The BOT-3 in Pediatric OT and PT: What Changed From the BOT-2, Scoring, and Reporting Tips

Plenty of us learned the Bruininks-Oseretsky Test of Motor Proficiency on the BOT-2 and still have that kit on the shelf. Pearson released the third edition, the BOT-3, in 2024 (Pearson, n.d.-d). Here is what it measures, how it is scored, what changed, and how to write it up.

Why school and clinic therapists use it

The BOT covers fine and gross motor skills in one standardized battery, so OTs and PTs can share it. It is useful for documenting motor delays in special education evaluations, contributing motor data when a physician is considering developmental coordination disorder (DCD), and comparing fine and gross motor performance in the same child.

What the BOT-3 is

• Authors: Brett D. Bruininks and Robert H. Bruininks
• Publisher: Pearson, published 2024
• Ages: 4:0 to 25:11
• Forms: Complete, Fine Motor, Gross Motor, and Digital
• Time: 50 to 90 minutes for the Complete Form; 25 to 45 minutes each for the Fine Motor and Gross Motor Forms
• Administration: paper and pencil, or digital record form through Q-global; scoring by hand or in Q-global
• Norms: United States
• Qualification level: B

These details come from the US product page (Pearson, n.d.-d), which does not list the norm sample size or demographics; check the manual. A separate 20 item BOT-3 Brief (about 25 to 35 minutes) yields a Total Motor standard score plus fine and gross motor cut scores (Pearson, n.d.-e). The authors say it should guide decisions about further testing, not eligibility (Pearson, 2024).

What it measures

The BOT-3 has eight core subtests and one optional supplementary subtest. Descriptions below follow Pearson's sample Q-global report (Pearson, n.d.-c).

Fine motor subtests

• Fine Motor Precision: precise finger and hand control, such as drawing, folding, or cutting within a boundary
• Fine Motor Integration: copying geometric figures of increasing complexity
• Manual Dexterity: timed, goal directed reaching, grasping, and bimanual work with small objects
• Upper Limb Coordination: visual tracking with coordinated arm and hand movements, such as catching and throwing

Gross motor subtests

• Bilateral Coordination: coordination of upper and lower limbs, sequentially and simultaneously
• Balance: postural control while standing, walking, or reaching
• Strength: trunk, upper body, and lower body strength
• Dynamic Movement: running speed and agility (this was called Running Speed and Agility on the BOT-2)
• Extended Balance (supplementary): more advanced balance tasks on a balance beam, which is sold separately

Subtests roll up into four motor area domains: Fine Manual Control (Fine Motor Precision and Fine Motor Integration), Manual Coordination (Manual Dexterity and Upper Limb Coordination), Body Coordination (Bilateral Coordination and Balance), and Strength and Agility (Strength and Dynamic Movement). Those feed a Fine Motor Composite, a Gross Motor Composite, and a Total Motor Composite (Pearson, n.d.-c).

How it is scored

According to Pearson's sample Q-global report, the BOT-3 produces (Pearson, n.d.-c):

• Scaled scores for subtests (mean 10, SD 3), with 90% confidence intervals
• Standard scores for domains, composites, and two supplemental scores (mean 100, SD 15), with 90% confidence intervals
• Percentile ranks and descriptive categories (Well below average through Well above average)
• Age equivalents and growth scale values (GSVs) for subtests

There are also three new supplemental scores (Pearson, n.d.-c, n.d.-d):

• Skilled Manual Performance: a norm referenced standard score combining Fine Motor Precision, Fine Motor Integration, and Manual Dexterity
• Planning and Coordination (called Motor Planning and Coordination on the product page): a norm referenced score built from items that best separated a DCD group from typically developing peers
• Movement Fundamentals: a criterion referenced score that describes a level of proficiency in basic motor skills, not a comparison to peers

The sample report does not publish the numeric cutoffs for each descriptive category, so take those from your manual or Q-global output.

