. All analyses were performed using SPSS (version 15.0, SPSS Inc., Chicago, IL, USA).
Moreover, a one-sample t-test was used so as the differences between MOT TRS of Germans and Greeks to be checked. For
this analysis, the German averages for each of the four groups from the reference group of the normative sample (Zimmer &
Volkamer, 1987) were used as reference values, with alpha level set at .05. Cohen’s d effect size interpretations for t-tests
(.20 = small, .50 = moderate, .80 = large) were used (Cohen, 1988). Greek preschoolers’ score distribution based on the MOT
4–6 cut-offs was compared using non-parametric chi-square statistics.
Finally, two aspects of the MOT 4–6 reliability were examined: (a) test–retest reliability of the TRS and (b) battery’s
internal consistency. The intraclass correlation coefficient (ICC) and specifically its (2.1) type was used to check test–retest
reliability in this study, while the Cronbach’s alpha coefficient was calculated so as the internal consistency of the test to be
measured.

3. Results

3.1. General observations

Greek children responded very positively to the tasks included in the MOT 4–6, with no one refusing to try any item of the
battery. Moreover, no administrative problems were noticed, except for the unfamiliarity of some examiners with the ring
throwing, a problem that was solved through practice before test administration.

3.2. Comparisons within Greek participants

The TRS of Greek participants on the MOT 4–6 are presented in Table 1. The 2  4 ANOVA revealed that MOT-total
performance improved significantly with increasing age (F = 367.80, p < .001, h2 = .595). Post hoc comparisons showed that
each age group scored significantly higher than their 6-months younger counterparts (p < .05 for all comparisons). Non-
significant sex differences were found (p = .715).

3.3. Comparisons between Germans and Greeks

An overview of the MOT TRS of Greek preschoolers from 2003 to 2009 and German ones from 1984 is displayed in Fig. 1.
Overall, the Greeks scored in generally lower than the Germans. However, the results of the t-tests indicated that statistically
significant differences were revealed for two of the four age-categories [54–59: t(153) = 2.58, p < .05, and 66–71:
t(222) = 5.81, p < .001]. However, the calculated Cohen’s d effect size was 0.228 and 0.281 respectively, representing a small
effect size (Cohen, 1988).

Table 1
MOT TRS scores (mean  SD) of the Greek boys and girls for the four age groups.

48–53 months 54–59 months 60–65 months 66–71 months

Boys 11.51  4.70 15.78  5.84 19.03  5.07 26.75  2.54

Girls 13.71  4.71 14.82  4.86 18.56  4.85 26.58  2.73
Total 12.58  4.81 15.33  5.41 18.79  4.96 26.68  2.62
 A. Kambas et al. / Research in Developmental Disabilities 33 (2012) 1626–1632 1629

Fig. 1. The MOT TRS of Greek sample from 2003 to 2009 and the German sample from 1984.

3.4. MOT MQ values and cut-off scores in Greek preschoolers

The distribution of Greek preschooler’s scores compared to German ones is presented in Fig. 2. According to the MOT 4–6
manual (Zimmer & Volkamer, 1987), a MQ above 70 is considered as ‘‘very good’’, between 60 and 70 as ‘‘good’’, between 40
and 60 as ‘‘average’’, while between 30 and 40 as ‘‘under average’’ and below 30 as ‘‘conspicuous’’.
The comparison between expected (German norms) and observed percentages in the Greek sample revealed a significant
difference (x2 = 18.15, p < .001). The percentage of German children in the ‘‘average’’ category was 68% and that of Greeks
64.8%, while 16% of Germans had a positive motor development (‘‘good’’ and ‘‘very good’’ performance) in comparison to a
14% of Greeks. However, a greater deviation was noticed at the opposite end of the distribution. Specifically, 16% of German
preschoolers had a poor performance (‘‘under average’’ and ‘‘conspicuous’’) in contrast with a 21.2% of Greeks.

