Paediatrica Indonesiana

VOLUME 50 November  NUMBER 6

Original Article

Normal motor milestone development for use to

promote child care
Mahdin A. Husaini1, Abas B. Jahari1, Jajah K. Husaini1, Yekti Widodo1,
Heryudarini Harahap1, Susi Suwarti1, Dewi Purnomosari2, Fawziah A. Hadis3

I
Abstract t is generally believed that activity levels are
Background Motor behavior is an essential aspect of child UHGXFHG LQ SRRUO\ PDOQRXULVKHG FKLOGUHQ DQG
GHYHORSPHQWDQGXVXDOO\DVVHVVHGLQWHUPVRIDJHRIDFKLHYHPHQW this may have a detrimental effect on motor
of motor milestone. The early detection of infants experiencing development. The onset of developmentally
subtle delays in motor maturation can allow early intervention
in developmental problems. Intervention can be more effective if
VLJQLILFDQW DFWLRQ HJ FUHHSLQJ VLWWLQJ VWDQGLQJ
delays are identified early. In order to facilitate the identification dependent on the reciprocal interactions of physical
RIHDUO\GHOD\VWKH&HQWHURI1XWULWLRQDQG)RRGV5HVHDUFKDQG activity and motor maturation.  These authors
Development in Bogor has designed a simple tool to monitor the VXJJHVWHGWKHPRWRUWHVWVFRUHVEXWQRWPHQWDOWHVW
FKLOGDJHGWRPRQWKVPRWRUGHYHORSPHQW
VFRUHV SUHGLFWHG FRJQLWLYH SHUIRUPDQFH GXULQJ WKH
Objective To develop an observable of normal gross motor
maturation for use to detect deviance or motor delay.
preschool years as well as in adolescent.
Methods$WRWDORIKHDOWK\FKLOGUHQDJHGPRQWKV An association between poor nutrition and
IURPKLJKVRFLRHFRQRPLFJURXSLQXUEDQDQGVXEXUEDQDUHDV development has been shown in several studies of
ZHUH VWXGLHG %RG\ OHQJWK ZHLJKW DQG PRWRU GHYHORSPHQW young children in the communities where under-
were measured on all children. Gross motor development was QXWULWLRQLVHQGHPLFHJLQ*XDWHPDOD4-DPDLFD
PHDVXUHGSUHVHOHFWHGPLOHVWRQHVOLHVLWFUDZOFUHHSVWDQG
ZLWK DVVLVWDQFH ZDON ZLWK DVVLVWDQFH VWDQG DORQH ZDON DORQH
Indonesia7 DQG &RVWD 5LFD ,Q WKRVH VWXGLHV WKH
and run. associations with poor development were more
Results and Conclusion There were no differences between IUHTXHQWO\ IRXQG ZLWK VWXQWLQJ WKDQ ZDVWLQJ The
males and females in the comparison of attainment motor UHVXOWVRIPHWDDQDO\VLVRIVL[ILHOGVWXGLHVLQ&RORPELD
maturation therefore a sex combined curve was developed. *XDWHPDOD,QGRQHVLD-DPDLFD7DLZDQDQG8QLWHG
Conclusion The curve of normal motor milestone development
FDQEHXVHGDVDWRROWRHYDOXDWHPRWRUGHYHORSPHQWRYHUWLPH
DQGRUDVDFKLOGGHYHORSPHQWFDUGIRUXVHLQSULPDU\KHDOWKFDUH
3UHVHQWHG DW WKH WK $VLDQ &RQIHUHQFH RQ 0HQWDO 5HWDUGDWLRQ
[Paediatr Indones. 2010;50:340-6].
<RJ\DNDUWD1RYHPEHU
Keywords: motor milestone development, nutrition,
child care )URP WKH &HQWHU RI 1XWULWLRQ DQG )RRGV 5HVHDUFK DQG 'HYHORSPHQW
%RJRU,QGRQHVLD)URPWKH)DFXOW\RI3V\FKRORJ\3DGMDMDUDQ8QLYHUVLW\
%DQGXQJ ,QGRQHVLD )URP WKH )DFXOW\ RI 3V\FKRORJ\ 8QLYHUVLW\ RI
,QGRQHVLD-DNDUWD,QGRQHVLD

