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The best answer to this can be made from by using a wonderful tool called as the GMFCS scale, we have that printed below Body support walker – A mobility device that supports the pelvis and trunk. The child/youth is physically positioned
in the walker by another person.
Hand-held mobility device – Canes, crutches, and anterior and posterior walkers that do not support the trunk during walking.

Physical assistance – Another person manually assists the child/youth to move.
Powered mobility – The child/youth actively controls the joystick or electrical switch that enables independent mobility. The mobility base may be a wheelchair, scooter or other type of powered mobility device.
Self-propels manual wheelchair – The child/youth actively uses arms and hands or feet to propel the wheels and move.
Transported – A person manually pushes a mobility device (e.g., wheelchair, stroller, or pram) to move the child/youth from one place to another.
Walks – Unless otherwise specified indicates no physical assistance from another person or any use of a hand-held mobility device. An orthosis (i.e., brace or splint) may be worn.
Wheeled mobility – Refers to any type of device with wheels that enables movement (e.g., stroller, manual wheelchair, or powered wheelchair).

LEVEL I - Walks without Limitations
LEVEL II - Walks with Limitations
LEVEL III - Walks Using a Hand-Held Mobility Device
LEVEL IV - Self-Mobility with Limitations; May Use Powered Mobility
LEVEL V - Transported in a Manual Wheelchair

Distinctions Between Levels I and II - Compared with children and youth in Level I, children and youth in Level II have limitations walking long distances and balancing; may need a hand-held mobility device when first learning to walk; may use wheeled mobility when traveling long distances outdoors and in the community; require the use of a railing to walk up and down stairs; and are not as capable of running and jumping.

Distinctions Between Levels II and III - Children and youth in Level II are capable of walking without a hand-held mobility device after age 4 (although they may choose to use one at times). Children and youth in Level III need a hand-held mobility device to walk indoors and use wheeled mobility outdoors and in the community.

Distinctions Between Levels III and IV - Children and youth in Level III sit on their own or require at most limited external support to sit, are more independent in standing transfers, and walk with a hand-held mobility device.

Children and youth in Level IV function in sitting (usually supported) but self-mobility is limited. Children and youth in Level IV are more likely to be transported in a manual wheelchair or use powered mobility.

Distinctions Between Levels IV and V - Children and youth in Level V have severe limitations in head and trunk control and require extensive assisted technology and physical assistance. Self-mobility is achieved only if the child/youth can learn how to operate a powered wheelchair.

Gross Motor Function Classification System – Expanded and Revised (GMFCS – E & R)

Between 0-2 years

LEVEL I: Infants move in and out of sitting and floor sit with both hands free to manipulate objects. Infants crawl on hands and knees, pull to stand and take steps holding on to furniture. Infants walk between 18 months and 2 years of age without the need for any assistive mobility device.

LEVEL II: Infants maintain floor sitting but may need to use their hands for support to maintain balance. Infants creep on their stomach or crawl on hands and knees. Infants may pull to stand and take steps holding on to furniture.

LEVEL III: Infants maintain floor sitting when the low back is supported. Infants roll and creep forward on their stomachs.

LEVEL IV: Infants have head control but trunk support is required for floor sitting. Infants can roll to supine and may roll to prone.

LEVEL V: Physical impairments limit voluntary control of movement. Infants are unable to maintain antigravity head and trunk postures in prone and sitting. Infants require adult assistance to roll.

between 2-4 years

LEVEL I: Children floor sit with both hands free to manipulate objects. Movements in and out of floor sitting and standing are performed without adult assistance. Children walk as the preferred method of mobility without the need for any assistive mobility device.

LEVEL II: Children floor sit but may have difficulty with balance when both hands are free to manipulate objects. Movements in and out of sitting are performed without adult assistance. Children pull to stand on a stable surface. Children crawl on hands and knees with a reciprocal pattern, cruise holding onto furniture and walk using an assistive mobility device as preferred methods of mobility.

LEVEL III: Children maintain floor sitting often by "W-sitting" (sitting between flexed and internally rotated hips and knees) and may require adult assistance to assume sitting. Children creep on their stomach or crawl on hands and knees (often without reciprocal leg movements) as their primary methods of self-mobility. Children may pull to stand on a stable surface and cruise short distances. Children may walk short distances indoors using a hand-held mobility device (walker) and adult assistance for steering and turning.

