Hand Assessment for Infants (HAI)

A new assessment of hand function has recently been developed for infants at risk of developing cerebral palsy (CP) in the age range 3-12 months

old. The development of this test has been done in collaboration between research groups at IRCCS Fondazione Stella Maris in Pisa, Italy, and at the

Karolinska Institutet in Stockholm, Sweden. The HAI intends to measure the degree and quality of goal-directed actions performed with each hand separately, as well as with both hands together. The outcome of the test renders a separate score for each hand, illustrating possible asymmetric hand use, a criterion-referenced measure of general upper limb ability, and age-norm references. As a first step, the HAI has been validated for infants with clinical signs of unilateral cerebral palsy. The HAI is scored on 17 items (12 uni-manual and 5 bi-manual) scored on a 3-point rating scale. The HAI is a criterion-referenced test useful for measuring hand function and norm-referenced values are also provided.

Preliminary results indicate high predictive validity for unilateral CP at 3.5-4.5 months of age.

The course teaches the reliable use of the HAI, in two steps: The first step involves a two-day workshop where participants will learn about the constructs underlying the HAI, test procedures, test objects used, and scoring of infants from video recordings. An HAI manual with detailed scoring criteria and a computer-based scoring form will be provided.

Following the course, the participants will be able to create their own test kit according to instructions given during the course. Feedback on the selected toys will be provided during the certification procedure. Additionally, participants will be required to achieve satisfactory scoring of test cases; some of which are provided by videos, and two from self-produced HAI play sessions.

Course Objectives

On completion of the course, participants will be able to:

  1. Demonstrate how to select appropriate toys for an HAI play session
  2. Demonstrate the set-up and video-recording of the session and how toys are used to provoke active hand use in infants
  3. Produce reliable scores according to the criteria in the manual
  4. Understand the constructs upon which the HAI is based and describe early psychometric evidence
  5. Interpret and communicate outcomes from the testing procedures


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




11.15 contact hours or CCU’s through TPTA and TOTA


Lena Krumlinde-Sundholm, Reg OT, PhD, 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/Continental Breakfast
  • 9:00 - 10:00  Early Development of hand function in CP
  • 10:00 - 10:30  Review: Tests of hand function for infants
  • 10:30 - 10:45  BREAK
  • 10:45 - 12:00  Concept and development of the HAI
  • 12:00 - 1:00  LUNCH
  • 1:00 - 2:00  HAI Test Items
  • 2:00 - 2:30  Score Form
  • 2:30 - 3:30  Scoring of children
  • 3:30 - 4:45  BREAK
  • 4:45 - 5:00  The HAI Test Kit and play session

Day 2

  • 9:00 - 10:00  Psychometric properties
  • 10:00 - 10:30  Scoring of Children
  • 10:30 - 10:45  BREAK
  • 10:45 - 11:30  Scoring of Children continues
  • 11:30 - 12:30  Feedback procedure
  • 12:30 - 1:30  LUNCH
  • 1:30 - 2:45  Scoring of Children continues
  • 2:45 - 3:00  Questions and answers/Wrap up


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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