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Melbourne Assessment 2 (MA2)
Availability
Please visit this website for more information about the instrument: Melbourne Assessment 2.
 
Please visit this website to order the instrument: MA2.
Classification
Supplemental: Cerebral Palsy (CP)
Short Description of Instrument
Construct measured: Assessment of quality of unilateral upper limb movement for children 2.5–15 years with neurological impairments.
Generic vs. disease specific: Disease specific.
Means of administration: Examiner administered and videotaped.
Intended respondent: Child.
Background: The Melbourne Assessment 2 (MA2) is a revision of the Melbourne Assessment published in 1999. The revised tool addresses gaps in tools available that are able to measure quality of UE movement. It also extends the age range to include younger children, and strengthens the measurement scale using Rasch analysis. The modified tool is valid for use with children aged 2.5 to 15 years who have either cerebral palsy or an acquired neurological condition. The MA2 has been developed for children with a range of different movement disorders including spasticity, dystonia, choreoathetosis, and ataxia. For children with bilateral involvement, it may be that only one upper limb is assessed. If both upper limbs are to be assessed, each upper limb is assessed and scored separately.
Comments/Special Instructions
The MA2 can be used to identify elements of a child’s movement for intervention planning, to evaluate change in an individual’s performance pre and post intervention, to compare one child’s performance to another over time, or following an intervention in order to monitor progress.
 
Test administrators should watch the training video and familiarize themselves with the test items, administration procedures, and scoring (training materials are available).
 
The test may be administered over several short sessions within a 2 week period. Administrators may vary the sequence of the test items to keep the child engaged.
Scoring
The MA2 is comprised of 14 test items, and 30 movement scores that are organised into four separate uni-dimensional sub-scales. These four sub-scales enable measurement of four specific elements of upper limb movement quality: range, fluency, accuracy, and dexterity. The child performs 14 everyday tasks requiring reach, grasp, release, and manipulation of items such as a crayon, a pellet, and a cube. Movement elements are scored on a 3, 4 or 5 point scale according to specific criteria. The four Subscales are: Range of Movement, Accuracy of Reach and Placement, Dexterity of Grasp, Release and Manipulation, and Fluency of Movement. The total raw score for each sub-scale is converted to a percentage of the maximum possible score for that sub-scale. The test is scored by watching videotapes.
 
Administration Time: 10–30 minutes; scoring of videotapes takes a further 20–30 minutes. Additional time is required to set up and pack up the equipment.
Rationale/Justification
Strengths/Weaknesses: Can be used with children with unilateral and bilateral impairments. Based on an instrument with well established reliability and validity. Psychometric properties of the revised version are not yet established (particularly sensitivity to change) and testing is ongoing.
 
Psychometric Properties: The MA2 is newly revised and psychometric testing is still underway. Initial testing was performed on 163 sets of Melbourne Assessment raw scores of children ages 2.5–15 with CP. Content validity: the MA2 is based on an earlier version of the test (which was developed using rigorous test development processes), and refined using Rasch analysis resulting in four distinct subscales (Rasch analysis did not support one unidimensional scale). Each subscale showed good fit to the Rasch model with high internal consistency and unidimensionality. Person Separation Index values for the four subscales ranged from 0.81 – 0.97.Construct validity : differential item function (DIF) was absent for age and sex (i.e., the scores were not influenced by sex or age
).
Further testing to determine intra/inter reliability, test-retest reliability, sensitivity to change and ability to discriminate between different levels of impairment is planned.
References
Randall M, Imms C, Carey LM, Pallant JF. Rasch analysis of the Melbourne assessment of unilateral upper limb function. Dev Med Child Neurol. 2014;56(7): 665–672.
 
Additional References:
 
Bourke-Taylor H. Melbourne Assessment of Unilateral Upper Limb Function: construct validity and correlation with the Pediatric Evaluation of Disability Inventory. Dev Med Child Neurol. 2003;45:92–96.
 
Bourke-Taylor H, Law M, Howie L, Pallant JF. Development of the Assistance to Participate Scale (APS) for children's play and leisure activities. Child Care Health Dev. 2009;35(5):738–745.
 
Randall M, Carlin JB, Chondros P, Reddihough D. Reliability of the Melbourne assessment of unilateral upper limb function. Dev Med Child Neurol. 2001;43(11):761–767.
 
Randall M, Imms C, Carey L. Establishing validity of a modified Melbourne Assessment for children ages 2 to 4 years. Am J Occup Ther. 2008;62(4):373–383.
 
Randall M, Imms C, Carey L. Further evidence of validity of the Modified Melbourne Assessment for neurologically impaired children aged 2 to 4 years. Dev Med Child Neurol. 2012;54(5): 424–428.
 
Randall M, Imms C, Carey LM Pallant J F. Rasch analysis of The Melbourne Assessment of Unilateral Upper Limb Function. Dev Med Child Neurol. 2014;56(7):665–672.
 
Spirtos M, O’Mahony P, Malone M. Interrater reliability of the Melbourne Assessment of Unilateral Upper Limb Function for children with hemiplegic cerebral palsy. Am J Occup Ther. 2011;65(4):378–383.
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