Research Quarterly for Exercise and Sport ISSN: 0270-1367 (Print) 2168-3824 (Online) Journal homepage: http://www.tandfonline.com/loi/urqe20 SKIPing With Head Start Teachers: Influence of TSKIP on Object-Control Skills Ali Brian, Jacqueline D. Goodway, Jessica A. Logan & Sue Sutherland To cite this article: Ali Brian, Jacqueline D. Goodway, Jessica A. Logan & Sue Sutherland (2017): SKIPing With Head Start Teachers: Influence of T-SKIP on Object-Control Skills, Research Quarterly for Exercise and Sport, DOI: 10.1080/02701367.2017.1375077 To link to this article: http://dx.doi.org/10.1080/02701367.2017.1375077 Published online: 19 Oct 2017. Submit your article to this journal Article views: 5 View related articles View Crossmark data Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=urqe20 Download by: [Tufts University] Date: 27 October 2017, At: 17:27 RESEARCH QUARTERLY FOR EXERCISE AND SPORT https://doi.org/10.1080/02701367.2017.1375077 SKIPing With Head Start Teachers: Influence of T-SKIP on Object-Control Skills Ali Brian ,1 Jacqueline D. Goodway,2 Jessica A. Logan,2 and Sue Sutherland2 University of South Carolina; 2The Ohio State University Downloaded by [Tufts University] at 17:27 27 October 2017 1 ABSTRACT ARTICLE HISTORY Purpose: Children from disadvantaged settings are at risk for delays in their object-control (OC) skills. Fundamental motor skill interventions, such as the Successful Kinesthetic Instruction for Preschoolers (SKIP) Program, are highly successful when led by motor development experts. However, few preschools employ such experts. This study examined the extent to which Head Start teachers delivering an 8-week teacher-led SKIP (T-SKIP) intervention elicited learning of OC skills for Head Start children. Method: Head Start teachers (n = 5) delivered T-SKIP for 8 weeks (450 min). Control teachers (n = 5) implemented the typical standard of practice, or well-equipped free play. All children (N = 122) were pretested and posttested on the OC Skill subscale of the Test of Gross Motor Development-2. Results: Descriptive analyses at pretest identified 81% of the children were developmentally delayed in OC skills (below the 30th percentile). A 2-level hierarchical linear model demonstrated the effectiveness of T-SKIP with significant differences (β = 4.70), t(8) = 7.02, p < .001, η2 = .56, between T-SKIP children (n = 63) and control children (n = 59) at posttest. Conclusion: Head Start teachers who delivered T-SKIP could bring about positive changes in children’s OC skills, thereby remediating the initial developmental delays presented. Control children remained delayed in their OC skills in spite of daily well-equipped free play, giving rise to concerns about their future motor competence and physical activity levels. Received 19 June 2016 Accepted 23 August 2017 Opportunities to engage in movement experiences are important to the overall development of a child (Gehris, Gooze, & Whitaker, 2015). Engagement with movement experiences enables children to explore the environment, which facilitates a child’s learning and cognitive development (Gehris et al., 2015), creativity (Davies, 1996), socialization skills (Mashburn & Pianta, 2006), and motor development (Gallahue, Ozmun, & Goodway, 2012). In recognition of the importance of movement experiences in the early years, SHAPE America – Society for Health and Physical Educators America created its Active Start Guidelines for children aged 0 to 5 years to provide a framework for early childhood educators to implement physical activity with their students (National Association for Sport and Physical Education [NASPE], 2009). The Active Start Guidelines state that “all children ages birth to five should engage in daily physical activity that promotes health-related fitness and movement skills” (NASPE, 2009, p. 4), and they include the following recommendations for preschoolers: (a) Each day, preschoolers should accumulate at least 60 min of structured physical activity; (b) preschoolers should engage in at least 60 min or more of unstructured physical activity per day and should not be sedentary for more than 60 min at a time; (c) preschoolers should develop competence in CONTACT Ali Brian © 2017 SHAPE America email@example.com KEYWORDS Fundamental motor skills; motor development; motor skill interventions; physical education fundamental movement skills; (d) preschoolers should have safe indoor and outdoor areas for movement; and (e) caretakers of preschoolers should be aware of the importance of physical activity and facilitate the child’s movement skills (NASPE, 2009). The Active Start Guidelines recommend both unstructured free play and structured gross motor activities as part of an overall balanced gross motor development program (NASPE, 2009). Early childhood centers generally provide 20 min to 60 min of well-equipped daily free play as the typical standard of practice aimed at fostering gross motor skill development and providing physical activity (McWilliams et al., 2009). However, although important for young children, free play alone may not be sufficient to foster the development of fundamental motor skill (FMS) competence (Altunsöz & Goodway, 2016; Brian, Goodway, Logan, & Sutherland, 2017; Logan, Robinson, Wilson, & Lucas, 2011; Riethmuller, Jones, & Okely, 2009). Fundamental motor skills are the building blocks to more complex movement patterns (e.g., games, sports, and lifestyle activities; Clark & Metcalfe, 2002) and physical activity participation (Robinson et al., 2015; Stodden et al., 2008). Fundamental motor skills consist of locomotor skills (e.g., running, leaping, and jumping), stability skills (e.g., bending, twisting, and curling), and object-control (OC) Department of Physical Education, University of South Carolina, 1300 Wheat Street, Columbia, SC 29208. Downloaded by [Tufts University] at 17:27 27 October 2017 2 A. BRIAN ET AL. skills (e.g., throwing, dribbling, and kicking). For young children, OC skills are particularly important, as they are critical for participating in sports, games, and activities. For example, to play T-ball safely, a child needs to be able to catch a ball. To play a game of soccer, children need to kick the ball. Not only are OC skills important to engagement in sports and games for young children, but they are also associated with future participation in physical activity in adolescence (Barnett, Van Beurden, Morgan, Brooks, & Beard, 2009). Participating in physical activity