Gross Motor Skills Predict Adaptive Behavior in Institutionalized Children With Severe Intellectual Disability: A Cross-Sectional Study

This study examines whether gross motor skills are linked to everyday functioning (adaptive behavior) in children with severe intellectual disability (ID) living in social welfare institutions. We recruited 227 orphaned children aged 6-12 years from six welfare institutions in China. Gross motor competence was assessed using the Test of Gross Motor Development-Second Edition (TGMD-2), which includes locomotor skills and object control skills. :contentReference\[oaicite:1\]{index=1} Adaptive behavior was assessed using the Adaptive Behavior Questionnaire for Children (ADQ), which provides an overall ADQ Index and scores for independence, cognition, and socialization. Assessments were conducted on site by a trained research team between May and June 2024. TGMD-2 sessions were video recorded and scored by trained raters, and caregivers completed the ADQ with assistance to ensure completeness. :contentReference\[oaicite:3\]{index=3} We will evaluate associations between TGMD-2 scores and ADQ outcomes and assess whether the TGMD-2 total score can help screen for children at risk of low adaptive functioning (ADQ Index \< 70). All procedures were approved by the local university ethics committee (approval number: 102772024RT062), and informed consent was obtained from institutional administrators and caregivers.