Comment mesurer le retentissement d’un traitement en situation écologique par une évaluation fiable de la fonction manuelle chez les enfants présentant une atteinte unilatérale : le Assisting Hand Assessment (AHA)

Abstract

Children with unilateral disability in hand function (cerebral palsy hemiplegia, brachial plexus palsy) manage bimanual activities by interacting their dominant hand with their affected one as an “assisting” hand. Assisting hand's characteristics are well defined by the concept which underlies the assisting hand assessment (AHA). This new assessment tool, developed by Lena Krumlinde-Sundholm et al., is valid for children between 18 months and 12 years of age, and presents interesting psychometric properties (internal consistency, test-retest reliability, intra- and inter-raters reliability, responsiveness to change). The AHA intends to measure and describe how effectively children with a unilateral disability use their affected hand in play activities requiring bimanual performance, through 22 items. Each item is scored on a 4-point scale, from 1 to 4, according to specific scoring criteria. Scoring is conducted by scrutinizing the video recording and results’ analysis allows defining treatment goals (hierarchy of items). The innovative point of the AHA lies in the fact that it considers real performance. It allows to measure one treatment's impact in real conditions. This tool can be used by French-speaking therapists who follow a course that lead to certification. Always being developed, the AHA will soon be usable for other age groups and diagnostic groups.