What changed from the BOT-2

• Score metrics changed. BOT-2 subtest scale scores used a mean of 15 and SD of 5, and composites used a mean of 50 and SD of 10 (Pearson, n.d.-b). BOT-3 uses scaled scores (mean 10, SD 3) and standard scores (mean 100, SD 15) (Pearson, n.d.-c). A BOT-2 composite of 40 and a BOT-3 composite of 85 both sit one SD below the mean, so update your report templates.
• Ages extended. The upper limit rose from 21:11 to 25:11 (Cooper, 2024; Deitz et al., 2007).
• New norms and content. About a quarter of the content is new (Pearson, 2024), including the Extended Balance subtest (Cooper, 2024).
• Streamlined administration. A second trial was dropped from 28 items, and the running course shrank from 50 to 30 feet, easier to fit in a school hallway (Cooper, 2024).
• Short Form replaced by the BOT-3 Brief (Pearson, 2024).
• New scores. GSVs and the three supplemental scores are new (Pearson, n.d.-d).
• Kit changes. Separate Fine Motor and Gross Motor kits, no balance beam included (a BOT-2 beam works), and no upgrade kit (Pearson, n.d.-d).

A realistic school example

Maya (fictional), age 8, has slow, effortful handwriting, avoids ball games, and trips often at recess. The OT gives the Fine Motor Form and the PT gives the Gross Motor Form, alongside history, classroom observation, and work samples.

Sample score summary (FICTIONAL)

These scores are invented for illustration only. They use the metrics in Pearson's sample report (scaled scores mean 10, SD 3; standard scores mean 100, SD 15) with normal curve percentiles. Real composites come from the manual's norm tables, not from averaging subtests.

• Fine Motor Precision: scaled score 7 (16th percentile)
• Fine Motor Integration: scaled score 8 (25th percentile)
• Manual Dexterity: scaled score 6 (9th percentile)
• Upper Limb Coordination: scaled score 8 (25th percentile)
• Bilateral Coordination: scaled score 6 (9th percentile)
• Balance: scaled score 5 (5th percentile)
• Strength: scaled score 8 (25th percentile)
• Dynamic Movement: scaled score 7 (16th percentile)
• Fine Motor Composite: standard score 85 (16th percentile)
• Gross Motor Composite: standard score 80 (9th percentile)
• Total Motor Composite: standard score 81 (10th percentile)
• Planning and Coordination: standard score 78 (7th percentile)

Report the descriptive category Q-global or the manual assigns to each score rather than inventing a label.

How to write it up

Lead with the referral question, then scores, then observations. Avoid leaning on age equivalents, which are easy to misread; GSVs are designed for tracking change over time.

Maya completed the Bruininks-Oseretsky Test of Motor Proficiency, Third Edition (BOT-3), a standardized test of fine and gross motor skills. Her Total Motor Composite standard score was 81 (10th percentile), with gross motor skills (Gross Motor Composite 80, 9th percentile) somewhat lower than fine motor skills (Fine Motor Composite 85, 16th percentile). Her lowest areas were Balance and Bilateral Coordination, consistent with reports of frequent trips at recess and avoidance of ball games. Within fine motor tasks, Manual Dexterity was an area of relative weakness; she worked accurately but slowly when handling small objects. Maya was cooperative but needed repeated demonstrations on multi-step movement tasks. Together with classroom observation and work samples, these results suggest motor difficulties affecting handwriting speed and participation in PE and recess.

Note that the BOT-3 alone does not diagnose DCD. The international DCD recommendations describe diagnosis as drawing on history, interviews, questionnaires, clinical examination, and motor testing, and they rule out the diagnosis when the motor problem is likely due to lack of practice (Blank et al., 2019). A low Planning and Coordination score is a reason to share findings with the physician, not a diagnosis.

What the research says

Most published evidence is on the BOT-2. A detailed review in Physical & Occupational Therapy in Pediatrics covered the BOT-2's development, psychometrics, strengths, and limitations for therapy practice (Deitz et al., 2007). In 100 children with intellectual disability ages 4 to 12, the BOT-2 total showed excellent test retest reliability and internal consistency, and responsiveness was acceptable for all measures except the Balance subtest (Wuang & Su, 2009). That Balance finding is worth keeping in mind when you use any edition to measure change.

Peer reviewed research on the BOT-3 itself is still thin. An independent review appears in the Buros Twenty-Second Mental Measurements Yearbook (Buros Center for Testing, n.d.), and the manual reports Pearson's reliability and validity studies. Do not assume BOT-2 findings carry over to the revised items and norms.

Practical cautions

• Do not mix editions in progress monitoring. Norms, items, and metrics all changed. If you switch, say so and treat the BOT-3 as a new baseline.
• Plan for time. The Complete Form can take up to 90 minutes; splitting forms between OT and PT or across sessions helps with fatigue.
• Note attention and behavior when they may have lowered performance.