combats diseases associated with sedentary lifestyles such as Type 2 diabetes, certain cancers, and sleep apnea (Institute of Medicine, 2011). Developing OC competence is a particularly important developmental outcome for young children and adolescents (Barnett et al., 2009). Two specific populations are particularly vulnerable to delays in their FMS: children from socioeconomically disadvantaged settings (Goodway & Branta, 2003) and girls (Goodway, Robinson, & Crowe, 2010). Children from socioeconomically disadvantaged settings (e.g., growing up in poverty) may have disparate opportunities to develop their FMS (Goodway & Branta, 2003). Indeed, many young children from disadvantaged settings consistently demonstrate delays in their FMS (Goodway & Branta, 2003; Goodway et al., 2010; Martin, Rudisill, & Hastie, 2009; Parish, Rudisill, & St. Onge, 2007; Robinson & Goodway, 2009; Valentini & Rudisill, 2004). In addition to socioeconomic status, young girls tend to demonstrate greater delays in their OC skills compared with young boys (Goodway et al., 2010). Although it is not completely understood why socioeconomic status and sex exacerbate motor skill delays (Goodway & Smith, 2005), it is well documented that early intervention is effective for remediating motor skill delays that may be present (Logan et al., 2011; Riethmuller et al., 2009). Recognizing the need for early intervention, motor development experts have developed structured programming to remediate and prevent motor skill delays among young boys and girls (Brian et al., 2017; Goodway & Branta, 2003; Martin et al., 2009; Parish et al., 2007; Robinson & Goodway, 2009; Valentini & Rudisill, 2004). One such approach is the Successful Kinesthetic Instruction for Preschoolers (SKIP) intervention (Altunsöz & Goodway, 2016; Brian et al., 2017; Goodway & Branta, 2003). After as little as 6 weeks (Brian et al., 2017) and as long as 12 weeks (Goodway & Branta, 2003), children who participated in the SKIP motor skill intervention, implemented by motor development and physical education experts, were able to remediate their FMS delays with powerful effect sizes ranging from η2 = .63 (Brian et al., 2017) to η2 = .89 (Goodway & Branta, 2003). The control groups within these studies participated in the early childhood center’s everyday curriculum of well-equipped free play monitored by the classroom teachers (Brian et al., 2017; Goodway & Branta, 2003; Robinson & Goodway, 2009). Although free play is an important part of a child’s day, it is important to note that the control children’s FMS skills remained delayed in spite of daily free play-based movement opportunities (Brian et al., 2017; Goodway & Branta, 2003; Robinson & Goodway, 2009), thereby placing them at risk for current and future sedentary behaviors (Robinson et al., 2015; Stodden et al., 2008). Furthermore, Stodden and colleagues’ (2008) developmental trajectory model suggests that children with low FMS competence will be drawn into a negative spiral of disengagement ultimately resulting in low levels of physical activity and a greater likelihood to be overweight or obese. Although motor skill interventions such as SKIP are very effective when implemented by experts (Logan et al., 2011; Riethmuller et al., 2009), little is known as to whether preschool classroom teachers can produce FMS outcomes if they implement motor skill interventions. A number of barriers to preschool teachers implementing motor skill interventions/structured motor programming are present (Hughes, Gooze, Finkelstein, & Whitaker, 2010). These barriers include: (a) a lack of confidence with their ability to perform the content, (b) limited or no equipment, (c) inadequate space, (d) a lack of time in the school day, (e) increased pressure to meet reading and math learning outcomes (Hughes et al., 2010), (f) little awareness of the Active Start Guidelines (Brian et al., 2017), (g) a lack of policy requiring structured motor programming (Brian, Pennell, Sacko, & Schenkelburg, in press; McWilliams et al., 2009), and (h) inadequate professional development opportunities within motor development and/or physical education for in-service teachers (Gehris et al., 2015; Hughes et al., 2010). Given the aforementioned barriers, there is a need to examine the fidelity of preschool teachers implementing a motor skill intervention such as SKIP. Fidelity refers to the extent to which an intervention is delivered as intended and provides a measure of internal validity (Carroll et al., 2007). Along with assessing fidelity, it is also important to examine the effectiveness of a teacher-led motor skill intervention on preschoolers’ learning of OC skills for boys and girls from disadvantaged settings. Intervention effectiveness examines the extent to which an intervention produces a desired result or effect (Guzik & Queenan, 2003). To address the barriers surrounding gross motor programming, it has been suggested that preschool teachers need to receive ongoing coaching, support, SKIPING WITH HEAD START TEACHERS Downloaded by [Tufts University] at 17:27 27 October 2017 and professional development in motor development and physical education (Gehris et al., 2015). Therefore, the purposes of this study were: (a) to examine the fidelity of Head Start preschool teachers implementing the teacher-led SKIP (T-SKIP) Program with ongoing coaching and support, and (b) to determine the effectiveness of T-SKIP on the OC skills of preschool boys and girls who are socioeconomically disadvantaged. To our knowledge, this study is the first to examine the effectiveness of a motor skill intervention implemented by classroom preschool teachers on the OC skills of young children. This study is significant because our results have the potential to translate across Head Start centers throughout the United States as an ecologically valid strategy to teach FMS. Methods Setting and participants Head Start is a federally funded early childhood program serving children from socioeconomically disadvantaged families with income at or less than 130% of the poverty line (U.S. Department of Health and Human Services, 2017). Five Head Start preschool centers were randomly selected from within a larger coalition of Head Start centers (N = 25) in a large, urban Midwestern city. All Head Start centers in this coalition used the same curriculum, featured the same schedule, and were all located in similar settings. Teachers (N = 10; aged 25–55 years) were randomly assigned