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A schedule of gross motor development for children with Down syndrome
P Winders1, K Wolter-Warmerdam1, F Hickey1,2
1Sie Center for Down Syndrome, Children's Hospital Colorado, Aurora, CO, USA.
Insights
This study establishes gross motor development norms for children with Down syndrome (DS), providing a schedule to identify developmental delays and guide interventions. This helps healthcare professionals and parents track progress for children with DS.
Area of Science:
- Pediatric Physical Therapy
- Developmental Pediatrics
- Genetics and Genetic Disorders
Background:
- Established gross motor milestones are lacking for typically developing children, creating uncertainty for those with Down syndrome (DS).
- The absence of a developmental schedule for children with DS hinders the identification of developmental delays and timely intervention.
- Medical professionals and parents need reliable data to assess gross motor skill acquisition in children with DS.
Purpose of the Study:
- To provide longitudinal data on gross motor development in children with DS for healthcare professionals and early intervention providers.
- To contribute to a definitive gross motor development schedule for children with DS.
- To enable the identification of delayed gross motor development in children with DS compared to their peers.
Main Methods:
- Longitudinal data on 44 gross motor skills were collected from a large cohort of 509 children with DS.
- Data were gathered prospectively from children receiving care at two specialized DS referral centers.
- Skill mastery was directly observed by physical therapists, with data retrospectively reviewed from a patient database.
Main Results:
- The study provides the mean, standard deviation, median age, and 5th, 25th, 75th, and 95th percentiles for the mastery of gross motor skills in children with DS.
- Data cover skills from birth to walking and post-walking milestones.
- No significant gender-by-age group differences were found in the 44 assessed skills.
Conclusions:
- This study presents a gross motor development schedule for children with DS based on prospective data from a large population.
- The schedule allows for the assessment of gross motor development relative to peers, enabling early identification of advanced, age-appropriate, or delayed development.
- This facilitates appropriate referrals for targeted interventions for children with DS.
Background:
Gross motor milestones for children who develop typically have been well established; however, norms for children with Down syndrome (DS) are uncertain. Without a developmental schedule for the gross motor development of children with DS, medical professionals are limited in their ability to identify if the development of a particular child with DS is delayed in comparison with his or her peers (i.e. other children with DS), assess when intervention is needed and answer the questions of parents regarding when their child can be expected to achieve developmental milestones. The objectives of this study are to: (1) provide health care professionals and early intervention providers with longitudinal data on the gross motor development of children with DS gathered prospectively; (2) contribute to the development of a definitive schedule of gross motor development for children with DS; (3) enable the identification of gross motor development that is delayed in comparison with other children with DS; and (4) help medical professionals address the questions of concerned parents who are anxious to know when their child will achieve gross motor skills such as sitting, crawling or walking.
Methods:
Longitudinal data on 44 defined gross motor skills were collected on a large cohort of children with DS (n = 509) who received care at two referral centres that specialise in DS. Mastery was awarded when skills were observed directly by the physical therapist. Clinical data were retrospectively reviewed from a prospective patient clinic database and analysed.
Results:
Specific age of mastery of gross motor skills was assessed. The mean, standard deviation and median age in months of gross motor skill achievement for children with DS, along with the 5th, 25th, 75th and 95th percentiles, are provided for birth to walking skills and post walking skills. No statistically significant gender-by-age group difference was observed in the 44 skills.
Conclusions:
This study provides a schedule of gross motor development for children with DS derived from data collected prospectively from a large population. The gross motor development of the child with DS can be assessed based on his or her performance relative to other children with DS enabling early identification of advanced, age appropriate or delayed development, allowing for appropriate referrals for targeted intervention.
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