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Gross Motor Function Classification System for Cerebral Palsy

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If your child has been diagnosed with cerebral palsy, they may be tested according to the Gross Motor Function Classification System, or GMFCS. The Gross Motor Function Classification System is a method for determining the movement abilities of a child with cerebral palsy. The system has five levels for classifying a child based on the extent of their gross motor function. Children who are classified in the higher levels have more severe cerebral palsy and associated functional impairments than those classified in the lower tiers. The GMFCS is a useful tool for healthcare providers when formulating a child’s treatment plan. It can also provide parents with a better understanding of how their child’s mobility may evolve and progress as they age.

What is the Gross Motor Function Classification System (GMFCS)?

The GMFCS evaluates a child with cerebral palsy on their movement abilities and limitations, particularly as it relates to sitting, walking, and the need for a wheelchair, cane, crutches, walker, or other assistive technology. It can be used in children from under the age of 2 to age 18. The age groups are categorized as follows: under age 2, 2 to 4 years-old, 4 to 6 years-old, 6 to 12 years-old, and 12 to 18-years old.

A variety of healthcare providers and professionals may use the Gross Motor Function Classification System to aid in understanding a child’s unique abilities and needs as it relates to mobility. For instance, medical doctors, physical therapists, occupational therapists and other members of your child’s care team may employ the GMFCS to construct the best treatment approach. The system is also useful when determining a child’s projected goals.

How does the Gross Motor Function Classification System Work?

The Gross Motor Function Classification System examines a child’s activities in everyday life, including at home, school, and social settings. It does not focus on what a child is capable of doing in terms of motor function, but what they are actually doing on a regular basis. Below provides a general understanding of a child’s abilities at each of the levels of the GMFCS based on their age group.

Level I

Children with cerebral palsy who are classified in Level I can usually walk with few limitations but may have some difficulties with advanced motor skills. Infants up to two years old in Level I begin to sit on the floor and manipulate objects. Children ages two to four years old can sit on the floor, and may be able to stand and walk, without support. Children ages four to six can sit and stand up from a chair, walk, and begin to run and jump, on their own. Children ages six to twelve may have difficulty with balance and coordination, but can generally conduct activities such as walking, running, jumping, and climbing stairs without assistance.

Level II

Children who fall under Level II in the Gross Motor Function Classification System have fewer motor skill abilities than those in Level I, but need less assistance with mobility than children classified in Levels III, IV, and V. Infants up to two years old can sit on the floor with outside assistance or by leaning on their hands. They may be able to crawl or inch along the floor on their stomach. Children ages two to four can sit on the floor with support and walk with an assistive device or by clinging to outside objects for support. Children ages four to six can sit in a chair on their own, walk without assistance for short periods, and climb stairs with the support of a railing. Children ages six to twelve can walk without support but may require assistance in certain situations. They will still have difficulty with running and jumping.

Level III

Level III of the GMFCS includes children who have more challenges with general and advanced motor skills. Infants up to age two need assistance when sitting and can inch along the floor on their stomachs. Children ages two to four can crawl and sit on the floor in certain positions. Children ages four to six can sit on a chair and remove themselves from a chair while stabilizing themselves with outside objects. They can walk with assistive devices and climb stairs with support. Children ages six to twelve can walk with assistive mobility tools and climb stairs with assistance.

Level IV

Children categorized in Level IV in the gross motor function system require more assistive technologies to move and perform activities in everyday life. Infants up to two years old can roll over but require assistance with sitting. Children ages two to floor can sit up while leaning on their hands and crawl. They require adaptive equipment for walking. Children ages four to six can sit on a chair with support and remove themselves with support for an outside object. They can walk for short periods but may still have problems with balance and coordination. Children ages six to twelve typically do not progress with motor abilities from age six. They usually need mobility assistive devices to perform activities outside of the home.

Level V

Children who are classified as Level V in terms of motor function typically have many limitations when it comes to mobility, even with the assistance of mobility devices. The potential for many forms of movement for children in Level V is very slight when compared with children in the other four levels. Infants up to two years old cannot sit, hold their head straight, or roll over without support. Children ages two to four cannot usually sit or crawl without assistance. Children ages four to six need adaptive equipment for sitting in a chair and cannot move around on their own. Children ages six to twelve typically need a wheelchair and adaptive equipment for sitting and standing.

Setting Goals for Children with Cerebral Palsy using the GMFCS

The Gross Motor Function Classification System is extremely useful to healthcare providers and parents when setting realistic goals for a child’s long-term mobility and understanding their limitations. It is also very helpful when formulating an appropriate intervention plan. For instance, plans for children in levels I, II, and III may be geared toward continued development of gross motor abilities over time. The intervention for children in levels IV and V may be aimed at maintaining good health, finding the right adaptive equipment and assistive mobility devices, and avoiding further impairments. It is up to your child’s care team to work with you to develop the best approach for their unique needs and goals.

Questions about Your Legal Options if Your Child had Cerebral Palsy in New Jersey?

If you have questions about the legal avenues that may be available to you if your child has been diagnosed with Cerebral Palsy, our experienced New Jersey Cerebral Palsy Attorneys can help. Contact us anytime at 866-708-8617 to discuss your child’s case and get answers to your questions and concerns in a free consultation. We are also reachable online to further assist you.

Resources:

Gross Motor Function Classification System – Expanded & Revised, CanChild

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