Reprint request to 0$ +XVDLQL &HQWHU RI 1XWULWLRQ DQG )RRGV
5HVHDUFKDQG'HYHORSPHQW%RJRU,QGRQHVLD7HO
E-mail: ma_husaini@yahoo.com

340Paediatr Indones, Vol. 50, No. 6, November 2010

 Mahdin A. Husaini Et al: Normal motor milestone development to promote child care

6WDWHV showed that early high energy and protein DORQH ZDON DORQH DQG UXQ 'HILQLWLRQ RI WKHVH
supplementary feeding has a beneficial effect on motor milestones and comparative definitions from the
GHYHORSPHQWLQ\RXQJLQIDQWVPRQWKVROGDQG 'HQYHU'HYHORSPHQWDO6FUHHQLQJ7HVW and Bayley
on both motor and mental development in older infant 6FDOHV RI ,QIDQW 'HYHORSPHQW 0RWRU 6FDOH  are
PRQWKVROGZKRDUHQXWULWLRQDOO\DWULVN provided in Figure 1 and Table 1. The milestones
Although some variability of motor skills among ZHUHVHOHFWHGWRUHSUHVHQWPDMRUODQGPDUNVLQVHOI
LQIDQWV LV UHFRJQL]HG LW LV ZLGHO\ DFFHSWHG WKDW WKH produced bipedal minus one standard deviation
VHTXHQFHRIPRWRUVNLOOVLVFRQVLVWHQW$FKLOGPD\PLVV from the mean for age. Based on our experience
DVNLOOVXFKDVFUDZOLQJZKLOHWKHRWKHUUHPDLQLQJVNLOOV on the development pathways of the malnourished
HPHUJHLQSUHGLFWHGRUGHU%HFDXVHRIWKLVSUHGLFWDEOH children E\ XVLQJ D WLPHVDPSOLQJ PHWKRG DQG
VHTXHQWLDOSDWWHUQRIPRWRUGHYHORSPHQWDVVHVVPHQW with aid of McGraws VFKHPH WKUHH 1XWULWLRQLVW
of milestones provides an observable tool to evaluate VSHQWRYHUKRXUVREVHUYLQJFKLOGUHQDJHG
motor skills and to detect deviance or motor delay. PRQWKVWRYHULI\ZKHWKHUWKHQDWXUHDQGFKURQRORJ\
,QWKLVDUWLFOHFXUUHQWLVVXHZLOOEHDGGUHVVHGRQWKH of the motor skills observed agreed with description.
development of a tool of gross motor maturation to Differences between our observation and McGraws
identify at risk children with motor delay based on the description led us to construct a new list of motor
study carried out in Indonesia. GHYHORSPHQWVNLOOVDQGDQHZRUGLQDOVHTXHQFH)LQDOO\
ZHDVVHPEOHGLQERRNOHWIRUPGUDZLQJVRIFKLOGUHQ
Methods HQJDJHG LQ DFWLYLWLHV WKDW UHTXLUHG WKH PRWRU VNLOOV
chosen for study. The milestones were selected to
This cross sectional study was conducted in four cities UHSUHVHQWWKHPDMRUUHFRJQL]HGLQWKHFXOWXUHEHLQJ
LQ-DYD6XUDED\D0DODQJ%DQGXQJDQG%RJRU7KLV tested (Figure1 and Table 1).
VWXG\LQYROYHGDWRWDORIKHDOWK\FKLOGUHQDJHG
 PRQWKV IURP KLJK VRFLRHFRQRPLF IDPLOLHV LQ Table 1/QVQTOKNGUVQPGFGXGNQROGPVD[FGPKVKQP
urban and suburban areas who does not constrain No. Label Motor Development Description
JURZWKKDYHDFFHVVWRKHDOWK\GULQNLQJZDWHUVDQG 1. Sit 1 Sit with support
environment. 2. Crawl 1 Lying on abdomen; can raise himself up
Body length and weight were measured on all with his hands
FKLOGUHQZLWKVWDQGDUGDQWKURSRPHWULFSURFHGXUHV 3. Sit 2 Sit without support; the body is not
/HQJWK ZDV PHDVXUHG WR WKH QHDUHVW  FP RQ D upright

