Motor development in children

NewsBot · Feb 22, 2013

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Press Release:
The age from when children can hop on one leg

Motor development in children under five years of age can now be tested reliably: Together with colleagues from Lausanne, researchers from the University Children’s Hospital Zurich and the University of Zurich have determined normative data for different exercises such as hopping or running. This enables parents and experts to gage the motor skills of young children for the first time objectively and thus identify abnormalities at an early stage.

My child still can’t stand on one leg or walk down the stairs in alternating steps while all the other children already can. Are my child’s motor skills normal or does he need therapy? Parents of children of a pre-school age often ask questions like these and experts wonder from which age a child should really be able to perform certain motor tasks.

Until now, there has been a lack of reliable data that describes the age from which children are able to stand on one leg, hop on one leg, climb stairs or run. Such standards have been lacking as it was assumed that motor performance in children under the age of five could not be measured reliably. For children aged between five and eighteen, however, there is an instrument called the Zurich Motor Assessment created by Remo Largo and his team at the University Children’s Hospital Zurich in 2001. This test procedure is used by many experts to examine neuromotor skills in children of a school age.
New tests for young children

Neurophysiologist Tanja Kakebeeke and developmental pediatrician Oskar Jenni from the University Children’s Hospital Zurich have now extended this test, simplified it for pre-school children aged between three and five and collected normative data for this age group. The test contains gross and fine motor exercises and additional tasks where children are supposed to run, hop, climb stairs and balance.

The tests described in their study reveal that young pre-school children are not yet able to perform certain tasks such as hopping or standing on one leg for longer than two seconds. “Children develop these skills between the age of three and five but very quickly and they are able to at the age of five,” explains Kakebeeke.

At the age of three, only forty percent of the children were able to stand on one leg briefly. At five years of age, they all could. As soon as a child was able to do a task and his or her performance was measurable, it was classified on a five-point scale. The best performance, for example, was thus: The child can stand on one leg – the right and the left – for longer than five seconds. The normative data then developed from the proportion of children who can perform a skill and the actual performance of these children. With the normative data, motor development abnormalities can now be diagnosed at an early stage and therapeutic measures initiated.
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Neuromotor development in children. Part 3: motor performance in 3- to 5-year-olds.
Tanja H. Kakebeeke, Jon Caflisch, Aziz Chaouch, Valentin Rousson, Remo H. Largo, Oskar G. Jenni.
Developmental Medicine & Child Neurology, 2013; 55 (3): 248

Aim The aim of this cross-sectional study was to provide normative data (ordinal scores and timed performances) for gross and fine motor tasks in typically developing children between 3 and 5 years of age using the Zurich Neuromotor Assessment (ZNA).

Method Typically developing children (n=101; 48 males, 53 females) between 3 and 5 years of age were enrolled from day-care centres in the greater Zurich area and tested using a modified version of the ZNA; the tests were recorded digitally on video. Intraobserver reliability was assessed on the videos of 20 children by one examiner. Interobserver reliability was assessed by two examiners. Test–retest reliability was performed on an additional 20 children. The modelling approach summarized the data with a linear age effect and an additive term for sex, while incorporating informative missing data in the normative values. Normative data for adaptive motor tasks, pure motor tasks, and static and dynamic balance were calculated with centile curves (for timed performance) and expected ordinal scores (for ordinal scales).

Results Interobserver, intraobserver, and test–retest reliability of tasks were moderate to good. Nearly all tasks showed significant age effects, whereas sex was significant only for stringing beads and hopping on one leg.

Interpretation These results indicate that timed performance and ordinal scales of neuromotor tasks can be reliably measured in preschool children and are characterized by developmental change and high interindividual variability.
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