to either the T-SKIP (n = 5) or control (n = 5) conditions. All teachers volunteered to participate. Teachers (1 man, 9 women) included Caucasian (n = 4), African American (n = 4), Hispanic (n = 1), and Asian (n = 1) participants. Teachers ranged in years of teaching experience (1–20 years, M = 5 years) and all had earned a bachelor’s degree in education with a teaching certification. No teachers possessed a master’s degree. No teachers claimed to have received any college coursework in motor development or physical education. Most of the teachers claimed no sporting or physical activity experience (n = 7), while 2 teachers claimed limited experience such as recreational yoga. One teacher self-reported no sporting or physical activity experience beyond walking for leisure. The children (N = 122) in this study were purposely selected and assigned from within either the T-SKIP classrooms (n = 63) or the control Head Start classrooms (n = 59) of the participating teachers. No children in this study possessed a documented disability. Children in the T-SKIP intervention group (37% boys, Mage = 4.7 years, SD = 2.4) possessed an ethnic/racial breakdown that included African American (n = 31; 49%), Caucasian (n = 9; 14%), Hispanic (n = 21; 34%), and Asian (n = 2; 3 3%). Control children (46% girls, Mage = 4.8 years, SD = 1.9) were students in classrooms of control teachers and did not participate in T-SKIP. The control children’s demographic breakdown was African American (n = 26; 44%), Caucasian (n = 4; 7%), Hispanic (n = 6; 10%), Asian (n = 0; 0%), and Other (n = 23; 39%). Procedures A university institutional review board granted permission to conduct this study prior to its start. Children assented to participate after each child’s parent/guardian provided written consent. Teachers consented to participate voluntarily upon receiving an invitation from Head Start area managers to participate in this study. Upon receiving consent, teachers subsequently participated in a 6-hr initial coaching session on T-SKIP when they first filled out a demographic questionnaire. During the first hour of the session, teachers received an information session discussing motor development and physical education content, theory, and principles. In addition, teachers were provided with a rationale for delivering T-SKIP to their children as well as all materials necessary to conduct the intervention. Teachers then participated in a 3-hr session, which featured active learning of motor skills (throw, catch, kick, strike, dribble, and roll) and physical education principles and content. All content covered during both the information session and the active-learning session aligned with the outcome measures of this study for both teachers and children. Throughout the 3-hr active-learning session, the teachers’ understanding of the content was evaluated via completion of six short motor development video exams that focused on each of the six OC skills covered in this study. All teachers were required to demonstrate 85% or higher mastery of the content before moving to the next skill. By the end of the 3-hr active-learning session, all teachers demonstrated 85% competency or higher for all six video exams with an average of 91% across all teachers and exams. After demonstrating competency on all six exams, teachers concluded the initial coaching session with a 2hr introduction and practice period of T-SKIP lessons, which is described in the next section. During this 2-hr period, teachers completed a series of modules where they demonstrated individual skills, task progressions, and an entire lesson plan to peers and the research team. In addition, mock scenarios occurred in which teachers had to provide verbal, physical, and visual prompts as well as modify tasks based on the present level of performance of the research team demonstrating different levels within a task analysis of a skill. During the practice teaching modules, the research team also calculated lesson plan Downloaded by [Tufts University] at 17:27 27 October 2017 4 A. BRIAN ET AL. fidelity via a check sheet (see “Fidelity” section) and shared the results with the teachers to reinforce outcomes desired of teachers during this study. At the end of the 6hr initial coaching session, teachers received all materials necessary (including lesson plans) to implement T-SKIP and were informed they would receive ongoing coaching and support throughout the intervention on a faded schedule. Ongoing coaching support varied based on teachers’ fidelity but within the parameters set within the faded schedule. For Weeks 1 to 2, the lead researcher prepared the teacher for setup and reviewed the skills to be taught on the Friday before the week of the intervention. During the lessons, the lead researcher provided support as needed—for example, by making sure progressions were set up properly. For Weeks 3 through 5, the lead researcher intervened during the lessons as needed but did not meet with the teachers ahead of time. For example, if a child was performing a skill incorrectly, the lead researcher suggested a modification to the task to elicit a more proficient response. During Weeks 6 through 8, the lead researcher only intervened if teachers solicited support and/or if a safety concern occurred. For example, during striking, if a child were to move too close to a swinging paddle, the researcher may intervene to stop the child. In total, during Weeks 6 through 8, the lead researcher intervened two times, both at the request of the teachers. The T-SKIP Program The T-SKIP Program is a modified version of the evidenced-based SKIP Program. The SKIP Program was originally designed for implementation by a motor development or physical education expert. The original SKIP Program has been validated during the past 20 years across several locations in the United States to remediate motor skill delays of young children who are disadvantaged and/or to significantly improve FMS in young children (Altunsöz & Goodway, 2016; Brian et al., 2017; Goodway & Branta, 2003; Robinson & Goodway, 2009). The SKIP Program features a variety of instructional approaches (e.g., direct instruction and mastery motivational climate/high autonomy); evaluation of the array of skill development of children; developmental task analyses of each skill, ranging from easy to complex; individualized and inclusive instruction; repetitive cycle of skills and tasks that increase and decrease with complexity; children