AIM To identify assessments, applicable to infants aged 3 months to 12 months, measuring hand function, and to discuss their usefulness in assessing infants at risk of developing unilateral cerebral palsy (CP).METHOD Instruments described in two previous systematic reviews were scrutinized for inclusion of fine motor components. Additionally, a new literature search was performed in Medline, PsychInfo, PubMed, and Cinahl (2007-2013) to identify newly developed assessments of infant motor functioning.RESULTS Five assessments from the two previous systematic reviews included fine motor components but only three provided separate measures of fine motor performance: the Peabody Developmental Motor Scales -version 2 (PDMS-2), the Bayley Scale of Infant and Toddler Development -version III, and the Posture and Fine Motor Assessment of Infants, each of which provided measures of the preferred hand only. From 531 papers retrieved, 10 new assessments were found, three of which met our inclusion criteria: the Infant Motor Profile (IMP), the Grasping and Reaching Assessment of Brisbane (GRAB), and the Hand Assessment for Infants (HAI). Only the GRAB and the HAI provide measures relevant for assessing infants at risk of developing unilateral cerebral palsy; however, both measures are still under construction.INTERPRETATION No currently available assessment for infants aged 3 to 12 months old measures aspects of hand function suitable for quantifying asymmetry between hands or quality of bimanual performance.Early infancy is a period of rapid motor development and is possibly the best period for therapeutic interventions addressing motor outcomes, owing to the period's great neural plasticity. 1,2 In infants developing unilateral cerebral palsy (CP), asymmetric segmental spontaneous upper limb movements can be observed as early as at 3 months of age after thorough video-based observation.3 Commonly, the first signs of asymmetric hand use are noticed later during the first 6 months of life. The possibility of measuring the extent of this asymmetry at an early age could offer an important method for diagnosis, predicting outcome, following development, and evaluating early intervention approaches. To provide valid and reliable quantifications, appropriate assessment tools are essential. Many assessment tools developed for use with infants include fine motor components. The question at issue is whether currently available tests could be useful in measuring fine motor performance in infants at risk of developing unilateral CP. It is well known that fine motor performance is complex and influenced by many components. From the aim of finding appropriate tools from an integrative and developmental approach to unilateral CP, the aspects of perception-action-cognition-environment (PACE) should be considered also when expressed by an infant's fine motor performance, namely when infants use their hands to act on an age-appropriate stimulus. The searched-for assessment should quantify possible differences between the two hands and the ...