wooden length-board developed by the NFRDC 4. Sit 3 Sit without support; the body is upright
LQ %RJRU ,QGRQHVLD :HLJKW ZDV PHDVXUHG WR WKH 5. Crawl 2 .[KPICVQPJKUCDFQOGPECPTCKUGVJG
body bearing his weight on his hands and
QHDUHVW  NJ RQ GLJLWDO 6HFFD 81,&() DQG DOO the tips of his toes alone
children were pondered without clothing. Length 6. Creep 1 Crawl and starting by going backwards
DQGZHLJKWPHDVXUHPHQWVZHUHFRQYHUWHGWR=VFRUHV 7. Creep 2 Creep on all fours (on his hands and
based on the means and standard deviations. A knees)
cut-off point of zero and above standard deviation 8. Stand 0 Learning to stand
RIDOOJURZWKLQGH[HVZHLJKWIRUDJHOHQJWKIRUDJH 9. Walk 0 Walk with assistance of other; his feet
and weight for length were used when identifying CVQPVJGQQT

FKLOGUHQWRLQFOXGHLQWKLVVWXG\DVDGHTXDWHLQWKHLU 10. Walk 1 Walk with assistance of other; his feet are
not steady yet
physical growth. Nutritional status is illustrated by
11. Stand 1 Stand with support
DQWKURSRPHWULFGLPHQVLRQFRQYHUWHGWR=VFRUHVXVLQJ
12. Walk 2 Walk by himself with support
WKH861DWLRQDO&HQWHUIRU+HDOWK6WDWLVWLF5HIHUHQFH
13. Stand 2 Stand without support
6WDQGDUG,IWKHUHVXOWLQJ=VFRUHZDVDERYHPLQXV
14. Walk 3 Walk a few steps without support
VWDQGDUGGHYLDWLRQVJURZWKZDVFRQVLGHUHGQRUPDO
Gross motor development was measured with 15. Walk 4 Walk alone with small steps

 SUHVHOHFWHG PLOHVWRQHV OLH VLW FUDZO FUHHS 16. Walk 5 Walk with large steps

VWDQG ZLWK DVVLVWDQFH ZDON ZLWK DVVLVWDQFH VWDQG 17. Run Run

Paediatr Indones, Vol. 50, No. 6, November 2010341

 Mahdin A. Husaini Et al: Normal motor milestone development to promote child care

1 2 3 4 5

6 7 8 9 10

11 12 13 14 15 16

Figure 1. Motor milestone development

7KHGDWDFROOHFWLRQRQVRFLRHFRQRPLFVWDWXV In order to ascertain that recorded data were

