In brief
- The Shoaib Sensorimotor Development Tool (SSDT) is a 72-item assessment that measures sensorimotor development across nine domains: gross motor, fine motor, sensory, tone, balance, gait, reflexes, social interaction, and speech.
- It was developed and validated in a 2025 study published in Annals of King Edward Medical University. The validation used two samples: 150 mothers of typically developing children aged 3 to 7 for an exploratory factor analysis, and 300 mothers for a separate confirmatory factor analysis. Seventy-five constructs were analysed initially and three were removed for cross-loading, leaving the final 72.
- The SSDT is one of three primary outcome measures in the completed clinical trial comparing DMI to the Bobath approach (NCT07238634), alongside the GMFM-88 and the Trunk Impairment Scale. It was developed by the trial's own principal investigator.
- The tool was validated only on typically developing children, which means its measurement properties in children with cerebral palsy are not yet established. This is an important limitation for interpreting the trial results.
- Understanding what the SSDT measures helps you read the trial results more carefully and ask better questions about how progress was evaluated.
The Shoaib Sensorimotor Development Tool appears on this site as one of three primary outcome measures in the completed clinical trial comparing DMI and the Bobath approach. Unlike the GMFM-88 and the Trunk Impairment Scale, it was developed recently and is less widely known. This post explains what the SSDT is, how it was validated, and what its strengths and limitations mean for reading the trial results.
What is the Shoaib Sensorimotor Development Tool?
The Shoaib Sensorimotor Development Tool (SSDT) is a standardized assessment of sensorimotor development. Its validation paper describes it as assessing children from birth to 36 months, and its scoring converts a child's total into a developmental age between 1 and 36 months. It was developed by Shoaib Waqas, Ashfaq Ahmad, Juliana Barbosa Goulardins, Asif Hanif, Muhammad Tariq, and Atiqa Niamat, and published in 2025 in Annals of King Edward Medical University (Lahore, Pakistan), volume 31, issue 3.
The tool contains 72 items (referred to as constructs in the validation study) organized into nine domains that span motor function, sensory processing, and developmental milestones. The goal was to create a single instrument that captures sensorimotor development holistically rather than requiring separate assessments for motor skills, reflexes, and social interaction.
The nine domains
The SSDT covers a broader range of function than a purely motor assessment. Its nine domains are:
Gross motor
15 items on milestones from head control, rolling, and sitting through standing, cruising, walking, climbing stairs, standing on one foot, jumping, running, and standing on tiptoe.
Fine motor
10 items including bringing the hands to the midline, passing an object between hands, reaching, letting go of an object, pincer and precision grasps, self-feeding, cutting with scissors, and throwing and catching a ball.
Sensory
10 items that range widely, including recognizing the scent of the mother's breast milk, handling different food textures, telling edible from inedible objects, toilet control, recognizing shapes and colors, and reasoning with "why" and "because."
Tone
3 items on how muscle tone changes in infancy, including whether the curled-up flexion of a newborn is resolving and whether tone is shifting from flexion to extension through tummy time.
Balance
3 items on the body's automatic reactions to small, moderate, and large losses of balance: righting reactions, equilibrium reactions, and protective extension.
Gait
6 items on early walking, including a wide base of support, frequent falls, leg alignment, single-leg stance, and a mature heel-to-toe pattern.
Reflexes
7 items on whether primitive reflexes and righting reactions have been integrated, including the Moro and startle reflexes, rooting and sucking, and the tonic neck and tonic labyrinthine reflexes.
Social interaction
8 items on early social milestones such as cooing and chuckling, responding to tone of voice, fear of strangers, games like peek-a-boo, tantrums, and sharing.
Speech
10 items on communication, from different cries and a social smile through babbling, gestures, first words, and 2- to 3-word sentences, including the size of the child's expressive and receptive vocabulary.
Most items are scored 0 if the child cannot do it, 0.5 if they can do it with assistance, and 1 if they can do it without assistance. Reflex items are scored as not, partially, or fully integrated. The total, out of 72, converts to a developmental age between 1 and 36 months, and the paper treats a score below 36 as atypical development.
How was it validated?
The validation study was a cross-sectional psychometric study using two samples. An exploratory factor analysis drew on 150 mothers of typically developing children aged 3 to 7, of whom 144 completed the assessment. A separate confirmatory factor analysis used 300 mothers, of whom 288 completed it. Seventy-five constructs were analysed initially and three were removed for cross-loading, leaving the final 72. Mothers completed the SSDT as a parent-report questionnaire. The model fit indices come from the confirmatory analysis.
Exploratory factor analysis confirmed that all 72 items loaded onto a single factor called "sensorimotor development," which explained 84.3 percent of the variance (eigenvalue of 3.897). The paper reports good model fit: CFI = 0.983, GFI = 0.962, TLI = 0.989, SRMR = 0.0325, and RMSEA = 0.076. The SSDT demonstrated excellent internal consistency, with a Cronbach's alpha of 0.963. The Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy was 0.992, and Bartlett's test of sphericity was significant (p < 0.001).
