Perceptual & Motor Skills: Motor Skills & Ergonomics 2015, 121, 3, 1-24. © Perceptual & Motor Skills 2015

CHILDREN'S MOVEMENT SKILLS WHEN PLAYING ACTIVE VIDEO GAMES1, 2 RYAN M. HULTEEN

TARA M. JOHNSON

Priority Research Centre in Physical Activity and Nutrition, University of Newcastle

School of Health and Social Development, Faculty of Health, Deakin University

NICOLA D. RIDGERS

ROBIN R. MELLECKER

Centre for Physical Activity and Nutrition Research Faculty of Health, Deakin University

School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University Department of Sports Science and Physical Education, The Chinese University of Hong Kong

LISA M. BARNETT School of Health and Social Development, Faculty of Health, Deakin University Summary.—Active video games (AVGs) may be useful for movement skill practice. This study examined children's skill execution while playing Xbox Kinect™ and during movement skill assessment. Nineteen children (10 boys, 9 girls; M age = 7.9 yr., SD = 1.4) had their skills assessed before AVG play and then were observed once a week for 6 wk. while playing AVGs for 50 min. While AVG play showed evidence of correct skill performance (at least 30–50% of the time when playing table tennis, tennis, and baseball), nearly all skills were more correctly performed during skill assessment (generally more than 50% of the time). This study may help researchers to better understand the role AVGs could play in enhancing real life movement skills.

National and international guidelines recommend children engage in 60 min. or more of moderate-to-vigorous intensity physical activity every day (World Health Organization, 2010; Commonwealth of Australia, 2014). However, data from 105 countries show that an estimated 81% of young people do not meet these guidelines (Hallal, Andersen, Bull, Guthold, Haskell, & Ekelund, 2012). Physical inactivity may be further exacerbated by children's increased use of electronic media during leisure time such as watching television and playing video games (Commonwealth of Australia, 2014). The combination of low physical activity and excessive screen-time may have serious consequences for children's current and future health, such as increased adiposity and all-cause mortality (Owen, Sparling, Healy, Dunstan, & Matthews, 2010). Address correspondence to Dr. Lisa M. Barnett, School of Health and Social Development, Deakin University, Melbourne VIC 3125, Australia or e-mail ([email protected]). 2 Funding for this project was provided by an internal grant from Deakin University. Dr. Barnett is supported by an Alfred Deakin fellowship, and Dr. Ridgers is supported by an Australian Research Council Discovery Early Career Researcher Award (DE120101173). 1

DOI 10.2466/25.10.PMS.121c24x5

ISSN 0031-5125

2

R. M. HULTEEN, ET AL.

Perhaps as a result of low physical activity and excessive screen-time, many children are not proficient in fundamental movement skills (Barnett, Bangay, McKenzie, & Ridgers, 2013). Such skills (e.g., kicking, throwing, catching) help children participate in and enjoy sports and physically active games (Lubans, Morgan, Cliff, Barnett, & Okely, 2010; Goodway, Famelia, & Bakhtiar, 2014). However, these skills are not naturally acquired (Gallahue & Ozmun, 2012). Studies typically report that only half of children are able to perform fundamental movement skills with proficiency (Goodway, Robinson, & Crowe, 2010; Hardy, Barnett, Espinel, & Okely, 2013; Spessato, Gabbard, Valentini, & Rudisill, 2013; Bryant, Duncan, & Birch, 2014). Research shows a strong relationship between lack of competency in these skills and decreased physical activity in children (Lubans, et al., 2010; Hardy, Reinten-Reynolds, Espinel, Zask, & Okely, 2012). Without these “building blocks,” children are at risk of being physically inactive and less fit later in life (Barnett, van Beurden, Morgan, Brooks, & Beard, 2008, 2009; Barnett, Hardy, Lubans, Cliff, Okely, Hills, et al., 2013). Therefore, identifying effective strategies for promoting children's mastery in fundamental movement skills is important for children's health (Lubans, et al., 2010). Active video games (AVGs) have been suggested as a strategy for overweight/obese and/or sedentary children to increase their light and moderate physical activity (O’Loughlin, Dugas, Sabiston, & O'Loughlin, 2012; Peng, Crouse, & Lin, 2012). However, there is a lack of evidence supporting their use as a means of meeting daily moderate-to-vigorous physical activity guidelines (i.e., 60 min. per day; LeBlanc, Chaput, McFarlane, Colley, Thivel, Biddle, et al., 2013). Yet, these games may have alternative benefits, such as movement skill development, which may help a child to be more physically active (Barnett, et al., 2013). These games may benefit particular populations in regard to increasing movement skill competency (Barnett, Hinkley, Okely, Hesketh, & Salmon, 2012), such as girls, who tend to have poorer ball-handling skills than boys (Barnett, van Beurden, Morgan, Brooks, & Beard, 2010; Hardy, et al., 2013). Sports-based AVGs require virtual movements that provide opportunities for the user to practice skills used during sports (e.g., striking a ball). These games have been primarily designed for fun and play, but they may also be a gateway to subsequent engagement in physical activity and sport by building children's movement skills and enabling them to participate in the “real sporting activity” that these games mimic (Krause & Benavidez, 2014). This premise relies on an underlying assumption that movements used during AVGs are the same movements a child uses in real life, which may not always be true. Active video game use has been shown to promote higher energy expenditure through movement, which is not evident in more sedentary,

ACTIVE VIDEO GAME MOVEMENT SKILLS

3

seated games (e.g., Sony Playstation 2; Graves, Stratton, Ridgers, & Cable, 2007). More specifically, higher reported use of AVGs (i.e., frequency of use) has been shown to explain 12% of variance in a child's object control skill (manipulation of an object such as a ball) competency after adjusting for age, sex, and physical activity (Barnett, et al., 2012). Additionally, the ability to elicit correct skill components during striking games on the Nintendo Wii™ has been demonstrated, with correct two-handed striking components (i.e., seen in baseball) more evident than correct throw or roll components (Rosa, Ridgers, & Barnett, 2013). This previous finding suggests that Wii games including ball skills may have potential for skill acquisition. However, the proportion of correct skill components identified using the Wii in this study was overall very low (2–20% dependent upon the skill observed), suggesting it may be appropriate to test another gaming platform/console that is more veridical in representing the skills involved. The low prevalence of correct skill components observed may be attributable to the use of a handheld controller, while, for example, the Xbox Kinect™ may elicit a more realistic movement due to the use of a live action camera that captures the movement of the gamer. Thus, the Xbox Kinect™ may provide a better opportunity to develop children's object control skills in terms of popular sports. This study focused on object control skills, particularly striking skills. Research goal. To investigate the extent to which correct skill components are present (a) when playing sports games on the Xbox Kinect™ and (b) during movement skill assessment. METHOD Participants The participants were recruited from a single school as part of a larger intervention trial that investigated whether children could improve movement skill competency via playing AVGs (Johnson, Ridgers, Hulteen, Mellecker, & Barnett, in press). The school principal gave written permission for the study. For the current study, data from the intervention children are examined to explore the extent to which correct skill components are present when (a) playing sports games on the Xbox Kinect™ and (b) performed during a skill assessment. Nineteen typically developing elementary school students in Grades 1–4 (10 boys, 9 girls) aged 6–10 years (M age = 7.9 yr., SD = 1.4) returned written informed parental consent to participate in the study. Both the university human ethics committee and the Victorian Department of Education and Early Childhood Development granted ethical approval for this project.