DQWKURSRPHWULFPHDVXUHPHQWVDQGPRWRUPLOHVWRQHV SURSHUO\UHSRUWHGWKHGDWDZHUHUHYLHZHGE\VHQLRU
observation were carried out by trained nutritionists. researchers. Then we calculated summary statistics
7KH\ZHUHUHFUXLWHGIURPORFDO$FDGHP\RI1XWULWLRQ ZKLFKLQFOXGHPHDQVWDQGDUGGHYLDWLRQSHUFHQWLOHV
and most of them were lecturers. They were assigned IRUFRQWLQXRXVYDULDEOHVIUHTXHQFLHVDQGSURSRUWLRQ
LQWRJURXSVFRQVLVWHGRIWZRSHUVRQVLQHDFKJURXS for each level of variables.
WKHUHIRUHWRJURXSVRIILHOGZRUNHUVLQHDFKVWXG\
DUHDVFLWLHV,QSDUWLFXODURQPRWRUPLOHVWRQHVWKH
observation was carried out by the two testers who had Results
been trained intensively by the authors. The training
consisted of observation of more than 50 children The characteristics of participating parents are shown
UDQJLQJ LQ DJH IURP  WR  PRQWKV ,QWHUSUHWHU in Table 2 0RVW RI DJH UDQJHV IRU PRWKHUV ZDV 
UHOLDELOLW\U ! ZDVHVWDEOLVKHGEHWZHHQSDLUV \HDUVDQGIDWKHUVZDV\HDUVJUDGXDWHG
RIWHVWHUVIRUFKLOGUHQDQGEHWZHHQDOOWZRWHVWHUV IURP XQLYHUVLW\ ZDV  IRU PRWKHUV DQG 
RQDQDGGLWLRQDOFKLOGUHQ IRU IDWKHUV DQG ELUWK ZHLJKW ZDV EHWZHHQ  WR
0RWRU VWDWXV ZDV DVVHVVHG GXULQJ  PLQ  J 7KH KLJKHVW SURSRUWLRQ RI IDWKHUV MRE ZDV
WHVWLQJVHVVLRQ'XULQJDWHVWLQJVHVVLRQHDFKFKLOG SULYDWH FRPSDQ\ VWDII DQG HQWUHSUHQHXUV 
was challenged to achieve the highest milestone Almost all birth assistance in this population was
SRVVLEOH,QVWUXFWLRQZDVJLYHQWRWKHFKLOGDQGRU KHDOWKSHUVRQQHOHLWKHUGRFWRUVRUPLGZLYHV
the caretaker encouraging these desired behaviors. 
7KHREVHUYDWLRQWRRNSODFHDWWKHVXEMHFWVKRPH Figure 2 shows the trend of nutritional status
'XULQJWKHFROOHFWLRQRIGDWDLQWKHILHOGUHVHDUFKHUV of the children studied. On average the weight for
from Bogor visited the area and supervised the DJHOHQJWKIRUDJHDQGZHLJKWIRUZHLJKWLQHDFKDJH
DFWLYLWLHV VXFK DV DFFXUDF\ RI WKH PHDVXUHPHQW JURXS ZDV DERYH PLQXV RQH = VFRUH ,W LV DSSDUHQW
LQWHUSUHWDWLRQRIWKHILQGLQJVFRYHUDJHDQGRWKHUV that nutritional status was better in younger children
5RXJK WDEXODWLRQ RI GDWD ZDV GRQH RQ VLWH VR HLWKHUE\WKHLQGH[RIZHLJKWIRUDJHOHQJWKIRUDJH
the local staff could know the temporary results. or weight for length.

342Paediatr Indones, Vol. 50, No. 6, November 2010

 Mahdin A. Husaini Et al: Normal motor milestone development to promote child care

Table 2. Characteristics of samples parents Motor development by age for sex combined
Characteristics Values (N=2100) is illustrated in Figure 3. The figure depicts the age
Average mothers age (years) 20-29 DW ZKLFK   DQG  LH WKH WK WK WK
Average fathers age (years) 30-39
percentiles) of the children reached a particular
University graduate:
PLOHVWRQHV)RUH[DPSOHDWPRQWKVRIFKLOGUHQ
a. Mothers (%) 27.6
b. Fathers (%) 42.5
DUHDEOHWRFUDZODUHDEOHWRZDONZLWKDVVLVWDQFH
Fathers occupation DQGRQO\FRXOGZDONDORQHVHYHUDOVWHSVTable 3
a. Private company staff (%) 79.2 presents the Mann-Whitney different test of motor
b. )QXGTPOGPVQHEKCNU
 14.4 achievement scales between males and females. The
c. Others (%) 6.4 difference is not significant at any points of observation
Place of birth: DWHDFKRIDJHJURXSVIURPWRPRQWKV
a. Hospital (%) 52.2
Based on these findings the sex combined
b. Birth clinics (%) 45.6
c. Missing (%) 2.2
motor milestone development as shown in Figure
Birth assistant: 4 represents for both females and males can be
a. Doctors (%) 48.3 used either for females or for males. This curve
b. Midwives (%) 50.1 is presented in the motor milestone development
c. Missing (%) 1.6 tool for use in identifying children at risk and for
Average birth weight (g) 3100-3400 monitoring.
2.0
1.5
1.0
0.5
Z-Score

