Proposed motor development assessment protocol for epidemiological studies in children.

This paper proposes an approach to the implementation of a large-scale epidemiological study of child development. It addresses specifically how one might assess gross motor development longitudinally in a large population-based study of children, and recommends a three-phase process. Phase I, applied at key ages with the entire population, involves the use of parent-report screening tools that ask about specific age-appropriate motor skills, as well as any parental concerns about "quantity" or "quality" of their child's motor function and about any loss of motor function. In phase II, children who "fail" the screening phase (at any stage) are evaluated with specified developmental motor assessments. Those who "pass" revert to the screening stream, while those who "fail" continue to phase III. In this third component of the study, children are referred to experts in child development formally engaged in the study (including developmental paediatricians, paediatric neurologists and developmental therapists). These experts will use protocol-based evaluations to ascertain whether a child has a problem in development, what the problem might be from a diagnostic perspective, how "severe" the problem is, and what management services are or should be provided. It is argued that this is an efficient approach to the study of a population that would enable investigators to detect specific relatively common developmental motor disorders (in particular, cerebral palsy and developmental coordination disorder).