as self-coaches and peer coaches who can focus on key words/cues; and the development of proprioception (Altunsöz & Goodway, 2016; Brian et al., 2017). The dosage of SKIP ranges from 6 weeks (Brian et al., 2017) to 12 weeks (Goodway & Branta, 2003) with a frequency of two times per week and a duration of 30 min to 45 min per lesson. The T-SKIP Program is a modification of SKIP designed specifically for early childhood teachers who have little to no previous background with motor development or physical education. The modification from SKIP to T-SKIP was based on a pilot study of SKIP with master early childhood teachers (Brian et al., 2017). T-SKIP includes the content and pedagogical approach of the SKIP Program for children along with all lesson plans, materials, equipment necessary to implement SKIP, and ongoing coaching and support for the teachers. Within T-SKIP, we only provided teachers with instruction to deliver content resulting in learning of OC skills. Given the time constraints of the T-SKIP intervention, we decided to prioritize OC instruction over locomotor instruction for the following reasons: (a) We did not want to overwhelm the teachers with learning 12 new skills and our previous pilot work indicated teachers found learning 6 OC skills very stressful and difficult (Brian et al., 2017), (b) OC competence in the early years is more predictive of physical activity participation in adolescence than are locomotor skills (Barnett et al., 2009), and (c) OC skills are more complex and require greater instruction and practice trials (Gallahue et al., 2012; Goodway & Branta, 2003). As such, we decided to just focus on OC skills within this study. For a further description of the initial pilot trial, see Brian et al. (2017). Measures The primary dependent variable for children in this study was OC skill competence. Object-control skill competence was measured via the OC Skill subscale of the Test of Gross Motor Development-2 (TGMD-2; Ulrich, 2000). The TGMD-2 is a valid and reliable norm- and criterion-referenced assessment of FMS for girls and boys ages 3 years, 0 months to 10 years, 11 months (Ulrich, 2000). The TGMD-2 includes a six-item OC Skill subscale assessing throw, strike, dribble, catch, kick, and roll. All six skills contain three to five critical elements that are scored with either a “0” if the critical element is not present or a “1” if the critical element is demonstrated. Each child completed two trials of the six skills (score = 0–10 points). The total raw score ranged from 0 points to 48 points. Raw scores were converted into standard scores and percentile ranks using age and sex (Ulrich, 2000). All children were pretested and posttested on the TGMD-2 following the standardized procedures within the TGMD-2 manual (Ulrich, 2000). Downloaded by [Tufts University] at 17:27 27 October 2017 SKIPING WITH HEAD START TEACHERS The TGMD-2 testing procedures were digitally recorded for coding purposes. Both coders were Ph.D. candidates in a physical education teacher education doctoral program pursuing cognates in motor development at the time of the study. An experienced coder with a doctorate in kinesiology with an emphasis in motor development trained both coders. The experienced coder also completed TGMD reliability training with the original TGMD developers. Training sessions occurred for 2 days for 2 hr per day. Both coders established 98% interrater agreement prior to coding against the experienced coder of the TGMD-2. We calculated interrater agreement based on coding the OC Skill subscale of 30 participants from a previous study by dividing the total score of all 30 participants (absolute agreement only) from each coder by the lead researcher’s total for the same participants. For example, if there were eight possible elements for the throw (two trials of four elements) and the lead researcher scored the throw as 1, 0, 1, 1, 1, 0, 1, 1 and Coder 1 scored the throw as 0, 1, 1, 1, 1, 0, 1, 1, there would be 75% absolute agreement as the first two items do not align (despite 100% score agreement). Overall, Coder 1 scored within 99% of the lead researcher and Coder 2 scored at 97% leaving a 98% interrater reliability before beginning the coding for the current study. After completion of the posttest, all participants were coded, with two raters who were double-blinded to treatment condition and time (pretest or posttest). The lead researcher conducted interrater reliability on an additional randomly selected 30% of the double-blind sample. We divided the first coder’s absolute agreement score of the OC Skill subscale for the randomly selected 30% by the total score calculated by the lead researcher for the same sample. We repeated the process for the scores for the second coder. The results for the first coder resulted in 94% agreement with the lead researcher. The results for the second coder compared with the lead researcher yielded 90% agreement for the same sample. Overall, interrater reliability for the double-blind sample was 92%. T-SKIP lesson plan fidelity We measured lesson plan fidelity for each lesson via a check sheet (Figure 1) developed prior to conducting each actual lesson. Measuring lesson plan fidelity via a check sheet is a common standard of practice within the motor skill and broader educational intervention literature (e.g., Kaderavek & Justice, 2010; Robinson & Goodway, 2009). All lessons were digitally recorded with each teacher wearing a wireless microphone. We developed the check sheet from the lesson plans, from the motor development and physical education literature (e.g., Gallahue et al., 2012; Rink, 2013b; Siedentop & Tannehill, 2000), and in 5 consultation with a panel of experts in motor development and early childhood physical education. The lead researcher observed each lesson and calculated lesson plan fidelity as a percentage of target behaviors demonstrated divided by the total possible number of behaviors to be observed (30–50 per lesson). Lesson plan fidelity was split into two measures: (a) Level 1 fidelity, or non-negotiable pedagogical behaviors attributing to skill development; and (b) Level 2 fidelity, or highly desired pedagogical behaviors. We split fidelity into two levels because the panel of experts recommended to do so to provide a more in-depth description for what occurred during T-SKIP and because it is more consistent with practices in the classroom intervention literature (O’Donnell, 2008) and the evidence