Subject: Child Health

Series: Clinics in Developmental Medicine

Publication date: 27/07/2021

ISBN: 9781911612490

Edition: 3rd

Pages: 320

Gross Motor Function Measure (GMFM-66 & GMFM-88) User’s Manual 3rd Edition

3rd Edition

Dianne J Russell, Marilyn Wright, Peter L Rosenbaum, Lisa M Avery

Ways to buy

Paperback edition (complete book)


Gross Motor Function Measure (GMFM-66 & GMFM-88) User’s Manual 3rd Edition (ebook) Ebook edition (complete book)


Buy individual chapters

The third edition of the Gross Motor Function Measure (GMFM-66 & GMFM-88) User’s Manual has retained the information contained in the original 2002 and 2013 publications which included the conceptual background to the development of the GMFM, and the administration and scoring guidelines for people to be able to administer this clinical and research assessment tool appropriately. Information is presented on the development and validation of two abbreviated methods of estimating GMFM-66 scores using the GMFM-66-Item sets (GMFM-66-IS) and the GMFM-66-B&C (Basal & Ceiling), and updates are included on the Challenge module and the Quality FM, translations, and the use of the GMFM in populations other than cerebral palsy and Down syndrome.

The new edition includes information and an Appendix on the updated version of the Gross Motor Ability Estimator scoring program (GMAE-3), which is available through the GMFM App+ (see the CanChild website at (



The GMFM User’s Manual, is used primarily by physical therapists and other health professionals who work with children, youth and adults with cerebral palsy. The tool has both wide clinical applicability as a means of assessing and describing current gross motor function in this population, and as a validated method of evaluating change in function over time. It serves the needs of clinical and health services researchers as an outcome measure to assess the impact of any of a host of interventions that are proposed as methods of enhancing or tacking gross motor function in this population.

Author Podcast

In this podcast, Peter L Rosenbaum discusses their newest publication, Gross Motor Function Measure (GMFM-66 & GMFM-88) User’s Manual 3rd Edition (July 2021).

Dianne J Russell

Dianne J Russell is Research and Knowledge Exchange Consultant and Professor Emeritus with CanChild Centre for Childhood Disability Research.  Dianne has been a health services researcher for over 30 years and a key individual in the development, evaluation and dissemination of clinical outcome measures such as the Gross Motor Function Measure (GMFM). Her consulting is focused on facilitating the use of research evidence in practice by engaging with research users throughout the research process and by making research results easily accessible in multiple formats to families, service providers, and policy decision-makers.

Marilyn Wright

Marilyn Wright is Clinical Consultant, CanChild Centre for Childhood Disability Research, Assistant Clinical Professor, McMaster University, Physiotherapist, McMaster Children’s Hospital. Marilyn is a physiotherapist who has worked in paediatric rehabilitation, research and education. This has included the development of Gross Motor Function Measure education and evaluation materials

Peter L Rosenbaum

Peter Rosenbaum is Canada Research Chair in Childhood Disability Co-Founder, CanChild Centre for Childhood Disability Research, a Developmental Paediatrician, health services research, teacher, writer and editor. His career has been devoted to childhood disability, and all his roles have involved work with, or about, children with impairments and their families. He has held over 75 research grants and has contributed to almost 300 peer-reviewed papers, book chapters, editorials and invited commentaries in his field.

Lisa M Avery

Lisa Avery is a statistical consultant specialising in longitudinal modelling and measurement development.