3.5. MOT TRS reliability

Regarding MOT TRS reliability, the ICC for test–retest criterion was found to be .87, a value that is considered to be
excellent (Cicchetti, 1994). Apart from that, the Cronbach’s alpha coefficient value was 0.801 and can be characterized as
sufficiently high (Cicchetti, 1994; Garson, 2006a, 2006b).

4. Discussion

Given the negative influence of motor difficulties not only on people’s participation in physical activity but also on the
quality of their social life and psychological health throughout the lifespan, their early identification seems to be crucial. In
that direction, the role of the information provided by a valid and reliable assessment tool is of great importance. However,
using the norms of a test to populations other than its standardization sample contains jeopardy (Miyahara et al., 1998).
Children in a country may have motor skill levels being typical of their own ethnic origin yet may appear advanced or delayed
compared to the normative data of a given test, leading in that way to incorrect conclusions regarding their development
(Mayson, Harris, & Bachman, 2007). That is why the validation of a test in a specific ethnic population should come before its

Fig. 2. Distribution of Greek and German preschoolers’ MQ based on Zimmer and Volkamer’s (1987) classification (%).
1630 A. Kambas et al. / Research in Developmental Disabilities 33 (2012) 1626–1632

use in that population. In the current study, the suitability of the MOT 4–6 (Zimmer & Volkamer, 1987) for the motor
assessment of Greek children aged 4–6 years was examined.
From the comparisons of the MOT 4–6 total scores within Greek children, positive and statistically significant differences
across age groups were revealed, a finding that is common among studies focusing on preschoolers (Lam, Ip, Lui, & Koong,
2003; Morris, Williams, Atwater, & Wilmore, 1982; Oja & Jurimäe, 1997; Toriola & Igbokwe, 1986; Venetsanou, Kambas,
Aggeloussis, Fatouros, & Taxildaris, 2009; Waelvelde, Peersman, Lenoir, Smits-Engelsman, & Henderson, 2008). The current
results confirm the need for separate norms for each 6-month age group of Greek children, as well as that the performance of
the MOT 4–6 sufficiently differentiates the motor development of Greek preschoolers.
Regarding gender, no differences were found, agreeing with MOT 4–6 authors who do not provide separate norms for
boys and girls. This finding was expected, as boys’ and girls’ performances are usually found to be quite similar in studies
where the motor performance of preschool children is examined by using total battery scores (for a recent review see
Venetsanou & Kambas, 2010). Besides, it is well known that in preschool age, boys’ and girls’ biological characteristics are
similar rather than different (Nelson, Thomas, Nelson, & Abraham, 1986; Thomas & French, 1985).
With respect to the comparisons between the performance of Greek and German preschoolers, it was found that Greeks
had generally lower total MOT 4–6 scores than Germans from 1984, while statistically significant differences were found for
the second (54–59 months) and the fourth (66–71 months) age group. However, even in those two cases, Cohen’s d values
represented small effect sizes (Cohen, 1988) indicating that the observed differences were not of great importance.
Nevertheless, if that trend of motor proficiency decline is to be explained, the decrease in physical activity (PA) levels and the
consequent increase of sedentary lifestyle reported by several researchers all over the world (suggestively: Dollman, Norton
& Norton, 2005; Livingstone, 2001; Sturm, 2005) might serve as a possible reason. It is known that nowadays preschoolers
are less physically active than it is recommended (Pate, O’Neil, & Mitchell, 2010). Due to the interactive relation between
children’s motor proficiency and their participation in PA (Cliff, Okely, Smith, & McKeen, 2009; Fisher et al., 2005; Graf, Koch,
& Kretschmann-Kandel, 2004; Kambas et al., 2012; Williams, Pfeiffer, & O’Neill, 2008; Wrotniack, Epstein, Dorn, Jones, &
Kondilis, 2006) one might argue that the sedentary lifestyle of today’s children undoubtedly affects the level of their motor
proficiency. In that direction, a study comparing the MOT performance of nowadays German preschoolers with that of the
standardization sample from 1984 would be worthwhile.
Regarding the distribution of children’s according to the MOT cut-off points (Zimmer & Volkamer, 1987), the graph shows
that Greek children’s scores are spread over all five classification categories (very good, good, average, under average,
