| 60689-7 | Observed items |
| 60690-5 | Elicited items |
| 60691-3 | Head in midline (qualitative) |
| 60692-1 | Individual right finger movement (qualitative) |
| 60693-9 | Individual left finger movement (qualitative) |
| 60694-7 | Fingers objects or surfaces on right (qualitative) |
| 60695-4 | Fingers objects or surfaces on left (qualitative) |
| 60696-2 | Bilateral hip and knee flexion (qualitative) |
| 60697-0 | Isolated right ankle movement (qualitative) |
| 60698-8 | Isolated left ankle movement (qualitative) |
| 60699-6 | Fidgety movements (qualitative) |
| 60700-2 | Ballistic movements of the arms or legs (swipes or swats) (qualitative) |
| 60701-0 | Oscillation of arm or leg during movement (qualitative) |
| 60702-8 | Reaches for person or object (qualitative) |
| 60703-6 | Total observed item score |
| 60704-4 | Head rotation side to side (qualitative) |
| 60705-1 | Head control - supported sitting (qualitative) |
| 60706-9 | Head control - posterior neck muscles (qualitative) |
| 60707-7 | Head control - anterior neck muscles (qualitative) |
| 60708-5 | Head control - lowered from sitting (qualitative) |
| 60709-3 | Inhibition of neonatal neck righting (right side) (qualitative) |
| 60710-1 | Inhibition of neonatal neck righting (left side) (qualitative) |
| 60711-9 | Head in midline without visual stimulation (qualitative) |
| 60712-7 | Head held in midline with visual stimulation (qualitative) |
| 60713-5 | Supine neck rotation (right) (qualitative) |
| 60714-3 | Supine neck rotation (left) (qualitative) |
| 60715-0 | Defensive Reaction - Head and Neck Response (qualitative) |
| 60716-8 | Defensive reaction - arm movements (qualitative) |
| 60717-6 | Hip and knee flexion (qualitative) |
| 60718-4 | Rolling - elicited from the legs (right) (qualitative) |
| 60719-2 | Rolling - elicited from the legs (left) (qualitative) |
| 60720-0 | Rolling - elicited from the arms (right) (qualitative) |
| 60721-8 | Rolling - elicited from the arms (left) (qualitative) |
| 60722-6 | Pull to sit (qualitative) |
| 60723-4 | Lateral straightening of the head and body with arm support (qualitative) |
| 60724-2 | Lateral hip abduction reaction (qualitative) |
| 60725-9 | Prone suspension (qualitative) |
| 60726-7 | Head lift in prone (qualitative) |
| 60727-5 | Crawling (qualitative) |
| 60728-3 | Head turn in prone to sound (right) (qualitative) |
| 60729-1 | Head turn in prone to sound (left) (qualitative) |
| 60730-9 | Standing (qualitative) |
| 60731-7 | Lateral head righting (right) (qualitative) |
| 60732-5 | Lateral head righting (left) (qualitative) |
| 60733-3 | Notes |
| 60734-1 | Total elicited items score |
| 60735-8 | Total score |
| 60736-6 | Reciprocal kicking (qualitative) |
| 61133-5 | Clinical impression (qualitative) |
| 61134-3 | Environment |
| 61135-0 | Environment.other specified |