Author Appointments

Preface to the Third Edition
Preface to the Second Edition
Preface to the First Edition

Acknowledgements to the Third Edition
Acknowledgements to the Second Edition
Acknowledgements to the First Edition


1. Overview of the Gross Motor Function Measure (GMFM)

2. Conceptual Background

3. Development and Validation of the GMFM-88
with Niina Kolehmainen

4. Development and Validation of the GMFM-66
with Niina Kolehmainen

5. GMFM-66: Two Short Forms of Administration

6. Part 1: Administration and Scoring Guidelines for the GMFM-88 and GMFM-66

6. Part 2: GMFM-88 and GMFM-66 Item Scoring Guidlelines
with Mary Lane

7. Interpretation and Uses of the GMFM-88 and GMFM-66

8. Applications of the GMFM: What We, and Colleagues Around the World, Have Learned, and Where Can We Go Next?



Appendix 1: Methods of Displaying Item Difficulty
Appendix 2: Display of Item Difficulties Using Thurstone Thresholds
Appendix 3: GMFM App+ Tutorial (Multi-user and Single-user Versions)
Appendix 4: Case Scenarios of Two Children Who Misfit the GMFM-66 Item Difficulty Model
Appendix 5: GMFM-66 Item Set Score Sheet
Appendix 6: GMFM-66 Basal & Ceiling Score Sheet
Appendix 7: Gross Motor Function Classification System – Expanded & Revised (GMFCS-E&R)
Appendix 8: GMFM-88 and GMFM-66 Score Sheet
Appendix 9: GMFM-66 and GMFM-88 Cross-Sectional and Change Scores
Appendix 10: Standard Error of Measurement
Appendix 11: Case Scenario of Trevor
Appendix 12: Additional Examples of the Use of the Motor Measures with Children with Cerebral Palsy in Physical Therapy Practice
Doreen J Bartlett and Laura K Brunton
Appendix 13: Ontario Motor Growth Curves
Appendix 14: The GMAE-3 and GMFM App+


The 3rd Edition of this classic manual reflects the ongoing development of the Gross Motor Function Measure (GMFM). The introduction of this measure was a turning point in the assessment, understanding, and measurement of basic gross motor skills, and the study of the effects of rehabilitation in children and young people with cerebral palsy. Both the GMFM and the subsequent Gross Motor Function Classification System (GMFCS) have become the criterion standard for recording gross motor functional ability and predicting mobility outcomes.
Much progress has been made from the 1980s’ print version to the very welcome GMFM App+, which coincides with this new edition of the manual. The measure has also been applied to other populations of children with neurological conditions (including acquired brain injury). Changes to this edition mostly relate to the GMFM App+. There is little difference in the standard use of the tool, with the notable exception of testing both with and without footwear; in the original print version there is just a short note about the use of footwear. The Gross Motor Ability Estimator (GMAE-2) program is freely downloadable but is incompatible with newer computer operating systems, hence the need for users to obtain the GMAE-3. The case studies in the manual are not impacted by the change from GMAE-2 to -3, although Appendix 14 states that GMAE-3 scores are more accurate. The difference in favour of accuracy seems to be negligible when it comes to score interpretation, with some exceptions exemplified by a case study in Appendix 14. There is a brief section offering extra details about the Quality Function Measure , the GMFM Challenge assessment, and the Acquired Brain Injury Challenge assessment and studies of their validity, etc. since the last edition (also available online).

Though the 3rd Edition offers little in the way of new material, all GMFM users would benefit from owning a copy as it is essential to enable accurate scoring of the test items. The GMFM App+ provides a basic reminder of what each score represents for each item (0–3 or NT) , but detailed information on decision-making for each level is only available in the manual. There is an online tutorial for use of the GMFM App+ and the GMAE-3, but the information is not as comprehensive as that obtained in the manual. Users familiar with GMAE-2 will have no difficulty adapting to the newer GMAE-3, which is easier to use and contains better summaries of the test data.

Future developments might include the relationship of the GMFCS to other functional measures and scales in development to understand how the mobility skills relate to other aspects of function such as hand function (Manual Ability Classification System).
In summary, the GMFM User’s Manual is essential for successful use of the measure and its interpretation. If you do not already own a manual and you are using the GMFM in any of its forms, this book is a must-have.

Margaret Mayston
University College London – Division of Biosciences, London, UK.

Gross Motor Function Measure (GMFM-66 & GMFM-88) User’s Manual 3rd Edition Chapter 1 (Free ebook) - £0