Gross Motor Development in Institutionalized Infants and Young Toddlers: A Systematic Review

Infants and young toddlers living in institutional care may experience limited opportunities for individualized interaction and age-appropriate movement.However, the extent of gross motor difficulties remains uncertain because available studies differ in design, assessment methods, and care settings.This systematic review examined gross motor development among children aged 0-24 months currently residing in orphanages or comparable non-family residential childcare settings.On 3 September 2026, two bibliographic databases (PubMed/MEDLINE and Scopus) were searched, supplemented by Google Scholar and the AI-assisted evidence-discovery platform Elicit.Seven peer-reviewed studies were included, comprising predominantly observational research and one non-randomized intervention study conducted across Thailand, Brazil, Sudan, and North Macedonia.The studies assessed gross motor performance, postural development, locomotion, and trunk control.Findings were synthesized narratively because clinical and methodological heterogeneity prevented meaningful meta-analysis.Common findings were low or atypical gross motor performance, postural delay, locomotor disadvantage, and trunk-control differences, although results varied across assessment instruments and outcome definitions.The intervention study reported greater improvement in motor performance following structured upright play, but non-randomized site allocation and methodological limitations prevented firm conclusions regarding effectiveness.Confidence in the findings was further limited by risk of bias, small samples, incomplete retrieval, and limited comparative evidence.Overall, the evidence suggests potential gross motor vulnerability among children in institutional care but does not establish a reliable prevalence estimate or a causal relationship with institutional residence.Stronger multicentre comparative and intervention research using standardized developmental assessments is needed.