LEVEL IV:
Children floor sit when placed, but are unable to maintain alignment and balance without use of their hands for support. Children frequently require adaptive equipment for sitting and standing. Self-mobility for short distances (within a room) is achieved through rolling, creeping on stomach, or crawling on hands and knees without reciprocal leg movement.

LEVEL V: Physical impairments restrict voluntary control of movement and the ability to maintain antigravity head and trunk postures. All areas of motor function are limited. Functional limitations in sitting and standing are not fully compensated for through the use of adaptive equipment and assistive technology. At Level V, children have no means of independent movement and are transported. Some children achieve self-mobility using a powered wheelchair with extensive adaptations.

4-6 years

LEVEL I: Children get into and out of, and sit in, a chair without the need for hand support. Children move from the floor and from chair sitting to standing without the need for objects for support. Children walk indoors and outdoors, and climb stairs. Emerging ability to run and jump.

LEVEL II: Children sit in a chair with both hands free to manipulate objects. Children move from the floor to standing and from chair sitting to standing but often require a stable surface to push or pull up on with their arms. Children walk without the need for a handheld mobility device indoors and for short distances on level surfaces outdoors. Children climb stairs holding onto a railing but are unable to run or jump.

LEVEL III: Children sit on a regular chair but may require pelvic or trunk support to maximize hand function. Children move in and out of chair sitting using a stable surface to push on or pull up with their arms. Children walk with a hand-held mobility device on level surfaces and climb stairs with assistance from an adult. Children frequently are transported when traveling for long distances or outdoors on uneven terrain.

LEVEL IV: Children sit on a chair but need adaptive seating for trunk control and to maximize hand function. Children move in and out of chair sitting with assistance from an adult or a stable surface to push or pull up on with their arms. Children may at best walk short distances with a walker and adult supervision but have difficulty turning and maintaining balance on uneven surfaces. Children are transported in the community. Children may achieve self-mobility using a powered wheelchair.

LEVEL V: Physical impairments restrict voluntary control of movement and the ability to maintain antigravity head and trunk postures. All areas of motor function are limited. Functional limitations in sitting and standing are not fully compensated for through the use of adaptive equipment and assistive technology. At Level V, children have no means of independent movement and are transported. Some children achieve self-mobility using a powered wheelchair with extensive adaptations

6-12 years

Level I: Children walk at home, school, outdoors, and in the community. Children are able to walk up and down curbs without physical assistance and stairs without the use of a railing. Children perform gross motor skills such as running and jumping but speed, balance, and coordination are limited. Children may participate in physical activities and sports depending on personal choices and environmental factors.

Level II: Children walk in most settings. Children may experience difficulty walking long distances and balancing on uneven terrain, inclines, in crowded areas, confined spaces or when carrying objects. Children walk up and down stairs holding onto a railing or with physical assistance if there is no railing. Outdoors and in the community, children may walk with physical assistance, a hand-held mobility device, or use wheeled mobility when traveling long distances. Children have at best only minimal ability to perform gross motor skills such as running and jumping. Limitations in performance of gross motor skills may necessitate adaptations to enable participation in physical activities and sports.

Level III: Children walk using a hand-held mobility device in most indoor settings. When seated, children may require a seat belt for pelvic alignment and balance. Sit-to-stand and floor-to-stand transfers require physical assistance of a person or support surface. When traveling long distances, children use some form of wheeled mobility. Children may walk up and down stairs holding onto a railing with supervision or physical assistance. Limitations in walking may necessitate adaptations to enable participation in physical activities and sports including self-propelling a manual wheelchair or powered mobility.