4

R. M. HULTEEN, ET AL.

Materials As this study examined whether “playing” sports-based games can elicit correct components of movement skills, the children were provided with some choice (2–3 games per session) in terms of what games they could play. The choice of games provided throughout the study was based on a content analysis of commercially available games prior to beginning the study (June 2014) that fit the research question. Games with object control skills were given higher priority. Thus, the children's choices were restricted to games the research team had specified. Games were allocated based on the following priorities. First priority games were any games with striking skills (e.g., tennis, table tennis, baseball, golf), second priority were games with other object control skills (e.g. bowling, soccer, beach volleyball), and last were sports games that did not fulfill either requirement (e.g., track and field). These third priority games were offered in Week 6 if children desired more choices. Sustaining the interest of children over the course of 6 weeks, as well as attempting to balance the interests of different children, was the main reason for providing choice (Pate, 2008), particularly because decreased interest and participation as time goes on has been a concern with AVG studies (Gao & Chen, 2014). Information related to the motor and perceptual demands of the games can be found in Table 1. Observation Tool for Active Gaming and Movement (OTAGM) The OTAGM was used to observe and record children's engagement, game or sport played, body movement, movement skills, and correct skill components exhibited during AVG play (Rosa, et al., 2013). The observation tool employs momentary time sampling techniques (i.e., 10 sec. observing period, directly followed by a 10 sec. period for recording the observations) provided through the use of audio cues on a MP3 player to the observer in real time (Ridgers, Stratton, & McKenzie, 2010). During a 10 sec. observation period, a rater is looking at the game being played, the first movement skill being performed, and whether or not correct skill components are being used to complete the movement skill. When the rater hears the word “record” via an audio cue on an MP3 player, the rater has an additional 10 sec. to record this information. The rater also assesses the body movement an individual uses and whether or not the child is engaged in the game. This combined 20 sec. period of observing and recording constitutes one interval, and this process is repeated 30 times for each child (20 sec. × 30 intervals = 10 min.). Over the 6 wk. AVG observation period, a child could have a maximum of 180 intervals (6 sessions × 30 intervals per session; mean intervals observed = 175.8; range = 143–180) of data. Intra-rater reliability from the OTAGM instrument (Rosa, et al., 2013), performed using interval-by-interval agreement, was high to excellent for body movement (83%) and movement skill components (90%), and 100%

5

ACTIVE VIDEO GAME MOVEMENT SKILLS TABLE 1 SPORT GAMES PLAYED WITH THEIR MAIN MOTOR AND PERCEPTUAL DEMANDS Striking Games

Motor Demands

Perceptual De- Non-strikmands ing Games

Motor Demands

Perceptual Demands Use visual cues to aim to throw ball and hit targets.

Baseball

Perform two-hand- Follow visual Bowling ed strike to hit and audio baseball, percues to either form overhand hit, catch, or throw to pitch or throw ball. throw ball to first base, catch ball if hit to outfield.

Perform underhand throw to knock down pins at the end of the lane.

Golf

Perform golf swing Use visual cues Soccer or golf putt in orto aim and der to hit the ball hit the ball into the hole. toward the target.

Perform kick Use audio to try and and visual score a goal cues to against the kick ball opposing into the team. net.

Table tennis

Perform one-hand- Follow visual ed strike to hit and audio ball over the net. cues to hit ball back over net.

Perform one- Follow visual handed and audio strike to hit cues to hit ball over ball back net. over net.

Tennis

Perform one-hand- Follow visual ed strike to hit and audio ball over the net. cues to hit ball back over net.

Volleyball

for engagement, movement skill, and sport/game played. Above 80% is acceptable (Ridgers, et al., 2010). For this study, each participant was observed during each single session (i.e., once per week for 6 wk.) for a 10 min. period of the 50 min. session (i.e., 30 data points per session). The order in which the participants were observed changed each week to ensure data from the beginning, middle, and end of a 50 min. session was obtained for each child (i.e., reduced potential timing effects of session on data). Engagement.—The children's engagement was classified as either ON (i.e., child is engaged, playing, watching, or talking about his game or that of his peers) or OFF (i.e., child is not engaged in playing, watching, or talking about the game) for each interval during a child's 10 min. observation period (Rosa, et al., 2013). Movement skills.—During the course of playing various AVGs, children were observed for their ability to perform eight different object control movement skills (one-handed strike, two-handed strike, golf swing, golf putt, overhand throw, catch, kick, and underhand throw). Movement skills and corresponding skill components that could be observed were dependent upon the sport game that each individual chose to play. For

6

R. M. HULTEEN, ET AL.

example, if golf was the chosen game, then raters could only assess the participant's ability in either the golf swing or the golf putt. However, if the participant later chose to play baseball, then different movement skills (two-handed strike, catch, throw) could be observed and recorded. If two or more different skills were exhibited in a single 10 sec. observation period, then only the first skill observed was recorded. Focusing on only one skill was done to minimize observer error that might result from trying to categorize components correctly from two different skills. However, this situation rarely occurred. Skill components.—One modification made from previous use of the OTAGM system (Rosa, et al., 2013) was that skill components were observed and recorded throughout the entire observation period (10 sec.) in this study and not restricted to observing skill components during a 1 sec. “snapshot” when the word “record” was heard, as was done in the previous study (Rosa, et al., 2013). This was done to allow more accurate identification of the specific components the children displayed when playing AVGs. A skill is essentially a movement pattern, and if there is incomplete observation of movements researchers may be underestimating the participants' ability to display certain components. Essentially, the changes used in the present study allow observation of skill components during half of the time (10 sec. of observation throughout a 20 sec. interval), whereas previous research (Rosa, et al., 2013) only observed skill components during a fraction of a second (~1 sec. throughout the 20 sec. interval). Movement skill components for six of the skills (two-handed strike, one-handed strike, catch, overhand throw, underhand throw, and kick) were assessed based on the Test of Gross Motor Development (TGMD– 3). The TGMD–3 is a norm-referenced measure of common gross motor skills validated for children ages 3–10 years, which is updated every 15 years. Version 3 is due for formal release in 2015 (skills and associated components obtained in advance directly from D. Ulrich) and is updated from Version 2 (Ulrich, 2000). Two additional skills, the golf swing and golf putt, assessed in a similar fashion to skills assessed in the TGMD–3, were also included (Barnett, Hardy, Brian, & Robertson, 2015). These skills have acceptable intra-rater (ICC = 0.79, 95%CI = 0.59, 0.90) and test-retest reliability (ICC = 0.60, 95%CI = 0.23, 0.82). It must be noted that the test-retest reliability was performed in a small sample and was 5 days apart, perhaps contributing to a slight learning effect (Barnett, et al., 2015). Not all skill components for these object control skills could be directly observed during AVG play, particularly the outcomes of an action; thus, the focus of the observations were on observable skill components. For example, when scoring the two-handed strike during AVG play, it is not possible to observe whether the ball is sent straight ahead after it is “hit.” Please see Table 2 - Observed Movement Skills and Associated Components for the

