Preschool Hand Function Assessment Instruments: A Scoping Review With Targeted Analysis of Performance-Based...

Hand function is a critical determinant of preschool children's participation in everyday occupations. Accurate hand function assessment is vital for guiding interventions, yet assessment practices are highly variable. Despite the abundance of instruments, only a few standardised performance-based tools assess all hand function components. No comprehensive mapping exists of key preschool instrument specifications to guide clinicians and researchers, particularly those working in diverse contexts. The study mapped all published hand function-relevant instruments used with children aged 3-5 years, including pathology-specific measures, proxy-report tools, classification systems, and multidomain developmental assessments. Employing scoping review methodology, 13 databases were searched, and all retrieved sources up to September 2024 were managed on Covidence. Two independent reviewers conducted title, abstract and full-text screenings based on eligibility criteria. The search found 810 sources, with 84 meeting inclusion criteria, identifying 62 instruments. Most were performance-based (n = 46; 74.2%), followed by proxy measures (n = 11), classifications (n = 3) and two unspecified. Over a third targeted children with health conditions, whilst 22 covered both typical and atypical development. Sources from the Global South and LMICs were notably scarce. Performance-based measures were examined in greater depth, with only one addressing all hand function domains. Findings highlight the need for a standardised, culturally adaptable performance-based tool that reflects preschool children's real-world occupations and is applicable across diverse settings. This review offers a structured foundation for developing or adapting such a tool, bridging current gaps in assessment practice in both high- and low-resource environments.