base in motor learning (Magill & Anderson, 2017). Examples of Level 1 fidelity items, which are also consistent with the Quality Measures of Teaching Physical Education Scale, included correct demonstrations, congruent feedback that was developmentally appropriate to the learner, and correct setup and instruction of progressions (Rink, 2013a, 2013b). Level 1 fidelity items are considered best practices of motor skill-learning principles and physical education teaching that are designed to elicit learning (Magill & Anderson, 2017; Rink, 2013b). For example, clarity is one of the critical factors that promotes student learning in physical education (Rink, 2013b). Checking for understanding (e.g., teacher asking students questions to ensure they understand the managerial system, task demands, and behavioral rules, etc.), featuring correct demonstrations, and providing congruent feedback improve clarity (Rink, 2013b; Siedentop & Tannehill, 2000) and thus improve student learning. Thus, the panel of experts agreed that Level 1 items are critical to clarity and are required for correct performance of each skill during the intervention. Level 2 fidelity behaviors were those behaviors that are highly desired practices but are not essential to correct performances of OC skills. Examples of Level 2 fidelity items include playing music during the warm-up, pacing of progressions, and intratask modifications (e.g., changing ball size, distance to/from targets, etc.). Level 2 items were developed based on consultation with a panel of experts in physical education and motor development and the existing literature in physical education pedagogy and motor learning (Magill & Anderson, 2017; Rink, 2013b). Pacing is important because young children have very short attention spans (Gallahue et al., 2012), so it is important to deliver the activities with high frequency of change and to verbalize instructions with brevity (Rink, 2013b). Intratask modifications can enhance learning by gearing each task to the present level of performance of each child. Providing intratask modifications is considered developmentally 6 A. BRIAN ET AL. Downloaded by [Tufts University] at 17:27 27 October 2017 appropriate (Gallahue et al., 2012) and can maximize student learning based on individual characteristics (Rink, 2013b). The panel of experts agreed these items (music in the warm-up, appropriate pacing, and intratask modification) were important but not critical to correct skill performance. Thus, Level 2 items were distinguished from Level 1 items. The lead researcher calculated all lesson plan fidelity from digitally recorded videos. Thirty percent of videos were double blind-coded by an outside, trained rater for interrater reliability. The trained rater observed Figure 1. Lesson plan fidelity check sheet. three videos from a previous study with the lead researcher. During the first video, the outside coder coded the items along with the lead researcher at 5min intervals. Next, the outside coder and the lead researcher coded a different video independently and compared results. The goal was to code as many videos as necessary until both coders agreed at 90% or greater. Both coders achieved a preliminary 92% interrater reliability by the end of the third training video. An interrater reliability of 93% was achieved for 30% of the T-SKIP videoed lesson plans between the two coders. 7 Downloaded by [Tufts University] at 17:27 27 October 2017 SKIPING WITH HEAD START TEACHERS Figure 1. Continued. As a final check, the lead researcher recoded 10% of the sample and achieved an intrarater reliability of 98%. T-SKIP teachers (n = 5) were originally instructed to implement T-SKIP two times per week for 30 min during each session for 9 weeks. Due to inclement weather and school closures, T-SKIP teachers each implemented 15 lessons (75 lessons from five teachers) for 8 weeks for a total of 450 min of intervention time. The two T-SKIP sessions per week replaced the typical Head Start everyday programming of well-equipped free play. On the remaining days of the week, T-SKIP teachers and children participated in the typical curriculum of approximately 30 min to 40 min of free play. At the same time, control teachers only implemented daily free play of 30 min to 40 min to their students, which was the business-as-usual curriculum across all sites. Well-equipped free play occurred indoors in a gross motor space and outdoors on the playground under the direct observation of the lead and assistant teachers at all sites. All sites possessed equipment such as balls, bats, and hoops that enabled children to practice OC skills during free play if they desired. To ensure that intervention integrity occurred, the lead researcher Downloaded by [Tufts University] at 17:27 27 October 2017 8 A. BRIAN ET AL. Figure 1. Continued. observed each site during free play three times on random, unannounced occasions. During the 30 observations that occurred in 10 classrooms, the lead researcher observed no contamination of the control condition (e.g., teachers instructing OC skills). Data analyses We conducted descriptive analyses to examine the fidelity percentage for teachers implementing T-SKIP. We conducted all TGMD-2 data analyses using OC standard scores; however, we calculated percentile ranks to examine the percentage of children demonstrating developmental delay. Scoring less than the 30th percentile places children highly at risk for developmental delays with their OC skills (Ulrich, 2000). Next, we conducted independent-samples t tests on OC standard scores to determine group or sex differences during the pretest and the posttest. In the present study, multiple children were nested within each teacher (who provided the intervention), and as such, this study is considered to be a multilevel design. A failure to account for nesting effects can bias the results and increase the likelihood for Type 1 errors (Raudenbush, 2011). In the present study, an intraclass correlation coefficient (ICC) was used to assess the extent to which posttest OC scores (at the child level) could be attributed to the teacher (i.e., the nesting effect). An ICC greater than 5% indicated that nesting effects are present and should be accounted for in analyses (Raudenbush & Bryk, 2002). In this study, the effects of the T-SKIP intervention on OC skills were analyzed using a two-level hierarchical linear model (HLM) with children nested within classrooms. Specifically, the outcome