Tactile assessment in children with cerebral palsy: a clinimetric review
Megan Louise Auld1, Roslyn Nancy Boyd, G Lorimer Moseley
1Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia. mauld@uq.edu.au
Insights
This review examines tactile assessments for children with cerebral palsy, finding the Sensory Integration and Praxis Test (SIPT) and Neurosensory Motor Developmental Assessment (NSMDA) offer strong validity. Exteroception and stereognosis show excellent reliability for tactile assessment in children.
Area of Science:
- Pediatric Rehabilitation
- Neuroscience
- Clinical Assessment
Background:
- Children with cerebral palsy often experience tactile sensory impairments.
- Accurate assessment of tactile function is crucial for effective intervention and rehabilitation planning.
- Existing clinimetric data on tactile assessments for this population is fragmented.
Purpose of the Study:
- To systematically review and evaluate the clinimetric properties of tactile assessments used in children with cerebral palsy.
- To identify reliable and valid tools for measuring tactile sensory function in this population.
- To highlight gaps in current tactile assessment methodologies.
Main Methods:
- Literature review of studies assessing tactile properties (registration, discrimination, localization, graphaesthesia, stereognosis) in children with cerebral palsy.
- Evaluation of assessments including Semmes Weinstein Monofilaments (SWMs), Disk-Criminator®, Neurosensory Motor Developmental Assessment (NSMDA), and Sensory Integration and Praxis Test (SIPT).
- Analysis of clinimetric properties such as content validity, inter-rater reliability, and test-retest reliability.
Main Results:
- The SIPT and NSMDA demonstrated superior content validity for tactile assessments.
- Inter-rater reliability was excellent for SIPT (ICC=0.99) and exteroception (k=0.88).
- Test-retest reliability was excellent for exteroception (k=0.89) and stereognosis (ICC=0.86), moderate for SIPT (r=0.69-0.74), and poor for SWM (k=0.22).
Conclusions:
- The SIPT and NSMDA are recommended for assessing tactile registration and spatial perception in children with cerebral palsy due to their stronger validity.
- While exteroception and stereognosis show good reliability, further development of temporal and textural tactile tests is needed for comprehensive evaluation.
- Reliable tactile assessment is essential for guiding therapeutic strategies in pediatric cerebral palsy management.
Abstract:
This review evaluates the clinimetric properties of tactile assessments for children with cerebral palsy. Assessment of registration was reported using Semmes Weinstein Monofilaments (SWMs) or exteroception. Assessment of two-point discrimination was reported using the Disk-Criminator® or paperclip methods; Single point localization and double simultaneous were reported from the Neurosensory Motor Developmental Assessment (NSMDA); graphaesthesia was reported from the Sensory Integration and Praxis Test (SIPT); and stereognosis was assessed using Manual Form Perception from the SIPT and the Klingels method (Klingels, K. et al. (2010). Upper limb motor and sensory impairments in children with hemiplegic cerebral palsy. Can they be measured reliably? Disability and Rehabilitation, 32(5), 409-416) and the Cooper method (Cooper, J., Majnemer, A., Rosenblatt, B., & Birnbaum, R. (1995). The determination of sensory deficits in children with hemiplegic cerebral palsy. Journal of Child Neurology, 10, 300-309). The SIPT and NSMDA demonstrated stronger content validity. Inter-rater reliability was excellent for SIPT (ICC = 0.99) and exteroception (k = 0.88). Test-retest reliability was excellent for exteroception (k = 0.89) and stereognosis (ICC = 0.86; 100%), moderate for SIPT (r = 0.69-0.74) and poor for SWM (k = 0.22). Together these assessments measure tactile registration and spatial perception. Temporal and textural tests are to be developed for comprehensive tactile examination.