0.0
-0.5
-1.0
-1.5
-2.0
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Age (Months)

Z-Sc W/A Z-Sc L/A Z-Sc W/L

Figure 2. Means of Z-score weight-for-age, length-for-age, and

weight-for-length, sex combined aged 3-18 months
17
16
15
Motor milestones achievements

14
13
12
11
10
9
8
7
6
5
4
3
2
1
0
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Age (months)

PCTL-05 PCTL-50 PCTL-95

Figure 3. Scattered of motor milestone percentiles, sex combined

aged 3-18 months

Paediatr Indones, Vol. 50, No. 6, November 2010343

 Mahdin A. Husaini Et al: Normal motor milestone development to promote child care

Table 3. Statistical different test of motor milestone achievements between boys and girls Mann-Whitney
Mann-Whitney Mann-Whitney
Age (months) Age (months)
Z-value P (2-tail) Z-value P (2-tail)
3 - 1.298 0.194 11 - 2.332 0.020
4 - 0.318 0.750 12 - 1.591 0.112
5 - 1.493 0.135 13 - 0.057 0.954
6 0.000 1.000 14 - 1.151 0.250
7 - 1.286 0.198 15 - 0.121 0.904
8 - 0.018 0.985 16 - 0.497 0.632
9 - 0.112 0.911 17 - 1.956 0.050
10 - 1.090 0.276 18 - 0.100 0.920
3-18 - 0.930 0.352 0QVUKIPKECPV

MOTOR MILESTONES
Run 17
Walk with large steps 16

Walk alone with small steps 15

Advanced
Walk a few steps without support 14

Stand without support 13

Walk by himself with support 12

Stand with support 11

10
Normal
Walk with assistance of other
Walk with assistance, his feet are not steady yet 9

Learning to stand 8

Creep on all fours (on his hands and knees) 7

Crawl and starting by going backwards 6
Lying flat on his abdomen, can raise the body 5
Delayed
on his hands, and the tips of his toes
4
Sit without support; the body is upright
Sit without support; the body is not upright 3
Lying on abdomen, can raise himself up with 2
his hands
1
Sit with support
Cannot do movement number 1 0
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Age (Months)
Figure 4. The motor development curve, sex combined, aged 3-18 months.

Discussion Indonesia.7,QWKHVHFRPPXQLWLHVZHIRXQGQR
ethnographic or statistical evidence of a bias against
The characteristics of education of parents as shown females children. These current findings are in part
in Table 2ZHUHUHODWLYHO\KLJKRIPRWKHUVDQG VLPLODUWRWKHVWXG\LQ86FDUULHGE\&DSXWHHWDO
RIIDWKHUVJUDGXDWHGIURPXQLYHUVLW\:KHQWKLV :+20XOWLFHQWUH*URZWK5HIHUHQFH6WXG\*URXS
condition is compared to the national wide where and in Japan. They reported that comparison of
women and men (sex combined) with university males and females in the attainment of milestones
JUDGXDWHLVWKHUHIRUHWKHSRSXODWLRQVWXGLHG scales revealed inconsistency within the race groups.
is belonged to the high socio-economic class. $PRQJZKLWHVPDOHVWHQGHGWREHDGYDQFHGUHODWLYH
This study revealed that there were no WR IHPDOHV EXW IHPDOHV ZHUH DGYDQFH UHODWLYH WR
differences in the comparison of the achievement males among black.
of motor milestones between females and males at ,QWKLVVWXG\PRQWKVLQFRQWUDU\ZLWKRXU
any age groups. This finding is consistent with the previous study in malnourished children7 the mean age
evidence from our previous study in Pengalengan RIZDONLQJZDVPRQWKV7KRVHVWXG\7 concluded