Both hands on imaginary Child's side on to intended target (i.e., non-pregolf club (non-dominant ferred hip should face hand toward the end toward target). Back is of the grip, dominant hand toward the shaft) straight (slight bend at bat above non-preferred waist), and feet about hand shoulder width apart

Both hands on imaginary golf club (i.e., grip not important)

Golf swing

Golf putt

Imaginary paddle follows through toward nonpreferred shoulder

Component 3

(continued on next page)

Child's side on to intend- Small backswing with ed target (i.e., non-prethe imaginary putter ferred hip/shoulder fac(i.e., arms remain fairly es toward target). Back straight) is straight (slight bend at waist) and feet about shoulder width apart

Child takes a high backswing with the imaginary club (i.e., raised to a position parallel to ground)

Child's non-preferred hip/ Hip and shoulder rotate shoulder faces straight and derotate during ahead swing

Child's preferred hand grips imaginary bat above non-preferred hand

Two-handed strike

Steps with non-preferred foot

Component 2

Child takes a backswing with the imaginary paddle

Component 1

One-handed strike

Skill

TABLE 2 OBSERVED MOVEMENT SKILLS AND ASSOCIATED COMPONENTS

The plane of the putter is toward the target in a smooth rhythmic pendular motion without break (no indication of high elbow)

Imaginary club follows through toward nonpreferred shoulder (indicated by high elbow facing to front), and in finish position child is facing screen with weight on front foot indicated by a rising of back heel

Steps with non-preferred foot

Component 4

ACTIVE VIDEO GAME MOVEMENT SKILLS

7

Component 2

Component 3

Child's hands positioned Arms extend, reaching for in front of body with elball as it arrives bows flexed

Child takes rapid, continu- Child takes an elongated ous approach to imagistep just prior to imaginary ball nary ball contact

Catch

Kick

Strides forward with foot opposite the preferred hand toward the screen

Preferred hand swings down and back, reaching behind the trunk while chest faces screen

Rotates hip and shoulders Steps with the foot oppoto a point where the site the throwing hand non-throwing side faces toward the wall/screen the wall/screen

Underhand throw

Component 1

Windup is initiated with downward movement of hand/arm

Overhand throw

Skill

TABLE 2 (CONT’D) OBSERVED MOVEMENT SKILLS AND ASSOCIATED COMPONENTS Component 4 Throwing hand follows through after the imaginary ball release, across the body toward the hip of the non-throwing side

8 R. M. HULTEEN, ET AL.

ACTIVE VIDEO GAME MOVEMENT SKILLS

9

skills and components observed in AVG play. Also note that the dribble, even though part of the TGMD–3, was not observed as part of the AVG play since basketball was not a priority game. It was possible for multiple skill repetitions to occur within one interval. Credit for components was given if it was seen in the first repetition or any subsequent repetitions within the interval. For example, if children gripped the bat with their preferred hand above their non-preferred hand on the imaginary bat (i.e., component one) in one repetition, but had their hips and shoulders facing straight ahead (i.e., component two) present in both repetitions, then they were credited with displaying both skill components for that observation interval. Body movement.—Body movement was classified and recorded on the “record” prompt as one of the following during each interval: (1) Stationary, no movement (i.e., standing still, laying); (2) Stationary, little movement, which includes incidental movement (i.e., shifting weight, scratching head); (3) Arm movement, which includes movement of only the wrist, forearm, or shoulder; (4) Leg movement, including ankle, knee, or hip movement only; and (5) Whole body movement (i.e., combined upper and lower body movement). Categorization of body movement was the same as in the original OTAGM (Rosa, et al., 2013), and was derived from a previously validated measure of assessing the intensity of physical activity (O'Hara, Baranowski, Wilson, Parcel, & Simons-Morton, 1989). Observer training.—For the current study, two trained observers collected all data live. The third and last authors developed the OTAGM and conducted the training. The observer training consisted of familiarization with the OTAGM instrument and protocols for the current study, as well as criteria specific to the TGMD–3 and golf skills that were being assessed (5 hr.). The observers practiced coding a video recording of a child (not in the intervention) playing the specified games on the Xbox Kinect™ prior to the beginning of the study. Interval-by-interval inter-observer agreement was set at > 80% to be acceptable. The observers independently rated a series of videos until inter-observer agreement was > 80% for engagement, body movement, and skill components (3 hr.). Inter-rater reliability checks were conducted simultaneously and independently on 10% of the total live sessions throughout the 6 wk. of data collection by the observers to check for observer drift. In total, 12 children were observed across 351 intervals. Agreement was good for body movement (84.3%) and excellent for skill components (93.1%) and engagement (99.7%). Movement Skill Competence in a Skill Assessment Context Data for actual movement skill competence (i.e., not during AVG play) was gathered for the study sample as part of the larger intervention study (Johnson, et al., in press). Competence in object control skills (two-hand strike,

