Early Human Development 132 (2019) 39–44

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Early Human Development

journal homepage: www.elsevier.com/locate/earlhumdev

Associations between gross motor skills and cognitive development in T

toddlers
Sanne L.C. Veldmana, , Rute Santosa,b, Rachel A. Jonesa, Eduarda Sousa-Sáa, Anthony D. Okelya,c
⁎

a
Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
b
Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
c
Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia

ARTICLE INFO ABSTRACT

Keywords: Background: The early years of life are critical for motor and cognitive development. A better understanding is
Locomotor skills needed on the associations between the control and development of motor and cognitive tasks.
Object manipulation skills Aim: This study aimed to examine the association between gross motor skills and cognitive development in
Stability skills toddlers.
Cognition
Study design: Cross-sectional study.
Early childhood
Subjects: This study included 335 toddlers (aged 19.80 ± 4.08 months, 53.7% boys) from 30 childcare services
in Australia.
Outcome measures: Children were assessed on gross motor skills (Peabody Developmental Motor Scales 2nd
Edition; PDMS-2) and cognitive development (Bayley Scales of Infant and Toddler development 3rd edition;
Bayley-III).
Data analysis: A one-way ANCOVA was conducted to assess associations between gross motor skills and cog-
nitive development controlling for childcare center, sex, age, body mass index and socioeconomic status.
Results: The average scores were 96.41 ± 9.84 for gross motor skills (range gross motor quotient 35–165) and
11.45 ± 3.03 for cognitive development (range standard score 1–19). There was a significant positive asso-
ciation between gross motor skills and cognition, F(2,260) = 12.245, p < 0.001. Both locomotion and object
manipulation were significantly positively associated with cognition, F(2,266) = 14.607, p < 0.001 and
F(2,265) = 9.039, p < 0.001 respectively.
Conclusions: Levels of gross motor skills are positively associated with cognitive development in this sample of
Australian toddlers. Results reinforce the need for early commencement of gross motor skill promotion as this
might be important for cognitive development in the early years.

1. Introduction
The early years of life are critical for a child's development [1,2]. In
this period, the brain and central nervous system grow rapidly as new
connections or synapses between cells are formed [3]. The early years are
also a critical time for gross motor development. During this period, the
foundation for advanced motor behavior is laid by the development of
infant reflexes and reactions, rudimentary motor skills and finally, gross
motor skills [4]. Gross motor skills are the building blocks of movement
and consist of locomotor, object manipulation and stability skills. These
skills include jumping, running and kicking and are critical in the pro-
motion and maintenance of healthy developmental trajectories.
Brain research suggests that motor and cognitive development are
interrelated, with neuroimaging studies showing the neocerebellum
and the dorsolateral prefrontal cortex are co-activated during both
motor and cognitive tasks [5,6]. Early childhood education and care
specialists and developmental psychologists also support the notion
that motor and cognitive development overlap and are interrelated [7].
Additionally, the inter-connectedness of motor development and cog-
nitive development has underpinned fundamental theories in child
development. According to Piaget's ‘Cognitive Development Theory’,
motor and cognitive development are related through “thinking by
bodily movement” [8]. Cognitive processes are enhanced by actions
created by the body and this is especially apparent in the sensorimotor
stage of development (ages zero to two years). ‘Dynamic Systems
Theory’ [9] proposes movement is produced as a result of the interac-
tion between sub-systems such as the cognitive, neurological, muscular
and skeletal. Additionally, the ‘Ecological Perspective’ [10] proposes

⁎
Corresponding author.
E-mail address: s.veldman1@vumc.nl (S.L.C. Veldman).

