Evaluating Gross Motor Functions Over Time - 10/1997

An important difficulty in communication between parents and clinicians, among clinicians and among scientists is that each group has developed its own language to describe motor performance of persons with developmental disabilities (e.g.: ability to sit; ability to walk with or without assistance, etc.) and the changes that occur over time and after therapy. In research, this has led to an inability to compare results describing the effects of interventions by different methods. Also, clinical and educational groups often have developed language and methods which describe one aspect of the disability, but not overall performance. This is particularly true in the area of the voluntary control of movement.

Clinician investigators at McMaster University in Hamilton, Ontario have addressed this problem. With modest financial assistance from our Foundation, a Gross Motor Function Classification System has been developed, evaluated and is now being distributed internationally.

The Gross Motor Function Classification System describes in detail five levels of function; within each level of function it describes performance at four age groups (before 2 years of age; ages 2 and 3; ages 4 and 5; and, ages 6 to 12). In the general terms, the five levels of performance are:

Level I: Walks Without Restrictions; limitations are present in more advanced motor skills.

Level II: Walks Without Assistive Devices; limitations are present in walking outdoors and in the community.

Level III: Walks With Assistive Mobility Devices; limitations are present in walking outdoors and in the community.

Level IV: Self Mobility With Limitations; children are transported or use power mobility outdoors and in the community.

Level V: Self Mobility Is Severely Limited; even with use of assistive technology.

The system has been published in an international journal¹ and has been widely distributed. It will undoubtably became established as a useful communication device and research tool.

1/ Palisano, R et al. Developmental Medicine and Child Neurology 1997; 39: 214-223