Definition and classification of negative motor signs in childhood

Terence D. Sanger, Daofen Chen, Mauricio R. Delgado, Deborah Gaebler-Spira, Mark Hallett, Jonathan W. Mink, Amy Bastian, Hilla Ben-Pazi, Nancy Byl, Sharon Cermak, Hank Chambers, Robert Chen, Diane Damiano, Martha Denckla, Ruthmary Deuel, Jules P. DeWald, Darcy L. Fehlings, Eileen Fowler, Marjorie A. Garvey, Mark GormleyEdward Hurvitz, Mary Jenkins, Jo Ann Kluzik, Andy Koman, Sahana Kukke, Maria Lebiedowska, Mindy Levin, Dennis Matthews, Margaret Barry Michaels, Helene Polatajko, Karl Rathjen, Jessica Rose Agramonte, W. Zev Rymer, Marc Schieber, Paul Steinbok, Dagmar Sternad, Ed Taub, Ann Tilton, Johan Van Doornik, Sam Ward, Max Wiznitzer

Research output: Contribution to journalReview articlepeer-review

150 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)2159-2167
Number of pages9
Issue number5
StatePublished - Nov 2006


  • Apraxia
  • Ataxia
  • Cerebral palsy
  • Developmental coordination disorder
  • Dyspraxia
  • Movement disorders
  • Selective motor control
  • Weakness

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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