10

R. M. HULTEEN, ET AL.

one-hand strike, catch, kick, overhand throw, underhand throw, and dribble) was assessed in real time using the TGMD–3. Additionally, the two golf skills, golf swing and golf putt, were assessed in a similar fashion (Barnett, et al., 2015). Levels of competency were determined by assessing the number of skill components present during two trials of the performed movement skill. If a skill component was performed correctly a score of 1 was given, and if the skill component was absent then a score of 0 was given. Instead of summing the number of correct components across the two trials (as per the TGMD–3 scoring protocol), if a child displayed a skill component during Trial 1 or Trial 2, then credit was given to the child for displaying that skill component. This change was made to match the component scoring system in the OTAGM. There are more components that can be assessed during the skill assessment, compared to AVG play (e.g., hits the ball straight ahead during the one-handed strike or places foot close to ball during the kick), so only those components that could be observed during the skill assessment and during AVG play were noted so that results could be compared. All children had seven TGMD–3 skills (catch, kick, dribble, two-hand and one-hand strike, and over- and underhand throws) assessed live by two trained observers (12 hr. conducted by an expert trainer) who had achieved excellent inter-rater reliability in a previous study (Barnett, Minto, Lander, & Hardy, 2014). In this study, both observers scored ≥ .95 in terms of agreement with coded sample videos issued by the instrument developers in 2014. The ICC for the seven skills in terms of rater agreement in the field was excellent .88 (.64–.96; Johnson et al., in press). The golf skills were assessed by one of the developers of this instrument, also with adequate reliability (Barnett, et al., 2015). Procedure First, the children were assessed in their skills in a skill assessment context. This was done outside at the school with appropriate equipment in small groups. Then, the children participated in one Xbox Kinect™ session a week for 6 wk. during school time. Lunch sessions (~50 min.) were used on a typical day, while shorter recess periods (~30 min.) were used for children who had missed a scheduled lunch session (this occurred for seven children). Regardless of whether they attended a lunch or recess period, the children were observed for the same amount of time per session (~10 min.). A typical session included the participation of four children at one time, with two children sharing a console. The children could elect to take turns or to play competitively. Once the children arrived, they were allowed to start playing the designated games for the given week without any formal instruction. One research assistant, separate from the observer, was present to facilitate each session. For example, the research assistant helped the child if the television

ACTIVE VIDEO GAME MOVEMENT SKILLS

11

or Xbox malfunctioned or if the child needed clarification pertaining to the game, but no formal skill “coaching” was done. After the first 5 min. of the session (which allowed for children to enter and play the different games), the trained observer would begin the live momentary time sampling for the first child (chosen randomly prior to arriving at the school by assigning an observation number, one through four, to each child) and observe/record all relevant information (i.e., engagement, sport/game played, movement skill, skill components, and body movement). Prior to each participant's individual observation period, child ID, observation number, sex, and session start time were recorded. After the first participant, the children were observed sequentially (according to observation number) until all present participants had been observed. The observer's audio started with a 10 sec. “observe” period. During this time, the skill, game/sport played, skill repetitions, and skill components performed were recorded. On the “record” prompt, engagement (ON or OFF) and the body movement (stationary, small movement, arm, leg, or body) were assessed and noted. Analysis The data were entered and analyzed in Microsoft Excel Version 14.3.9. For the AVG play, total summed scores were created for variables (engagement, movement skill, skill components, and body movement) for each of the eight movement skills. The total number of times each skill component was observed and body movement exhibited, as well as the total percentage of correct skill components observed, were calculated for each sport. This was performed to see whether certain sport games had more opportunity for skill components to be identified. For example, both tennis and table tennis exhibit the same skill, the one-handed strike, but different components may appear more in one striking skill than the other. The percentage of total correct skill components observed for a given sport was calculated by dividing the total number of components observed by the total number of skill components possible for the number of intervals a skill was observed. For example, the one-handed strike has three components. Thus, if this skill was observed for 30 intervals, then the total possible number of components is 90. If Component 1 and 2 were each observed 20 times each and Component 3 was observed only five times, then to calculate the percentage of correct components we would divide 45 (the sum of Components 1, 2, and 3) by 90. The percentage of observations for a specific body movement or for engagement in a given sport was calculated by dividing the number of times a body movement or engagement was observed divided by the total number of intervals a sport was played. For skill assessment execution, the percentage of time a skill component was displayed for the skills assessed live (i.e. one-handed strike, two-handed

12

R. M. HULTEEN, ET AL.

strike, golf swing, golf putt, kick, catch, throw, underhand throw) was calculated by dividing the number of times a skill component was correctly performed (in Trial 1 or Trial 2) by the total number of intervals the skill was performed. As there were 19 participants and each participant completed two trials, or one interval of each skill, the total number of intervals was 19. RESULTS The games the participants played, and the time spent playing each AVG, is presented in Table 3. The most played games (in order by most minutes played) were golf, baseball, table tennis, tennis, soccer, bowling, and volleyball. TABLE 3 TIME SPENT IN AVGS AND PERCENTAGE OF TOTAL TIME IN AVGS Activity Golf

Time Spent in Activity (min.)

% of Total Time

1,032

18.8

Baseball

877

16.0

Table tennis

791

14.4

Tennis Striking total

560

10.2

3,260

59.3

Soccer

537

9.8

Bowling

320

5.8

70

1.3

Volleyball American football Other object control total Party games

10

0.2

937

17.1

150

2.7

Track and field

85

1.5

Ralleyball

40

0.7

Rafting

35

0.6

Space adventures

25

0.5

Reflex game

20

0.4

Water adventures

20

0.4

4,197

76.4

Setup, e.g., choosing game or character

494

9.0

Other, e.g., left classroom, not participating

200

3.6

Waiting for turn

113

2.1

Eating lunch

110

2.0

All object control games total

Administrative Non-game total

5

0.1

922

16.8

ACTIVE VIDEO GAME MOVEMENT SKILLS

13

Engagement Overall, levels of engagement in AVG play were high (above 90% for all games). The lowest recorded engagement was for golf, which was 91.5%. Movement Skills and Components The one-handed strike was observed in tennis and table tennis. The one-handed strike was also seen in volleyball (where children made a striking motion to “hit” the ball); however, volleyball only accounted for 66 intervals of the one-handed strike out of a total of 1,050 intervals. In total, the one-handed strike was the most commonly observed skill (n = 1,050 or ~34% of all intervals). Golf was the most commonly played game, which led to the golf swing being the second most observed skill (n = 587 or ~19% of all intervals). However, the golf putt constituted less than 10% of intervals (i.e., observed for 194 intervals). Kicking, used predominantly in soccer, was recorded during 14% of intervals. Baseball, while being the game the participants played the second most, only had one skill (two-handed strike) which appeared in more than 10% of all intervals (n = 336). However, baseball also allowed for 251 intervals of throwing and two intervals of catching to be recorded. Thus, this game allowed for the most diverse sample of skills to be performed by the participants. The last remaining movement skill, the underhand throw (used in bowling), was observed during only 210 intervals. Skill component frequency during AVG play is presented in Table 4. Overall, the catch was the best performed skill (correct components were present 100% of the time, although this was only observed in two intervals), followed by the one- and two-handed strike (correct components were present 38.0–42.3% of the time). The kick was very poorly performed (correct components were present 4.9% of the time). The single most correctly performed skill component that was observed throughout all games was C2 (Child's non-preferred hip/shoulder faces straight ahead) of the two-handed strike used in the game of baseball (58.0%). Next, C1 (Child's preferred hand grips imaginary bat above non-preferred hand) of the same skill was properly performed during 55.7% of two-handed strike observations. These two skill components, other than the two components of catching (which had minimal observations in the game of baseball) and C1 (child takes a backswing with the imaginary paddle) for the one-handed strike in tennis (57.0%), were the only skill components to be correctly displayed during more than 50% of the observations, although C1 in table tennis was close (49.7%). For non-striking movement skills, C1 (windup initiated with downward movement of hand/arm) of the overhand throw (42.8%) was displayed with moderate accuracy by the participants, especially during baseball (44.6%). All remaining skill components were properly executed on no more than 35% of all observations.

