The relationship between motor abilities and early social development in a preschool cohort of children with cerebral palsy.
In preschoolers with cerebral palsy, gross motor level on the GMFCS predicts social development as early as eighteen months.
01Research in Context
What this study did
Koa and colleagues tracked preschool children with cerebral palsy.
They used the GMFCS to rate each child’s gross motor level.
They also gave the PEDI social scale to see how the kids played and talked with peers.
The team looked both at one point in time and again months later.
What they found
Lower GMFCS level went hand in hand with lower social scores.
The link showed up as early as eighteen months and stayed strong.
Kids who could move more easily also showed better sharing, greeting, and group play.
How this fits with other research
Compagnone et al. (2014) widened the lens. They linked GMFCS with MACS and CFCS in school-age children. Severe motor limits usually meant severe hand and communication limits too.
Carter et al. (2011) kept the motor rule but swapped the outcome. They saw that milder gross motor impairment predicted faster non-verbal IQ growth between ages five and nine.
Asano et al. (2025) pushed the idea further. Manual ability, not gross motor, forecast fluid intelligence after the preschool years.
Hansen et al. (2025) looked earlier. High-risk infants already showed lower social engagement at fifteen months. The gap sets the stage for the preschool delays Koa found.
Why it matters
You now have a timeline. Motor signs at eighteen months flag later social risk.
Use GMFCS during intake, then watch social play just as closely as you watch gait.
Pair kids who have GMFCS levels IV-V with peer models and plenty of hand-on-hand prompting.
Start parent coaching early; the social gap is already opening in infancy.
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02At a glance
03Original abstract
AIM: To investigate the relationship between motor ability and early social development in a cohort of preschool children with cerebral palsy (CP). DESIGN: Population-based cohort study. METHODS: Participants were 122 children with CP assessed at 18, 24 and 30 months, corrected age (ca). Motor ability was measured by the Gross Motor Function Classification System (GMFCS) with classification assigned by physiotherapists. The sample was representative of a population-based cohort (I=48, 38.4%, II=19, 15.2%, III=17, 13.6%, IV=22, 17.6% and V=19, 15.2%). Social development was measured by the Paediatric Evaluation of Disability Inventory (PEDI) and included capabilities in social interaction, social communication, interactive play and household/community tasks. RESULTS: Cross-sectional analyses indicated a significant relationship between motor ability and social development at 18 months, F(4, 56)=11.44, p<.0001, η(2)=.45, at 24 months, F(4, 79)=15.66, p<.0001, η(2)=.44 and at 30 months, F(4, 76)=16.06, p<.0001, η(2)=.49. A longitudinal analysis with a subset of children (N=24) indicated a significant interaction between age at assessment and GMFCS, F(2, 21)=7.02, p=.005, η(2)=.40. Comparison with community norms indicated that at 18 months corrected age, 44.3% of the cohort was greater than two standard deviations below the mean (>2SD) for social development and a further 27.9% of the cohort was greater than one standard deviation below the mean (>1SD). INTERPRETATION: There is a relationship between motor ability and social development in preschool children with CP. Children with CP may require support for social development in additional to physical interventions, from as early as 18 months.
Research in developmental disabilities, 2010 · doi:10.1016/j.ridd.2010.07.006