The Assisting Hand Assessment (AHA) provides a new perspective of hand function evaluation relevant for children with unilateral upper limb disabilities. It measures how effectively the involved hand is actually used for bimanual activity, which, for these children, might be the most important aspect of their hand function. The aim of this paper is to report the conceptual framework and the evidence for validity, reliability, and responsiveness to change for the measures. Previously, the AHA has been evaluated for children aged 18 months to 5 years and excellent inter-and intrarater reliability was demonstrated. This paper reports further evidence of construct validity and reliability for the AHA measures involving an extended age range of children with hemiplegic cerebral palsy or obstetric brachial plexus palsy from 18 months to 12 years of age (mean age 4y 11mo [SD 2y 9mo] range 18mo-12y 8mo). A Rasch measurement model was used to analyze 409 assessments from 303 children (170 males, 133 females). The analysis generated a scale demonstrating large capacity to reliably separate and spread personal ability measures, indicating sensitivity to change and a hierarchy of the items ranging them from easy to hard. Aspects of item fit, relationship between age and ability measures, and development of assisting hand function are discussed.When hand function impairment leads to intervention, the overall aim is generally to increase the functional use of the hands for everyday task performance. Most activities in daily life normally involve the collaborative use of two hands together. However, instruments evaluating hand functioning commonly entail testing one hand at a time. Furthermore, they evaluate maximum capability in contrast to performance, i.e. what the person can do rather than what he/she actually does do.In bimanual performance, the two hands have different roles: the dominant hand manipulates objects to a higher extent and is also quicker than the non-dominant hand, which more often has a holding and stabilizing role. 1,2 Given a unilateral deficit, the difference between these roles becomes even more pronounced. It is natural for people with unilateral hand impairment from early age to use the well-functioning hand as a first choice whenever this is possible. Even though some activities can be performed one-handed, and compensatory strategies may be functional, the use of two hands together is often essential for successful task accomplishment. 3 The affected hand/arm can be described as a helper or an assisting hand rather than a non-dominant hand. 4 Characteristics that specify a useful assisting hand are, to our knowledge, not described elsewhere.The Assisting Hand Assessment (AHA) is a recently developed test intended for use with children who have a unilateral upper limb dysfunction, in particular children with hemiplegic cerebral palsy (CP) or obstetric brachial plexus palsy (OBPP). 4 The core concept of the AHA is based on recognition of the different roles the two hands play and the fact that an ass...

Research conducted during the last decades has provided increasing evidence for the use of psychological treatments for a number of psychiatric disorders and somatic complaints. However, by focusing only on the positive outcomes, less attention has been given to the potential of negative effects. Despite indications of deterioration and other adverse and unwanted events during treatment, little is known about their occurrence and characteristics. Hence, in order to facilitate research of negative effects, a new instrument for monitoring and reporting their incidence and impact was developed using a consensus among researchers, self-reports by patients, and a literature review: the Negative Effects Questionnaire. Participants were recruited via a smartphone-delivered self-help treatment for social anxiety disorder and through the media (N = 653). An exploratory factor analysis was performed, resulting in a six-factor solution with 32 items, accounting for 57.64% of the variance. The derived factors were: symptoms, quality, dependency, stigma, hopelessness, and failure. Items related to unpleasant memories, stress, and anxiety were experienced by more than one-third of the participants. Further, increased or novel symptoms, as well as lack of quality in the treatment and therapeutic relationship rendered the highest self-reported negative impact. In addition, the findings were discussed in relation to prior research and other similar instruments of adverse and unwanted events, giving credence to the items that are included. The instrument is presently available in eleven different languages and can be freely downloaded and used from www.neqscale.com.

Taken together, the findings underscore the plausibility of disability already in people with MCI, as the use of ET strongly correlates to involvement in activities. It is therefore important that professionals who meet older adults with cognitive impairment take this aspect of function into account in assessments and targeted interventions.

key words: instrumental activities of daily living, older adults, dementia ABSTRACT People with mild cognitive impairment or dementia in a mild phase who live at home are expected to manage the everyday technology that is common in this context. However, the knowledge of how technology use may interfere with the performance of daily activities is sparse. The purpose of this study was to evaluate whether a new instrument measuring relevance and competence in everyday technology use, the Everyday Technology Use Questionnaire, could generate linear measures of competence in a valid manner when used in a population of 157 older adults with and without cognitive impairment or dementia. The results from this study indicate that the Everyday Technology Use Questionnaire demonstrates acceptable levels of scale validity and person response validity, supporting researchers and clinicians with a tool that generates a valid measure of competence in use of everyday technology for people with mild cognitive impairment or dementia in a mild phase who live at home.