66

Volleyball

Bowling

2

2

66

15

112

127

58

163

187

2

231

288

521

n

100

31.4

32.6

44.6

42.8

29.9

27.8

55.7

3.0

57.0

49.7

49.6

%

Component 1

2

45

13

65

78

50

160

195

2

144

166

312

n

100

21.4

28.3

25.9

26.3

25.8

27.3

58.0

3.0

35.6

28.7

29.7

%

Component 2

14

63

77

35

64

106

2

136

226

364

n

30.4

25.1

25.9

18.0

10.9

31.6

3.0

33.6

39.0

34.7

%

Component 3

13

76

89

26

63

81

n

1

28.3

30.3

30.0

13.4

10.7

24.1

%

Component 4

(continued on next page) Total successful components for all sport and each sport. 2Mean percent of successful components for each sport.

Baseball

Catch

210

46

Track and field

Underhand throw

297

251

Baseball

194

587

All sports

Throw

Golf

Golf putt

Golf

Golf swing

Baseball

336

405

Tennis

Two-handed strike

579

1050

n

Intervals

Table tennis

All sports

One-handed strike

Skill Sport

TABLE 4 PERFORMANCE OF CORRECT SKILL COMPONENTS IN EACH MOVEMENT SKILL AND SPORT DURING AVG PLAY

4

111

55

316

371

169

450

569

6

511

680

1197

Success1

100

26.4

29.9

31.5

31.2

21.8

19.2

42.3

3.0

42.1

39.2

38.0

%2

14 R. M. HULTEEN, ET AL.

1

427

1

1

6

Tennis

Track and field

Volleyball

0

1

0

4

5

n

0.0

100

0.0

0.9

1.2

%

Component 1

0

1

0

37

38

n

0.0

100

0.0

8.7

8.7

%

Component 2 n

%

Component 3 n

%

Component 4

Total successful components for all sport and each sport. 2Mean percent of successful components for each sport.

435

Soccer

n

Intervals

All sports

Kick

Skill Sport

TABLE 4 (CONT’D) PERFORMANCE OF CORRECT SKILL COMPONENTS IN EACH MOVEMENT SKILL AND SPORT DURING AVG PLAY

0

2

0

41

43

Success1

0.0

100

0.0

4.8

4.9

%2

ACTIVE VIDEO GAME MOVEMENT SKILLS

15

16

R. M. HULTEEN, ET AL.

The majority of movement was rated as either small movement or full body movement. Small movement was the most prevalent in baseball (47.4%), bowling (43.8%), golf (41.9%), table tennis (42.5%), and tennis (41.7%). Meanwhile, full body movement was more commonly observed during soccer (44.7%), track and field (43.7%), and volleyball (41.9%). Interestingly, sports that had small movement observed the most always had full body movement as the second most commonly cited body movement. Sports with full body movement as the most frequently occurring had small movement as the second most common body movement. All other types of movement (i.e., stationary/no movement, arm, and leg) were observed for less than 19% of intervals and were rarely observed for more than 10% of the time. Movement Skill Assessment Execution The best performed skills during skill assessment were the catch, underhand throw, two-handed strike, and overhand throw, respectively. The best performed components in the skill assessment were C1 of the onehanded strike (Child's preferred hand grips imaginary bat above nonpreferred hand) and C1 of the golf swing (Both hands on imaginary golf swing), both of which were performed 100% of the time. Additionally, 94.7% of the time C1 of both the catch (Child's hands positioned in front of body with elbows flexed) and the underhand throw (Preferred hand swings down and back, reaching behind trunk while chest faces screen) were correctly performed. All other skill components were correctly performed 15.8 to 89.5% of the time. The results for successful components during skill assessment can be found in Table 5. Comparison of Performance in the AVG and Assessment Context With the exception of C2 of the golf putt (child side-on to intended target; back is straight and feet about shoulder-width apart) and the two components of the catch, all skill components were more correctly performed during the skill assessment compared to AVG play. Most notable is the fact that the majority of skill components displayed were recorded as correctly being performed more than 50% of the time. Meanwhile, 22 of 26 skill components were performed less than 50% of the time during AVG play. DISCUSSION This study examined whether correct skill components were used when playing sports games on the Xbox Kinect™ and as part of a skill assessment. If children are able to execute movement skills correctly while playing sport AVGs, then these games might provide opportunities for less skilled, inactive children to be introduced to these sports. The study found that when comparing the percentage of correct skill components ob-

17

ACTIVE VIDEO GAME MOVEMENT SKILLS TABLE 5 PERFORMANCE OF CORRECT SKILL COMPONENTS IN REAL LIFE AND DURING AVG PLAY Actual Assessment in Field (%)

Observed While Playing on Kinect (%)

One-handed strike

Actual Assessment in Field (%)

Observed While Playing on Kinect (%)

Underhand throw

CI

78.95

49.62

CI

94.74

31.43

C2

57.89

29.71

C2

73.68

21.43

C3

73.68

34.67

CI

100.00

55.65

CI

63.16

42.76

C2

84.21

58.04

C2

73.68

26.26

C3

57.89

31.55

C3

84.21

25.93

C4

68.42

24.11

C4

73.68

29.97

Two-handed strike

Overhand throw

Golf swing

Catch

CI

94.74

27.77

CI

94.74

100.00

C2

42.11

27.26

C2

89.47

100.00

C3

42.11

10.90

C4

26.32

10.73

CI

73.68

29.90

CI

68.42

1.15

C2

15.79

25.77

C2

26.32

8.74

C3

89.47

18.04

Golf putt

Kick

C4 31.58 13.40 Note.—C: Component; see Table 2 for description of components.

served during AVG play and real life (i.e., during TGMD–3 assessments) it is clear that in skill assessment execution there is much more potential for correct performance. Only one component was performed correctly substantially more often during AVG play than real life. C2 of the golf putt (child side-on to intended target with non-preferred hip/shoulder facing toward target, back is straight, and a slight bend at waist with feet about shoulder-width apart) was performed correctly more frequently during AVG play (26%) than as part of a skill assessment (16%). This component of golf may have been more commonly performed during AVG play due to the fact that, similar to baseball, some alignment of the body needed to be recognized by the Xbox sensor in order for the child to hit the ball. In the catch, two components were performed marginally more in AVG play, C1 (child's hands positioned in front of the body with elbows flexed) and C2 (arms extend reaching for the ball as it arrives) of the catch. It should be noted that while both of these components were performed correctly 100% of the time during AVG play compared to 93% (C1) and 95% (C2)