344Paediatr Indones, Vol. 50, No. 6, November 2010

 Mahdin A. Husaini Et al: Normal motor milestone development to promote child care

WKDWDPRQJSRSXODWLRQDWULVNIRUPDOQXWULWLRQPRWRU PD\OHDGWRVXEVHTXHQWSUREOHPVLQGHYHORSPHQW6
development is more likely to correlate with length- ,QWKHDUHDVZKHUHPDOQXWULWLRQLVHQGHPLFLWLVOLNHO\
for-age than weight-for-length. When these findings that the influence of nutrition is becoming more
comparing the mean age of walking for American significant. The motor development tool is useful in
DQG (XURSHDQ SRSXODWLRQ WKHUH ZDV D GHOD\ LQ WKH evaluating and monitoring the motor development
achievement of motor milestones. Malina reported RIPDOQRXULVKHGFKLOGUHQDQGRUDWULVNFKLOGUHQRYHU
WKDWWKHPHGLDQDJHDWZDONLQJLVPRQWKV time. It will be also expected to promote better child
IRU $PHULFDQ VDPSOHV DQG  PRQWKV IRU FDUHE\LQFUHDVLQJWKHOHYHORIDZDUHQHVVRIWKHZRPHQ
(XURSHDQVDPSOHV,QDGGLWLRQD:+2ORQJLWXGLQDO village cadres and health personnel.
multi-centre growth reference study showing that
the role of nutrition in motor development of infants
provides an important addition to the literature and Acknowledgments
should serve as a baseline for more focused studies of
both motor and cognitive development. The study was funded by the Indonesian Ministry of Health . The
In contrast to early theories of motor develop- authors wish to thank the director and staff of Nutrition Academy
ment  the onset changes among individuals does LQ6XUDED\D0DODQJDQG%DQGXQJIRUWKHLUJUHDWFRRSHUDWLRQDQG
not follow a fixed chronology as suggested by the ZRUNIRUGDWDFROOHFWLRQDQGWR6XGMDWPLNR0'IRUKLVDGYLFH
curves generated in this cross-sectional study (Figure during the preparation of the study.
4+RZHYHUWKHVHGDWDEDVHGRQHVWLPDWHVRIWKHDJHV
DWZKLFKLQGLYLGXDOFKLOGUHQDFTXLUHSDUWLFXODUPRWRU
PLOHVWRQHSURYLGHDUHIHUHQFHIRUFRPSDUDWLYHSXUSRVHV References
among individuals.
6LQFH WKH PDMRULW\ RI VWXGLHV RI LQIDQW PRWRU  6DPHURII $- 0F'RQRXJK 6& 7KH UROH RI PRWRU DFWLYLW\
development have collected cross-sectional rather LQ KXPDQ FRJQLWLYH DQG VRFLDO GHYHORSPHQW ,Q 3ROOLWW (
WKDQORQJLWXGLQDOGDWDYDULDWLRQDPRQJLQGLYLGXDOV $PDQWH3HGLWRUV(QHUJ\LQWDNHDQGDFWLYLW\FXUUHQWWRSLFV
