Development of the Assisting Hand Assessment: A Rasch-built Measure intended for Children with Unilateral Upper Limb Impairments

TLDR

The study reports the first step in developing the Assisting Hand Assessment (AHA), a tool to measure how effectively children with unilateral impairment use their affected hand during bimanual activities. The AHA, designed for children aged 18 months to 5.

Abstract

AbstractThe purpose of this paper was to report on the first step in the development of a new instrument, the Assisting Hand Assessment (AHA), that measure the effectiveness with which a child with unilateral impairment makes use of his/her affected hand in bimanual activity performance. The assessment is intended for children with hemiplegic cerebral palsy or obstetric brachial plexus palsy, from age 18 months to 5 years. The AHA is conducted through observations of performance skills exposed during play where toys requiring bimanual handling are used. The validity and reliability of the measures were explored using a Rasch measurement model for analysis. In the AHA, 22 items consisting of observable actions are scored on a 4-point rating scale evaluating the quality of the performance. The Rasch analysis suggests that the test rationale, the usefulness of the assisting hand, does form a unidimensional construct and that the items represent the tested phenomenon well. The results show potential for the AHA to become a useful tool for both clinical practice and research.KeywordsBrachial Plexus PalsyHand FunctionHemiplegic Cerebral PalsyObstetricTest Performance Analysis