AI-Based Video Analysis for Motor Development Assessment in Children

This study is a prospective, non-interventional observational study conducted to develop and validate an artificial intelligence-based system for the assessment of motor development in children. The study includes children aged between 5 and 10 years who have no previously diagnosed neurological, developmental, or orthopedic disorders.

All participants will complete the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition - Short Form (BOT-2 SF), which will serve as the reference standard for motor performance. Based on BOT-2 scores, participants will be categorized into typical and atypical motor development groups using predefined thresholds derived from normative data and statistical distribution methods.

In addition to standardized testing, participants will perform a series of structured motor tasks, including jumping jacks, tandem walking, skipping, single-leg balance, finger-to-nose coordination, and protective extension responses. These tasks will be recorded using high-resolution video under controlled environmental conditions.

Video data will be processed using computer vision pipelines. Skeletal keypoints will be extracted using pose estimation models, and silhouette segmentation will be obtained using deep learning-based segmentation models. Extracted features will be normalized and used as input for machine learning and deep learning architectures, including transformer-based models and graph-based networks.

The primary outcome is the classification performance of the AI model in distinguishing typical versus atypical motor development profiles, evaluated using metrics such as ROC-AUC, accuracy, sensitivity, specificity, F1-score, and balanced accuracy. Secondary outcomes include regression performance for predicting continuous motor scores, evaluated using MAE, RMSE, and R-squared values.

Inter-rater reliability of expert evaluations will be assessed using intraclass correlation coefficients (ICC). Additional analyses will include error distribution examination and Bland-Altman analysis to assess agreement between AI predictions and standardized test scores.

This study does not involve any intervention, treatment, or risk beyond standard observational procedures. All participants are healthy volunteers, and informed consent will be obtained from parents or legal guardians. The study has been approved by the Istanbul Medipol University Non-Interventional Clinical Research Ethics Committee.

Inclusion criteria

• Children aged between 5 and 10 years
• No diagnosed neurological, developmental, or orthopedic disorders
• Ability to follow verbal instructions
• Informed consent obtained from parents or legal guardians
• No prior participation in sensory integration therapy or special education programs

Exclusion criteria

• Diagnosed neurological, developmental, or orthopedic conditions (e.g., autism spectrum disorder, cerebral palsy, epilepsy)
• Visual or hearing impairments affecting task performance
• Severe attention or behavioral problems preventing test completion
• Physical limitations preventing participation in motor tasks