How it compares with related tools

• Movement Assessment Battery for Children, Third Edition (Movement ABC-3): three components (Manual Dexterity, Aiming and Catching, Balance and Locomotion), about 30 to 45 minutes, with norms collected in the UK, Australia, and New Zealand (Pearson, n.d.-f). It is quicker to give; the BOT-3 offers broader coverage, including strength, and US norms.
• Beery VMI, Sixth Edition: a 10 to 15 minute test of visual motor integration with supplemental Visual Perception and Motor Coordination tests, ages 2 to 99 (Pearson, n.d.-a). It pairs well with BOT-3 fine motor subtests when handwriting is the main concern, but it does not assess gross motor skills.

Bottom line

The BOT-3 keeps the familiar structure while adding new norms, ages to 25:11, GSVs, and supplemental scores. The biggest trap for BOT-2 users is the new score metric. Use it as one part of a full evaluation and confirm details in your manual.

References

Blank, R., Barnett, A. L., Cairney, J., Green, D., Kirby, A., Polatajko, H., Rosenblum, S., Smits-Engelsman, B., Sugden, D., Wilson, P., & Vinçon, S. (2019). International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder. Developmental Medicine & Child Neurology, 61(3), 242-285. https://doi.org/10.1111/dmcn.14132

Buros Center for Testing. (n.d.). Bruininks-Oseretsky Test of Motor Proficiency, Third Edition [Test review]. University of Nebraska-Lincoln. https://marketplace.unl.edu/buros/bruininks-oseretsky-test-of-motor-proficiency-third-edition.html

Cooper, M. (2024, February 7). What's new with the BOT-3? Pearson. https://www.pearsonassessments.com/professional-assessments/blog-webinars/blog/2024/02/whats-new-with-the-bot3.html

Deitz, J. C., Kartin, D., & Kopp, K. (2007). Review of the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2). Physical & Occupational Therapy in Pediatrics, 27(4), 87-102. https://doi.org/10.1080/J006v27n04_06

Pearson. (n.d.-a). Beery-Buktenica Developmental Test of Visual-Motor Integration, Sixth Edition. https://www.pearsonassessments.com/en-us/Store/Professional-Assessments/Motor-Sensory/Beery-Buktenica-Developmental-Test-of-Visual-Motor-Integration-%7C-Sixth-Edition/p/100000663

Pearson. (n.d.-b). BOT-2 complete form sample report [PDF]. https://www.pearsonclinical.asia/content/dam/school/global/clinical/us/assets/bot-2/bot-2-complete-form-sample-report.pdf

Pearson. (n.d.-c). BOT-3 Q-global sample report [PDF]. https://pearsonassessments.com/content/dam/school/global/clinical/us/assets/bot-3/sample-q-global-bot-3-report.pdf

Pearson. (n.d.-d). Bruininks-Oseretsky Test of Motor Proficiency, Third Edition (BOT-3). https://www.pearsonassessments.com/en-us/Store/Professional-Assessments/Motor-Sensory/Bruininks-Oseretsky-Test-of-Motor-Proficiency-C-Third-Edition/p/P100071001

Pearson. (n.d.-e). Bruininks-Oseretsky Test of Motor Proficiency, Third Edition, Brief Form. https://www.pearsonclinical.com.au/en-au/Store/Professional-Assessments/Motor-Sensory/Bruininks-Oseretsky-Test-of-Motor-Proficiency%2C-Third-Edition---Brief-Form/p/P100092001

Pearson. (n.d.-f). Movement Assessment Battery for Children, Third Edition (Movement ABC-3). https://www.pearsonclinical.co.uk/store/ukassessments/en/en-gb/Store/Professional-Assessments/Motor-Sensory/Movement-Assessment-Battery-for-Children-%7C-Third-Edition/p/P100057001

Pearson. (2024, April). Author Q&A with Drs. Brett and Bob Bruininks. https://www.pearsonassessments.com/professional-assessments/blog-webinars/blog/2024/04/author-q-and-a-with-drs-brett-and-bob-bruininks.html

Wuang, Y.-P., & Su, C.-Y. (2009). Reliability and responsiveness of the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition in children with intellectual disability. Research in Developmental Disabilities, 30(5), 847-855. https://doi.org/10.1016/j.ridd.2008.12.002

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