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[15] The GMFM-88 is an expanded version of the GMFM-66 and includes an additional 22 motor skills tasks, resulting in a total of 88 items. This version provides a more comprehensive assessment of gross motor function and allows for a finer-grained analysis of a childs abilities across a broader range of motor skills.
There is a scoring system with each item scored as 0, 1, 2, 3, or not tested. A scoring key of 0 does not initiate, 1 initiates, 2 partially completes, and 3 completed, is used; however parameters such as distance, time, support provided, accuracy, counts, and tasks will determine specific item scores.
The GMFM is a clinical assessment tool designed and validated to evaluate the change in gross motor function in children with cerebral palsy. The original GMFM-88 version has 88 items grouped into 5 dimensions (A: Lying and Rolling, B: Sitting, C: Crawling and Kneeling, D: Standing, E: Walking, Running, and Jumping).
The GMFCS, or Gross Motor Function Classification System, is a five-level classification that differentiates children with cerebral palsy based on the childs current gross motor abilities, limitations in gross motor function, and need for assistive technology and wheeled mobility.
The validation sample for the original GMFM included children 5 months to 16 years of age. The items are appropriate for those with motor skills at or below those of a 5-year-old child without any motor disability.
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Testing Children with Down syndrome The GMFM-88 is valid for use in children with Down syndrome. Specific guidelines are available in the GMFM manual. For example, some items can be scored automatically.
Validity was confirmed by a correlation of 0.82 between GMFM-88 scale changes and the clinical judgments of blinded assessors [1]. Both versions of the GMFM are reliable, valid, and responsive to change in children with CP.

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