Protocol - Gross Motor Function - 4-6 Years Old
Protocol Name from Source:
Gross Motor Function Classification System (GMFCS) Family Report Questionnaire
The Gross Motor Function Classification System (GMFCS) Family Report Questionnaire is a five-item parent-report instrument that classifies children with cerebral palsy based on current motor ability, including the need for assistive technology.
Please read the following and mark only one box beside the description that best represents your child’s movement abilities.
[ ] Has difficulty sitting on their own and controlling their head and body posture in most positions
and has difficulty achieving any voluntary control of movement
and needs a specially adapted supportive chair to sit comfortably
and has to be lifted or hoisted by another person to move
[ ] Can sit on their own but does not stand or walk without significant support and adult supervision
and may need extra body/trunk support to improve arm and hand function
and usually needs adult assistance to get in and out of a chair
and may achieve self-mobility using a powered wheelchair or is transported in the community
[ ] Can walk on their own using a walking aid (such as a walker, rollator, crutches, canes, etc.)
and can usually get in and out of a chair without adult assistance
and may use a wheelchair when travelling long distances or outside
and finds it difficult to climb stairs or walk on an uneven surface without considerable help
[ ] Can walk on their own without using a walking aid, but has difficulty walking long distances or on uneven surfaces
and can sit in a normal adult chair and use both hands freely
and can move from the floor to standing without adult assistance
and needs to hold the handrail when going up or down stairs
and is not yet able to run and jump
[ ] Can walk on their own without using a walking aid, including fairly long distances, outdoors, and on uneven surfaces
and can move from the floor or a chair to standing without using their hands for support
and can go up and down stairs without needing to hold the handrail
and is beginning to run and jump
© Claire Kerr and Brona McDowell, 2007
Personnel and Training Required
|Average time of greater than 15 minutes in an unaffected individual||No|
|Specialized requirements for biospecimen collection||No|
Mode of Administration
September 8, 2017
A questionnaire to assess the larger body movements that develop during childhood such as sitting, standing, and walking.
This measure is used to assess impairment of gross motor function. Development of gross motor function can be impaired by injury, congenital defects, and neurological and developmental disorders such as muscular dystrophy and cerebral palsy.
The Gross Motor Function Classification System (GMFCS) Family Report Questionnaire was compared to similar protocols and selected because it is a validated, relatively short questionnaire that offers a low-cost alternative to physician-reported scales or medical records abstraction.
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|Common Data Elements (CDE)||Neurology Child Gross Motor Function Assessment Description Text||3076202||CDE Browser|
|Logical Observation Identifiers Names and Codes (LOINC)||Gross motor func 4-6Y proto||62781-0||LOINC|
Process and Review
[link[phenx.org/node/103|Expert Review Panel 4]] (ERP 4) reviewed the measures in the Neurology, Psychiatric, and Psychosocial domains.
Guidance from ERP 4 included the following:
· No changes
The Gross Motor Function Classification System (GMFCS) Family Report Questionnaire is available from CanChild Centre for Childhood Disability Research website, McMaster University,
Institute for Applied Health Sciences, McMaster University
1400 Main Street West, Rm. 408
Hamilton, ON, Canada L8S 1C7
Tel: 905-525-9140 Ext. 27850
Palisano, R., Rosenbaum, P., Walter, S., Russell, D., Wood, E., & Galuppi, B. (1997). Development and reliability of a system to classify gross motor function in children with cerebral palsy. Developmental Medicine & Child Neurology, 39, 214-223.
Morris, C., Galuppi, B. E., & Rosenbaum, P. L. (2004). Reliability of family report for the Gross Motor Function Classification System. Developmental Medicine and Child Neurology, 46, 455-460.
|Variable Name||Variable ID||Variable Description||Version||dbGaP Mapping|