Accepted Manuscript Title: Does playing a sports active video game improve young children’s ball skill competence? Author: Tara M. Johnson Nicola D. Ridgers Ryan M. Hulteen Robin R. Mellecker Lisa M. Barnett PII: DOI: Reference:
S1440-2440(15)00101-2 http://dx.doi.org/doi:10.1016/j.jsams.2015.05.002 JSAMS 1183
To appear in:
Journal of Science and Medicine in Sport
Received date: Revised date: Accepted date:
6-2-2015 20-4-2015 8-5-2015
Please cite this article as: Johnson TM, Ridgers ND, Hulteen RM, Mellecker RR, Barnett LM, Does playing a sports active video game improve young children’s ball skill competence?, Journal of Science and Medicine in Sport (2015), http://dx.doi.org/10.1016/j.jsams.2015.05.002 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
1 1 2
Does playing a sports active video game improve young children’s ball skill competence?
3 Tara M. Johnson1, Nicola D. Ridgers2, Ryan M. Hulteen3, Robin R. Mellecker4, Lisa M. Barnett1,2§
ip t
4
cr
5 6
1
7
Australia
8
2
9
Burwood Hwy, Burwood, VIC, Australia
us
School of Health and Social Development, Deakin University, Burwood Hwy, Burwood, VIC,
an
Centre for Physical Activity and Nutrition, School of Exercise and Nutrition, Deakin University,
3
School of Education, University of Newcastle
11
4
Institute of Human Performance, University of Hong Kong
M
10
15 16 17 18
Corresponding author
te
14
§
Ac ce p
13
d
12
Email addresses:
TMJ: [email protected]
LMB: [email protected] NDR: [email protected]
19
RMH: [email protected]
20
RRM: [email protected]
21 22 23 Page 1 of 18
2
Abstract
24
Objectives: Actual and perceived object control (commonly ball) skill proficiency is associated with
25
higher physical activity in children and adolescents. Active video games (AVGs) encourage whole
26
body movement to control/play the electronic gaming system and therefore provide an opportunity for
27
screen time to become more active. The purpose of this study was to determine whether playing sports
28
AVGs has a positive influence on young children’s actual and perceived object control skills.
29
Design: Two group pre/post experimental design study.
30
Methods: Thirty-six children aged 6-10 years old from one school were randomly allocated to a
31
control or intervention condition. The Test of Gross Motor Development-3 assessed object control
32
skill. The Pictorial Scale of Perceived Competence for Young Children assessed perceived object
33
control skill. The intervention consisted of six x 50 minute lunchtime AVG sessions on the Xbox
34
Kinect. Two to three sport games were chosen for participants to play each session. General linear
35
models with either perceived object control or actual object control skill as the outcome variables were
36
conducted. Each base model adjusted for intervention status and pre-score of the respective outcome
37
variable. Additional models adjusted for potential confounding variables (sex of child and game at
38
home).
39
Results: No significant differences between the control and intervention groups were observed for
40
both outcomes.
41
Conclusions: This study found that playing the Xbox Kinect does not significantly influence
42
children’s perceived or actual object control skills, suggesting that the utility of the Xbox Kinect for
43
developing perceived and actual object control skill competence is questionable.
Ac ce p
te
d
M
an
us
cr
ip t
23
44 45
Keywords: exergaming, child, motor skills, Xbox, fundamental movement skills
46
Introduction
Page 2 of 18
3 Physical activity (PA) has been identified to have multiple health benefits for children1,2 . As such, it is
48
recommended children aged 5-12 years accumulate at least 60 minutes of moderate to high intensity
49
PA per day3. However, many children around the world do not meet the PA guidelines4. In Australia
50
only one in five 5-17 year olds achieve this recommendation5. Furthermore, with the number of screen
51
based devices available there is concern for the time spent in sedentary behaviours6. The Australian
52
electronic entertainment recommendation of ‘no more than two hours of screen-based entertainment’ a
53
day was met by less than one third (29%) of children and young people between the ages of 5 and 17
54
years old5.
