Children with biological risk for motor delay are those born with certain adversities (e.g., prematurity, low birth weight, perinatal complications, etc.) and may experience limitations in daily activities. Despite existing evidence, knowledge about the developmental trajectory of functional skills in real-life contexts during the first two years of life is still limited.

To verify the development trajectory of functional skills (mobility, daily activities and social-cognitive) of children with biological risk at 12 and 24 months of age.

This was a prospective, observational multicenter study. Eighteen infants with biological risk and their families participated in the study (mean gestational age: 37.55 weeks- SD 3.12 weeks; birth weight: 3.01 kg- SD 0.905g; stay in NICU: 8.55 days; 61.11% received oxygen therapy, and 27.77% required cardiopulmonary resuscitation). Functional abilities were assessed using the Pediatric Evaluation of Disability Inventory - Computer Adaptive Test (PEDI-CAT) - speed version. The normative score (scores between 30 and 70 are within the expected range for age) and the continuous score (individual functional progress) for each domain were used. The paired t-test was applied to compare the children at 12 and 24 months, considering a significance level of 5%.

The children exhibited an average normative score above 50 for all skills. At 24 months, children had higher continuous and normative scores for daily activities than at 12 months (p = 0.024 and p < 0.001, respectively), and higher continuous scores at 24 months in mobility (p < 0.001) and social-cognitive domain (p < 0.001).

The children evaluated showed functional progress in mobility, daily activities and social-cognitive. Furthermore, these children did not show motor delay in these activities.

Understanding the trajectory of functional skills in a real-life context enables the monitoring of adaptive behaviors and the identification of potential delays in important domains of functioning. Additionally, this knowledge can be useful for providing support to families.