18

R. M. HULTEEN, ET AL.

during skill assessment, these skills were minimally performed. These results suggest that AVGs, while attempting to provide a forum for the mimicking of real life skills, do not yet allow for all components to be correctly executed and performed. To illustrate this point further, although the one- and two-handed strikes had a higher total percentage of correct skill components than many other skills during AVG play, these games could be played successfully by the participants without the need for correctly executing all the correct skill components. Mainly, the follow-through components of the skills did not affect one's success in the videogame. Previous research has identified minimal movement and subsequently lower energy expenditure while still succeeding in a game as a potential downfall for AVGs (Graves, et al., 2007; Levac, Pierrynowski, Canestraro, Gurr, Leonard, & Neeley, 2010). Despite the need for whole body movement to correctly play certain games or perform certain movements (e.g., one-handed strike in tennis), the games are not programmed to demand specific, precise movements. Therefore, wrong movements could still result in a particular action being “performed.” For example, this is shown by successfully playing tennis using the Nintendo Wii™ when only doing small flicking movements of the wrist rather than a realistic tennis stroke. The use of modified movement sequences may indicate that children do not possess the necessary competency or that the children are purposely choosing not to use their full range of skill competency, since the game compensates for children not performing the skill to the fullest extent. The results indicated the latter is more likely, at least for this sample. Thus, a major limitation of examining movement skill components using AVG play is that “real” movements do not always need to be exhibited in order to succeed (Levac, et al., 2010; Berry, Howcroft, Klejman, Fehlings, Wright, & Biddiss, 2011; Bianchi-Berthouze, 2013). These results perhaps help to explain the outcome of the wider trial that these children were involved in. Children in the intervention trial did not increase their skill ability as a result of the 6-wk. intervention (Johnson, et al., in press). Nevertheless, AVG play did provide some opportunity for correct skill performance. When playing AVG table tennis, tennis, and baseball, correct components were present at least 30–50% of the time. In particular, games such as baseball gave the children the opportunity to exhibit multiple movement skills, such as the two-handed strike, throw, and catch. These three movement skills in baseball were among the four most correctly performed skills (catch = 100%, two-handed strike = 42.3%, and throw = 31.5%). However, it should be noted that catching, observed only in baseball, was only observed twice during the 589 intervals in which baseball was played. Thus, the sample for this specific skill is not sufficient to say that AVGs may help improve this skill. Correct performance of two components, C1 (child's

ACTIVE VIDEO GAME MOVEMENT SKILLS

19

preferred hand grips imaginary bat above non-preferred hand; 55.7%) and C2 (58.0%) of the two-handed strike (child's non-preferred hip/shoulder face straight ahead), were especially apparent. High levels of C2 for the two-handed strike in baseball may be more prevalent because the Kinect prompts participants to stand side-on during batting in baseball; otherwise, the game would not continue. Both tennis and table tennis showed a high frequency of children exhibiting C1 (child takes a backswing with the imaginary paddle), as well as moderate ability in eliciting C2 (steps with non-preferred foot) and C3 (imaginary paddle follows through toward non-preferred shoulder). This suggests that some skills can be more readily practiced than others during AVG play, particularly if the game requires them in order for the game to be played correctly. Therefore, game developers could build into the games more such requirements for other skills in order for them to be practiced more regularly. AVGs have been designed primarily for fun, and for this reason it is possible that the game designer(s) may implement features that prioritize fun over skill development. It may also suggest that if children are to correctly practice movement skills some type of coaching would be beneficial. An example of a skill that AVG play may not help elicit is kicking in soccer, which had extremely low levels of all components (C1 = 0.9% and C2 = 8.7%). The two criteria for kicking were C1 (rapid continuous approach to the ball), and C2 (elongated step). Both these components were inhibited by the fact the children needed to stay within a certain area of the Xbox to be detected by the camera and also that many children, though successful in the game, incorrectly performed the kick by just standing and swinging one leg. For the kick, it is not clear if the presence/absence of correct skill components are truly indicative of the participant's ability to perform the skill or just the necessary response to the requirements of the game. Perhaps the kicking used in soccer is akin to flicking the wrist in tennis and other sports games, which while not technically correct for performing the real movement, may help a child achieve a better score or win more during AVG play (Pasch, Bianchi-Berthouze, van Dijk, & Nijholt, 2009). Furthermore, even though golf was the most played game, correct skill components were observed less than one-quarter of observations in both the swing (19.2%) and putt (21.8%). Children may be able to learn skill components through the use of AVGs, especially if more feedback and instruction is incorporated, although additional practice of skills independent of AVGs is most likely needed. Perhaps AVG games may allow an individual to learn and transfer movement skill ability to a “real life” context. The ability of individuals to learn, retain, and transfer skills during AVG play, specifically on the functional reach test, has been shown in patients with Parkinson's disease 60

20

R. M. HULTEEN, ET AL.

days after baseline measures (Mendes, Pompeu, Lobo, Silva, Oliveira, Zomignani, et al., 2012). These data would suggest that there is some transference from the virtual world to the real world. Additionally, a study with 10–15-yr.-old participants reported that those who had higher movement skill proficiency (according to the Movement Assessment Battery for Children 2), tended to perform better on movement skills performed during Xbox Kinect™ game play involving the javelin (rs = .42) and target kick (rs = .58; Reynolds, Thornton, Lay, Braham, & Rosenberg, 2014). This would suggest that there may be similarities in skill performance in these two domains. Findings from the present study in terms of correct performance of skill components while playing AVGs are in contrast to findings from the only other study to employ the OTAGM. The previous study found that no skill component appeared more than 10% of the time for the two-handed strike and less than 2% of correct throwing skill components were displayed (Rosa, et al., 2013). In contrast, the current study found that the two-handed strike components were apparent in 24–58% of intervals that exhibited this skill, while throwing components were exhibited between 25–45% of intervals. However, these differences may be attributed to the change in gaming console (i.e., Nintendo Wii™ vs Xbox Kinect™) and observing skill components for a full 10 seconds. Previously, the skill components were only observed and recorded during a “snapshot” of less than 1 sec. To reiterate, this change was made to observe full movement patterns and avoid underreporting competency in various movement skills. The Xbox Kinect™ is sensor-based and is controlled by body movements providing the opportunity for both upper and lower body movement (Peng, et al., 2012). The Kinect platform may have more potential for eliciting correct skill components due to the requirement for full body movements (O'Donovan, Hirsch, Holohan, McBride, McManus, & Hussey, 2012). The Nintendo Wii™ requires the use of a handheld controller, which may lessen the opportunity for movement. Additionally, as stated previously, movement skills may not need to be executed correctly (e.g., flicking the wrist to swing a tennis racquet) for the controller to perform the ingame action. Thus, the original OTAGM (Rosa, et al., 2013) may not record as many correct skill components because there were not many “correct” skill components to record. Compared to the previous AVG study using the OTAGM (Rosa, et al., 2013), where participants reported 62% of intervals with no movement, the current study reported only 8% of intervals with no movement, thus supporting the usefulness of the Xbox Kinect™ in providing more movement. In the current study, whole body movement, while not commonly observed for most activities, was still recorded a minimum of 31% of

