Name be V/I) TGMD TEST OFGROSSMOTOR

DEVELOPMENTSchool! Agency ~l,,-,,~-,-,-~-,-,rc=f.,-,-'.f ~ _

Sex: Male ~ Female G rade ---",J~ _Dale A. Ulrich

TESTING INFORMATION::::=""

2ND ~F-ESTING---.~--.----..

Year Month Day

Date Tested 2t:Jo& '1 Jg Date Tested

Date of Bi rth 17'14 10 /0 Date of Birth

Chronological Age Br 1/ '" g t'r I Chronological Age

(Ik, ..E...""J......", :r~ne!;:;; Examiner's Name

Year Month Day

Examiner's Name

Examiner's Title Examiner's Title

Purpose of Testing Purpose of Testing

RECORD OF SCORES

SubtestsRaw

Scores %ilesStd.

Scores I SubtestsRaw

Scores %ilesStd.

Scores

1ST TESTING 2ND TESTING

Locomotor Ski IIs Locomotor Ski lis

Object Control Skills Object Control Skills

Sum of Standard Scores = Sum of Standard Scores =

Gross Motor Development Quotient (GMDQ) = Gross Motor Development Quotient (GMDQ) =

COMMENTS/RECOMMENDATIONS

~Copyright 1985 by PRO·ED, Inc. Additional copies of this form (i'0552) may be purchased fromPRO-ED. 8700 Shoal Creek Blvd., Austin, Texas 78758, 512/451-3246

--- --~

~t6 .LOCOMOTOR SKILLS

Skill Equipment Directions Performance Criteria I 1st~

RUN 50 feet of clear Mark off two lines 50 1. Brief period where bothspace, colored feet apart feet are off the groundtape, chalk or

Instruct student to "run 2. Arms in opposition toother markingfast" from one line to legs, elbows bentdevicethe other 3. Foot placement near or on

a line (not flat footed)4. Nonsupport leg bent

approximately 90 degrees(close to buttocks)

GALLOP A minimum of 30 Mark off two lines 30 1. A step forward with thefeet of c Iear feet apart lead foot followed by aspace

Tell student to gallop step with the trailing footfrom one line to the to a position adjacent toother three times or behind the lead foot

Tell student to gallop2. Brief period where both I (feet are off the g rou nd

leading with one foot3. Arms bent and lifted to Hand then the other

waist level4. Able to lead with the right

and left foot

HOP A minimum of 15 Ask student to hop 3 1. Foot of nonsupport leg isfeet of clear times, first on one foot bent and carried in backspace and then on the other of the body

2. Nonsupport leg swings inpendular fashion toproduce force

3. Arms bent at elbows andswing forward on take off

4. Able to hop on the rightand Ieft foot

LEAP A minimum of 30 Ask student to leap 1. Take off on one foot andfeet of c Iear

Tell him/her to take land on the opposite footspace

large steps leaping from 2. A period where both feetone foot to the other are off the ground (longer

than running)3. Forward reach with arm I 1opposite the lead foot

HORIZONTAL 10 feet of clear Mark off a starting line 1. Preparatory movementJUMP space, tape or on the floor, mat, or includes flexion of both \other marking carpet knees with arms extended

devicesHave the student start behind the bodybehind the line 2. Arms extend forcefully ,

forward and upward,Tell the student to reaching full extension"jump far" above head

3. Take off and land on both )feet simultaneously4. Arms are brought (downward during landing

LOCOMOTOR SKILLS-

Skill Equipment Directions Performance Criteria 1st 2ndSKIP A minimum of 30 Mark off two lines 30 1. A rhythmical repetition of

1feet of clear feet apart the step-hop on alternatespace, marking

Tell the student to skip feetdevice

from one line to the 2. Foot of nonsupport leg (other three times carried near surfaceduring hop

3. Arms alternately moving in

Iopposition to legs atabout waist level

SLIDE A minimum of 30 Mark off two lines 30 1. Body turned sideways tofeet of clear feet apart desired direction of travel 1space, colored

Tell the student to slide 2. A step sideways followedtape or otherfrom one line to the by a slide of the trail ing Imarking deviceother three times facing foot to a point next to thethe same direction lead foot

. 3. A short period where both \feet are off the floor

4. Able to slide to the right 1and to the left side

LOCOMOTOR SKILLS SUBTEST SCORE

OBJECT CONTROL SKILLSSkill Equipment Directions Performance Criteria 1st 2ndTWO-HAND 4-6 inch light- Toss the ball softly to 1. Dominate hand grips bat ISTRIKE weight ball, the student at about above nondominant hand

plastic bat waist level2. Nondominant side of body

Tell the student to hit faces the tosser (feet Ithe ball hard parallel)Only count those tosses 3. Hip and spine rotation Ithat are between thestudent's waist and 4. Weight is transferred by (shoulders stepping with front foot

STATIONARY 8-10 inch Tell the student to 1. Contact ball with one DBOUNCE playground ball, bounce the ball three hand at about hip height'hard, flat surface times using one hand

2. Pushes ball with fingers I(floor, pavement)Make sure the ball is (not a slap)not underinflated

3. Ball contacts floor in front lRepeat 3 separate trials of (or to the outside of)foot on the side of thehand being used

OBJECT CONTROL SKILLS

iIII

Skill Equipment Directions Performance Criteria 1st 2nd

3.ration phase wherevs are flexed and Is are in front of body

extend inlration for ball Ilct

s caught and Ioiled by hands only

vs bend to absorb Ishoulders and waist.

KICK 8·10 inch plastic Mark off one line 30 1. Rapid continuous ,or slightly feet away from a wall approach to the balldeflated and one that is 20 feet

2. The truck is inclinedplayground ball, from the wall. Place thebackward during ball \30 feet of clear ball on the line nearest

space, tape or the wall and tell the contactother marking student to stand on the 3. Forward swing of the arm Idevice other line. Tell the opposite kicking leg

student to kick the ball4. Fallowing-through f"hard" toward the wall.

by hopping on nonkickingfoot

OVERHAND 3 tennis balls, a Tell student to throw the 1. A downward arc of theTHROW wall, 25 feet of ball "hard" at the wall throwing arm initiates the Iclear space windup

2. Rotation of hip and

\shoulder to a point wherethe nondominant sidefaces an imaginary target

3. Weight is transferred by

\stepping with the footopposite the throwinghand

4. FOllowing-through beyondball release diagonally \across body toward sideopposite throwing arm

OBJECT CONTROL SKILLS SUBTEST SCORE

pro:eCJ