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The Assisting Hand Assessment: A New Perspective on 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. The AHA has been used as the principal outcome measure in several studies, e.g., in studies evaluating Constraint Induced Movement Therapy, and has demonstrated evidence of responsiveness to change. With the AHA also longitudinal development of hand function has been studied.  Please visit the web site www.ahanetwork.se for more information.

The course teaches the Assisting Hand Assessment Version 5.0. It 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. Second, to achieve certification the participant is to complete six additional cases and get satisfactory results. Some of these are 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.

Course Objectives

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

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


Texas Children's Hospital
Feigin Center
1102 Bates, 1st Floor Conference Room A
Houston, TX 77030

Cost -  


Earned credits -  

16.75 contact hours or CCU’s through TPTA and TOTA

Registration - Register online


Lena Krumlinde-Sundholm, Reg OT, Ph.D., Associate Professor, is an Occupational Therapist and a senior researcher at the Neuropediatric Unit, Department of Woman’s and Children’s Health, Karolinska Institutet in Stockholm, Sweden.


Day 1

  • 8:30 - 9:00  Registration and continental breakfast
  • 9:00 - 10:15  Introduction about the concept, theoretical background and development of the test
  • 10:15 - 10:30  Break
  • 10:30 - 12:00  Definitions of the test items and scoring criteria
  • 12:00 - 1:00  Lunch
  • 1:00 - 2:30  Continued; definitions of the test items and scoring criteria
  • 2:30 - 2:45  Break
  • 2:45 - 4:00  Scoring of children
  • 4:00 - 5:00  How to set up the test situation

Day 2

  • 9:00 - 10:15  Validity, reliability and responsiveness to change
  • 10:15 - 10:30  Break
  • 10:30 - 12:00  Scoring of small children 18 months – 5 years
  • 12:00 - 1:00  Lunch
  • 1:00 - 2:30  Test situation with older children
  • 2:30 - 2:45  Break
  • 2:45 -  5:00  Scoring of older children 6-12 years

Day 3

  • 8:30 -  9:00  Certification procedure
  • 9:00 - 10:30  Scoring of children
  • 10:30 - 10:45  Break
  • 10:45 - 11:45  AHA in the perspective of  ICF and other tests
  • 11:45 - 12:30  Concluding remarks


Wyndham Medical Center
6800 Main
Houston, Texas 77030
Nightly rate: $115.00 (price varies based on room availability)

Ask for Texas Children’s Hospital ESP Rate

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