https://doi.org/10.1016/j.earlhumdev.2019.04.005
Received 12 December 2018; Received in revised form 19 March 2019; Accepted 2 April 2019
0378-3782/ © 2019 Elsevier B.V. All rights reserved.
S.L.C. Veldman, et al.
infants can perceive information from the environment and act on this,
thereby linking cognitive and motor processes.
Gross motor skills have been positively associated with physical
activity and fitness [11,12], perceived competence [13,14] and body
weight [12,15] in children and adolescents. A recent systematic review
examined the relationship between motor and cognitive skills in typi-
cally developing children aged four to 16 years [16]. Twenty-one arti-
cles were included in the review with mixed (weak-to-strong) evidence
for correlations when examining underlying categories of motor and
cognitive skills. The categories of motor skills with the most evidence
for a correlation were object control skills, fine motor skills and timed
performance in movements. This relationship was stronger for pre-
pubertal children compared to pubertal children (> 13 years). To date,
few studies have examined the relationship between gross motor skills
and cognition in children below the age of five. Two studies examining
this relationship in infants (aged three to 16 months) concluded they
were strongly associated and dependent on each other [17,18]. When
examining studies conducted in pre-schoolers, measures of cognition
often include measuring executive functions. Executive functions can be
described as a set of control processes that help managing and directing
attention, thoughts and actions [19]. Examples of executive functions
include working memory (e.g. “holding information in mind and
working with it”), inhibition (e.g. “inhibiting attention to other things
in the environment and staying focused”) and cognitive flexibility or
shifting (e.g. “to shift mental sets or see something from different per-
spectives”) [20]. Executive functions have been identified as a predictor
for children's academic achievement [21,22]. Houwen et al. [23] ex-
amined the associations between motor performance and parent-rated
executive functions in 153 pre-schoolers (mean age 4.1 years). They
found several positive relationships between motor performance and
executive function subscales; however, only the working memory sub-
scale was associated after adjusting for age, sex, socioeconomic status
and attention deficit hyperactivity disorder (ADHD) symptomatology.
Two studies conducted in older preschoolers (aged five to six years)
showed positive associations between subtests of motor skills and
cognition [24,25]. One of these studies showed associations between
both agility (obstacle course) and dynamic balance and spatial working
memory, and between agility and attention [24]. The other study
showed shifting (accuracy) was related to all motor functions (manual
dexterity, ball skills, dynamic balance), cognitive inhibition (reaction
times) was related to all motor functions except for balance, and motor
inhibition (accuracy) was related to dynamic balance [25].
The importance of both gross motor skill development as well as
cognitive development for school readiness and long-term academic
success have been recognized in the revised ‘Head Start Early Learning
Outcomes Framework: Ages Birth to Five’ [26,27]. This framework
states motor and cognitive development, together with social-emotional
development, form the three main, inter-related, developmental areas
in the early years of learning and development. Research also supports
the long-term importance as early motor development, age birth to four
years, has been shown to be a predictor of processing speed and
working memory in children aged six to 11 years [28]. Additionally,
two studies have examined motor milestones and found earlier attain-
ment (at ages one and two) was related to better educational mean
scores at age 16 [29] and better intellectual performance at ages eight,
26 and 53 [30].
To our knowledge, there are no studies that have examined these
relationships in toddlers. This information will be valuable from both a
theoretical and practical perspective. It will contribute to a better un-
derstanding of the association between the control and development of
motor and cognitive tasks, and might benefit intervention studies aimed
at improving motor skills and cognition in the early years of life. The
aim of this study was to examine the associations between gross motor
development and cognitive development in Australian toddlers (aged
11 to 29 months).
40
Early Human Development 132 (2019) 39–44
2. Materials and methods
This study used a cross-sectional design and was conducted con-
currently with the baseline data collection of the ‘Get Up’ study [31].
‘Get Up’ is a 12-month 2-arm parallel-group cluster randomized con-
trolled trial evaluating the effects of reduced sitting time on toddlers'
cognitive development [31].
2.1. Participants
Recruitment took place in 30 early childhood education and care
(ECEC) services across New South Wales, Australia. Ineligibility criteria
for children included being born preterm, having any disabilities or
being diagnosed with a medical condition. More information on pro-
tocols and procedures of the ‘Get Up’ Study have been previously
published [31]. Recruitment took place between October 2015 and May
2016. More centers were recruited than originally intended due to the
lower amount of eligible children in attendance at each center. Data
were collected through week-long visits in the participating centers by