In plain terms, the validation study found that the SSDT items hang together as a coherent measure of sensorimotor development, that internal consistency across items was high, and that the sample was adequate for the statistical methods used. Stability of scores when the same child is assessed twice was not tested.
What the SSDT adds to the DMI trial
The DMI clinical trial (NCT07238634) used three primary outcome measures, each measuring a different aspect of function. The GMFM-88 measures gross motor skills. The Trunk Impairment Scale measures trunk control specifically. The SSDT adds coverage of areas neither of the other two includes: fine motor skills, sensory responsiveness, muscle tone, reflexes, social interaction, and speech.
That is potentially valuable, with the limitations described below. By including the SSDT, the trial investigators chose to look at whether DMI produces changes beyond motor function, in sensory processing, tone, social engagement, and communication. If the results show improvements on the SSDT in the DMI group compared to the Bobath group, that would be information no purely motor assessment could provide.
The validation study collected data through mothers completing the tool about their children, but the paper also reports that the SSDT takes an average of 21 minutes to complete and that administration is feasible for trained therapists after a brief workshop. It is therefore designed for both parent report and therapist administration. What the trial registration does not specify is which of the two the trial used, and that is worth noting when the results appear, since the two methods can produce different results.
Important limitations to understand
The SSDT was validated only on typically developing children. The children in both validation samples were developing typically. The study excluded children with developmental, neurological, musculoskeletal, genetic, nutritional, or traumatic conditions. This means the tool's measurement properties (reliability, validity, sensitivity to change) in children with CP are not established. A tool that works well for typically developing children does not automatically work the same way for children with motor delays.
The tool's age range, its validation sample, and the trial do not line up. The validation paper describes the SSDT as assessing children from birth to 36 months, and its scoring converts a child's total into a developmental age between 1 and 36 months. But it was validated with mothers of typically developing children aged 3 to 7, and the DMI trial enrolled children aged 2 to 4. The trial's 2-year-olds are younger than any child in the validation sample, and its 4-year-olds are older than the range the tool is built to describe.
The tool was developed by the trial's principal investigator. Shoaib Waqas, the SSDT's lead developer and the validation paper's corresponding author at Lahore University of Biological and Applied Sciences, is also listed on ClinicalTrials.gov as the principal investigator of the DMI trial. That does not mean the results will be wrong. It does mean that the only published study of this measure so far comes from the team that created it.
The validation study is not in PubMed. The journal that published it, Annals of King Edward Medical University, is not indexed for MEDLINE, so the study does not appear in PubMed. That does not make it invalid, but it means the standard bibliographic check is not available, and the journal's peer-review process may be harder to verify than for a MEDLINE-indexed journal.
The study was based on parent report, not direct child assessment. Mothers completed the questionnaire about their children. Parent-report measures are a legitimate method of assessment, but they can differ from direct clinician observation, particularly for domains like tone and reflexes where a parent's judgment may not match a trained therapist's.
What this means for reading the trial results
When the DMI trial results are published, three questions about the SSDT data are worth asking:
- How was the SSDT administered: as a parent-report questionnaire or as a therapist-scored assessment? The tool supports both methods, so the answer affects how the results should be interpreted.
- Did the SSDT detect differences between the DMI and Bobath groups that the GMFM-88 and TIS did not? The SSDT covers domains the other two measures do not, so detecting change there would be new information.
- Were the 2-year-old participants included in the SSDT analysis, or were they excluded from that measure because they fell below the validated age range? How the researchers handled this matters for whether the findings apply to younger children.
None of these limitations invalidate the trial or the tool. But they give you the context to evaluate the results fairly.
What you can do with this information
The SSDT is new, and the only published study of it comes from the team that developed it. Its validation paper calls it promising but says broader validation and longitudinal studies are needed before it is widely adopted.
What you can do is use the framework it represents. If a provider tells you their approach improves your child's motor skills, it is a reasonable follow-up to ask: "Does it also affect sensory processing, tone, reflexes, social engagement, or communication?" The SSDT reflects the idea that motor development and sensorimotor development are not the same thing, and that a complete picture requires looking at more than walking and standing. That question is worth asking whether or not you have a specific assessment tool to answer it.
Where it appears on this site
The SSDT is referenced in our cerebral palsy guide as one of the three primary outcome measures in the completed DMI clinical trial. If you are reading that page and the trial results when they appear, you now know what the SSDT measures and what it does not.
Sources
- Waqas S, Ahmad A, Goulardins JB, Hanif A, Tariq M, Niamat A. Development and Validation of Shoaib Sensorimotor Development Tool for Normal Pediatric Population. Annals of King Edward Medical University. 2025;31(3):302-313. doi:10.21649/akemu.v31i3.5888. Full text (PDF)
- ClinicalTrials.gov. Effects of DMI vs Bobath on Neuromuscular Development in CP (NCT07238634). ClinicalTrials.gov
- NLM Catalog. Annals of King Edward Medical University: indexing status. NCBI
Nothing here is medical advice, and no single assessment or tool should change your child's care on its own. Discuss anything you read here with your child's pediatrician or therapist.