AIM The aim of this cross-sectional study was to provide normative data (ordinal scores and timed performances) for gross and fine motor tasks in typically developing children between 3 and 5 years of age using the Zurich Neuromotor Assessment (ZNA).METHOD Typically developing children (n=101; 48 males, 53 females) between 3 and 5 years of age were enrolled from day-care centres in the greater Zurich area and tested using a modified version of the ZNA; the tests were recorded digitally on video. Intraobserver reliability was assessed on the videos of 20 children by one examiner. Interobserver reliability was assessed by two examiners. Test-retest reliability was performed on an additional 20 children. The modelling approach summarized the data with a linear age effect and an additive term for sex, while incorporating informative missing data in the normative values. Normative data for adaptive motor tasks, pure motor tasks, and static and dynamic balance were calculated with centile curves (for timed performance) and expected ordinal scores (for ordinal scales).RESULTS Interobserver, intraobserver, and test-retest reliability of tasks were moderate to good.Nearly all tasks showed significant age effects, whereas sex was significant only for stringing beads and hopping on one leg.INTERPRETATION These results indicate that timed performance and ordinal scales of neuromotor tasks can be reliably measured in preschool children and are characterized by developmental change and high interindividual variability.Motor development in children is described as a dynamic process in which new forms of motion emerge through both intrinsic processes and by interaction with the environment. 1,2Obviously, motor development is highly variable from child to child because each individual has distinctive neural and physical properties and is growing up in a unique environment. 3,4The question therefore arises -particularly in the clinical setting -as to what extent the variability can be considered normal and when does abnormality start?3 To answer this question, normative measures for typically developing children are needed that can illustrate the variability and evolution of motor skills with increased age. In recent years, our group has developed the Zurich Neuromotor Assessment (ZNA), a neurodevelopmental approach for the description of motor development from school age to adolescence that takes into account the large variability between children. [5][6][7] We note, however, that the ZNA was not designed for young children and is only applicable in individuals older than 5 years of age. Although several assessment batteries have been developed to detect motor abnormalities and movement disorders in preschool children, 8,9 there are currently no data available that demonstrate the variability and evolution with increased age of gross and fine motor skills in typically developing preschool children.In very young children (<2y) motor development has been described primarily on the basis of motor milestones, 10,11 without taking ac...

Antiplatelet and direct antithrombin agents may be useful in the prophylaxis of IE in humans. In particular, the potential dual benefit of dabigatran etexilate might be reconsidered for patients with prosthetic valves, who require life-long anticoagulation and in whom S. aureus IE is associated with high mortality.

The relationship between motor and intellectual functions was examined in 252 healthy children from 7 to 18 years using the Zurich Neuromotor Assessment and standardized intelligence tests. The magnitude of Spearman correlations between neuromotor and intellectual scores was generally weak (r = 0.15-0.37). The strongest correlations were found between performance in the pegboard task and visuomotor intelligence (r = 0.35) and between contralateral associated movements and intelligence in boys (r = 0.37). We conclude that specific connections between motor and intellectual functions may exist. However, because the magnitude of correlations is generally weak, we suggest that motor and intellectual domains in healthy children are largely independent.

The Zurich Neuromotor Assessment, Second Edition (ZNA-2) provides new norms for motor proficiency in children between 3 years and 18 years. High reliabilities suggest that the revised test battery is a useful tool for assessing neuromotor development. Integration of a 'not able to perform' category makes the ZNA-2 suitable for clinical purposes.

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An established test instrument for the assessment of motor performance in children between 3 and 16 years is the Movement Assessment Battery for Children - Second Edition (M-ABC-2). The Zurich Neuromotor Assessment (ZNA) is also widely used for the evaluation of children's motor performance but has not been compared with the M-ABC-2 for children below five years for the purpose of convergent validity. Forty-seven children (26 boys, 21 girls) between three and five years of age were assessed using the M-ABC-2 and the ZNA3-5. Rank correlations between scores of different test components were calculated. Only low-to-moderate correlations were observed when separate components of these tests were compared (.31 to .68, p < .05), especially when involving the associated movements from the ZNA3-5 (-.05 to -.13, p > .05). However, the correlation between summary scores of the two tests was .77 (p < .001), and it increased to .84 when associated movements were excluded, which was comparable in magnitude to the test-retest reliability of the M-ABC-2, supporting convergent validity between the two tests. Although the ZNA3-5 and M-ABC-2 measure different aspects of motor behavior, the two instruments may thus measure essentially the same construct.

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