Miller Function and Participation Scales

Miller Function and Participation Scales

1. Miller Function & Participation Scales Monica Kim, Johnny Nguyen, Nirali Patel, John Resurreccion

2. Agenda/Outline Introductions Background Description of M-FUN Administering the Assessment Summary Quiz

3. Monica Kim, OTS B.A in Human Development at UCSD in La Jolla, CA M.S in Occupational Therapy at Stanbridge University in Irvine, CA

4. Johnny Nguyen, OTS B.S in Exercise Science at Carroll University in Waukesha, WI M.S in Occupational Therapy at Stanbridge University in Irvine, CA

5. Nirali Patel, OTS B.A. in Psychology and Social Behavior at UCI in Irvine, CA M.S in Occupational Therapy at Stanbridge University in Irvine, CA

6. John Resurreccion, OTS B.S in Architecture at California State Polytechnic University in Pomona, CA M.S in Occupational Therapy at Stanbridge University in Irvine, CA

7. Introduction Standardized tool used to assess young children’s performance abilities as well as their participation in their daily life within their school and home environment Third assessment created by Lucy Jane Miller Ph.D., OTR, FAOTA Focuses on children’s developmental delays and challenges Created in 2006 Also developed Miller Assessment for Preschoolers in 1998 First STEp: a Screening Tool for Evaluating Preschoolers in 1993 Spirtos, M., & Cremin, K. (2008). Article: the Miller Function and Participation Scales, M-FUN-PS: a critical appraisal. Irish Journal Of Occupational Therapy, 36(2), 24-27.

8. Development of the M-FUN-PS The International Classification of Function, Disability, and Health (ICF) called for need to focus less on disability and more on the needs and abilities of the whole child M-FUN combines ideologies and terminology from different constructs in order to create a comprehensive assessment tool Evaluates a child’s performance within the context of his or her life situation by examining participation, activities, and foundations Provides a functional framework and normative information to assist in determining eligibility for services Miller, L.J. (2006). Miller Function and Participation Scale (M-FUN). San Antonio, TX: Harcourt Assessment Inc.

9. Uses M-FUN can be administered to determine or identify the following: A visual motor, fine motor, and/or gross motor delay Eligibility for services to address motor delays Motor abilities that may benefit from home and/or classroom adaptations and accommodations Underlying neuromotor foundational issues Curriculum-relevant interventions A child’s progress toward intervention goals Miller, L.J. (2006). Miller Function & Participation Scales: M-FUN [computer software]. Available from www.therapybc.ca/eLibrary/docsResources/M-FUN%20Assessment%20Review.doc

10. Purpose Designed for children 2 years 6 months through 7 years 11 months May be used for children older than 7 years 11 months with developmental delays, but there is no normative data available for this population Includes a performance and participation component Performance component includes a workbook to stimulate visual motor abilities and play activities to assess fine and gross motor abilities Participation component includes observation checklists which rate a child’s participation in home and school environments Miller, L.J. (2006). Miller Function & Participation Scales: M-FUN [computer software]. Available from www.therapybc.ca/eLibrary/docsResources/M-FUN%20Assessment%20Review.doc

11. Population Assessment is geared towards children who may have mild to moderate motor delays The M-FUN addresses an age range from 2 years 6 months to 7 years 11 months Can be used for older children in the intervention planning process Can be used as an outcome measure without the normative component* Miller, L.J. (2006). Miller Function & Participation Scales: M-FUN [computer software]. Available from www.therapybc.ca/eLibrary/docsResources/M-FUN%20Assessment%20Review.doc

12. Performance Component Yields a visual motor, fine motor, and gross motor normative scale score Each test may be administered independently or all at once Consists of 15 activities for children ages 2 years 6 months to 5 years 11 months 16 activities for children ages 6 years 0 months to 7 years 11 months For children of all ages, a Behavioral Rating assessment is given following each test Miller, L.J. (2006). Miller Function & Participation Scales: M-FUN [computer software]. Available from www.therapybc.ca/eLibrary/docsResources/M-FUN%20Assessment%20Review.doc

13. Participation Component Includes three measures of a child’s participation at home or school The Home Observations Checklist Caregiver rates child’s participation in ADL’s and leisure in the home on a 4-point scale The Classroom Observations Checklist Teacher or examiner rates child’s participation in classroom activities on a 4-point scale The Test Observation Checklist Examiner rates child’s behavior during M-FUN testing on a 4-point scale Miller, L.J. (2006). Miller Function & Participation Scales: M-FUN [computer software]. Available from www.therapybc.ca/eLibrary/docsResources/M-FUN%20Assessment%20Review.doc