55
Fundamental movement skills (FMS) are considered the building blocks for sport-specific activities7
56
and provide an important foundation for human movement and PA throughout the life span8. The
57
battery of FMS typically includes locomotion skills (walking, leaping, jumping, and running), object
58
control skills (catching, kicking and throwing) and stability skills (balance)7. The acquisition of FMS
59
in early childhood provides the opportunity for children to master movement skills and increases the
60
likelihood that children will enjoy participating in physical activities9. Mounting evidence suggests a
61
strong positive relationship between FMS acquisition during childhood, PA participation10 and health
62
benefits11. Yet few children meet basic FMS competency12-14. In Australia, between 1997 and 2010,
63
less than 50% of children aged 9-15 years old achieved mastery of the FMS of running, jumping,
64
kicking, overarm throwing and catching13 and this trend is reported globally12-14. The increased time
65
children spend in front of screens coupled with physical inactivity, is potentially a contributing factor
66
to the lack of FMS mastery in children12.
67
Active video games (AVGs) are designed to encourage whole body movement to control/play the
68
electronic gaming system15 and thus provide an opportunity for screen time to become more active. A
69
recent systematic review suggested that AVGs have the potential to develop motor skills16. Children
70
have reported that AVGs are easier than actually playing the game in real life15, potentially providing a
71
platform for skill development. Some evidence supports the idea that AVG use is associated with
72
higher object control proficiency17. Striking has been found to have the highest proportion of correctly
Ac ce p
te
d
M
an
us
cr
ip t
47
Page 3 of 18
4 demonstrated components compared to other object control skills (rolling and throwing) when playing
74
AVGs18.
75
According to Harter’s competence motivation theory19 a child is more likely to continue a
76
behaviour/activity if they believe they are proficient and have a positive self-perception of their
77
performance. Children proficient in object control skill have higher perceptions of competence and PA
78
as adolescents20. Children’s perception of their movement ability in a range of movement tasks were
79
improved after an AVG intervention21, and a dance mat AVG intervention increased obese
80
adolescents’ perceived competence to engage in exercise22, suggesting that perceived competence may
81
be improved through AVG play.
82
AVGs have the potential to positively impact children’s object control skills and their perceived skill
83
competency. Sensor-based technology offers a new software element with web-cam styled devices
84
enabling the user to interact directly without a controller, potentially increasing whole body
85
movement6. The study aim was to explore whether the Xbox Kinect can be used as a novel strategy to
86
increase children’s actual and perceived competence in object control skills.
87
Methods
88
Informed written consent was obtained from one school principal for their school to participate in the
89
study. Forty-three children aged 6-10 years (grades 1-4) and parents provided written informed
90
consent for their children’s participation. All study procedures were approved and in accordance with
91
the ethical standards of the University and the Department of Education and Early Childhood
92
Development. At the time of consent, demographic information was gathered through a parent survey,
93
which asked for the child’s sex, date of birth, weekly time (minutes) in AVG play (i.e. any AVG play,
94
not necessarily sport games) and enrolment in organised sports/activities outside of school in for the
95
school term preceding the study and the current term. Each listed sport/activity was coded as either a
96
‘ball sport’ (e.g. golf, tennis, football) or ‘non-ball sport’ (e.g. swimming, martial arts). Parents were
97
also asked to provide demographic information such as their country of birth, language spoken most at
98
home, highest level of education attained, and employment status. Inclusion criteria was for children
Ac ce p
te
d
M
an
us
cr
ip t
73
Page 4 of 18
5 with no/minimal previous AVG experience. Thus, seven children were excluded because they reported
100
90 minutes or more of regular weekly AVG game play (the upper fifth of this sample in terms of time
101
in AVG play). Participants were randomly allocated to the intervention or control groups using a
102
random number generator. This resulted in 19 children (53% boys) being allocated to the intervention
103
group (mean age 7.9 years, SD 1.5) and 17 allocated to the control group (53% boys; mean age 8.0
104
years, SD 1.2).
105
The Test of Gross Motor Development (TGMD-3) assessed object control competence (two hand
106
strike, one hand strike, ball bounce, catch, kick, underarm throw, overarm throw) according to
107
established protocols. The TGMD23 is normed every 15 years and the third version will be formally
108
released in 2015. Each skill had a number of components that needed to be demonstrated for the skill
109
to be performed proficiently. Every attempt was scored with each component of the skill receiving a
110
‘1’ if correctly executed or a ‘0’ if the skill was incorrectly performed. Scores of the two trials were
111
summed to obtain a raw score for each skill. All children had their TGMD-3 skills assessed live in the
112
school setting by two trained observers (12 hours conducted by an expert trainer) blinded to
113
intervention status. Both observers coded sample videos of children performing the TGMD-3 online as
114
issued by the instrument developers in 2014 and scored ≥0.95 in terms of agreement with the coded
115
videos. Excellent inter-rater reliability using the TGMD-2 in a previous study has been reported for
116
these raters23. The two raters simultaneously evaluated 14% of the observations in this study. Using a
117
two-way random effects model where both people effects and measures effects are random, the ICC
118
for the seven ball skills was excellent 0.88 (0.64-0.96).
