Introduction. When children present difficulties in daily activities such as buttoning, cutting or hand writing, a deficit of in-hand manipulations may be suspected. To confirm this deficit, it is important to be able to evaluate it with a standardized test. Most of the tests found in the literature do not have a standardized test protocol, have few quality criteria and have not been subjected to a fidelity analysis. The aims of this study are : (1) to identify a reproducible handover protocol and valid quality criteria ; (2) to analyze inter-rater and test-retest reliability and (3) to study the relationship between in-hand manipulations and handwriting.
Method. The TMDM-M is an adapted version of the Test of In-Hand manipulation. It was administered to 111 children aged 6.5 and 9.5 years old. The tests were filmed to identify objective quality criteria. An intra-class correlation analysis was used to define test-retest and inter-rater reliability. Handwriting was evaluated using the Beknopte Beoordelingsmethode voor Kinder Handschriften (BHK) – Concise Assessment Method for children’s handwriting which measures the quality and speed of writing. A Pearson correlation analysis was performed to analyze the relationship between handwriting and in-hand manipulations.
Results. A test protocol and quality criteria were defined. A total score combining quality and speed was established. Test-retest reliability was excellent for speed (ICC = .84 ; 95% CI = .73-90) and good for quality (ICC = .62, 95% CI = .36-78). Inter-rater reliability was excellent for speed (ICC = .85 ; 95% CI = .75-91) and quality (ICC = .87 ; 95 IC = .78-92). While we found a significant relationship between TMDM-M and BHK speeds (r = .21 ; p < .05), this was not the case between TMDM-M and BHK qualities. Conclusion. The TMDM-M has good test-retest and inter-rater reliability. It can contribute to identify difficulties of in-hand manipulations. However, it still requires more research to obtain reliable data. For the moment, it is recommended only to use it in conjunction with a test measuring fine motor skills.
Article rédigé par :
Haute École de santé, Genève
HES-SO Haute École spécialisée de Suisse occidentale
Centre hospitalier universitaire vaudois Suisse