What assessments evaluate use of hands in infants? A literature review

Area of Science:

• Pediatric Neurology
• Developmental Pediatrics
• Motor Function Assessment

Background:

• Early identification of unilateral cerebral palsy (CP) in infants is crucial for timely intervention.
• Hand function development is a key indicator of neurological development in infants.
• Existing assessments may not capture subtle hand function asymmetries relevant to CP risk.

Purpose of the Study:

• To identify and evaluate existing hand function assessments for infants aged 3-12 months.
• To determine the suitability of these assessments for identifying infants at risk of unilateral CP.
• To highlight gaps in current assessment tools for infant hand function.

Main Methods:

• Systematic review of existing literature on infant motor assessments.
• New literature search (2007-2013) in major databases (Medline, PsychInfo, PubMed, Cinahl).
• Scrutiny of fine motor components within identified assessments.

Main Results:

• Three existing assessments (PDMS-2, Bayley Scale III, PFMAI) measure fine motor skills but focus on the preferred hand only.
• Ten new assessments were identified, with three meeting inclusion criteria (IMP, GRAB, HAI).
• Only GRAB and HAI show potential for assessing unilateral CP risk, but are still under development.

Conclusions:

• No current assessment tool effectively quantifies hand function asymmetry or bimanual performance in infants aged 3-12 months.
• Further development and validation of specific hand function assessments are needed for early CP detection.
• The identified emerging tools (GRAB, HAI) require further refinement and validation.