119
Two additional skill tests, the golf swing and putt stroke, were developed to be appropriate to the
120
games offered through the Kinect; one of which was golf. These skills were developed via a Delphi
121
consultation based on the TGMD skill assessment protocols. Each skill had six components to be
122
marked as present/absent. These skills were assessed by one of the developers of this instrument
123
blinded to intervention status. These skills have acceptable intra-rater (ICC = 0.79, 95% CI 0.59, 0.90)
124
and test retest reliability (ICC = 0.60, 95% CI 0.23, 0.82)24.
Ac ce p
te
d
M
an
us
cr
ip t
99
Page 5 of 18
6 The Pictorial Scale of Perceived Movement Skill Competence for Young Children (PMSC) assessed
126
children’s perceived competence25. The instrument is designed for use with children to rate perceived
127
movement skills using pictures which correspond to a number from one (‘poor’ skills) to four (‘good’
128
skills). The most recent version of the instrument (used in this study) matches the skills included in the
129
TGMD-3 and maintains the wording structure of the version aligned with the TGMD-223. The seven
130
object control skills were assessed in this study along with two golf skills (swing and putt) maintaining
131
the same format. Prior to using the rating scale, we assessed test retest reliability over a seven-day
132
cycle. The instrument demonstrated excellent reliability, with an ICC of 0.84 (95% CI 0.73-0.91). The
133
pre/post intervention perceived competence testing was administered during school hours prior to
134
actual skill assessment.
135
The six week intervention consisted of 50-minute gaming sessions which were conducted once a week
136
during school lunch time (1pm-1.50pm). Two Xbox Kinect gaming consoles were connected to two
137
televisions in the school media room. The following Xbox Kinect games were chosen: Kinect Sports
138
Season 1, Kinect Sports Season 2, and Sports Rivals. Specific mini-games (e.g. baseball, golf, tennis,
139
table tennis, soccer, bowling, volleyball and football) were identified from these 3 games that involved
140
object control skills (one/two hand strike, golf swing/putt, catch, over/under-arm throw, bounce and
141
kick). Kinect Adventure, with limited object control games, was offered in the final week to maintain
142
interest. Week one games consisted of tennis, table tennis and baseball, week two: baseball and golf,
143
week three: table tennis and soccer, week four: golf and beach volleyball and week five: tennis,
144
baseball and golf. In week six children were given the opportunity to choose their game. If a child
145
missed a session they were asked to attend at the next available session. A game record form was
146
completed by the researchers on the amount of time (in minutes) each child spent playing each
147
sport/game during each intervention session.
148
Independent t-tests were used to determine whether sex, owning an AVG at home and prior
149
participation in organised striking sports influenced the outcome scores and therefore should be
150
considered a confounding variable (p < 0.10). A general linear model was used to find whether there
151
was a significant difference between the pre- and post-intervention perceived object control results of
Ac ce p
te
d
M
an
us
cr
ip t
125
Page 6 of 18
7 the intervention group relative to the control group. Three models were used due to the limited power
153
of the sample. Each regression model had post perceived object control score as the outcome,
154
control/intervention status as the predictor and was adjusted for pre- intervention perceived object
155
control score. Child age was initially adjusted for but removed due to lack of significance. Model two
156
also adjusted for owning a game at home, while model three also adjusted for participant sex. The
157
same analysis process and series of models were used to assess actual skill improvement, except with
158
post object control score as the outcome and adjusted for pre- intervention object control. All analysis
159
were performed using SPSS v.22.
160
Results
161
Table 1 reports descriptive baseline information. There were no significant differences between
162
control and intervention children for any demographic or background variables and for actual or
163
perceived skill at baseline.
