Abstract: Objective To investigate the population distribution of gross motor milestones in children under 3 years old in China, and to map the development process of major indicators of gross motor development, so as to provide evidence for individualized assessment and intervention for infants and toddlers. Methods From September to December 2020, a cross-sectional survey was conducted on the development of normal children aged 1 to 36 months in 30 districts/counties of 15 cities in 15 provinces (autonomous regions/municipalities) of China. The developmental process map was drawn according to 10 categories of motor abilities, including "head control", "sitting", "turning over", "crawling", "standing", "walking/running", "upper limb strength", "squatting/jumping", "walking up stairs" and "single-foot use", and the 50th percentile age of each indicator was described. Results A total of 8 010 normal children aged 1 to 36 months were included in this study. The milestone curves of gross motor development showed the achievement of 30 indicators of gross motor development in Chinese infants. The median age of "lifts head 90°(prone)" was at 3.2 months, "supine turning prone" was at 4.6 months, "sit without hand support" was at 6.3 months, "hands-and-knees crawling" was at 7.6 months, "stand alone" was at 11.4 months,"walk alone" was at 13.1 months, "run with good balance" was at 15.8 months, "balance on each foot(≥1 s)" was at 18.7 months, "jump up with both feet together" was at 20.4 months. The curves reflected the attainment of milestones at different ages and suggested that the rate of attainment of each milestone increased rapidly over a certain age range of months. For example, infants' head control ability developed mainly within 6 months of age. The rate of turning over at 3 months was less than 15%. It took a certain amount of time for infants to transform their gross motor ability and develop proficiency. The median switching time between "sit without hand support" and "stand alone" was about 5.1 months. It took about 2.2 months from "sit with support" to "sit without hand support". Conclusion The milestone curve of gross motor development reflects the development trajectory of 30 gross motor development indicators of infants in China, providing basis for clinical evaluation, early intervention and development prediction of children's health care in China.

Key words: gross motor, milestone, development process, children

摘要： 目的 调查我国现阶段婴幼儿大运动发育里程碑在人群的分布,绘制我国婴幼儿大运动发育里程碑曲线图,为开展婴幼儿个体评估与干预提供依据。方法 于2020年9—12月,在中国15省(自治区/直辖市)15个城市30个区/县,对 1～36 月龄正常发育儿童的照养人进行婴幼儿发育里程碑指标的横断面调查,获得照养人自我报告的婴幼儿大运动发育里程碑的达到情况,按“头部控制”、“坐”、“翻身”、“爬行”、“站”、“走、跑”、“上肢力量”、“蹲、跳”、“上楼梯”、“单脚使用”10类大运动能力绘制大运动发育里程碑曲线图,并描述各指标的第50百分位月龄。结果 本研究共纳入1～36月龄正常儿童8 010例,绘制的大运动发育里程碑曲线图显示我国婴幼儿在30个大运动发育指标中的达到情况。其中部分里程碑的中位月龄为:“俯卧抬头90度”3.2月龄,“仰卧翻俯卧”4.6月龄,“独坐稳”6.3月龄,“用手和膝爬”7.6月龄、“独站稳”11.4月龄、“独走稳”13.1月龄、“跑稳”15.8月龄、“单脚独站1秒以上”18.7月龄,“双脚同时离地跳起”20.4月龄。曲线图反映出不同月龄里程碑的达到情况,并提示各里程碑的达到率在一定月龄段迅速增加。如婴儿头部控制能力发展主要集中在6月龄内,3月龄翻身的达到率不足15%,婴幼儿大运动能力转换和熟练发展需要一定时间,其中“独坐稳”和“独站稳”的中位转换时间约为5.1个月,同类指标中从“扶坐”到“独坐稳”约需2.2个月。结论 大运动发育里程碑曲线图反映了我国婴幼儿30个大运动发育指标的发展轨迹,为我国儿童保健临床评估、早期干预和发展预测等提供依据。

关键词: 大运动, 里程碑, 发育进程, 儿童