Hand Assessment for Infants: normative reference values

Abstract

Aim To create normative reference values for unilateral and bilateral use of the hands, using the Hand Assessment for Infants (HAI), a newly developed criterion‐referenced assessment measuring hand use in infants aged 3 months to 12 months at risk of cerebral palsy (CP). Method In total, 489 HAI assessments of typically developing infants (243 females, 246 males), aged 3 months to 10 months (mean 6mo 14d [SD 2mo 5d]), were collected in Italy and Sweden. Normative growth curves based on mean and SDs were created, as well as skill acquisition curves for each test item. Correlation to age and differences between groups based on sex and nationality, as well as differences between the right and the left hand, were investigated. Results The growth curves showed a steady increase in mean value and a decrease in SD over age. There were no differences between groups based on sex or nationality. There was a negligible mean difference (0.1 raw score) between the right and left hands. Interpretation HAI normative reference values are now available, which can assist in identifying deviating hand use for each month of age, as well as a side difference between hands in infants at risk of CP. What this paper adds A Hand Assessment for Infants (HAI) result greater than 2SD below the mean indicates atypical hand use. Skill acquisition curves describe the age at which typically developing infants master the HAI items. Most typically developing infants do not demonstrate asymmetry in hand use.

Early prediction of unilateral cerebral palsy in infants with asymmetric perinatal brain injury – Model development and internal validation

“…28 Additionally, normative values of different HAI scores are established and can be used to further compare the development of infants at risk of UCP and typical developing infants. 29 In future, HAI may not only serve as a predictive tool, but also as an outcome measure of early intervention. It has already been used in a study demonstrating improvement of manual ability after constraint induced movement therapy in infants younger than 12 months of age.…”

Do Infants at Risk of Developing Cerebral Palsy or Other Neurodevelopmental Disorders Learn What They Practice?

“…GMFM-66 has shown good psychometric properties [ 21 , 22 , 23 ]. The Hand Assessment for Infants (HAI) was used, another observational and criteria-referenced measure with excellent interrater and test retest reliability that assesses hand use in 3–12-month-old infants at risk of developing CP on a scale from 0 (low capacity) to 100 (high capacity) [ 24 , 25 ]. The Hammersmith Infant Neurological Examination (HINE) and Alberta Infant Motor Scale (AIMS), both assessments that have good psychometric properties, [ 26 , 27 , 28 , 29 ] were used here to control for potential differences in baseline characteristics.…”

The Hand Assessment for Infants at risk for cerebral palsy

“…The Hand Assessment for Infants (HAI) addresses the youngest age group in a suite of Rasch‐derived assessments of upper limb and hand function. The assessments now span from ages 3 months through to adulthood and include the well‐known Assisting Hand Assessment and Mini‐Assisting Hand Assessment, amongst others .…”

“…The most recent work on the HAI attends to another crucial area of research and one which is unique amongst this suite of assessments. Ek et al . have developed normative values for the HAI.…”

“…Clinicians can use this knowledge to communicate with families and target interventions and family support.The most recent work on the HAI 1 attends to another crucial area of research and one which is unique amongst this suite of assessments. Ek et al 1 have developed normative values for the HAI. The norms are reported in monthly increments based on assessment of 445 typically developing infants (489 assessments), aged 3 to 10 months.…”