THE HAND ASSESSMENT FOR INFANTS (HAI);
A TEST TO MEASURE INFANTS USE OF HANDS, EACH HAND SEPARATLEY AND BOTH HANDS TOGETHER
As part of the AHA battery of assessments a hand function assessment has been developed for infants at risk of developing cerebral palsy (CP) in the age range 3-12 months old. The development of this test has been done in collaboration between research groups at IRCCS Fondazione Stella Maris in Pisa Italy, and at the Karolinska Institutet in Stockholm, Sweden. The HAI intends to measure the degree and quality of goal directed actions performed with each hand separately as well as with both hands together. The outcome of the test renders a separate score for each hand, illustrating possible asymmetric hand use as well a measure a criterion referenced measure of general upper limb ability, as well as age norm references. As a first step the HAI has been validated for infants with clinical signs of unilateral cerebral palsy; results indicate high predictive validity for unilateral CP at 3.5-4.5 months of age.
The course teaches the reliable use of the HAI, in two steps: The first step involves a two-day workshop where participants will learn about the constructs underlying the HAI, test procedures, test objects used, and scoring of infants from video recordings. A HAI manual with detailed scoring criteria and a computer based scoring form will be provided. Following the course, the participants will be able to create their own test kit according to instructions given during the course. Feedback on the selected toys will be provided during the certification procedure. Additionally participants will be required to achieve satisfactory scoring of test cases; some of which are provided by videos, and two from self-produced HAI play sessions.
Course objectives
On completion of the course participants will be able to:
Demonstrate how to select appropriate toys for a HAI play session
Demonstrate the set-up and video-recording of the session and how toys are used to provoke active hand use in infants
Produce reliable scores according to the criteria in the manual
Understand the constructs upon which the HAI is based and describe early psychometric evidence
Interpret and communicate outcomes from the testing procedures
Program, HAI workshop
Day 1 (9:00:17:00)
- Introductions
- Early development of hand function in CP
- Review: tests of hand function for infants
- Concept and development of the HAI
- HAI test items
- Score form
- Scoring of children
- The HAI test kit and play session
Day 2 (9:00-15:00)
- Psychometric properties
- Scoring of children
- feedback procedure
- Scoring of children
- Wrap-up
Course Tutors
Associate Professor Lena Krumlinde-Sundholm, Reg OT, PhD. Lena is a senior researcher at the Karolinska Institutet in Stockholm, Sweden, and an Occupational Therapist with many years of experience in paediatrics and in research predominantly with development of assessment tools.
Elisa Sicola, senior neuromotor-physiotherapist, with many years' experience in paediatrics at the Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
References:
Krumlinde-Sundholm, L; Ek, L; Sicola, E; Sjöstrand, L; Guzzetta, A; Sgandurra, G; Cioni, G; Eliasson, AC (2017) Development of the Hand Assessment for Infants: evidence of internal scale validity. Dev Med Child Neurol. 2017 Dec;59(12):1276-1283.
Krumlinde-Sundholm L, Ek L, Eliasson AC. What assessments evaluate use of hands in infants? A literature review. Developmental medicine and child neurology 2015, 57 Suppl 2; 37-41
Eliasson, AC; Nordstrand, L; Ek, L; Lennartsson, F; Sjöstrand, L; Tedroff, K; Krumlinde-Sundholm, L (2018) The effectiveness of Baby-CIMT in infants younger than 12 months with clinical signs of unilateral-cerebral palsy; an explorative study with randomized design. Research in developmental disabilities. Volume 72; 191-201.
Linda Ek, Ann-Christin Eliasson, Elisa Sicola, Lena Sjöstrand, Andrea Guzzetta, Giuseppina Sgandurra, Giovanni Cioni, Lena Krumlinde-Sundholm (2019) The Hand Assessment for Infants (HAI): Normative reference values [E-published ahead of print, 2018] Dev Med Child Neurol.
