Assisting Hand Assessment Workshop

Thu, May 1, 2014
9:00 am 5:00 pm

Assisting Hand Assessment Workshop: 
A new perspective in evaluating hand function in children with unilateral impairments. 

The Assisting Hand Assessment (AHA) is now a well-established and frequently used evaluative tool to measure how effectively children with unilateral hand dysfunction actually use their involved hand collaboratively with their well-functioning hand to perform bimanual tasks. For the child the AHA is an enjoyable 10 to 15 minute semi-structured play session using a test-kit of selected toys requiring bimanual use. The AHA is then scored from structured video recordings of the observable performance skills during this play. The AHA measurement contains twenty items scored on a four-point rating scale. The outcome is an evaluative interval level measure, which together with the individual child’s response profile, can guide intervention. AHA is a standardized test intended for children with unilateral Cerebral Palsy or Brachial Plexus Palsy between the ages of 18 months and 12 years. A teenage- and adult version is currently being developed.

Validity and reliability of the AHA scores are well documented in several studies i, ii, iii, iv. The AHA has been widely used to evaluate various upper limb interventions including constraint- induced movement therapy (e.g., Eliasson et al 2011, Sakzewski et al., 2011, Aarts et al., 2011), bimanual therapy (Gordon et al., 2011), Botulinum toxin-A (Hoare et al., 2010, 2012), hand surgery (Ponten et al., 2011), splinting (Louwers et al., 2011) and allowed the exploration of longitudinal development of bimanual hand function in children with unilateral cerebral palsy (Holmefur et al. 2010 v, vi). Please visit the web site for more information.

The course teaches the Assisting Hand Assessment Version 5.0 and is conducted in two steps. First, a 2½- day training course is given including information about the test construct, testing procedure and scoring practice on a range of children from videos. A manual with detailed scoring criteria and a computer based scoring form is provided. To achieve certification, the participant is to complete six additional cases and get satisfactory results. Some of these from videos provided on a web based e-learning platform, and some self-produced AHA play sessions. Individual feedback of these cases is provided. The AHA test kit for children between 18 months and 12 years with specific toys can be ordered from Handfast Inc., at the course or later during the certification procedure at a cost of approximately 3,900 SEK/610 USD (dependent of the current currency, exact price will be given when course dates are set) + shipping costs.


Upon completion of this course, participants will be able to:

  • Demonstrate the set up, conduct and video record an Assisting Hand Assessment session and produce reliable scores according to the criteria in the manual 
  • Verbalize the concept and construct of the test and its psychometric properties 
  • Interpret and communicate the outcome of the test.


  • Lena Krumlinde-Sundholm, Reg OT, Ph.D., is Associate Professor, Senior Occupational Therapist, and a researcher in the Neuropediatric Unit, Department of Women’s and Children’s Health, Karolinska Institutet in Stockholm.
  • Lisa Wagner, DHS, OTR/L, is Senior Occupational Therapist at Shriners Hospital for Children in Greenville, SC, and OT consultant with the School District of Pickens County.


April 30 – May 2, 2014

  • April 30: 9am – 5pm 
    Rosedale Room, Billings Building, Floor 2, Burke Rehabilitation Center 785 Mamaroneck Avenue White Plains, NY 10605
  • May 1: 9am – 5pm 
    Blythedale Children’s Hospital, Valhalla, NY 10595.
  • May 2: 9am – 1pm 
    Rosedale Room, Billings Building, Floor 2, Burke Rehabilitation Center 785 Mamaroneck Avenue White Plains, NY 10605


$1,000 USD
The fee includes a copy of the AHA manual and unlimited number of score forms as paper copies and the electronic version. The fee also includes three light breakfasts and two lunches during the course.

To register for the workshop, or for more information, please contact:

Rae Krauss 
Blythedale Children’s Hospital
95 Bradhust Avenue
Valhalla, NY 10595 
(914) 592-7555, ext. 71575

i. Krumlinde-Sundholm L., Eliasson A-C. (2003) Development of the Assisting Hand Assessment, a Rasch-built measure intended for children with unilateral upper limb impairments. Scand J Occup Ther 10: 16-26.
ii. Krumlinde-Sundholm L., Holmefur M., Kottorp A., Eliasson A-C. (2007) The Assisting Hand Assessment: Current evidence of validity, reliability and responsiveness to change. Dev Med Child Neur 49, 259-264.
iii. Holmefur M, Krumlinde-Sundholm L, Eliasson A-C. (2007) Interrater and intrarater Reliability of the Assisting Hand Assessment. Am Journ Occup Ther 61, 79-84. 
iv. Holmefur M, Aarts P, Hoare B, Krumlinde-Sundholm L (2009) Retest and alternate forms reliability of the Assisting Hand Assessment. Journal of Rehabilitation medicine. 41: 886–891.
v. Holmefur M, Krumlinde-Sundholm L, Bergström J, Eliasson A-C (2010) Longitudinal development of hand function in children with unilateral cerebral palsy. Developmental Medicine and Child Neurology 52(4): 352-357.
vi. Holmefur M, Kits A, Bergström J, Krumlinde-Sundholm L, Flodmark O, Forssberg H, Eliasson AC (2012) Neuroradiology Can Predict the Development of Hand Function in Children With Unilateral Cerebral Palsy. Neurorehabil Neural Repair published online 6 June 2012.

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