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ABILHAND-Kids

A measure of manual ability in children with cerebral palsy

From the Laboratory of Rehabilitation and Physical Medicine (C. Arnould, and Drs. Renders and Thonnard), Université catholique de Louvain, Brussels; and the Laboratory of Physiology and Biomechanics of Locomotion (Dr. Penta), Université catholique de Louvain, Louvain-la-Neuve, Belgium.

Address correspondence and reprint requests to Prof. J.-L. Thonnard, Université catholique de Louvain, Unité de Réadaptation, Tour Pasteur (5375), Avenue Mounier, 53, 1200 Bruxelles, Belgium; e-mail: Thonnard{at}read.ucl.ac.be

Objective: To develop a clinical tool for measuring manual ability (ABILHAND-Kids) in children with cerebral palsy (CP) using the Rasch measurement model.

Methods: The authors developed a 74-item questionnaire based on existing scales and experts’ advice. The questionnaire was submitted to 113 children with CP (59% boys; mean age, 10 years) without major intellectual deficits (IQ > 60) and to their parents, and resubmitted to both groups after 1 month. The children’s and parents’ responses were analyzed separately with the WINSTEPS Rasch software to select items presenting an ordered rating scale, sharing the same discrimination, and fitting a unidimensional scale.

Results: The final ABILHAND-Kids scale consisted of 21 mostly bimanual items rated by the parents. The parents reported a finer perception of their children’s ability than the children themselves, leading to a wider range of measurement, a higher reliability (R = 0.94), and a good reproducibility over time (R = 0.91). The item difficulty hierarchy was consistent between the parents and the experts. The ABILHAND-kids measures are significantly related to school education, type of CP, and gross motor function.

Conclusions: ABILHAND-Kids is a functional scale specifically developed to measure manual ability in children with CP providing guidelines for goal setting in treatment planning. Its range and measurement precision are appropriate for clinical practice.

Received November 4, 2003. Accepted in final form May 25, 2004.

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