Bruininks-Oseretsky Test of Motor Proficiency – 2nd Edition

The Bruininks-Oseretsky Test of Motor Proficiency, 2nd Edition (BOT-2) is a standardized assessment used by physical and occupational therapists. This assessment is appropriate for children and adolescents aged four to 22. Oseretsky first published the evaluation in Russia in 1923. The latest update, however, is from 2005. It is commonly used in pediatric outpatient and school-based settings and stands out from other assessments due to its wide age span and sensitivity.

The assessment is task-based, and the evaluator records scores in each section based on the client's performance. A number is assigned based on the number of items completed, the time, or if the child passed the task. Overall, the assessment is fast-paced and tends to be engaging and fun for many pediatric clients.

What does BOT-2 measure?

The assessment has four subtests that break down into eight composites.

  • The fine manual control subtest consists of fine motor precision and integration tasks. Each of these composites is untimed. For fine motor precision, the child will fold paper and cut on a line. To demonstrate fine motor integration skills, the child will draw increasingly complex shapes.
  • Manual coordination is made up of manual dexterity and upper body coordination composites. To demonstrate dexterity, the child practices moving small items (like pennies and pegs) and stringing beads with speed and accuracy. The upper-body coordination category measures hand-eye coordination for tasks like throwing and catching a ball.
  • The body coordination subtest is composed of bilateral coordination and balance tasks. In the bilateral coordination subtest, the child will perform items like jumping jacks and simultaneously tapping alternating hands and feet. For the balance composite, trunk stability, postural control, and using visual cues is addressed by balancing with and without movement and sight.
  • The strength and agility subtest has composites that include running speed, agility, and strength. In these composites, the child will hop, run, and perform sit-ups and push-ups to demonstrate upper and lower body strength.

What does the BOT-2 include?

The BOT-2 can be purchased as an entire kit with materials to administer both fine and gross motor components or separately if only one is needed. Materials are high quality, with some being developed specifically for the test (the penny set) and others easily accessible (a tennis ball).

The fine motor kit includes:

  • An instruction manual
  • A supplemental manual
  • An administration easel (this contains pictures and instructions of the tasks to be completed)
  • Record forms for 25 clients
  • 25 Examinee booklets for tasks such as coloring and cutting (you’ll use one per client)
  • A scoring transparency
  • Blocks and string
  • Penny box, pad, and plastic pennies
  • Red pencil
  • Scissors
  • Target to be taped to the wall
  • Tennis ball
  • Shape cards
The gross motor kit includes both manuals, the administration easel, record forms, and target, as well as:
  • A shuttle block
  • Balance beam
  • Knee pad

Tips for using the BOT-2

Schedule plenty of time. The entire test takes about an hour to complete, but depending on your client's needs, it may take longer. Because the test is standardized, you'll spend much of the evaluation explaining the rules for each task and ensuring that the child understands. For some children, it is appropriate to schedule breaks or administer the test over two sessions.

Take notes. You'll have the chance to make various clinical observations while administering the assessment. Don't forget to write down comments about hand preference, tool grasp, posture, regulation, movement quality, ability to follow multi-step directions, etc. Since the test is standardized, if necessary, you'll also want to note any accommodations or modifications you make.

Use the short form. If you are performing a screen or have limited time to complete an evaluation or re-evaluation, the Short Form is a helpful tool that only takes about 20 minutes to complete. However, suppose you are looking for complete data regarding both fine and gross motor skills (for example, an initial evaluation to check for eligibility for OT and PT). In that case, the complete form will give you the most information.

Try online scoring. Professionals who conduct frequent evaluations will save time by purchasing a subscription to Pearson's Q-Global. The evaluator can add online scoring and reporting a la carte, or you can get unlimited access with a digital subscription fee.

How to score the BOT-2

The scoring manual is an essential part of the BOT-2 kit, as using it will give meaning to the raw scores you captured during the assessment. The first step in scoring is to determine the client's chronological age. Scale scores will differ depending on the child's age and sex, and the scoring manual is categorized by age. After locating the correct age group, you can convert raw scores to scale scores.

Scale scores are then converted to standard scores and percentile ranks. Confidence intervals, z-scores, age-equivalents, and a total motor component can all be calculated with the scoring manual index. A descriptive category (ranging from well-above-average to well-below-average) is then assigned.

Disadvantages of using the BOT-2

While the BOT-2 provides comprehensive data, there are some slight disadvantages:

Managing materials: While you are testing a child, you'll need to have the scoring booklet nearby, the administration easel, and the materials for the given task. Time spent flipping through pages of the easel (each task is one page) takes your eyes off the client and limits the time you can make clinical observations. Managing the many testing materials can be tricky when the client has special needs or attentional challenges.

The price: If you want to purchase the entire kit with gross and fine motor subtests and materials, the starter kit will run $1,055. You can buy just the fine or gross motor components (you may want to do this if your practice is exclusively PT or OT), but that will still cost $636.

BOT-2 advantages

The Short Form: The Short Form is an excellent option for busy clinicians and provides sufficient data for a quick and easy-to-score screen.

It is engaging: A functional pediatric motor assessment should be fast-paced and engaging. This test is both. Older children will love the challenges, and younger clients will enjoy the novelty.

A single scoring form: For this assessment, you assign points and obtain standardized scores all on the same recording form. This differs from the Peabody Developmental Motor Scale or  PDMS-2 in which you must transfer scores from the actual test to a summary form.

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The Bruininks-Oseretsky Test of Motor Proficiency – 2nd Edition is an excellent resource for physical and occupational therapists interested in delving into their clients' gross and fine motor skills. The wide age range and ability to administer it in different settings make it an assessment of choice for many therapists.

TheraPlatform provides many built-in tools for pediatric motor intervention, from reinforcers to games and activities designed for occupational therapists. Through TheraPlatform, you can quickly look up ICD-10 codes which auto-populate to your documentation, billing, and claims. TheraPlatform, an all-in-one EHR, practice management and teletherapy tool was built for therapists to help them save time on admin tasks. TheraPlatform offers a 30-day-free trial. No credit card is required.  

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