GMFCS - Original Version (1997)

The Gross Motor Function Classification System (GMFCS) is a 5 level classification system that describes the gross motor function of children and youth with cerebral palsy on the basis of their self-initiated movement with particular emphasis on sitting, walking, and wheeled mobility. Distinctions between levels are based on functional abilities, the need for assistive technology, including hand-held mobility devices (walkers, crutches, or canes) or wheeled mobility, and to a much lesser extent, quality of movement.

The focus of the GMFCS is on determining which level best represents the child's or youth's present abilities and limitations in gross motor function. Emphasis is on usual performance in home, school, and community settings (i.e., what they do), rather than what they are known to be able to do at their best (capability). It is therefore important to classify current performance in gross motor function and not to include judgments about the quality of movement or prognosis for improvement.

Within each of the five levels, descriptions of motor function are given for several age bands in the following ranges: before age 2, 2 to 4 years, 4 to 6 years, 6 to 12 years, and 12 to 18 years (12 to 18 year bands found in GMFCS E&R - Expanded and Revised). The descriptions for the 6 to 12 year and 12 to 18 year age bands reflect the potential impact of environment factors (e.g., distances in school and community) and personal factors (e.g., energy demands and social preferences) on methods of mobility. The scale is ordinal, with no intent that the distances between levels be considered equal or that children and youth with cerebral palsy are equally distributed across the five levels.

Children who have motor problems similar to those classified in "Level I" can generally walk without restrictions but tend to be limited in some of the more advanced motor skills. Children whose motor function has been classified at "Level V" are generally very limited in their ability to move themselves around even with the use of assistive technology.

The GMFCS has good inter-rater reliability, particularly for children over two years of age, and has application for clinical practice, research, teaching and administration.

Distributing the GMFCS

CanChild grants permission for printing, but does not allow the sale of the GMFCS, which should be made available for free everywhere. To download the English version of the GMFCS, click here.

In addition, the GMFCS has been translated by colleagues and shared with us. Some, but not all, have had a 'back translation' done. To download the GMFCS in one of the additional languages made available to us, click on the appropriate language: Dutch, French, German, Greek, Icelandic, Korean, Norwegian, Portuguese, Romanian, Slovene,  Spanish, Swedish, Ukranian. See also CanChild Guidelines for Translation of the GMFCS.

Other GMFCS-related tools/products:

The recently developed GMFCS Family Report Questionnaire presents an option for parent involvement in classifying children's motor abilities and is available for three age groups of children: 2 to 4 years, 4 to 6 years, and 6 to 12 years and is also available in French/aussi disponible en français.

GMFCS E&R Descriptors and Illustrations are available for the 6 to 12 year and 12 to 18 year bands of the GMFCS E&R.

 Find out the answers to Frequently Asked Questions about the GMFCS. 

The Motor Growth Curves and Percentiles for children with cerebral palsy describe the motor development of children with cerebral palsy grouped by GMFCS level. These "growth curves" help doctors, therapists, and families understand how the gross motor abilities of children in each level change with age and how much independence children are likely to achieve.

For more information:

Palisano, R., Rosenbaum, P., Walter, S., Russell, D., Wood, E., & Galuppi, B. (1997). Development and reliability of a system to classify gross motor function in children with cerebral palsy. Developmental Medicine & Child Neurology, 39, 214-223.

Rosenbaum, P., Walter, S., Hanna, S., Palisano, R., Russell, D., Raina, P., Wood, E., Bartlett, D., & Galuppi, B. (2002). Prognosis for gross motor function in cerebral palsy: Creation of motor development curves. Journal of the American Medical Association, 288 (11), 1357-1363.