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Supplemental: Cerebral Palsy (CP)
Short Description of Instrument
Construct measured: manual ability – ability to manage daily activities that require the use of the upper extremities such as filling a glass of water, putting on a backpack, or squeezing toothpaste onto a toothbrush.
Generic vs. disease specific: Disease specific.
Means of administration: Self-administered questionnaire.
Intended respondent: Parent of child with cerebral palsy.
Background: The ABILHAND-Kids is a clinical tool developed to measure the manual ability of children with upper limb impairments. It measures how easy or difficult it is for children to manage everyday tasks that require the use of one or both upper extremities, regardless of which limb is used or how the task is performed. It measures performance, i.e., what a child does in everyday environments from the perspective of the parent. It has been validated on 115 children ages 6 – 15 years with cerebral palsy GMFCS levels I–V with unilateral and bilateral involvement.
Comments/Special Instructions
The parent is asked to estimate how easy or difficult it is for their child to complete each activity independently, regardless of how the child performs the activity. The child is not asked to perform the activity in front of the evaluator. The evaluation is presented in random order, and the evaluator selects from one of 10 random order layouts each time the assessment is given.
This tool was originally developed in French and has been translated into Dutch and English. Some items like "opening a bread bin" might not be culturally relevant for some US parents or children.
The parent rates each of the 21 items on a three-point scale "Impossible, Difficult, or Easy". Activities not attempted by the child within the last 3 months are not scored and are entered as not applicable (recorded as a question mark "?" on the scoring sheet). The activities that the child does not perform because they are too difficult must be scored as "Impossible".
Scores are submitted to an online scoring system which converts raw scores into a linear measurement scale expressed in logits. The online system produces an evaluation report showing the child's manual ability with 95% confidence intervals on an item map. A raw score, and an overall score with its standard error (in logits) are provided.
Administration time: not specified, estimated 10 – 15 minutes to administer & score.
Strengths/Weaknesses: Can be performed quickly in a clinical setting without special equipment. High clinical utility (free, easy to administer and score). Measures ability to perform everyday tasks that require both unilateral and bimanual UE use.
Psychometric Properties: the questionnaire was developed using the Rasch measurement model. Person separation reliability estimate was 0.94 in a sample of 113 children with cerebral palsy, GMFCS levels I – V, ages 6 – 15; test-retest r = 0.91 (n=36). Content validity: the scale was based on an existing generic scale, and then refined based on expert advice and parent perceptions. The scale was refined using Rasch analysis resulting in a unidimensional measure ordered in decreasing item difficulty. Construct validity was demonstrated through significant relationships with educational setting, type of CP, and GMFCS level.
Key Reference:
Arnould C, Penta M, Renders A, Thonnard JL. ABILHAND-Kids: a measure of manual ability in children with cerebral palsy. Neurol. 2004;63(6):1045-1052.
Additional References:
Arnould C, Vandervelde L, Batcho CS, Penta M, Thonnard JL. Can manual ability be measured with a generic ABILHAND scale? A cross-sectional study conducted on six diagnostic groups. BMJ open. 2012;2(6).
Arnould C, Penta M, Thonnard JL. Hand impairments and their relationship with manual ability in children with cerebral palsy. J Rehabil med. 2007;39(9):708-714.
Gilmore R, Sakzewski L, Boyd R. Upper limb activity measures for 5- to 16-year-old children with congenital hemiplegia: a systematic review. Dev Med Child Neurol. 2010;52(1):14-21.


Document last updated February 2018