was OC standard scores from the TGMD-2 at posttest, which was predicted from group (T-SKIP vs. control). Pretest standard scores were entered as covariates. The equation took the form of: SKIPING WITH HEAD START TEACHERS 9 teachers demonstrated 34% (SD = 15%) Level 2 fidelity across all lessons. Overall, teachers delivered T-SKIP with a grand mean of 47% fidelity (SD = 12%; Figure 2). Figure 2. Lesson plan fidelity for each teacher by level. Downloaded by [Tufts University] at 17:27 27 October 2017 Yij ¼ β00 þ β10 ðOC Pretest Þ þ β01 ðT SkipÞ (1) þ u0 þ u1 þ r where Yij is each child’s observed OC score at posttest, β00 is the average posttest score for all children, β10 is the weight relating the OC pretest to the posttest, β01 is the expected difference between the T-SKIP control and treatment-group teachers, u0 is the error associated with the average posttest score, allowing it to be a random effect across teachers, u1 is the error associated with treatment group, and r is the remaining studentspecific error. We conducted all HLM analyses via HLM Version 7 (Raudenbush, Bryk, & Congdon, 2004). We conducted an additional two-level HLM to analyze sex effects of T-SKIP. Again, posttest OC standard scores were the outcome predicted from group, sex, and the interaction. Pretest scores were entered as covariates. The equation took the form of: Yij ¼ β00 þ β10 ðOC Pretest Þ þ β20 ðsexÞ þ β01 ðT SkipÞ þ β11 ðT Skip sexÞ þ u0 þ u1 þ r (2) with all previous weights retaining their meaning and with β20 as the difference between the boys and girls and β11 as the interaction coefficient. Effect sizes for T-SKIP were calculated in a manner consistent with HLM via Cohen’s d (Hox, 2010). Next, Cohen’s d scores were converted to eta squared (Becker, 2000) to provide direct comparison of effect sizes between previous studies. Results T-SKIP lesson plan fidelity The first research question examined the extent to which Head Start preschool teachers could deliver T-SKIP with fidelity. T-SKIP teachers obtained an average of 63% (SD = 19%) of Level 1 fidelity across all lessons. In addition, Pretest and posttest scores of OC skills Table 1 includes the pretest and posttest raw scores, standard scores, and percentile ranks for OC skills by condition and sex. Independent-samples t tests revealed that 81% of all children tested scored less than the 30th percentile at the pretest with no significant differences between groups, t(120) = 0.11, p = .916, d = 0.02, regardless of condition (Table 1). By the posttest, T-SKIP children improved, on average, from the 21st percentile to the 54th percentile (Table 1). In contrast, control children regressed slightly starting at the 15th percentile and lowering to the 13th percentile. By the posttest, independent-samples t tests revealed a significant difference between groups for OC standard scores, t(120) = 12.60, p < .001, d = 2.30. The gains for the T-SKIP group were consistent across sex with girls (gain of 31%) improving from the 18th percentile to the 50th percentile, which was similar to the improvement for boys from the 27th percentile to the 62nd percentile (gain of 35%). The OC posttest scores for the control children were also consistent across sex with control girls regressing from the 19th percentile to the 15th percentile and boys remaining constant at the 12th percentile by the posttest. Influence of T-SKIP on OC skills The second research question investigated the influence of T-SKIP on the OC skills of preschoolers who were socioeconomically disadvantaged. Results from the HLM examining the effects of T-SKIP on the OC skills of children indicated that 30% of the variance in children’s OC Table 1. Means and standard deviations for pretest–posttest OC percentile ranks and standard scores. Pretest Group T-SKIP Boys SD Girls SD Overall SD Control Boys SD Girls SD Overall SD Posttest Raw Standard Score Percentile Rank Raw Standard Score Percentile Rank 19.43 6.04 15.38 6.53 16.86 6.61 7.87 1.69 6.63 2.20 7.08 2.11 27 16 18 17 21 17 28.61 6.71 25.25 4.98 26.48 5.85 11.00 1.62 10.00 1.40 10.37 1.55 62 19 50 17 54 19 15.19 5.75 16.93 5.53 15.98 5.67 5.84 1.97 6.89 1.93 6.32 2.00 12 15 19 15 15 15 15.78 5.72 16.22 6.91 15.98 6.24 5.41 2.42 5.85 2.70 5.61 2.53 12 15 15 17 13 16 Note. OC = Object-Control Skill subscale; Raw = raw scores; T-SKIP = teacher-led Successful Kinesthetic Instruction for Preschoolers. 10 A. BRIAN ET AL. Downloaded by [Tufts University] at 17:27 27 October 2017 standard scores at posttest was attributable to the classroom (ICC = .30). Children in the T-SKIP condition showed significantly higher posttest OC scores compared with control children (β = 4.70), t(8) = 7.02, p < .001, η2 = .56 (Table 2). Specifically, while controlling for pretest scores, T-SKIP children scored an average of 5 standard score points higher compared with control students (Table 2). The control autoregressive pretest score was also an important predictor of posttest OC skills (β = 0.50), t(9) = 3.44, p = .007 (Table 2). Differential effects of sex We added child’s sex and a cross-level interaction to the model between sex at the child level and T-SKIP at the classroom level to examine the differential effects of sex within T-SKIP (Table 2). After controlling for sex, there remained a main effect of T-SKIP favoring the treatment group over the control group (β = 5.37), t (8) = 6.819, p < .001, η2 = .60 (Table 2). There was no main effect found for sex (β = –0.19), t(8) = –0.46, p = .650, nor was there an interaction between sex and T-SKIP (β = –0.66), t(8) = −1.15, p = .290, suggesting that the T-SKIP intervention was equally effective for both boys and girls. Discussion The primary aims of this study were to determine whether Head Start teachers could implement T-SKIP with fidelity and to examine the extent to which T-SKIP improved the OC skills of young children from disadvantaged settings. The fidelity of Head Start teachers implementing T-SKIP was less than the standards of the educational intervention literature, thus making T-SKIP’s internal validity questionable. O’Donnell (2008) recommended intervention fidelity greater than 50% for a study to be considered internally valid. Although it was alarming to see an overall Table 2. Hierarchical linear model for effect of T-SKIP, sex, and pretest OC scores on posttest OC scores. Level 1 Effects of T-SKIP Intercept T-SKIP Pretest scoresa Effects of Sex and T-SKIP Intercept T-SKIP Sex T-SKIP Pretest Scoresa Level 2 β SE t