We currently offer two forms of upper limb assessment, both of which are specifically designed for children and young people with hemiplegia.

Each assessment is tailored to different age ranges and provides a unique focus on upper limb function and capacity.

Assisting Hand Assessment (AHA)

The AHA is a standardised test intended for children and young people with hemiplegic cerebral palsy or brachial plexus palsy between the ages of 18 months and 18 years.

It is an evaluative tool to measure how effectively children and young people with unilateral hand dysfunction actually use their involved hand collaboratively with their well-functioning hand to perform bimanual activities.

It involves us filming a 10 to15 minute semi-structured play session using select toys / objects requiring bimanual use. This will either take the form of exploratory play with toys, a board game or wrapping a present - the choice of activity is largely age-dependent.

Shriners Hospital Upper Extremity Evaluation (SHUEE)

The SHUEE analyses the spontaneous use and position of the involved hand and arm joints by observing and filming the performance during defined tasks. It is validated for children and young people between three and 18 years with hemiplegic cerebral palsy.

Validation of the SHUEE for Children with Hemiplegic Cerebral Palsy

Assessment

Before the AHA / SHUEE, a thorough clinical examination will be carried out. This includes evaluating range of motion, muscle strength and spasticity.

The usage of the involved hand / arm in the AHA / SHUEE is interpreted in relation to the clinical findings.

This is then reviewed by a multidisciplinary team and, if appropriate, treatment recommendations made.

Types of analysis

  • Baseline assessment of upper limb capacity
  • Repeat assessments to monitor deterioration in posture / function
  • Pre-intervention assessment for both botulinum toxin therapy and surgery
  • Post-intervention assessment including:
    • within three months following botulinum toxin therapy
    • at six, 12 and 24 months following surgery
  • Questions related to orthotic management
  • AHA-specific assessments:
    • ongoing assessment of performance to guide therapeutic goal-setting
    • documentation of hand skills progression over time following therapy.

Patient suitability

This is suitable for patients with hemiplegia or brachial plexus palsy (AHA only), within the following age ranges.

  • three to 18 years (SHUEE)
  • 18 months to 12 years: Child Assessment (AHA)
  • 13 to 18 years:Adolescent Assessment (AHA)

Report

Report includes:

  • patient history
  • clinical examination
  • interpretation
  • treatment recommendations including:
    • Physiotherapy (e.g. constraint induced movement therapy)
    • Occupational Therapy
    • Orthotic Provision
    • Botulinum Toxin Injections
    • Surgery
    • others as applicable, such as imaging or referrals to other specialised services.