Development of the Assisting Hand Assessment for adolescents (Ad-AHA) and validation of the AHA from 18 months to 18 years.
OBJECTIVE
To develop and evaluate a test activity from which bimanual performance in adolescents with unilateral cerebral palsy (CP) can be observed and scored with the Assisting Hand Assessment (AHA), and to evaluate the construct validity of the AHA test items for the extended age range 18 months to 18 years.


METHODS
A new test activity was developed and evaluated for its ability to elicit bimanual actions in adolescents with (n=20) and without (n=10) unilateral CP. The AHA scores of 126 adolescents (mean age 14y 3mo, SD 2y 6mo; 71 males, 55 females) and 157 children with unilateral CP (mean age 6y 1mo, SD 2y 10mo; 102 males, 55 females) were analysed using the Rasch measurement model.


RESULTS
The test activity elicited bimanual actions in 100% of typically developing adolescents and in 96.8% and 57.9% of adolescents with unilateral CP (moderately and severely limited hand function respectively). The scale demonstrated good construct validity; thus the same scoring criteria can be used for the age range studied.


CONCLUSIONS
The new Assisting Hand Assessment for adolescents (Ad-AHA) activity is valid for use with 13- to 18-year-olds to elicit bimanual performance in adolescents with unilateral CP. The same AHA scoring criteria can be used both for children and for adolescents within the age range 18 months to 18 years.
Department of Rehabilitation, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.
Annoek
A
Louwers
Department of Rehabilitation, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.
Anita
A
Beelen
School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
Marie
M
Holmefur
Neuropediatric Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Lena
L
Krumlinde-Sundholm
D000293:Adolescent; D002547:Cerebral Palsy / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D005080:Exercise Test / Q000379:methods* / Q000592:standards; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D015203:Reproducibility of Results; D012720:Severity of Illness Index