(inter individual variability) are discussed more often LQQXWULWLRQDQGGLVHDVH9RO1HZ<RUN$ODQ5/LVV,QF
in developmental literature than is variation within the S
same infants (intra individual variability). Although  0HHNV *DUGQHU -0 *UDQWKDP0F*UHJRU 6 &KDQJ 60
some variability of motor skills among infants is Powell CA. Dietary intake of observed activity of stunted and
UHFRJQL]HG LW LV ZLGHO\ DFFHSWHG WKDW VHTXHQFH RI QRQVWXQWHGFKLOGUHQLQ.LQJVWRQ-DPDLFD3DUW,,2EVHUYHG
motor skills is consistent. A child may miss a skill DFWLYLW\(XU-&OLQ1XWU
HQWLUHO\VXFKDVFUDZOLQJZKLOHWKHRWKHUUHPDLQLQJ  3ROOLWW(*RUPDQ.6/RQJWHUPGHYHORSPHQWDOLPSOLFDWLRQRI
skills emerge in a predicted order. Because of this motor maturation and physical activity in a nutritionally at risk
SUHGLFWDEOHVHTXHQWLDOSDWWHUQRIPRWRUGHYHORSPHQW SRSXODWLRQ,Q6FKXUFK%6FULPVKDZ16HGLWRUV$FWLYLW\
assessment of milestones provides an observable way HQHUJ\H[SHQGLWXUHDQGHQHUJ\UHTXLUHPHQWVRILQIDQWVDQG
to evaluate motor skills and to detect deviance or FKLOGUHQ/DXVDQQH6ZLW]HUODQG,'(&*S
motor delay. The pattern of skills may vary across  /DVN\ 5( .OHLQ 5( <DUEURXJK & (QJOH 3 /HFKWLJ $
LQGLYLGXDOV EXW WKH RUGHU UHPDLQV FRQVWDQW IRU WKH Martorell R. The relationship between physical growth and
PDMRULW\RIQRUPDOO\GHYHORSLQJLQIDQWV infant behavioural development in rural Guatemala. Child
The curve of motor milestones for normal 'HY
children in Indonesia has been constructed to measure  3RZHOO &$ *UDQWKDP0F*UHJRU 6 7KH HFRORJ\ RI
WKH PRWRU GHYHORSPHQW RI FKLOGUHQ DJH  WR  nutritional status and development in young children in
months. The purpose of this particular assessment is .LQJVWRQH-DPDLFD$P-&OLQ1XWU
to identify children who are delayed or deviant in their  *UDQWKDP0F*UHJRU 6 0HHNV *DUGQHU -0 :DONHU 6
motor development and evaluate motor development 3RZHOO&$7KHUHODWLRQVKLSEHWZHHQXQGHUQXWULWLRQDFWLYLW\
or maturation over times. Infants are considered to be OHYHOVDQGGHYHORSPHQWLQ\RXQJFKLOGUHQ,Q6FKXUFK%
DWULVNEHFDXVHRIDGYHUVHJHQHWLFSUHQDWDOQHRQDWDO 6FULPVKDZ 16 HGLWRUV $FWLYLW\ HQHUJ\ H[SHQGLWXUH DQG
SRVWQDWDOHQYLURQPHQWRUQXWULWLRQLQIOXHQFHVWKDW HQHUJ\ UHTXLUHPHQWV RI LQIDQWV DQG FKLOGUHQ /DXVDQQH