conspicuous). This means that the MOT 4–6 scores classify the whole performance range of children, differentiating the
normal performance not only from the poor but also from the advanced one. According to the chi-square results, the
distribution of the Greeks’ scores diverges from that of their German age-mates. Although there was not much difference in
the high scores (‘‘good’’ and ‘‘very good’’ performance), a considerable percentage of Greek preschoolers (21.2%) had a poor
score (‘‘under average’’ and ‘‘conspicuous’’) in comparison with a 16% of Germans. This could lead us to propose the
adjustment of the norms, so as to be population specific for Greek preschoolers. However agreeing with Vandrope et al.
(2011), we strongly believe that instead of lowering the norms, this finding should result to more efforts to stop the decline in
motor performance.
In that direction, the great influence the educational system may have on children’s motor development should be taken
into consideration. Preschool settings should provide many opportunities to preschoolers in order both their gross and fine
motor skills to be developed. However, this is not the case in Greece where not any organized movement programs are
included in the preschool educational program, nor physical educators are included in the staff of Greek preschools. If
preventing the decline of children’s motor performance is to be achieved, Physical Education should be placed in the center
of Greek preschool education programs.
On the subject of the MOT 4–6 reliability when it is used in Greek preschoolers, the test–retest index in this study was
found to be R = .87, a value thought to show ‘‘excellent’’ reliability (Cicchetti, 1994). Taking into consideration the
variability of young children’s motor behavior a feature undoubtedly affecting the reliability of a measurement (Goshi,
Demura, Kasuga, Sato, & Minami, 1999; Kroes et al., 2004; Morris et al., 1982; Toriola & Igbokwe, 1986) it becomes
obvious that the values found in the present study for the MOT 4–6 provide sufficient evidence for the reliability of this
specific instrument and enhance its use for the evaluation of a movement program. Moreover, the internal consistency of
the battery, expressed by the Cronbach’s alpha, was found to be a = .80. Given that the lower limit of Cronbach’s Alpha
value in order the internal consistency of a test to be considered as accepted is a = .70 (Cicchetti, 1994; Garson, 2006a,
2006b) and that this value increases as the number of the items included in a battery increase (Garson, 2006a) it can be
concluded that the findings of the present study support the internal consistency of the MOT 4–6 in Greek preschool
population.
A last but not least issue that should be discussed in order the suitability of the MOT 4–6 to be established, is its ecological
validity. Ecological validity is maximized when familiar materials are used and data are gathered in familiar environments.
Especially for preschoolers, their unique characteristics require a motor assessment that provides a high level of comfort
(Bailey & Wolery, 1989). Attending to these key characteristics makes sure that more accurate information is collected
(Bricker, 1989). The MOT 4–6 meets all the above requirements, as the materials needed for its implementation are very
common in the kindergartens. Moreover, the measurement does not require much space and it can take place in the school
environment. This is very important for the test use in Greece where most kindergartens are sited in the ground floors of
apartment buildings and do not have adequate space either inside or outside. Apart from that, Greek preschoolers’ positive
 A. Kambas et al. / Research in Developmental Disabilities 33 (2012) 1626–1632 1631

respond to the measurement should be noticed too. The children were enthusiastic with the test procedure, probably due to
the play-like measurement conditions.
Summarizing the aforementioned, the MOT 4–6 seems to be a useful tool in order the motor development of Greek
preschoolers to be displayed and their possible motor difficulties to be identified, comprising the whole range of
developmental levels, with sufficient test–retest reliability and internal consistency. Regarding MOT 4–6 norms, their
lowering is not considered essential, however both the official State and all these who are involved in children’s education
(physical educators, parents and teachers) have to reinforce their efforts for increasing children’s physical activity.

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