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Gross motor function of children with down syndrome: creation of motor growth curves
R J Palisano1, S D Walter, D J Russell
1Department of Rehabilitation Sciences, MCP Hahnemann University, Philadelphia, PA 19102-1192, USA. robert.j.palisano@drexel.edu
Insights
Children with Down syndrome (DS) achieve motor milestones later, with severity impacting the rate of progress. These findings aid in setting expectations and guiding interventions for motor development in DS.
Area of Science:
- Pediatric Physical Therapy
- Developmental Pediatrics
- Down Syndrome Research
Background:
- Children with Down syndrome (DS) often experience delays in gross motor function development.
- Understanding typical motor development trajectories is crucial for early intervention and support.
Purpose of the Study:
- To establish normative gross motor function growth curves for children with Down syndrome (DS).
- To determine the age-specific probabilities of achieving key motor milestones in children with DS.
- To analyze the influence of impairment severity on motor development patterns.
Main Methods:
- Nonlinear growth curve analysis using a 2-parameter model (rate and upper limit).
- Involved 121 children with DS, aged 1 month to 6 years.
- Utilized the Gross Motor Function Measure (GMFM) to assess motor function and severity.
Main Results:
- Growth curves demonstrated a higher rate of GMFM score increase during infancy, slowing as children approached maximum potential.
- Estimated probabilities: 51% roll by 6 months, 78% sit by 12 months, 34% crawl by 18 months, 40% walk by 24 months.
- Achievement probabilities for running, stair climbing, and jumping by age 5 ranged from 45% to 52%.
Conclusions:
- Children with DS require extended periods to acquire complex motor skills.
- Motor impairment severity influenced the rate of motor development but not the ultimate functional ceiling.
- Findings are vital for parental counseling, intervention planning, and realistic expectation setting regarding motor milestones.
Objective:
To create gross motor function growth curves for children with Down syndrome (DS) and to estimate the probability that motor functions are achieved by different ages.
Design:
Nonlinear growth curve analysis by using a 2-parameter (rate, upper limit) model.
Setting:
Early intervention programs, schools, and children's homes.
Participants:
One hundred twenty-one children with DS, ages 1 month to 6 years.
Main Outcome Measures:
Gross Motor Function Measure (GMFM) and severity of motor impairment.
Results:
The curves for children with mild (n = 51) and moderate/severe (n = 70) impairment were characterized by a greater increase in GMFM scores during infancy and smaller increases as the children approached the predicted maximum score of 85.9 or 87.9. The estimated probability that a child would roll by 6 months was 51%; sit by 12 months, 78%; crawl by 18 months, 34%; walk by 24 months, 40%; and run, walk up stairs, and jump by 5 years, 45% to 52%.
Conclusions:
Children with DS require more time to learn movements as movement complexity increases. Impairment severity affected the rate but not the upper limit of motor function. The results have implications for counseling parents, making decisions about motor interventions, and anticipating the time frame for achievement of motor functions.