164
> > > > > > > > > > > > > > > > > Insert Table 1 Here < < < < < < < < < < < < < <
> > > > > > > > > > > > > > > > Insert Tables 2 and 3 Here < < < < < < < < < < <
S1440-2440(15)00101-2 http://dx.doi.org/doi:10.1016/j.jsams.2015.05.002 JSAMS 1183
To appear in:
Journal of Science and Medicine in Sport
Received date: Revised date: Accepted date:
6-2-2015 20-4-2015 8-5-2015
Please cite this article as: Johnson TM, Ridgers ND, Hulteen RM, Mellecker RR, Barnett LM, Does playing a sports active video game improve young children’s ball skill competence?, Journal of Science and Medicine in Sport (2015), http://dx.doi.org/10.1016/j.jsams.2015.05.002 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
1 1 2
Does playing a sports active video game improve young children’s ball skill competence?
3 Tara M. Johnson1, Nicola D. Ridgers2, Ryan M. Hulteen3, Robin R. Mellecker4, Lisa M. Barnett1,2§
ip t
4
cr
5 6
1
7
Australia
8
2
9
Burwood Hwy, Burwood, VIC, Australia
us
School of Health and Social Development, Deakin University, Burwood Hwy, Burwood, VIC,
an
Centre for Physical Activity and Nutrition, School of Exercise and Nutrition, Deakin University,
3
School of Education, University of Newcastle
11
4
Institute of Human Performance, University of Hong Kong
M
10
15 16 17 18
Corresponding author
te
14
§
Ac ce p
13
d
12
Email addresses:
TMJ: [email protected]
LMB: [email protected] NDR: [email protected]
19
RMH: [email protected]
20
RRM: [email protected]
21 22 23 Page 1 of 18
2
Abstract
24
Objectives: Actual and perceived object control (commonly ball) skill proficiency is associated with
25
higher physical activity in children and adolescents. Active video games (AVGs) encourage whole
26
body movement to control/play the electronic gaming system and therefore provide an opportunity for
27
screen time to become more active. The purpose of this study was to determine whether playing sports
28
AVGs has a positive influence on young children’s actual and perceived object control skills.
29
Design: Two group pre/post experimental design study.
30
Methods: Thirty-six children aged 6-10 years old from one school were randomly allocated to a
31
control or intervention condition. The Test of Gross Motor Development-3 assessed object control
32
skill. The Pictorial Scale of Perceived Competence for Young Children assessed perceived object
33
control skill. The intervention consisted of six x 50 minute lunchtime AVG sessions on the Xbox
34
Kinect. Two to three sport games were chosen for participants to play each session. General linear
35
models with either perceived object control or actual object control skill as the outcome variables were
36
conducted. Each base model adjusted for intervention status and pre-score of the respective outcome
37
variable. Additional models adjusted for potential confounding variables (sex of child and game at
38
home).
39
Results: No significant differences between the control and intervention groups were observed for
40
both outcomes.
41
Conclusions: This study found that playing the Xbox Kinect does not significantly influence
42
children’s perceived or actual object control skills, suggesting that the utility of the Xbox Kinect for
43
developing perceived and actual object control skill competence is questionable.
Ac ce p
te
d
M
an
us
cr
ip t
23
44 45
Keywords: exergaming, child, motor skills, Xbox, fundamental movement skills
46
Introduction
Page 2 of 18
3 Physical activity (PA) has been identified to have multiple health benefits for children1,2 . As such, it is
48
recommended children aged 5-12 years accumulate at least 60 minutes of moderate to high intensity
49
PA per day3. However, many children around the world do not meet the PA guidelines4. In Australia
50
only one in five 5-17 year olds achieve this recommendation5. Furthermore, with the number of screen
51
based devices available there is concern for the time spent in sedentary behaviours6. The Australian
52
electronic entertainment recommendation of ‘no more than two hours of screen-based entertainment’ a
53
day was met by less than one third (29%) of children and young people between the ages of 5 and 17
54
years old5.
