Pediatric Developmental Motor Assessment Inspection

Standardized inspection template to document administration of pediatric motor assessments such as the Peabody Developmental Motor Scales or BOT-2, capture score results, and record developmental age equivalents for identifying potential developmental delays.

Assessment Details

• Assessment date and time documented
• Child age at time of assessment documented
• Standardized motor assessment identified
• Assessment purpose documented
  Document whether the assessment was completed for screening, baseline evaluation, progress monitoring, or discharge planning.

Testing Conditions and Child Readiness

• Child was alert, medically stable, and able to participate
• Testing environment was quiet, safe, and free from distractions
• Required accommodations or modifications documented
  Document any approved accommodations such as rest breaks, adaptive positioning, interpreter support, or sensory supports, and note whether they were consistent with standardized administration rules.
• Behavior, attention, and cooperation level documented

Administration Fidelity

• Test instructions were delivered consistently with the manual
• Items were administered in the correct sequence and age-appropriate start point
• Basal and ceiling rules were applied and documented
• Any deviations from standardized administration were documented

Scoring and Developmental Interpretation

• Raw scores documented for each administered subtest
• Standard scores or percentile ranks documented
• Developmental age equivalents documented where applicable
• Results interpreted for gross motor, fine motor, or overall motor delay

Clinical Summary and Follow-Up

• Summary includes functional impact of motor findings
• Recommendations for therapy, referral, or re-evaluation documented
• Results communicated to caregiver or referring provider as appropriate
• Inspector sign-off completed