Assisting Hand Assessment and Children's Hand-Use Experience Questionnaire - Observed Versus Perceived Bimanual Performance in Children with Unilateral Cerebral Palsy

Aims: To explore the differences, relationship, and extent of agreement between the Assisting Hand Assessment (AHA), measuring observed ability to perform bimanual tasks, and the Children's Hand-Use Experience Questionnaire (CHEQ), assessing experienced bimanual performance. Methods: This study investigates a convenience sample of 34 children (16 girls) with unilateral cerebral palsy aged 6-18years (mean 12.1, SD 3.9) in a cross-sectional design. Results: The AHA and CHEQ subscales share 8-25% of their variance (R-2). Bland-Altman plots for AHA and all three CHEQ subscales indicate good average agreement, with a mean difference approaching zero but large 95% confidence intervals. Limits of agreement were extremely wide, indicating considerable disagreement between AHA and CHEQ subscales. Conclusion: AHA and CHEQ seem to measure different though somewhat related constructs of bimanual performance. Results of this investigation reinforce the recommendation to use both instruments to obtain complementary information about bimanual performance including observed and perceived performance of children with unilateral cerebral palsy.