Peabody assessment

The Peabody Developmental Motor Scales- Second Edition (PDMS-2)

The Peabody Developmental Motor Scales, Second Edition (PDMS-2) is a standardized assessment used to measure motor skills, identify motor deficits, and determine eligibility for disability services. The PDMS-2 (2nd edition) is still in use, as the PDMS-3 was published in May of 2023. 

Updates to PDMS (or the PDMS-3) include a more in-depth assessment of gross and fine motor skills, changes to test item names, and a new physical fitness section to reflect current literature’s interest in overweight and obesity in today’s children.

What is PDMS-2 used for?

The purpose of the PDMS-2 is to assess fine and gross motor skills in early childhood, identify motor delays, and determine a child’s functional capacity to aid in clinical decision-making. 

Occupational therapists often use this assessment in early intervention settings to determine the need for an occupational therapy motor program to improve motor deficits that may limit a child’s independence during their daily routine.

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Background of the PDMS-2

The original Peabody Developmental Motor Scales originated in 1983 by Rhonda Folio and Rebecca Fewell. At the time, there was no measure available to assess and guide interventions for young children. The current Peabody Developmental Motor Scales version (PDMS-2) was updated in 2000. Occupational and physical therapists, psychologists, early intervention specialists, adapted physical education instructors, and diagnosticians often use the assessment.

Overview of the Peabody Developmental Motor Scales

The PDMS-2 is normed for children ages birth to five years old. Evaluators can use it in clinical and educational settings. Depending on which subtests the evaluator uses, administration can take between 30 minutes – for partial completion of the test – to 90 minutes to complete the entire assessment. A total of 2,003 children were tested to gather normative data in various geographical locations in the United States. Validity studies show that the PDMS-2 is valid for many different subgroups and the general population.

Peabody Developmental Motor Scales subtests

The Peabody Developmental Motor Scales has a total of six subtests. The evaluator can complete some or several of the PDMS-2 subtests depending on the information they are looking to gather. Each subtest has an entry point unique to the child's chronological age. This prevents the examiner from administering tasks that are too easy or too difficult for the child. The examiner finds the baseline (three tasks in a row in which the child scored total points) and ceiling (three tasks in a row where the child could not score any points). This shortens the testing time and keeps the child engaged.

Subtests for the PDMS-2 include:

• Reflexes: This subtest is only given to infants up to 11 months old. It examines primitive reflexes, including walking, asymmetrical tonic neck reflex, landau, protecting, and righting reactions. This is a quick subtest with only eight items in it.

• Stationary: In this subtest, tasks are presented to test children’s ability to control their bodies.

• Locomotion: The locomotion subtest measures a child’s ability to move in a way that is appropriate for their chronological age. This may be crawling, walking, running, and even hopping and skipping for older children. 

• Object manipulation: This subtest starts at 12 months and measures ball skills such as kicking, throwing, and catching.

• Grasping: The grasp subtest measures a child’s ability to use their hands for increasingly complex movements and to hold objects.

• Visual-motor integration: This subtest involves hand-eye coordination activities such as visual tracking and reaching for objects, clapping hands, placing items in a designated spot, copying shapes, and early scissor skills.

Updates to the PDMS assessment include renamed subtests in the PDMS-3 with better descriptions of the skills required for each test item. The PDMS-3 also includes a physical fitness subtest respecting recent literature covering obesity and physical fitness in today’s youth and its impact on daily participation. 

The subtests for the PDMS-3 include: 

• Body control: Assesses the child’s postural reactions, ability to move their limbs, and ability to control their body while maintaining balance.

• Body transport: Same as Locomotion in the PDMS-2, assesses the child’s ability to move from one place to another including skills such as crawling, walking, jumping, and bearing weight.

• Object control: Associated with Object Manipulation in the PDMS-2, this subtest measures the child’s ability to manipulate items like throwing a ball or kicking. This subtest is reserved for children older than 12 months of age.

• Hand manipulation: Referred to as Grasp in the PDMS- 2 looks at child’s hand control for pinching and grasping.

• Eye-hand coordination: Formerly visual-motor integration that looks at skills such as copying prewriting designs and using scissors.

And one supplemental subtest:

• Physical fitness: A new subtest with the PDMS-3, assessing child’s physical health as related to participation in age-appropriate activities.

Normative values for the PDMS-3 were also updated, with a sample of 1,425 children tested from the spring of 2016 to the spring of 2021.

Populations the PDMS-3 assesses include children from birth through 5 years and 11 months. Scoring provides information for age equivalents, percentile ranks, scaled scores, and composite index scores for gross motor, fine motor, and total motor indexes.

Critics of this assessment argue that the test item organization and scoring procedures may not accurately predict a child’s developmental trajectory and may be difficult for children who have difficulty following directions to receive an accurate score on motor ability. 

Updates to the PDMS-3 aim to improve test item descriptions with updated explanations of the purpose of each test item.

What does the PDMS-2 test include?

• An examiner’s manual
• Profile/summary forms
• Examiner record booklets
• Guide to item administration
• Motor activities program
• Peabody motor development chart
• Test manipulatives: This is a mesh bag that includes a black shoelace, six square beads, twelve cubes, a bottle with a screw-on top, a button strip with three buttons, a pegboard, three pegs, a form board with three forms, a lacing card, measuring tape, masking tape, shape cards, and masters of items to trace and reuse (such as a circle for the child to cut out).