trained data collectors between March and July 2016. All data collec-
tors participated in a two-day training workshop facilitated at the
University of Wollongong prior to data collection. This training in-
cluded measurement and practical sessions to ensure correct adminis-
tration of the data collection instruments. It also focused on the im-
portance of rapport building and collaboration with setting staff in this
young age group.
Written informed consent was obtained from the participant's par-
ents or carers prior to data collection. The study was approved by the
Human Research Ethics Committee of the University of Wollongong,
Australia (HE15/236) and the study was registered in the Australian
New Zealand Clinical Trials Registry: ACTRN12616000471482, 11/04/
2016 (retrospectively registered).
2.2. Gross motor skills
The gross motor skill subtest of the Peabody Developmental Motor
Scales – 2nd Edition (PDMS-2) was used to assess gross motor skills
[32]. This assessment tool has been validated in children aged
0–5 years. The PDMS-2 consists of three subtests: stationary, locomo-
tion and object manipulation [32]. The age of the child determined the
entry point of the test and the child had to be able to perform the first
three items per subtest correctly. If the child was not able to do so, the
subtest was administered backwards until a child reached three con-
secutive ‘2’ scores. Assessments were scored according to the scoring
options provided per item. That is, “2 – The child performs the item
according to the criteria specified for mastery”, “1 – The child's per-
formance shows a clear resemblance to the item mastery criteria but
does not fully meet the criteria”, or “0 – The child cannot or will not
attempt the item, or the attempt does not show that the skill is emer-
ging”. Trained data collectors administered the items by demonstrating
the item correctly. An example of an item of the stationary subtest is
standing on one foot: Stand on one foot, hands on hip with free leg bent
back at knee. Say “Put your hands on your hips and stand on one foot like I
did”. An example of the locomotion subtest is creeping up stairs: Place a
toy on the 3rd step. Say “Get the toy”. An example of an item of the object
manipulation subtest is throwing a ball: Give tennis ball to child and stand
5 ft. away. Say “Throw the ball to me”. Children were allowed up to three
trials per item to receive a maximum score of 2. The assessment finished
if a child received a ‘0’ score on three consecutive items. The total
number of points per subtest (raw score) was converted into a standard
score (scoring range 1–20) using the examiner's manual and software
provided [32] and labelled with a description: ‘Very superior’, ‘Su-
perior’, ‘Above average’, ‘Average’, ‘Below average’, ‘Poor’ and ‘Very
poor’. [32] The Gross Motor Quotient (GMQ; scorings ranges 35–165)
measures a child's overall gross motor development and can be derived
from standard scores of the three subtests. For the purpose of analysis,
S.L.C. Veldman, et al.
children belonging in the groups ‘Very superior’, ‘Superior’ and ‘Above
average’ were grouped together and formed a group named ‘Above
average’ and children in the groups ‘Below average’, ‘Poor’ and ‘Very
poor’ were grouped together and formed a group labelled ‘Below
average’. This was done given the small numbers in the groups: ‘Very
superior’, ‘Superior’, ‘Poor’ and ‘Very poor’.
2.3. Cognitive development
Cognitive development was assessed using the cognitive subtest of
the Bayley Scales of Infant and Toddler development – 3rd edition
(Bayley-III) [33]. This test is reliable and valid for the age range of
children examined in this study [34]. This subtest has a total of 74 items
and covers sensorimotor development, exploration and manipulation,
object relatedness, concept formation, memory, and problem solving.
The entry point of the assessment was based on the age of the child. A
child was required to score a ‘1’ on the first three consecutive items to
continue; otherwise the test would start again at the entry point of the
previous age. A score of ‘1’ was given a child was able to complete the
item accordingly. The assessment finished when a child scored ‘0’,
meaning the child was not able to complete the item accordingly, on
five consecutive items. Examples of items include pegboard games,
understanding the concept of one and matching sizes. Children receive
a score of ‘1’ if they meet the following: ‘Child places all six pegs in
pegboard within 25 s’, ‘Child hands you only one block within 5 s’ and ‘Child
correctly identifies big blue duck’. The total number of points (raw score)
were converted into a standard score using the examiner's manual [33].
The standard score (range 1–19) was used in the analyses.
2.4. Weight status
Height and weight were measured using standardized procedures
[31,35]. For height, the child was positioned upright with their head in
the “Frankfort Plane”. A portable Seca 254 stadiometer (Seca, Ham-
burg, Germany) was used to measure this to the nearest 0.1 cm. A
portable Seca 254 electronic Scale (Seca, Hamburg, Germany) was used
to measure weight to the nearest 0.1 kg. Children were measured with
light clothes (t-shirt and shorts), without shoes and diapers. Body mass
index (BMI) was calculated as weight (kg) / height (m2).
2.5. Demographics
The child's date of birth, sex, and the child's family postcode were
self-reported by parents or caregivers. The family's postcode was con-