14. Validity & Reliability Inter rater reliability Used five pairs of examiners for 29 children Correlation between rater’s scores .91 for visual motor .93 for fine motor .91 for gross motor Validity Comparison between M-FUN-PS and the Miller Assessment of Preschoolers (MAP) Correlation ranged from 0.47 - 0.83 Fine motor = 0.83 Gross motor = 0.47 Spirtos, M., & Cremin, K. (2008). Article: the Miller Function and Participation Scales, M-FUNPS: a critical appraisal. Irish Journal Of Occupational Therapy, 36(2), 24-27.

15. Standardization Process Norm-referenced data enables administrators to compare a child’s score to the performances of other children in the same age in the standardization sample. Normative sample: 414 children in the USA, distributed throughout age bands, gender, geographic areas of U.S., parent education (measure of socioeconomic status), and ethnicity; 2004-2005. Normative data reported in 6 month age intervals 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 Miller, L.J. (2006). Miller Function & Participation Scales: M-FUN [computer software]. Available from www.therapybc.ca/eLibrary/docsResources/M-FUN%20Assessment%20Review.doc

16. Administering the M-FUN Hidden Forks (visual motor; 60 sec) Jumping Game (gross motor; 10 sec, 60 sec) Copying a Sentence (fine motor; 90 sec) Draw a Kid Game (fine motor; 60 sec) Throw & Catch Game (gross motor) Miller, L. J. (2006). Miller function & participation scales: Examiner’s manual. Bloomington, MN: NCS Pearson, Inc.

17. Hidden Forks Miller, L. J. (2006). Miller function & participation scales: Examiner’s manual. Bloomington, MN: NCS Pearson, Inc. ① Point to fork on top of page and say: “See the fork right here? Mark this fork with your pen.” ② Use your finger to make a slash over the fork, then instruct child to do the same with pen. ③ Point to spoon at top of page and say: “Here is a spoon. Do not mark any spoons.”

18. Hidden Forks Miller, L. J. (2006). Miller function & participation scales: Examiner’s manual. Bloomington, MN: NCS Pearson, Inc. ④ Direct child to rest of page and say: “This picture has forks and spoons hidden in the picture. Just mark the forks.” ⑤ Then say: “Do not mark any spoons.” ⑥ Provide cues as necessary if child has not found all forks before 30 seconds are up.

19. Hidden Forks Miller, L. J. (2006). Miller function & participation scales: Examiner’s manual. Bloomington, MN: NCS Pearson, Inc.

20. Throw and Catch Game ① Have the child stand on a mat. ② Place a small ball in the child’s hands and say: “Hold the ball! I’m going to stand over there. ③ Stand 4 ft from the child and extend your arms and say: “Okay, now throw the ball to me” ④ Provide the child with as many opportunities as needed to understand the task. ⑤ Perform the throwing and catching task standing 8 ft and 12 ft apart. Miller, L. J. (2006). Miller function & participation scales: Examiner’s manual. Bloomington, MN: NCS Pearson, Inc.

21. The Jumping Game Teaching and Practice Item - Have the child stand on the mat and say: “Now we are going to jump! Stand here. Jump up and down!” Use verbal cues as necessary. You may demonstrate task or cue hips (Note: if child cannot do this task, skip items 1 to 6 and go to last page of record form for follow-up questions) ① Jump in place (10 seconds) “Now jump in place. I’ll tell you when to stop” ② Jump in together/out together (10 seconds) “In” (while feet are in), “Out” (while feet are out) Miller, L. J. (2006). Miller function & participation scales: Examiner’s manual. Bloomington, MN: NCS Pearson, Inc.

22. The Jumping Game ③ Jump side to side (10 seconds) “Now you’re going to jump from side to side. Start here.” “Now I’ll go back to the other side” “Now you jump . I’ll tell you when to stop” ④ Jump forward and backward (10 seconds) “Now you’re going to jump forwards and backwards. Do this” “Now you jump forwards and backwards until I tell you to stop.” Miller, L. J. (2006). Miller function & participation scales: Examiner’s manual. Bloomington, MN: NCS Pearson, Inc.