ACTIVE VIDEO GAME MOVEMENT SKILLS

21

the time for sport-based games. This may show that while AVGs do elicit some meaningful movement, it may be short bursts of “all or nothing” movement. The use of a camera with the Xbox Kinect™, as opposed to the Nintendo Wii™ controller, may have allowed the participants to display a wider range of body movements, especially full body movement. The comparison of body movement elicited by the Xbox Kinect™ compared to the Nintendo Wii™ is pertinent, as the “body movement” aspect of the OTAGM was not changed compared to the original tool (Rosa, et al., 2013). A key difference in the practice of movement skills during AVG play compared to practice during skill assessment is the role that coaching may have. Participants playing AVGs tend to receive alternative forms of feedback, such as audio (e.g., virtual crowd cheering) or video (e.g., fireworks appear on the television screen) cues that indicate whether someone is performing well in the game, rather than coaching feedback on skill performance. The only exceptions during this study were in the baseball and golf games, and the child was prompted to stand in a certain position in front of the sensor to hit the ball. This appeared to result in more correct skill performance, at least for the golf putt. Interestingly, a recent study has reported that coaching by a trained facilitator in an AVG context did result in positive changes to ball skill ability, which lends promise to this type of intervention (Vernadakis, Papasterigiou, Zetou, & Antoniou, 2015). A positive outcome of the AVG play was the high engagement of participants (greater than 90% for all activities). As a whole, high engagement levels may be due to the appeal of AVGs and enjoyment of such games that others have previously reported (LeBlanc, et al., 2013). Another potential reason for high engagement was the constant change of playable games for each of the first 3 wk., as well as choice within each session in terms of what game to play. Thus, the participants were given added choice and control in the games they played (e.g., choice in sport, how long, with whom). The ability to change playing partners at any point during a session may have provided a sense of novelty, even if the same game was played. The findings from this study illustrate that the Kinect does not yet appear to elicit the same skill execution as a real-life (i.e., during skill assessment) performance. However, it should be noted that the skill assessment was performed over two trials only in a static closed environment, not in the context of a game. It is possible had this study observed children executing these skills in a game context (such as playing actual tennis) over a period of time that it would have seen a different picture of skill performance. This study also has limited generalization due to the small sample (n = 19). Game engagement was defined broadly in terms of cognitive engagement. While most games played on the Xbox Kinect™ involved two participants playing at the same time, one exception would be golf. Dur-

22

R. M. HULTEEN, ET AL.

ing this game, one child would be “hitting” or lining up the shot to “hit” the ball, while the second child was watching or talking about the game. This study's definition may be a limitation if seeking to find out the exact time spent executing motor skills. Future research could continue to test the ability of gaming consoles for movement skill acquisition. As gaming systems become more advanced and more accurate at identifying various movement skills, these gaming systems may become more useful to motor behavior and physical activity researchers. Future work in this area may also seek to investigate the role of prior skill performance level in AVG skill execution and how this interacts with game design features. REFERENCES

BARNETT, L., BANGAY, S., MCKENZIE, S., & RIDGERS, N. D. (2013) Active gaming as a mechanism to promote physical activity and fundamental movement skill in children. Frontiers in Public Health, 1, 124. BARNETT, L., HARDY, L., BRIAN, A., & ROBERTSON, S. J. (2015) The development and validation of a golf swing and putt skill assessment for children. Journal of Sports Science & Medicine, 14(1), 147-154. BARNETT, L., HARDY, L., LUBANS, D., CLIFF, D., OKELY, A., HILLS, A., & MORGAN, P. J. (2013) Australian children lack the basic movement skills to be active and healthy. Health Promotion Journal of Australia, 24(2), 82-84. BARNETT, L. M., HINKLEY, T., OKELY, A. D., HESKETH, K., & SALMON, J. (2012) Use of electronic games by young children and fundamental movement skills? Perceptual & Motor Skills, 114(3), 1023-1034. BARNETT, L. M., MINTO, C., LANDER, N., & HARDY, L. L. (2014) Interrater reliability assessment using the Test of Gross Motor Development–2. Journal of Science and Medicine in Sport, 17(6), 667-670. BARNETT, L. M., VAN BEURDEN, E., MORGAN, P. J., BROOKS, L. O., & BEARD, J. R. (2008) Does childhood motor skill proficiency predict adolescent fitness? Medicine & Science in Sports & Exercise, 40(12), 2137-2144. BARNETT, L. M., VAN BEURDEN, E., MORGAN, P. J., BROOKS, L. O., & BEARD, J. R. (2009) Childhood motor skill proficiency as a predictor of adolescent physical activity. Journal of Adolescent Health, 44(3), 252-259. BARNETT, L. M., VAN BEURDEN, E., MORGAN, P. J., BROOKS, L. O., & BEARD, J. R. (2010) Gender differences in motor skill proficiency from childhood to adolescence: a longitudinal study. Research Quarterly for Exercise and Sport, 81(2), 162-170. BERRY, T., HOWCROFT, J., KLEJMAN, S., FEHLINGS, D., WRIGHT, V., & BIDDISS, E. (2011) Variations in movement patterns during active video game play in children with cerebral palsy. Journal of Bioengineering & Biomedical Science, 51:001. DOI: 10.4172/21559538.51-001 BIANCHI-BERTHOUZE, N. (2013) Understanding the role of body movement in player engagement. Human–Computer Interaction, 28(1), 40-75. BRYANT, E. S., DUNCAN, M. J., & BIRCH, S. L. (2014) Fundamental movement skills and weight status in British primary school children. European Journal of Sport Science, 14(7), 730-736. DOI: 10.1080/17461391.2013.870232

