Miller Function & Participation Scales: M-FUN

Lucy Jane Miller, 2006

PURPOSE: To assess children’s visual motor, fine motor, and gross motor skills, in order to identify delays, determine eligibility for services, need for intervention and classroom adaptations, or need for further assessment of neuromotor status.

Performance component of the test is norm-referenced Participation component of the test is criterion-referenced

POPULATION:For children ages 2 years 6 months to 7 years 11 monthsCan also be used for older children to direct treatment or as an outcome measure (but don’t use norms)

ICF DOMAIN:M-FUN incorporates elements of body function, activities and participation domains

TEST MATERIALS: Examiner’s Manual Administration Directions Record forms (2 yrs 6 mo – 3 yrs 11 mo & 4 yrs to 7 years 11 mo)

o Form includes Test Observations Checklist and Neurological Foundations Profile

Workbooks (same age categories) Home observations checklist Classroom observations checklist Objects & toys needed for assessment Environment : quiet area, distractions minimized, enough room for all

activities, solid or carpeted surface, adequate lighting, good shoes or barefoot, child-size table and 2 chairs

TIME TO ADMINISTER:40 to 60 minutes for performance components, 5-10 minutes for participation component

TEST COMPONENTS: Performance component:

o workbook activities & play activitieso visual motor, fine motor, & gross motor gameso Age 2:6 – 5:11: 15 activities; age 6 – 7:11: 16 activitieso Norm-referenced

Participation component:

kmckellar Page 1 4/7/2023

o Home observation checklist, classroom observation checklist, test observations checklist

o Criterion-referenced

ADMINISTRATION: Warm-up activity to get acquainted Then do activities: natural, fun games that are typical of children’s daily

leisure and school activities. Use standard instructions: bolded in admin section of manual Keep other materials out of sight to ensure focus Administer items in order except for children who are more challenging

and need adaptation (note changes on record form): 1st Visual motor, 2nd Fine motor, 3rd Gross motor

Score sheet indicates equipment needed and time limits (if applicable) for each item. Answers are also noted on the score sheet.

Scoring is multifaceted. The child receives points for different aspects of the motor skill he or she is demonstrating

Do teaching and practice of item first (up to 60 sec.), then do actual test item.

Complete Behavior Ratings after each section of the test Complete Test Observations Checklist (p. 4 of the score sheet) during or

after the test

STRENGTHS: Neurological Foundations Profile is very useful clinically, particularly for

newer therapists Kids love it: skills are tested in a game format You can do and score sections independently For each activity, the examiner’s manual goes over the objectives of the

activity, information that you obtain about the child’s motor skills, what the performance results mean in relation to a child’s home or school environment, and an item analysis that indicates the neurological foundations for each task and the corresponding items. (p. 23 – 36)

The manual is very thorough, and relatively easy to follow.

LIMITATIONS: Limited age range for SAP Recording all of the components and following the standardized

instructions can be difficult (a lot to do and watch for at once). Suggestion: 2 assessors when starting to use this assessment.

The snack section means a bit more preparation - having crackers and a water bottle on hand. 

Reliability for Visual Motor section is fairly low for 7:0-7:11 age band (0.67)

STANDARDIZATION:

kmckellar Page 2 4/7/2023

Normative sample: 414 children in the USA, distributed throughout age bands, gender, geographic areas of USA, parent education (measure of socio-economic status), and ethnicity; 2004-2005.

Normative data in 6 month age bands except 5:0 –7:11 (1 year) Sample sizes for each age group ranged from 45-60 kids 6.8% of the children received some type of school service or were

identified as having a specific condition requiring PT or OT

VALIDITY: Test content: Reflects developmental progression of motor abilities in

children aged 2:6 to 7:11. Assesses VM, FM and GM skills relevant to tasks leading to early school success. The Neurological Foundations Profile (P.110-111) summarizes the areas of motor ability covered in each M-FUN test. Checklists also evaluate social participation in the home, classroom, and during testing; this is a key construct of the WHO-ICF. Response processes for the activities have excellent face validity because they are very functional activities.

Internal structure: Moderate correlations (0.47 to 0.58) between FM, VM, and GM scaled scores: supports the concept that these are indexes of different aspects of motor abilities

Relationship to other variables: Correlations between M-FUN scores and MAP (Miller Assessment of Preschoolers) ranged from moderate to high (0.47-0.83)

Clinical validity statistics: Excellent sensitivity (the probability that someone who has the condition will test positive for it) and good specificity (the probability that someone who does not have the condition will test negative) at –1 and –1.5 standard deviations below the mean when clinicians are testing a referral population.

RELIABILITY: Test-retest reliability: corrected reliability coefficients ranged from .77

(Visual Motor and Gross Motor) to .82 (Fine Motor): Moderately high Internal consistency: implies that the items in the domain tested are

measuring one construct. o For the standardization sample:

The average reliability coefficients were good (0.85 for VM) to excellent (0.90 for FM and 0.92 for GM).

Reliabilities were high for VM and FM for ages 2:6-5:11 (0.82 and 0.91).

Reliabilities for VM were lower for ages 6:0-6:11 (0.76) and 7:0-7:11 (0.67).

Reliabilities for FM were lower for ages 6:0-6:11 (0.79) and 7:0-7:11 (0.85).

GM reliabilities were 0.91-0.93 for all ages except 2:6-2:11 (0.88)

kmckellar Page 3 4/7/2023

Average reliability coefficients for the checklists were excellent, ranging from 0.95-0.96. When examined by age, coefficients ranged from very good (0.87) to excellent (0.98)

o For a clinical group: Similar to above, therefore equally reliable for measuring

skills of children from the general population and children who are at risk for motor impairment

Inter-rater reliability: Correlation between raters’ scores was 0.91 for VM, 0.93 for FM, and 0.91 for GM. (High degree of consistency.)

Standard error of measurement: related to reliability coefficients and variability of test scores. Can be used to place a confidence interval around the child’s score (the range of scores within which the child’s true score is likely to be).

kmckellar Page 4 4/7/2023