55
Fundamental movement skills (FMS) are considered the building blocks for sport-specific activities7
56
and provide an important foundation for human movement and PA throughout the life span8. The
57
battery of FMS typically includes locomotion skills (walking, leaping, jumping, and running), object
58
control skills (catching, kicking and throwing) and stability skills (balance)7. The acquisition of FMS
59
in early childhood provides the opportunity for children to master movement skills and increases the
60
likelihood that children will enjoy participating in physical activities9. Mounting evidence suggests a
61
strong positive relationship between FMS acquisition during childhood, PA participation10 and health
62
benefits11. Yet few children meet basic FMS competency12-14. In Australia, between 1997 and 2010,
63
less than 50% of children aged 9-15 years old achieved mastery of the FMS of running, jumping,
64
kicking, overarm throwing and catching13 and this trend is reported globally12-14. The increased time
65
children spend in front of screens coupled with physical inactivity, is potentially a contributing factor
66
to the lack of FMS mastery in children12.
67
Active video games (AVGs) are designed to encourage whole body movement to control/play the
68
electronic gaming system15 and thus provide an opportunity for screen time to become more active. A
69
recent systematic review suggested that AVGs have the potential to develop motor skills16. Children
70
have reported that AVGs are easier than actually playing the game in real life15, potentially providing a
71
platform for skill development. Some evidence supports the idea that AVG use is associated with
72
higher object control proficiency17. Striking has been found to have the highest proportion of correctly
Ac ce p
te
d
M
an
us
cr
ip t
47
Page 3 of 18
4 demonstrated components compared to other object control skills (rolling and throwing) when playing
74
AVGs18.
75
According to Harter’s competence motivation theory19 a child is more likely to continue a
76
behaviour/activity if they believe they are proficient and have a positive self-perception of their
77
performance. Children proficient in object control skill have higher perceptions of competence and PA
78
as adolescents20. Children’s perception of their movement ability in a range of movement tasks were
79
improved after an AVG intervention21, and a dance mat AVG intervention increased obese
80
adolescents’ perceived competence to engage in exercise22, suggesting that perceived competence may
81
be improved through AVG play.
82
AVGs have the potential to positively impact children’s object control skills and their perceived skill
83
competency. Sensor-based technology offers a new software element with web-cam styled devices
84
enabling the user to interact directly without a controller, potentially increasing whole body
85
movement6. The study aim was to explore whether the Xbox Kinect can be used as a novel strategy to
86
increase children’s actual and perceived competence in object control skills.
87
Methods
88
Informed written consent was obtained from one school principal for their school to participate in the
89
study. Forty-three children aged 6-10 years (grades 1-4) and parents provided written informed
90
consent for their children’s participation. All study procedures were approved and in accordance with
91
the ethical standards of the University and the Department of Education and Early Childhood
92
Development. At the time of consent, demographic information was gathered through a parent survey,
93
which asked for the child’s sex, date of birth, weekly time (minutes) in AVG play (i.e. any AVG play,
94
not necessarily sport games) and enrolment in organised sports/activities outside of school in for the
95
school term preceding the study and the current term. Each listed sport/activity was coded as either a
96
‘ball sport’ (e.g. golf, tennis, football) or ‘non-ball sport’ (e.g. swimming, martial arts). Parents were
97
also asked to provide demographic information such as their country of birth, language spoken most at
98
home, highest level of education attained, and employment status. Inclusion criteria was for children
Ac ce p
te
d
M
an
us
cr
ip t
73
Page 4 of 18
5 with no/minimal previous AVG experience. Thus, seven children were excluded because they reported
100
90 minutes or more of regular weekly AVG game play (the upper fifth of this sample in terms of time
101
in AVG play). Participants were randomly allocated to the intervention or control groups using a
102
random number generator. This resulted in 19 children (53% boys) being allocated to the intervention
103
group (mean age 7.9 years, SD 1.5) and 17 allocated to the control group (53% boys; mean age 8.0
104
years, SD 1.2).
105
The Test of Gross Motor Development (TGMD-3) assessed object control competence (two hand
106
strike, one hand strike, ball bounce, catch, kick, underarm throw, overarm throw) according to
107
established protocols. The TGMD23 is normed every 15 years and the third version will be formally
108
released in 2015. Each skill had a number of components that needed to be demonstrated for the skill
109
to be performed proficiently. Every attempt was scored with each component of the skill receiving a
110
‘1’ if correctly executed or a ‘0’ if the skill was incorrectly performed. Scores of the two trials were
111
summed to obtain a raw score for each skill. All children had their TGMD-3 skills assessed live in the
112
school setting by two trained observers (12 hours conducted by an expert trainer) blinded to
113
intervention status. Both observers coded sample videos of children performing the TGMD-3 online as
114
issued by the instrument developers in 2014 and scored ≥0.95 in terms of agreement with the coded
115
videos. Excellent inter-rater reliability using the TGMD-2 in a previous study has been reported for
116
these raters23. The two raters simultaneously evaluated 14% of the observations in this study. Using a
117
two-way random effects model where both people effects and measures effects are random, the ICC
118
for the seven ball skills was excellent 0.88 (0.64-0.96).
