The feasibility and reliability of the Test of Gross Motor Development (TGMD-3) for children with disabilities in regional Australia: a pragmatic pilot study

Aims: Evaluate feasibility and preliminary inter- and intra-rater reliability of the Test of Gross Motor Development, third edition (TGMD-3) for children with disabilities in regional Australia; comparing "live" and videorecorded scoring. Methods: Three physiotherapists (one familiar with TGMD administration, two unfamiliar) completed "live" administration and scoring. Five raters (three physiotherapists, two familiar and one unfamiliar, and two unfamiliar student physiotherapists) scored video-recordings at normal and slow speed. Semi-structured interviews explored raters' experiences using the TGMD-3 for children with disabilities in a regional context, and/or scoring via videorecording. Agreement within and among raters were reported using intraclass correlation coefficients. Results: Raters agreed that TGMD-3 was feasible in terms of acceptability (mean 22.5 min scoring, slow-speed assisted accuracy), practicality (minimal resources), demand (addressed client goals), and implementation and integration into practice in regional Australia. Subscale and total scores showed good-to-excellent intra-rater (ICC = 0.73-0.99), and moderate-to-good inter-rater reliability for all but one student rater (ICC = 0.29-0.88). Filming recommendations were developed to enhance scoring. Conclusions: The TGMD-3 is feasible and has acceptable reliability when measuring high-level gross-motor performance for children with disabilities in regional Australia using live or video scoring. Modifications to criterion descriptors and more disability-targeted training, are recommended to optimize scoring consistency for this population.