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Objective. The objective was to determine the validity of the Targeted Motor Control (TMC) screening tool with the Neurosensory Motor Developmental Assessment (NSMDA) in 4-year-old children. Methods. In this single cohort observational study, children (3 years 9 months to 4 years 5 months) completed the TMC and the NSMDA in a randomized order 5 to 14 days apart. Results. Seventy-six children (mean age = 4 years 2 months; standard deviation = 2.5 months; n = 35 male) completed both assessments. Forty-two children performed within the normal range on the NSMDA. There were significant and positive moderate correlations between the item totals overall and for each area on the NSMDA and the TMC (r = 0.40-0.61), and between the NSMDA functional grade for each area and the corresponding TMC areas (r = 0.47-0.67). However, the correlation between the NSMDA sensorimotor functional grade and the TMC sensory score was significant but low and positive (r = 0.35). The optimal cut-off score for detecting children at risk of atypical development on the TMC was a score of Conclusion. The TMC is a valid screening tool to identify 4-year-old children at risk of motor delay. Impact. Early identification of developmental concerns using a validated screening tool is recommended. The TMC is a valid performance-based screening tool that can be used to identify children at risk of atypical motor development who would benefit from further developmental assessment so that, if indicated, timely intervention can be implemented. Keywords: Child, Developmental Disabilities, Early Diagnosis, Pediatrics, Introduction Developmental delay occurs when a child is not achieving developmental milestones within the expected timeframe. (1) Delays can be temporary or ongoing and can occur in social, emotional, motor, [...]

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