119
Two additional skill tests, the golf swing and putt stroke, were developed to be appropriate to the
120
games offered through the Kinect; one of which was golf. These skills were developed via a Delphi
121
consultation based on the TGMD skill assessment protocols. Each skill had six components to be
122
marked as present/absent. These skills were assessed by one of the developers of this instrument
123
blinded to intervention status. These skills have acceptable intra-rater (ICC = 0.79, 95% CI 0.59, 0.90)
124
and test retest reliability (ICC = 0.60, 95% CI 0.23, 0.82)24.
Ac ce p
te
d
M
an
us
cr
ip t
99
Page 5 of 18
6 The Pictorial Scale of Perceived Movement Skill Competence for Young Children (PMSC) assessed
126
children’s perceived competence25. The instrument is designed for use with children to rate perceived
127
movement skills using pictures which correspond to a number from one (‘poor’ skills) to four (‘good’
128
skills). The most recent version of the instrument (used in this study) matches the skills included in the
129
TGMD-3 and maintains the wording structure of the version aligned with the TGMD-223. The seven
130
object control skills were assessed in this study along with two golf skills (swing and putt) maintaining
131
the same format. Prior to using the rating scale, we assessed test retest reliability over a seven-day
132
cycle. The instrument demonstrated excellent reliability, with an ICC of 0.84 (95% CI 0.73-0.91). The
133
pre/post intervention perceived competence testing was administered during school hours prior to
134
actual skill assessment.
135
The six week intervention consisted of 50-minute gaming sessions which were conducted once a week
136
during school lunch time (1pm-1.50pm). Two Xbox Kinect gaming consoles were connected to two
137
televisions in the school media room. The following Xbox Kinect games were chosen: Kinect Sports
138
Season 1, Kinect Sports Season 2, and Sports Rivals. Specific mini-games (e.g. baseball, golf, tennis,
139
table tennis, soccer, bowling, volleyball and football) were identified from these 3 games that involved
140
object control skills (one/two hand strike, golf swing/putt, catch, over/under-arm throw, bounce and
141
kick). Kinect Adventure, with limited object control games, was offered in the final week to maintain
142
interest. Week one games consisted of tennis, table tennis and baseball, week two: baseball and golf,
143
week three: table tennis and soccer, week four: golf and beach volleyball and week five: tennis,
144
baseball and golf. In week six children were given the opportunity to choose their game. If a child
145
missed a session they were asked to attend at the next available session. A game record form was
146
completed by the researchers on the amount of time (in minutes) each child spent playing each
147
sport/game during each intervention session.
148
Independent t-tests were used to determine whether sex, owning an AVG at home and prior
149
participation in organised striking sports influenced the outcome scores and therefore should be
150
considered a confounding variable (p < 0.10). A general linear model was used to find whether there
151
was a significant difference between the pre- and post-intervention perceived object control results of
Ac ce p
te
d
M
an
us
cr
ip t
125
Page 6 of 18
7 the intervention group relative to the control group. Three models were used due to the limited power
153
of the sample. Each regression model had post perceived object control score as the outcome,
154
control/intervention status as the predictor and was adjusted for pre- intervention perceived object
155
control score. Child age was initially adjusted for but removed due to lack of significance. Model two
156
also adjusted for owning a game at home, while model three also adjusted for participant sex. The
157
same analysis process and series of models were used to assess actual skill improvement, except with
158
post object control score as the outcome and adjusted for pre- intervention object control. All analysis
159
were performed using SPSS v.22.
160
Results
161
Table 1 reports descriptive baseline information. There were no significant differences between
162
control and intervention children for any demographic or background variables and for actual or
163
perceived skill at baseline.
164
> > > > > > > > > > > > > > > > > Insert Table 1 Here < < < < < < < < < < < < < <
> > > > > > > > > > > > > > > > Insert Tables 2 and 3 Here < < < < < < < < < < <
