Published online November 1, 2006
PEDIATRICS Vol. 118 No. 5 November 2006, pp. 2159-2167 (doi:10.1542/peds.2005-3016)
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REVIEW ARTICLE

Definition and Classification of Negative Motor Signs in Childhood

Terence D. Sanger, MD, PhDa, Daofen Chen, PhDb, Mauricio R. Delgado, MDc, Deborah Gaebler-Spira, MDd, Mark Hallett, MDb, Jonathan W. Mink, MD, PhDe and the Taskforce on Childhood Motor Disorders

a Division of Child Neurology and Movement Disorders, Stanford University Medical Center, Stanford, California
b National Institute of Neurological Disorders and Stroke, Bethesda, Maryland
c Texas Scottish Rite Hospital for Children, Dallas, Texas
d Rehabilitation Institute of Chicago, Chicago, Illinois
e Department of Child Neurology, University of Rochester Medical Center, Rochester, New York

In this report we describe the outcome of a consensus meeting that occurred at the National Institutes of Health in Bethesda, Maryland, March 12 through 14, 2005. The meeting brought together 39 specialists from multiple clinical and research disciplines including developmental pediatrics, neurology, neurosurgery, orthopedic surgery, physical therapy, occupational therapy, physical medicine and rehabilitation, neurophysiology, muscle physiology, motor control, and biomechanics. The purpose of the meeting was to establish terminology and definitions for 4 aspects of motor disorders that occur in children: weakness, reduced selective motor control, ataxia, and deficits of praxis. The purpose of the definitions is to assist communication between clinicians, select homogeneous groups of children for clinical research trials, facilitate the development of rating scales to assess improvement or deterioration with time, and eventually to better match individual children with specific therapies.

"Weakness" is defined as the inability to generate normal voluntary force in a muscle or normal voluntary torque about a joint. "Reduced selective motor control" is defined as the impaired ability to isolate the activation of muscles in a selected pattern in response to demands of a voluntary posture or movement. "Ataxia" is defined as an inability to generate a normal or expected voluntary movement trajectory that cannot be attributed to weakness or involuntary muscle activity about the affected joints. "Apraxia" is defined as an impairment in the ability to accomplish previously learned and performed complex motor actions that is not explained by ataxia, reduced selective motor control, weakness, or involuntary motor activity. "Developmental dyspraxia" is defined as a failure to have ever acquired the ability to perform age-appropriate complex motor actions that is not explained by the presence of inadequate demonstration or practice, ataxia, reduced selective motor control, weakness, or involuntary motor activity.

Key Words: weakness • selective motor control • ataxia • apraxia • dyspraxia • developmental coordination disorder • cerebral palsy • movement disorders

Abbreviations: DCD—developmental coordination disorder

Accepted Jun 9, 2006.




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