Reliability evaluation of the Hand Assessment for Infants (HAI)
Ullenhag A, Ek L, Eliasson AC, Krumlinde-Sundholm (2021) Interrater and test-retest reliability of the Hand Assessment for Infants. Dev Med Child Neurol . 63 (12) , pp.1456-1461. DOI: 10.1111/dmcn.14967
In this study agreement between raters and stability of repeated assessment were evaluated.
HAI assessments of 55 infants, 25 of them with clinical signs of unilateral cerebral palsy (CP) and 30 typically developing infants were scored individually by three occupational therapists with extensive experience in using the HAI.
Interrater and test–retest reliability was excellent for the Both Hands Measure (BoHM) and the Each Hand Sum score (EaHS), with ICCs of 0.96 to 0.99. Interrater and test–retest reliability was good to excellent (ICC 0.81–0.99). The Smallest Detectable Difference (SDD) for the EaHS was 2 points, and for the BoHM the SDD it was 3 HAI units for infants with signs of unilateral CP.
Conclusion: The HAI results showed good to excellent reliability. The SDDs were low, indicating that results beyond these levels exceed the measurement error and, thus, can be considered true changes.
External validity of the Both Hands Assessment (BoHA)
Elvrum AG, Johansen GO, Vik T, Krumlinde-Sundholm L. (2021) External validity of the Both Hands Assessment for evaluating bimanual performance in children with bilateral cerebral palsy. Dev Med Child Neurol. Dec 14. DOI: 10.1111/dmcn.15127
In this study the external validity of the BoHA was evaluated, i.e. how well the results of the BoHA corresponds to outcomes of other test measuring the same concept.
Thirty-nine children with bilateral CP and manual ability corresponding to MACS levels I to III completed the BoHA. Furthermore, unimanual capacity was assessed using the BFMF classification, the Box and Block Test (BBT), and the Melbourne Assessment 2 (MA2). Self-care skills were assessed with the Pediatric Evaluation of Disability Inventory (PEDI). Spearman’s correlation coefficient (q) suggested high correlation between the BoHA and MACS (p=0.89), BFMF classification (p=0.84), and BBT for the non-dominant (p=0.85) and dominant hand (p=0.72). The Spearman’s q between the BoHA and the MA2 subscales varied between 0.48 and 0.83, while the PEDI’s q was 0.51.
Conclusion; The BoHA provides valid measures of hand use as suggested by its high correlation with other activity-based measures of hand function.