ACTIVE VIDEO GAME MOVEMENT SKILLS

23

COMMONWEALTH OF AUSTRALIA. (2014) Australia's physical activity and sedentary behaviour guidelines. Canberra, Australia: Department of Health and Aging. GALLAHUE, D. L., & OZMUN, J. C. (2012) Understanding motor development: infants, children, adolescents, adults. (6th ed.) New York: McGraw-Hill. GAO, Z., & CHEN, S. (2014) Are field-based exergames useful in preventing childhood obesity? A systematic review. Obesity Reviews, 15(8), 676-691. DOI: 10.1111/obr.12164 GOODWAY, J. D., FAMELIA, R., & BAKHTIAR, S. (2014) Future directions in physical education & sport: developing fundamental motor competence in the early years is paramount to lifelong physical activity. Asian Social Science, 10(5), 44-54. GOODWAY, J. D., ROBINSON, L. E., & CROWE, H. (2010) Gender differences in fundamental motor skill development in disadvantaged preschoolers from two geographical regions. Research Quarterly for Exercise and Sport, 81(1), 17-24. GRAVES, L., STRATTON, G., RIDGERS, N. D., & CABLE, N. T. (2007) Comparison of energy expenditure in adolescents when playing new generation and sedentary computer games: cross-sectional study. British Medical Journal, 335(7633), 1282-1284. HALLAL, P. C., ANDERSEN, L. B., BULL, F. C., GUTHOLD, R., HASKELL, W., & EKELUND, U. (2012) Global physical activity levels: surveillance progress, pitfalls, and prospects. The Lancet, 380(9838), 247-257. HARDY, L. L., BARNETT, L., ESPINEL, P., & OKELY, A. D. (2013) Thirteen-year trends in child and adolescent fundamental movement skills: 1997–2010. Medicine & Science in Sports & Exercise, 45(10), 1965-1970. HARDY, L. L., REINTEN-REYNOLDS, T., ESPINEL, P., ZASK, A., & OKELY, A. D. (2012) Prevalence and correlates of low fundamental movement skill competency in children. Pediatrics, 130(2), 390-398. JOHNSON, T. M., RIDGERS, N. D., HULTEEN, R. M., MELLECKER, R. R., & BARNETT, L. M. (in press) Does playing a sports active video game improve young children's ball skill competence? Journal of Science and Medicine in Sport. DOI: 10.1016/j. jsams.2015.05.002 KRAUSE, J. M., & BENAVIDEZ, E. A. (2014) Potential influences of exergaming on selfefficacy for physical activity and sport. Journal of Physical Education, Recreation & Dance, 85(4), 15-20. LEBLANC, A. G., CHAPUT, J-P., MCFARLANE, A., COLLEY, R. C., THIVEL, D., BIDDLE, S. J. H., MADDISON, R., LEATHERDALE, S. T., & TREMBLAY, M. S. (2013) Active video games and health indicators in children and youth: a systematic review. PLOS ONE, 8(6), e65351. DOI: 10.1371/journal.pone.0065351 LEVAC, D., PIERRYNOWSKI, M. R., CANESTRARO, M., GURR, L., LEONARD, L., & NEELEY, C. (2010) Exploring children's movement characteristics during virtual reality video game play. Human Movement Science, 29(6), 1023-1038. LUBANS, D. R., MORGAN, P. J., CLIFF, D. P., BARNETT, L. M., & OKELY, A. D. (2010) Fundamental movement skills in children and adolescents. Sports Medicine, 40(12), 1019-1035. MENDES, F. A. S., POMPEU, J. E., LOBO, A. M., SILVA, K. G., OLIVEIRA, T. P., ZOMIGNANI, A. P., & PIEMONTE, M. E. P. (2012) Motor learning, retention and transfer after virtual-reality-based training in Parkinson's disease – effect of motor and cognitive demands of games: a longitudinal, controlled clinical study. Physiotherapy, 98, 217-223. O'DONOVAN, C., HIRSCH, E., HOLOHAN, E., MCBRIDE, I., MCMANUS, R., & HUSSEY, J. (2012) Energy expended playing Xbox Kinect™ and Wii™ games: a preliminary study comparing single and multiplayer modes. Physiotherapy, 98(3), 224-229.

24

R. M. HULTEEN, ET AL.

O'HARA, N. M., BARANOWSKI, T., WILSON, B. S., PARCEL, G. S., & SIMONS-MORTON, B. G. (1989) Validity of the observation of children's physical activity. Research Quarterly for Exercise and Sport, 60(1), 42-47. O'LOUGHLIN, E. K., DUGAS, E. N., SABISTON, C. M., & O'LOUGHLIN, J. L. (2012) Prevalence and correlates of exergaming in youth. Pediatrics, 130(5), 806-814. OWEN, N., SPARLING, P. B., HEALY, G. N., DUNSTAN, D. W., & MATTHEWS, C. E. (2010) Sedentary behavior: emerging evidence for a new health risk. Mayo Clinic Proceedings, 85(12), 1138-1141. PASCH, M., BIANCHI-BERTHOUZE, N., VAN DIJK, B., & NIJHOLT, A. (2009) Movement-based sports video games: investigating motivation and gaming experience. Entertainment Computing, 1, 49-61. PATE, R. R. (2008) Physically active video gaming: an effective strategy for obesity prevention? Archives of Pediatrics & Adolescent Medicine, 162(9), 895-896. PENG, W., CROUSE, J. C., & LIN, J-H. (2012) Using active video games for physical activity promotion: a systematic review of the current state of research. Health Education & Behavior, 40(2), 171-192. DOI: 10.1177/1090198112444956 REYNOLDS, J., THORNTON, A. L., LAY, B. S., BRAHAM, R., & ROSENBERG, M. (2014) Does movement proficiency impact on exergaming performance? Human Movement Science, 34, 1-11. RIDGERS, N. D., STRATTON, G., & MCKENZIE, T. L. (2010) Reliability and validity of the System for Observing Children's Activity and Relationships During Play (SOCARP). Journal of Physical Activity and Health, 7(1), 17-25. ROSA, R. L., RIDGERS, N. D., & BARNETT, L. M. (2013) Development and use of an Observation Tool for Active Gaming and Movement (OTAGM) to measure children's movement skill components during active video game play. Perceptual & Motor Skills, 117(3), 935-949. SPESSATO, B. C., GABBARD, C., VALENTINI, N., & RUDISILL, M. (2013) Gender differences in Brazilian children's fundamental movement skill performance. Early Child Development and Care, 183(7), 916-923. ULRICH, D. A. (2000) Test of Gross Motor Development–2. Austin, TX: PRO-ED. VERNADAKIS, N., PAPASTERIGIOU, M., ZETOU, E., & ANTONIOU, P. (2015) The impact of an exergame-based intervention on children's fundamental motor skills. Computers & Education, 83, 90-102. WORLD HEALTH ORGANIZATION. (2010) Global recommendations on physical activity for health. Geneva, Switzerland: Author. Accepted October 2, 2015.