Gross motor function in children with spastic Cerebral Palsy and Cerebral Visual Impairment: A comparison between outcomes of the original and the Cerebral Visual Impairment adapted Gross Motor Function Measure-88 (GMFM-88-CVI).
Use the CVI-adapted GMFM-88 to avoid underestimating gross motor skill in children with both cerebral palsy and visual impairment.
01Research in Context
What this study did
The team gave the same kids two versions of the Gross Motor Function Measure-88.
One was the original. The other was re-worded for children who also have cerebral visual impairment.
All children had spastic cerebral palsy plus CVI. Each child took both tests so the scores could be compared head-to-head.
What they found
Kids scored higher on the CVI-adapted form.
The gains suggest the original test underestimates gross motor skill when visual understanding is poor.
How this fits with other research
Perez et al. (2015) already showed the CVI version gives steady answers across raters and days. The 2017 paper moves the story forward by proving the adapted form also lifts scores, not just reliability.
Hattier et al. (2011) tweaked the Berg Balance Scale for clients with severe visual and intellectual disabilities and saw the same pattern: once visual demands are cut, ability shines through.
Himuro et al. (2017) validated a different mobility scale in CP-only children. Their work reminds us that choosing the right ruler matters, especially when vision problems enter the mix.
Why it matters
If you assess motor skills in children who have both CP and CVI, switch to the GMFM-88-CVI. You will get a truer picture of what the child can do, not what they can see. That clearer picture leads to sharper goals and better therapy choices.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Pull your current GMFM-88 scores for any child with CP and CVI and re-test with the CVI-adapted version to see if the score rises.
02At a glance
03Original abstract
PURPOSE: To investigate whether the adapted version of the Gross Motor Function Measure-88 (GMFM-88) for children with Cerebral Palsy (CP) and Cerebral Visual Impairment (CVI) results in higher scores. This is most likely to be a reflection of their gross motor function, however it may be the result of a better comprehension of the instruction of the adapted version. METHOD: The scores of the original and adapted GMFM-88 were compared in the same group of children (n=21 boys and n=16 girls), mean (SD) age 113 (30) months with CP and CVI, within a time span of two weeks. A paediatric physical therapist familiar with the child assessed both tests in random order. The GMFCS level, mental development and age at testing were also collected. The Wilcoxon signed-rank test was used to compare two different measurements (the original and adapted GMFM-88) on a single sample, (the same child with CP and CVI; p<0.05). RESULTS: The comparison between scores on the original and adapted GMFM-88 in all children with CP and CVI showed a positive difference in percentage score on at least one of the five dimensions and positive percentage scores for the two versions differed on all five dimensions for fourteen children. For six children a difference was seen in four dimensions and in 10 children difference was present in three dimensions (GMFM dimension A, B& C or C, D & E) (p<0.001). CONCLUSION: The adapted GMFM-88 provides a better estimate of gross motor function per se in children with CP and CVI that is not adversely impacted bytheir visual problems. On the basis of these findings, we recommend using the adapted GMFM-88 to measure gross motor functioning in children with CP and CVI.
Research in developmental disabilities, 2017 · doi:10.1016/j.ridd.2016.10.007