*2.4. Developmental Motor Assessment*

The Peabody Developmental Motor Scale-Second Version (PDMS-II), the motor subscale [10] was used to evaluate motor development. This scale evaluates gross and fine motor development in toddlers from birth to five years. The gross motor component included three subtests for toddlers ages two to three: stationary (standing balance, sit-ups, and push-ups), locomotion (walking, running, jumping, and hopping), and object manipulation (throwing and taking different size balls). The fine motor component is composed of two subtests, grasping and visual motor integration. The mean between both scales is considered the total motor development score. The test requires the child to perform specific motor activities that are scored with a 2, 1, or 0 depending on whether the child partially or correctly completes an activity according to the description. Results obtained are standard scores, percentiles, age equivalents, quotient scores in fine and gross motor areas, and total motor development.

The mean value of the development quotients is 100 [10]. Above 100 (quotient > 100), motor development is considered rapid and below 100 (quotient < 100), development is considered slower. We presented two groups, toddlers with fast gross motor development (quotient > 100) and a group of toddlers with slow gross motor development (quotient < 100) based on the variable gross motor quotient (GMQ). The entire PDMS-II can be finished in 45 to 60 min. Separate fine or gross motor subtest administration takes 20 to 30 min.

The PDMS-II is primarily designed to examine and evaluate motor development, but as a secondary objective, it was developed as a research tool. The general test administration procedure is standardized, and formal training is not required. Griffiths et al. [27] reviewed the characteristics and psychometric properties of different tools for evaluating motor development. They determined that the PDMS-II has good psychometric characteristics to evaluate motor development. Hua et al. [28] reported that the scale's internal consistency is excellent. Folio and Fewwell [10] determined that it is good (24–35 months, α = 0.97). Wuang et al. [29] reported that the test has good reliability (test-retest *n* = 141, ICC = 0.97), and excellent validity. The content and the structural validity are also excellent [10,28]. The minimal detectable change was 7.76 (sensitivity 60.65%, specificity 74.13%) [29] and standard error mean (SEM) for 24–59 months was 3 [10].