Level IV: Children use methods of mobility that require physical assistance or powered mobility in most settings. Children require adaptive seating for trunk and pelvic control and physical assistance for most transfers. At home, children use floor mobility (roll, creep, or crawl), walk short distances with physical assistance, or use powered mobility. When positioned, children may use a body support walker at home or school. At school, outdoors, and in the community, children are transported in a manual wheelchair or use powered mobility. Limitations in mobility necessitate adaptations to enable participation in physical activities and sports, including physical assistance and/or powered mobility. Level V: Children are transported in a manual wheelchair in all settings. Children are limited in their ability to maintain antigravity head and trunk postures and control arm and leg movements. Assistive technology is used to improve head alignment, seating, standing, and and/or mobility but limitations are not fully compensated by equipment. Transfers require complete physical assistance of an adult. At home, children may move short distances on the floor or may be carried by an adult. Children may achieve selfmobility using powered mobility with extensive adaptations for seating and control access. Limitations in mobility necessitate adaptations to enable participation in physical activities and sports including physical assistance and using powered mobility.

12-18 years

Level I: Youth walk at home, school, outdoors, and in the community. Youth are able to walk up and down curbs without physical assistance and stairs without the use of a railing. Youth perform gross motor skills such as running and jumping but speed, balance, and coordination are limited. Youth may participate in physical activities and sports depending on personal choices and environmental factors.

Level II: Youth walk in most settings. Environmental factors (such as uneven terrain, inclines, long distances, time demands, weather, and peer acceptability) and personal preference influence mobility choices. At school or work, youth may walk using a handheld mobility device for safety. Outdoors and in the community, youth may use wheeled mobility when traveling long distances. Youth walk up and down stairs holding a railing or with physical assistance if there is no railing. Limitations in performance of gross motor skills may necessitate adaptations to enable participation in physical activities and sports.

Level III: Youth are capable of walking using a hand-held mobility device. Compared to individuals in other levels, youth in Level III demonstrate more variability in methods of mobility depending on physical ability and environmental and personal factors. When seated, youth may require a seat belt for pelvic alignment and balance. Sit-to-stand and floor-to-stand transfers require physical assistance from a person or support surface. At school, youth may self-propel a manual wheelchair or use powered mobility. Outdoors and in the community, youth are transported in a wheelchair or use powered mobility. Youth may walk up and down stairs holding onto a railing with supervision or physical assistance. Limitations in walking may necessitate adaptations to enable participation in physical activities and sports including self-propelling a manual wheelchair or powered mobility.

Level IV: Youth use wheeled mobility in most settings. Youth require adaptive seating for pelvic and trunk control. Physical assistance from 1 or 2 persons is required for transfers. Youth may support weight with their legs to assist with standing transfers.
Indoors, youth may walk short distances with physical assistance, use wheeled mobility, or, when positioned, use a body support walker. Youth are physically capable of operating a powered wheelchair. When a powered wheelchair is not feasible or available,
youth are transported in a manual wheelchair. Limitations in mobility necessitate adaptations to enable participation in physical activities and sports, including physical assistance and/or powered mobility.


Level V: Youth are transported in a manual wheelchair in all settings. Youth are limited in their ability to maintain antigravity head and trunk postures and control arm and leg movements. Assistive technology is used to improve head alignment, seating, standing,
and mobility but limitations are not fully compensated by equipment. Physical assistance from 1 or 2 persons or a mechanical lift is required for transfers. Youth may achieve self-mobility using powered mobility with extensive adaptations for seating and control access. Limitations in mobility necessitate adaptations to enable participation

Usually we have seen that with therapy /treatment continuously we can upgrade the child by at least one gmfcs level,this depends on a lot of factors like

  • Timing of achievement of landmarks.
  • Severity of development landmarks.
  • Degree of intellectual involvement.
  • Sensory perception. of the child to his/her surroundings
  • Motivation in child to move / explore the world.
  • Family support of the parents and the grandparents
  • Environment factors
  • Presence/absence of fits –children who have fits do not progress as fast as children who don’t
  • Repeated chest infections- children who have repeated cough cold do not progress as fast as children who don’t
  • Body awareness.
  • Ability to plan| execute function.
  • Behavior / cooperation of the child .
  • Medical problems
I
This is just one way to know what level your child is on clinically and this is so simple that even you can do this for yourself, we need to do this regularly just to know how much progress we have made over the last few months-

keep assessing regularly in conjunction with the team
the process of treatment in cerebral palsy is prolonged and usually the children who get better are the ones who’s parents show consistency and purpose over years it is easy to loose heart but believe us in doing that you inadvertently damage the cause of the one thing that you love best-your children!!!

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