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Title of manuscript: Validation of the Sensorimotor History Questionnaire for Preschooler and Soft Sign Cambridge Neurological Inventory Against Intelligent Quotient

Author(s) 1^st author

First name : Siti Aminah Last name : Sobana

Academic degree(s): dr. Siti Aminah Sobana, Sp.S(K), M.Si. Med

Affiliation: Neurology Department, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin Central General Hospital

Address: Jalan Pasteur 38, Bandung, West Java, Indonesia 40161 Phone: +62 812-2109-005

Email: [email protected]

2^nd author First name: Tiara Last name : Pramesya

Academic degree(s): dr. Tiara Pramaesya, Sp.N

Address: Jalan Pasteur 38, Bandung, West Java, Indonesia 40161 Phone: 0812 2164592

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3^rd author First name: Uni Last name : Gamayani

Academic degree(s): Dr. dr. Uni Gamayani, Sp.S(K)

4^th author First name: Lisda Last name : Amalia

Academic degree(s): Dr. dr. Lisda Amalia, Sp.S(K)

5^th author

First name: Suryani Last name : Gunadharma

Academic degree(s): Dr. dr. Suryani Gunadharma, Sp.S(K), M.Kes

Address: Jalan Pasteur 38, Bandung, West Java, Indonesia 40161 Phone: 0812122386118

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6^th author

First name: Andi Basuki Prima Last name : Birawa

Academic degree(s): Dr. dr. Andi Basuki Prima Birawa, Sp.S(K), MARS Affiliation: National Brain Centre Hospital, Jakarta, Indonesia

Email:

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Prospective Reviewer

I hereby suggest prospective reviewer(s) to Majalah Kedokteran Bandung (MKB) by filling in all required information:

Reviewer 1

Full name with academic degree(s): Dr. Elsa Pudji Setiawati, dr., MM

Affiliation/institution: Department of Public Health, Faculty of Medicine, Universitas Padjadjaran Email: [email protected]

Expertise: Public health, research methodology, questionnaire validation

Reviewer 2

Full name with academic degree(s): Dr.med. dr. Muhammad Hasan Bashari, M.Kes Affiliation/institution: Department of Biomedical Science, Faculty

Email: [email protected] Expertise: Research methodology