A schedule of gross motor development for children with Down syndrome.

Abstract

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. 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. 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. 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.