β SE t 5.66 .54 10.38** 5.66 4.69 −0.50 .48 .67 .14 11.81** 7.02** 3.44** 5.64 .56 10.06** 5.64 5.37 −0.19 −0.66 0.47 .54 .79 .18 .26 .15 10.41** 6.82** −1.09 −2.55* 3.12* * p ≤ .05. ** p < .001. Note. OC = Object-Control Skill subscale; T-SKIP = teacher-led Successful Kinesthetic Instruction for Preschoolers. a Grand mean centered. fidelity at 47%, it was not surprising given the barriers for preschool teachers in implementing FMS programming (Gehris et al., 2015; Hughes et al., 2010). Similar to what was identified in the literature (e.g., Brian et al., in press; Gehris et al., 2015), the Head Start teachers in this study reported little to no motor development/physical education content in their preservice training programs, and prior to the study starting, each of them indicated they did not feel comfortable implementing FMS programing both from a content knowledge perspective and with regard to their own abilities to perform the skills. Despite overall low levels of fidelity, teachers were successful with implementing Level 1 fidelity items (more than 63%) or what we deemed as non-negotiable behaviors that directly relate to OC skill learning for children (e.g., correct demonstration, positive-specific congruent feedback, correct skill progression equipment setup). In physical education, student learning is maximized when students receive feedback that is aligned with the purpose of the task, see correct demonstrations, and have opportunities to engage in skill practice that is developmentally appropriate (Rink, 2013b). Level 1 fidelity is directly aligned with best practices in physical education pedagogy, and we believe it was critical that teachers achieved greater than the 50% threshold for children to improve their OC skills. Although Level 2 fidelity behaviors were desirable (e.g., appropriate pacing, intratask modifications), it appeared that children were still able to learn OC skills in spite of low levels (37%) of these behaviors. The findings from teacher fidelity also speak to the robustness of the SKIP Program as an effective curriculum through which young children improve their OC skills regardless of implementer (e.g., motor development experts [SKIP] and teachers [T-SKIP]). The effect sizes in this study were high (η2 = .59) but not as high as when delivered by an expert (η2 = .68–.89; Goodway & Branta, 2003; Robinson & Goodway, 2009). The lower effect sizes may be due to lower overall fidelity (e.g., 47%). According to Brian et al. (2017), every 1% increase in fidelity can yield an average increase in posttest TGMD standard scores (approximately 0.13 standard score points). Having a robust curriculum like T-SKIP is important. However, the effectiveness of T-SKIP may be affected by the quality of teaching, thereby warranting the consideration of employing motor development and physical education experts to assist classroom teachers. The second major finding of this study centered on the pretest to posttest OC skill scores. Prior to the start of the T-SKIP Program, the business-as-usual approach to gross motor skill development in the Head Start centers was well-equipped free play, which is consistent across the motor skill intervention literature (Logan et al., 2011). The majority of this sample (81%) was delayed with Downloaded by [Tufts University] at 17:27 27 October 2017 SKIPING WITH HEAD START TEACHERS their OC skills at the pretest and fell at or below the 30th percentile on the TGMD-2. Our sample’s pretest OC skill scores directly aligned with previous literature in that many children (as many as 86%; Goodway et al., 2010) from disadvantaged settings repeatedly revealed delays in their FMS (Goodway et al., 2010; Martin et al., 2009; Parish et al., 2007; Robinson & Goodway, 2009; Valentini & Rudisill, 2004). The pretest results provide support for the notion that FMS will not develop through well-equipped free play alone. Although well-equipped free play is an important part of a child’s developmental experience, these findings suggest, in alignment with the previous literature (e.g., Logan et al., 2011; Riethmuller et al., 2009), that it is not sufficient to develop OC. In fact, the control-group findings suggest that not only are the children delayed, but they become further delayed across time (22nd percentile–17th percentile), which is consistent with the findings of previous studies (e.g., Brian et al., 2017; Goodway & Branta, 2003; Robinson & Goodway, 2009; Valentini & Rudisill, 2004). We are uncertain as to why the OC scores for the control group regressed from pretest to posttest given that conditions did not change from the business-as-usual condition throughout the intervention. Children who are unskilled are often unstable in their motor performance. As such, shifting downward is not a surprising finding and instability may be a potential rationale for this shift. Anecdotal evidence from control-group observations of free play suggest that in spite of access to motor skill equipment such as balls, bats, and hoops, children were not engaging in the necessary activities to improve their OC skills. Thus, it is recommended to add structured motor programming in addition to well-equipped free play as part of the weekly schedule in preschool. Free play is necessary for children to explore and learn socialization skills, creativity, and critical thinking. However, by replacing free play 2 out of the 5 days per week with structured motor programming, the children in this sample remediated their delays and jumped from the 21st percentile to the 54th percentile in only 8 weeks (450 min) of instruction. We believe the experimental children in this study achieved significant gains due to the high percentage of Level 1 fidelity items. This study, may be one of the first to explicitly describe what occurred during the intervention via fidelity. As a result, we can speak to what actually occurred during the intervention. Many previous intervention studies that have only shown minimal or nonsignificant gains as well as those with significant intervention effects have failed to show in-depth details regarding what occurred during the actual intervention (Logan et al., 2011; Riethmuller et al., 2009). Thus, a pointed rationale as to why or why not young children did not improve skills in previous studies is not possible. Our 11 teachers were able to deliver correct demonstrations, provided congruent feedback, differentiated instruction (individual and group