title: Assessment of upper-limb capacity, performance, and developmental disregard in children with cerebral palsy: validity and reliability of the revised Video-Observation Aarts and Aarts module: Determine Developmental Disregard (VOAA-DDD-R).
abstract: OBJECTIVE
  To investigate the validity and reliability of the revised Video-Observation Aarts and Aarts module: Determine Developmental Disregard (VOAA-DDD-R).
  
  
  METHODS
  Upper-limb capacity and performance were assessed in children with unilateral spastic cerebral palsy (CP) by measuring overall duration of affected upper-limb use and the frequency of specific behaviours during a task in which bimanual activity was demanded ('stringing beads') and stimulated ('decorating a muffin'). Developmental disregard was defined as the difference in duration of affected upper-limb use between both tasks. Raters were two occupational and one physical therapist who received 3 hours of training. Construct validity was determined by comparing children with CP with typically developing children. Intrarater, interrater, and test-retest reliability were determined using the intraclass correlation coefficient. Standard errors of measurement and smallest detectable differences were also calculated.
  
  
  RESULTS
  Twenty-five children with CP (15 females, 10 males; mean age 4 y 9 mo [SD 1 y 7 mo], range 2 y 9 mo-8 y; Manual Ability Classification System levels I-III) scored lower on capacity (p=0.052) and performance (p<0.001), and higher on developmental disregard (p<0.001) than 46 age- and sex-matched typically developing children (23 males; mean age 5 y 3 mo [SD 1 y 5 mo], range 2 y 6 mo-8 y). The intraclass correlation coefficients (0.79-1.00) indicated good reliability. Absolute agreement was high, standard errors of measurement ranged from 4.5 to 6.8%, and smallest detectable differences ranged from 12.5 to 19.0%.
  
  
  CONCLUSIONS
  The VOAA-DDD-R can be reliably and validly used by occupational and physical therapists to assess upper-limb capacity, performance, and developmental disregard in children (2 y 6 mo-8 y) with CP.
authors.affiliation: Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Department of Rehabilitation, Nijmegen, The Netherlands. a.houwink@reval.umcn.nl
authors.forename: Annemieke
authors.initials: A
authors.lastname: Houwink
authors.forename: Yvonne A
authors.initials: YA
authors.lastname: Geerdink
authors.forename: Bert
authors.initials: B
authors.lastname: Steenbergen
authors.forename: Alexander C H
authors.initials: AC
authors.lastname: Geurts
authors.forename: Pauline B M
authors.initials: PB
authors.lastname: Aarts
mesh_terms: D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000150:complications / Q000175:diagnosis* / Q000534:rehabilitation; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000150:complications / Q000175:diagnosis*; D004185:Disability Evaluation; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D009788:Occupational Therapy; D059825:Physical Therapists / Q000523:psychology; D015203:Reproducibility of Results; D034941:Upper Extremity / Q000503:physiopathology*; D014741:Video Recording / Q000379:methods