23. The Jumping Game ⑤ Jump in triangle pattern (10 seconds) “This is a fun one! We’re going to jump in a triangle.” “Now jump from here until I tell you to stop.” ⑥ Jump (60 seconds) “This is the last jump! Jump up and down right here until I tell you to stop.” Miller, L. J. (2006). Miller function & participation scales: Examiner’s manual. Bloomington, MN: NCS Pearson, Inc.

24. Copying a Sentence Miller, L. J. (2006). Miller function & participation scales: Examiner’s manual. Bloomington, MN: NCS Pearson, Inc. ① Instruct child to look at page. Say: “This sentence says Fuzzy ducks jump over the white box. When I say go, copy this sentence on these lines. Remember to write neatly. Ready? Go!” ② Record the number of letters the child writes in the first 20 seconds, then between 20 to 40 seconds, and then between 40 to 60 seconds. Record the total number of seconds to complete the task. The time limit allowed is 120 seconds ③ If child is unable to print two consecutive words, gets frustrated, or is not finished within the 120 second time limit, discontinue the game

25. Copying a Sentence Miller, L. J. (2006). Miller function & participation scales: Examiner’s manual. Bloomington, MN: NCS Pearson, Inc.

26. Drawing A Kid Game ① Draw a picture of yourself on a blank page (Make sure to include a head, body, arms, legs, facial features, and clothes; do not include fine details such as belts or buttons) ② Instruct child to draw picture on separate page and include a head, body, arms, legs, facial features, and clothes. Provide cues as necessary to ensure child understands task ③ Once child is ready to draw, remove the sample image and say that he or she has one-minute to finish

27. Drawing A Kid Game

28. Drawing A Kid Game

29. Benefits of the M-FUN-PS Client-centered The assessment is geared towards children, and they find it fun and appealing Holistic Compared to other assessments who solely focus on acquiring a child’s motor abilities Scores on the observation checklist help provide an indication as to how poor the motor performance affects a child’s participation at home or school Leniency Parts of the assessment can be utilized without completing in its entirety Example: an OT can get standardised results for visual motor and gross motor without doing the fine motor component or observation checklists Coverage Basic skills required for a child entering school, such as visual scanning and tracking, scissor skills, and ability to sit for a prolonged time (45 minutes) are addressed throughout the assessment Miller Function & Participation Scales (M-FUN-PS) Review. (2016, January 13). OT Equip [Blog post]. Retrieved from http://otequip.info/2016/01/13/mfun.html

30. Complications of M-FUN-PS Gross motor section can be difficult Requires prior setup of measured lines and markers Requires smooth walls and concrete floors for a ball can be kicked for soccer section Obtaining a standardized score can be troublesome If one item in a performance domain can’t be done, the standard score for the domain can’t be calculated Ex: If it starts raining, the soccer game may not be completed, and the standardised gross motor section can’t be obtained; even for upper body items Preparation time May take a longer preparation time than other assessments that are similar Completion of activity Children don’t always get to finish their work, may hinder establishing rapport Children may lose the sense of accomplishment Miller Function & Participation Scales (M-FUN-PS) Review. (2016, January 13). OT Equip [Blog post]. Retrieved from http://otequip.info/2016/01/13/mfun.html

31. Summary/Conclusion The M-FUN-PS is a comprehensive assessment that measures all aspects of a child’s performance ability in their home and school environment The assessment is client-centered, and the child enjoys completing the VM, GM, and FM activities required The examiner can choose to complete certain sections, rather than administering the test completely The M-FUN-PS can be used with older children as an outcome measure or intervention planning Miller, L.J. (2006). Miller Function and Participation Scale (M-FUN). San Antonio, TX: Harcourt Assessment Inc.

32. References Miller Function & Participation Scales (M-FUN-PS) Review. (2016, January 13). OT Equip [Blog post]. Retrieved from http://otequip.info/2016/01/13/mfun.html Miller, L. J. (2006). Miller function & participation scales: Examiner’s manual. Bloomington, MN: NCS Pearson, Inc. Miller, L.J. (2006). Miller Function and Participation Scale (M-FUN). San Antonio, TX: Harcourt Assessment Inc. Miller, L.J. (2006). Miller Function & Participation Scales: M-FUN [computer software]. Available from www.therapybc.ca/eLibrary/docsResources/M-FUN%20Assessment%20Review.doc Spirtos, M., & Cremin, K. (2008). Article: the Miller Function and Participation Scales, M-FUN-PS: a critical appraisal . Irish Journal Of Occupational Therapy, 36 (2), 24-27.