Additional items not provided in the PDMS-2 kit and may be required for some subtests include a rattle, a soft plush toy, a stopwatch, stairs with a 7-inch rise, scissors, cereal, and a board book, among other small items.

Administering the PDMS-2 assessment

This assessment requires approximately 60-90 minutes to administer and currently is only available to be administered using paper and pencil recording. Items are organized and administered with motor skills increasing in complexity as the test progresses. Scoring can be performed online using the PDMS-3 Scoring and Report System or by manually scoring paper recording forms. 

Structured observations are allowed for this assessment, with instructions for scoring included on the PDMS-3 scoring sheets, allowing the examiner to interpret more information without the need to view the examiner's manual. 

Therapists are encouraged to record details of their structured observations, including if the child understands the directions, their interest in each task, their ability to problem solve, or if the child can self-correct.

Scoring for the PDMS

The evaluator calculates the child's chronological age, selects the appropriate subtests and materials, and can get started with the examiner record booklet based on the suggested age range for each task. Instructions for administering each given task are present in the record booklet, so there is no need to reference another manual. 

The evaluator will have to manage the materials required for most items and differ between subtests. The evaluator will end the subtest when the child cannot get a score for three items in a row (the ceiling).

To score the Peabody Developmental Motor Scales, you'll need to use the examiner's manual. You can translate the raw scores based on the child's age into standard ones in the appendix. The results can be added and converted to total, gross, or fine motor subtests.

Therapists ask the child to perform each test item and score performance as a 2, 1, or 0.

• 2: Child performs skill meeting all criteria for mastering the skill.

• 1: Child performs a task but does not meet all the criteria for mastery, but demonstrates the skill is emerging.

• 0: Child cannot or does not perform skill at all with no demonstration that skill may be emerging. 

This test may move quickly, and caregivers can be present for administration, allowing transparency and a chance to establish rapport. Subtests can be administered separately or altogether, offering flexibility to which skills are tested per provider and the ability to align testing to the client's priorities. 

Scores describe information for age equivalents, percentile ranks, scaled scores, descriptive categories, and composite index scores for gross motor, fine motor, and total motor indexes, which can be used for eligibility of services and as a reliable outcome measure to monitor progress.

Composite scores can form either a gross motor or fine motor quotient, which may help individuals and teams determine eligibility for services such as physical or occupational therapy. The gross motor quotient comprises the reflex or object manipulation subtests plus the stationary and locomotion subtests. The fine motor quotient is a composite of the grasp and visual-motor subtests.

Pros and cons of the Peabody Developmental Motor Scales

The PDMS-2 is a comprehensive assessment of early childhood motor skills. However, the evaluation has areas of strength and areas that future editions could improve.

Pros:

• The ability to score for partial credit. This differs from the original PDMS-2 and allows for more precise scoring and the ability to capture emerging skills.

• The basal/ceiling design. This saves time for the evaluator and helps the child stay engaged by not presenting items that are too easy or too difficult.

• It is well-known among early childhood professionals. The PDMS-2 helps many therapists and clinical or educational teams determine service eligibility.

Cons:

• Managing materials. There are many small materials in the test kit, plus the ones the therapist is expected to provide. The number of materials introduced and removed for each task can prove disruptive to the child and inconvenient for the evaluator.

• The scoring booklet. It is very thick (28 pages!), and you cannot buy the booklet with only specific subtests.

• The descriptions of scoring criteria. Sometimes the requirements do not describe how the child performed the task. This can cause confusion on scoring and potentially inflate or deflate where the child’s scores.

Using PDMS results for treatment planning

This assessment can identify developmental delays in children, comparing a child’s motor skill competence compared to peers of the same age. Results from this assessment identify a client’s strengths, and weaknesses, identify motor delays, and are used as a regular outcome measure to monitor progress over time. Scoring information from the PDMS, including age equivalent, percentile rank, and descriptive categories, can be uniformly understood by caregivers and other members of the child’s care team. Task items include descriptions to aid clinicians in accurate scoring to support appropriate treatment planning and goal creation. Also included with the PDMS-2 is a planned program that provides motor activity ideas to promote a client’s progress in motor skill development. 

Collaborating with caregivers and other professionals

With a client-centered, strength-based approach to evaluation, caregiver involvement is crucial for building your client’s occupational profile during an initial evaluation. Information provided by the caregiver can give you a wider perspective on the child's functional ability and areas that need to be addressed based on their situation. 

The PDMS kit includes a developmental chart and descriptive language that help clinicians communicate, using direct and clear communication to share the results of their child’s motor skill profiles. Results from the PDMS can be shared with other professionals on the child’s care team, such as physicians, educators, and other therapists, to identify specific areas occupational therapy will address and offer scoring for monitoring progress as time goes on.

Strategies for effective collaboration with other professionals include clear documentation explaining what skills and activities occupational therapy plans to address. Reach out to your team members to discuss progress, barriers the client may face, or if you have concerns about the rate of progress. Effective communication with fellow team members can increase outcome success and promote quality coordinated care for your client.