Paediatr Indones, Vol. 50, No. 6, November 2010345

 Mahdin A. Husaini Et al: Normal motor milestone development to promote child care

6ZLW]HUODQG,'(&*S development in undernourished children. Eur J Clin Nutr.

 3ROOLWW(+XVDLQL0$+DUDKDS++DODWL61XJUDKHQL$ 66
6KHUORFN$26WXQWLQJDQGGHOD\HGPRWRUGHYHORSPHQWLQ  &DSXWH $- 6KDSLUR ). 3DOPHU )% 5RVH $ $FKWHO 5&
UXUDO:HVW-DYD$P-+XP%LRO 1RUPDO JURVV PRWRU GHYHORSPHQW WKH LQIOXHQFH RI UDFH
 6KDILU7$QJXOR%DUURVR5&DODWURQL$-LPHQH](/R]RII% sex and socio-economic status. Dev Med Child Neurol.
Effects of iron deficiency on patterns of motor development 
RYHUWLPH+XP0RY6FL  %36 %XUHDX RI 1DWLRQDO 6WDWLVWLFV :HOIDUH ,QGLFDWRUV
 &KDYH] $ 0DUWLQH] & %HKDYLRUDO PHDVXUHPHQWV RI 686(1$6'DWD
activity in children and their relation to food intake in poor  :+2 0XOWLFHQWUH *URZWK 5HIHUHQFH 6WXG\ *URXS
FRPPXQLWLHV,Q3ROOLWW($PDQWH3HGLWRUV(QHUJ\LQWDNH Assessment of sex differences and heterogeneity in motor
DQGDFWLYLW\FXUUHQWWRSLFVLQQXWULWLRQDQGGLVHDVH9RO milestone attainment among populations in the WHO
1HZ<RUN$ODQ5/LVV,QFS &HQWUH*URZWK5HIHUHQFH6WXG\$FWD3DHGLDWU6XSSO
 3ROOLWW2K6(DUO\VXSSOHPHQWDU\IHHGLQJFKLOGGHYHORSPHQW 450:66-75.
DQGKHDOWKSROLF\)RRG1XWU%XOO  +RNRPD76XVKL.01DVDNR1,URQGHILFLHQF\DQHPLDDQG
 -HOOLIIH '% 7KH $VVHVVPHQW RI WKH QXWULWLRQDO VWDWXV RI FKLOGGHYHORSPHQW$3-3+
FRPPXQLW\*HQHYD:+20RQRJUDSK  0DOLQD 50 3K\VLFDO DFWLYLW\ DQG PRWRU GHYHORSPHQW
 +DPLOO 399 -RKQVRQ &/ 5HHG 5% $UFKHU $) 1&+6 SHUIRUPDQFHLQSRSXODWLRQQXWULWLRQDOO\DWULVN,Q3ROOLWW(
JURZWKFXUYHVIRUFKLOGUHQIURPELUWKWR\HDUV9LWDO+HDOWK $PDQWH3HGLWRUV(QHUJ\LQWDNHDQGDFWLYLW\&XUUHQWWRSLFV
6WDWLLY LQQXWULWLRQDQGGLVHDVH9RO1HZ<RUN$ODQ5/LVV,QF
 )UDQNHQEXUJ :. 'RGGV -% 'HQYHU GHYHORSPHQWDO S
screening test. Colorado: University of Colorado Medical  'H2QLV0*DU]D&9LFWRULD&*2Q\DQJR$:)URQJLOR
&HQWHU ($0DUWLQH]-7KH:+2PXOWLSOHJURZWKUHIHUHQFHVWXG\
 %D\OH\1%D\OH\VFDOHVRILQIDQWGHYHORSPHQW1HZ<RUN SODQQLQJ VWXG\ GHVLJQ DQG PHWKRGRORJ\ )RRG 1XWU %XOO
3V\FKRORJLFDO&RUSRUDWLRQ 6
 -DKDUL$%6DFR3ROOLWW&+XVDLQL0$3ROOLWW((IIHFWVRIDQ  :LMQKRYHQ 70$ GH 2QLV 0 2Q\DQJR $: :DQJ 7
energy and micronutrient supplement on motor development %MRHUQHERH *($ %KDQGDUL 1 /DUWH\ $ 5KDVLGL %
and motor activity in undernourished children in Indonesia. Assessment of gross motor development in the WHO
(XU-&OLQ1XWU66 multicentre growth reference study. Food Nutr Bull.
 0F*UDZ0%7KHQHXURPXVFXODUPDWXUDWLRQRIWKHKXPDQ 6
LQIDQW1HZ<RUNDQG/RQGRQ+DIQHU3XEOLVKLQJ&RPSDQ\  *HVHOO$7KHRQWRJHQHVLVRILQIDQWEHKDYLRU,Q&DUPLFKDHO
&ROXPELD8QLYHUVLW\3UHVVS /HGLWRU0DQXDORIFKLOGSV\FKRORJ\1HZ<RUN:LOH\
 +DUDKDS+-DKDUL$%+XVDLQL0$6DFR3ROOLWW&3ROOLWW S
E. Effects of an energy and micronutrient supplement on iron  3LSHU 0& 'DUUDK - 0RWRU DVVHVVPHQW RI WKH GHYHORSLQJ
GHILFLHQF\DQHPLDSK\VLFDODFWLYLW\DQGPRWRUDQGPHQWDO LQIDQW3KLODGHOSKLD:%6DXQGHUV&RPSDQ\

346Paediatr Indones, Vol. 50, No. 6, November 2010