verted into a SEIFA Index. This Index ranks areas according to relative
socio-economic disadvantage on a scale from 1; most disadvantaged, to
10; least disadvantaged. This Index was developed by the Australian
Bureau of Statistics and for the current study was reported in tertiles as
follows: low (deciles 1–3), middle (deciles 4–6) and high (deciles 7–10).
2.6. Data analysis
Descriptive analyses were presented as mean ± standard deviation
(SD) and percentages. Sex differences were examined conducting two-
tailed student's t-tests (normally distributed variables) and Mann-
Whitney tests (not normally distributed variables) for continuous
variables and Chi-square tests for categorical variables.
A one-way ANCOVA was conducted to determine the statistically
significant differences between the three categories (below average,
average and above average) of the GMQ and standard scores of the
subtests (locomotion, object manipulation and stationary) on cognitive
development. The ECEC services were entered as a random factor to
adjust for clustering and confounders included age, sex, BMI and socio-
economic status. Post-hoc analyses were conducted using Bonferonni
analysis. Data were analyzed using SPSS software, version 21 [36].
41
Early Human Development 132 (2019) 39–44
3. Results
A total of 335 toddlers aged 11 to 29 months (mean
age = 19.80 ± 4.08 months) completed all measures of gross motor
skills and cognitive development. There were slightly more boys
(n = 180, 53.7%) than girls and the mean BMI was 17.84 ± 1.69 kg/
m2. The average standard score for cognitive development was
11.45 ± 3.03. For gross motor skills, the average GMQ score was
96.41 ± 9.84 and 23.3% of the children scored ‘below average’. For
the different subtests, the standard scores were 8.42 ± 2.21 for loco-
motion, 9.86 ± 2.21 for object manipulation and 10.11 ± 1.24 for
stationary. The percentage of children scoring ‘below average’ for the
subtests was 34.3% for locomotion, 10.1% for object manipulation and
0.3% for stationary. For object manipulation boys scored higher than
girls (p = 0.01). Overall, 43.6% of the children had a low socio-eco-
nomic status. Participants' characteristics can be found in Table 1.
There was a significant positive association between gross motor
skills and cognitive development after controlling for childcare center,
sex, age, BMI, and socioeconomic status (F(2, 260) = 12.245, p < 0.001;
Table 2). Both locomotion and object manipulation were also sig-
nificantly positively associated with cognitive development after con-
trolling for the same variables (F(2, 266) = 14.607, p < 0.001 and F(2,
265) = 9.039, p < 0.001). There was no association between stationary
skills and cognitive development. Post-hoc analyses revealed significant
differences between GMQ groups with children in the average group
having better cognitive development compared to children in the below
average group (p < 0.001), and children in the above average group
had better cognitive development compared to children in the average
(p < 0.05) and below average group (p < 0.001). Similar results were
seen for locomotion; with increasing locomotion group, cognitive de-
velopment significantly increased compared to the group(s) below them
(p < 0.001). For object manipulation, children in both the average and
above average groups had significantly better cognitive development
than children in the below average group (p < 0.001).
4. Discussion
There was a significant difference in cognitive development for
different levels of gross motor skills in this sample of Australian toddlers
aged 11 to 29 months. Results show significant differences in cognitive
development for the GMQ as well as for two of the subtests (locomotion
and object manipulation). Since there are no known studies in toddlers
(children aged one to three years), results will be compared to studies
conducted in infants [17,18] and preschoolers [23–25]. These studies
found somewhat similar results to the current study – i.e. significant
associations were reported for either total score or subtests of motor
skills and cognition or executive functions although the strengths of the
associations varied from weak to strong. In young children (~under the
age of four), the association seems stronger whereas with increasing age
associations are more pronounced for specific areas of either motor or
cognitive development [16]. This also raises a methodological issue as
comparing results is difficult due to the different assessment tools used
across studies. This is the case for both the assessment of gross motor
skills (e.g. different performance criteria and process versus product-
oriented assessments; meaning assessing the quality of movements
(process) versus the outcome of movements (product)) as well as the
assessment of cognition (e.g. parent-reported, the use of different ex-
ecutive function subtests vs overall cognitive test). Especially for cog-
nitive development, there is a limitation around measurement tools in
toddlers, since none of the available tools measure different aspects of
cognition (e.g. executive functions such as working memory, inhibition
and shifting) but rather assess cognitive development as a whole. This
makes it impossible to examine associations with different areas of
cognitive development and could be an explanation for the differences
in results across ages. The cognitive assessment used in this study
provided one outcome for cognition which only allowed us to examine
S.L.C. Veldman, et al. Early Human Development 132 (2019) 39–44