modifications; visual, verbal, and physical prompting), and did so in alignment with physical education and motor development best practices (e.g., Gallahue et al., 2012; Rink, 2013b). As a result, we can infer that young children experiencing developmentally appropriate structured gross motor time for as little as 60 min per week for 6 weeks may have resulted in T-SKIP children significantly improving their OC skills. Unfortunately, previous researchers may not be able to assess why or why not children in their interventions did or did not significantly improve their FMS. Although the T-SKIP children overall were able to show improvements in their OC skills, it was important to assess whether girls improved at a rate similar to that of the boys. Historically, young girls demonstrate greater delays than boys in their OC skills (Goodway et al., 2010). Some physical education, gross motor, or physical activity environments result in differential pedagogical treatment by sex. For example, boys are encouraged to have correct skill performance, while girls are encouraged to just participate (Garcia, 1994; Lubans Morgan, Cliff, Barnett, & Okely, 2010). The findings from this study suggest that T-SKIP was developmentally and pedagogically appropriate for both boys and girls with respect to OC skill learning. The T-SKIP girls in this study improved their OC skills along with the T-SKIP boys indicating that the teachers implemented T-SKIP without any differential effects of sex. Limitations and strengths There are several limitations to this study. First, when data collection occurred, schools lost days due to extreme winter weather. Inclement weather resulted in only 8 weeks of intervention when originally 9 weeks were scheduled. Second, due to the nature of ecologically valid classroom research, random assignment of condition occurred at the teacher level and not the child level. As a result, HLM was warranted to account for nesting effects that occurred. As the sample size of our teachers was small, generalizability to other teachers is a limitation. In addition, HLM may have overcorrected differences between teachers. Despite this limitation, using HLM is a strength of this study. HLM is a rigorous technique that accounts for nesting effects that occur in multilevel analyses within educational settings where it is difficult to randomly assign children within intact classrooms. Additional strengths include providing detailed description for fidelity and featuring teachers as the implementers of T-SKIP. Report fidelity assists in replication and provides a snapshot into what actually occurred during our intervention. Moreover, using teachers has the 12 A. BRIAN ET AL. potential for sustainability after the research intervention concludes. In addition, having teachers deliver T-SKIP instead of motor development experts is an ecologically valid option for potentially reaching the 900,000 children enrolled throughout the Head Start network. lower levels of fidelity by the teachers, results of this study revealed an ecologically valid option to combat FMS delays present in children from socioeconomically disadvantaged settings. Acknowledgments Downloaded by [Tufts University] at 17:27 27 October 2017 Implications for future research Future research is needed to scale up this initial T-SKIP trial and conduct a group randomized trial of T-SKIP across the Head Start network. Replication of this study can help address the generalizability limitations present when featuring a small sample size of teachers despite a large sample of students. Longitudinal follow-up is also necessary to examine if intervention effects on OC skills persist across time. Results of a longitudinal follow-up would elucidate the retention effects of the children’s FMS and whether teachers will continue to implement T-SKIP beyond the duration of the study. Longitudinal study would enable examination of whether giving young children an early “boost” in their motor competence would result in them being drawn into a positive spiral of engagement across childhood and adolescence resulting in higher levels of physical activity and a greater likelihood for healthy weight (Stodden et al., 2008). The authors would like to thank the director, teachers, children, and parents from the centers for their participation and support throughout this study. Without their generous support, this study would not have been possible. In addition, the authors thank several students at The Ohio State University for their assistance, including Mark Roser, Nadia Elfessi, Ruri Famelia, and Emi Tsuda. Finally, the authors thank Dr. Phillip Ward for his comments, feedback, and advice on this project. Funding North American Society for the Psychology of Sport and Physical Activity (NASPSPA) provided a Graduate Student Research Grant to fund this project; North American Society for the Psychology of Sport and Physical Activity Research Grant. ORCID Ali Brian http://orcid.org/0000-0002-6541-0938 What does this article add? References This research contributes to an existing line of inquiry developed in response to the growing number of children from disadvantaged settings who are highly at risk for delays in their FMS. During the past two decades, the SKIP Program has successfully remediated FMS delays present in young children from socioeconomically disadvantaged settings with powerful effect sizes. This study was the first of its kind to modify and transform SKIP into T-SKIP and feature Head Start teachers. The two main research aims within this study were to examine the extent to which Head Start teachers could implement T-SKIP with fidelity and to determine the effectiveness of T-SKIP on improving the OC skills of boys and girls from disadvantaged settings. T-SKIP teachers were able to implement T-SKIP. There are significant barriers present for early childhood teachers delivering programming like T-SKIP. As a result, it was necessary to provide the teachers with ongoing coaching and support on a faded schedule throughout the intervention. Despite low Level 2 fidelity, T-SKIP teachers were able to bring about significant changes to the OC skills of both boys and girls compared with the control group. Lower Level 2 fidelity may explain why the effect sizes within this study, although interpreted as high, are not as high the effect sizes from the previous SKIP literature. Despite Altunsöz, I. H., & Goodway, J. D. (2016). 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