Table 1
Participants' characteristics.
All (n = 335) mean ± SD Girls (n = 155) mean ± SD Boys (n = 180) mean ± SD p valuea

Age (months) 19.80 ± 4.08 19.69 ± 4.05 19.89 ± 4.12 0.645

Body mass index (kg/m2) 17.84 ± 1.69 17.71 ± 1.75 17.96 ± 1.63 0.179b
Cognitive development: standard score (range 1–19) 11.45 ± 3.03 11.71 ± 3.05 11.23 ± 3.00 0.146
Gross motor skills: gross motor quotient (range 35–165) 96.41 ± 9.84 96.30 ± 9.66 96.50 ± 10.03 0.455
- Locomotion standard score (range 1–20) 8.42 ± 2.21 8.52 ± 2.20 8.33 ± 2.21 0.348
- Object manipulation standard score (range 1–20) 9.86 ± 2.20 9.53 ± 2.31 10.15 ± 2.06 0.001⁎
- Stationary standard score (range 1–20) 10.11 ± 1.24 10.23 ± 1.32 10.02 ± 1.17 0.295
n (%) n (%) n (%)
Socio-economic status Low (decile 1–3) 146 (43.6%) 61 (39.4%) 85 (47.2%) 0.293
Middle (decile 4–6) 135 (40.3%) 69 (44.5%) 66 (36.7%)
High (decile 7–10) 54 (16.1%) 25 (16.1%) 29 (16.1%)
Gross motor quotient Below average (n, %) 78 (23.3%) 35 (22.6%) 43 (23.9%) 0.885
Average (n, %) 234 (69.8%) 110 (71.0%) 124 (68.9)
Above average (n, %) 23 (6.9%) 10 (6.4%) 13 (7.2%)
Locomotion Below average (n, %) 115 (34.3%) 49 (31.6%) 66 (36.7%) 0333c
Average (n, %) 213 (63.6%) 104 (67.1%) 109 (60.6%)
Above average (n, %) 7 (2.1%) 2 (1.3%) 5 (2.8%)
Object manipulation Below average (n, %) 34 (10.1%) 19 (12.3%) 15 (8.3%) 0.422
Average (n, %) 272 (81.2%) 125 (80.6%) 147 (81.7%)
Above average (n, %) 29 (8.7%) 11 (7.1%) 18 (10.0%)
Stationary Below average (n, %) 1 (0.3%) 0 1 (0.6%) –d
Average (n, %) 323 (96.4%) 146 (94.2%) 177 (98.3%)
Above average (n, %) 11 (3.3%) 9 (5.8%) 2 (1.1%)

a
Mann-Whitney test for continuous variables and Chi-square test for categorical variables.
b
Two-tailed Student's t-test.
c
Chi-square test was performed after collapsing the categories average and above average.
d
Chi-square test was not performed as some categories had < 5%.
⁎
p < 0.05.

the subtests of gross motor skills. The two studies conducted in infants children to perform certain skills and targets infants 0–18 months. The
(ages three to 16 months; [17,18]) used an earlier version of the Bayley studies conducted in pre-schoolers used agility and dynamic balance as
Scales of Infant Development – 2nd edition (BSID-II) to assess cognition. a measure of motor skills [24,25] or a parent questionnaire to assess
This earlier version consistently reports lower scores for cognitive de- executive functions [23]. A direct comparison across studies is therefore
velopment compared to the 3rd edition used in this study [37,38]. difficult.
Additionally, the two studies in infants used a different motor skills There are several explanations for the association between gross
measurement, the Alberta Infant Motor Scale (AIMS). This scale is ad- motor skill development and cognition. First, behavioral research has
ministered by observation of spontaneous activity rather than asking shown that both developmental domains follow a similar develop-
mental timetable with the early years being the most important and
Table 2 showing the most rapid development [1–3,23]. Brain research also
Analysis of covariance of cognitive development for the gross motor quotient supports the association. Diamond (2000, 2007) discusses the co-acti-
and subcategoriesa. vation of certain brain areas during the performance of both motor and
Cognitive development
cognitive tasks [5,6]. Motor action mainly activates the cerebellum,
which is also co-activated during cognitive action. Similarly, cognitive
Mean Std. error 95% CI action activates the prefrontal cortex, which is also co-activated during
motor action. The same areas in the brain can therefore be activated in
Lower bound Upper bound
different situations with different task requirements regardless of the
Gross motor quotient categories predetermined functional areas in the primary cortex [5]. Koziol et al.
Below average 9.897⁎ 0.387 9.136 10.659 [39] posit that the brain evolved for the control of action and not
Average 11.603⁎ 0.209 11.193 12.014 specifically for the development of cognition. They describe how
Above average 13.368⁎ 0.665 12.057 14.678
movement requires anticipatory control and thereby links movement
Locomotion and executive function, as executive function is described as an ex-
Below average 10.195⁎⁎ 0.331 9.543 10.848 tension of the motor control system [39]. More brain research is needed
Average 11.752⁎⁎ 0.225 11.308 12.196
Above average 16.114⁎⁎ 1.211 13.729 18.499
in this area as there is little known about the neural basis underlying the
development of functional motor control as well as cognition and how
Object manipulation
these are connected. Nishiyori et al. [40] examined hemodynamic ac-
Below average 9.443⁎⁎ 0.533 8.393 10.493
Average 11.430⁎⁎⁎ 0.193 11.050 11.811 tivity of the primary motor cortex in infants (six and 12 months) during
Above average 12.761⁎⁎⁎ 0.619 11.542 13.979 reaching for an object and stepping with support on a treadmill. They
Stationaryb used functional near-infrared spectroscopy (fNIRS) and results suggest
Below average or average 11.274 0.186 10.907 11.641 the area of activity in the primary motor cortex during motor tasks
Above average 12.406 0.963 10.510 14.301 narrows and becomes more specific with increasing goal-directed ac-
a
tivity. Future research should extend on this study by examining more
Analysis were adjusted for age, sex, BMI and socio-economic status.
b (complex) motor tasks, different ages and different areas of the brain in
Analysis was performed after collapsing the categories below average
order to answer the question on the relationship between motor and
(n = 1) and average.
⁎
p < 0.05 compared to all groups.
cognitive development from a neurological perspective.
⁎⁎
p < 0.001 compared to all groups. There was no association between stationary skills and cognitive
⁎⁎⁎
p < 0.001 compared to below average. development in this young sample of Australian toddlers. This can be

42
S.L.C. Veldman, et al.
explained by the low variability between stationary skill scores. The
items of the stationary subtest of the PDMS-2 cover wide age ranges
(e.g. three items for children aged 27–48 months) and is therefore less
sensitive to development compared to the other two gross motor skill
subtests that contain more items.
Strengths of this study include the relative large sample size of
toddlers. Also, validated measurements have been used to assess both
gross motor skills and cognition. Limitations of the study include the
cross-sectional design, which only allows the examination of associa-
tions, and the low variability between the results. The norms presented
to interpret gross motor skill scores and cognition in the assessment
tools, the PDMS-2 and Bayley-III, were based on samples from the USA.
Since these are the only norms available, some results should be in-
terpreted with caution due to differences in cultural background.
Another limitation of the study is the absence of intra- and inter-rater
reliability assessments.
It is also important to mention that children in this young age group
react differently to new people and test situations. This might influence
cooperation and/or performance on any assessment (e.g. shy children
might not perform to the best of their ability). The importance of rap-
port building in this young age group and collaboration with setting
staff should therefore be included in training for data collectors.
For future studies it would be interesting to longitudinally examine
the relationship between gross motor skills and cognitive development
in the early years and investigate how this relationship changes with
age. To date, cross-sectional studies have been conducted in several age
groups but none of the studies have tracked children during the first
years of life. Furthermore, examining the factors that have an influence
on this relationship at each point in time would increase our under-
standing of a child's development and help identify children who are at
risk of developmental delay throughout childhood. Given the outcomes,
it would be interesting to examine interventions targeting cognition
through the promotion of gross motor skills.
In conclusion, gross motor skill levels have a significant positive
association with cognitive development in this sample of toddlers.
These results, in addition to the positive results found in previous stu-
dies [17,18,23–25,28–30], implicate early promotion of gross motor
skill development might be important for cognitive development
throughout life. This data will add to our understanding of a child's
development, the influence of gross motor skills on cognitive develop-
ment, and reinforces the importance of early commencement of gross
motor skill promotion. However, additional studies are needed, as
evidence remains limited in this area.
Conflict of interest statement
None declared.
Acknowledgements
We would like to thank all Early Childhood Education and Care
(ECEC) services and participants involved in this study. We acknowl-
edge that the results of the study are presented clearly, honestly, and
without fabrication, falsification, or inappropriate data manipulation.
Declarations of interest
None.
Funding sources
This project was funded by a Discovery Early Career Research
Award from the Australian Research Council (DE150101921). The
funding source had no role in the design of the study, and will not have
any role during its execution, analysis, interpretation of the data, or
decision to submit results.
43
Early Human Development 132 (2019) 39–44
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