Development and validation of a WHO ICF compliant hand and upper limb assessment tool for children: The Reach Out questionnaire.

Background: Current tools for evaluating hand and upper limb function in children do not represent all domains of the World Health Organization International Classification of Disability, Functioning and Health (ICF) framework and may not capture an accurate progression or regression of function over time.

Purpose: Based on this framework, we have developed an assessment tool (Reach Out) to evaluate function in children aged from 2 to 16 years following consultation with an advisory panel of specialists.

Study Design: Primary clinical study.

Methods: Construct validity along with test-retest reliability, inter-rater reliability and sensitivity to change have all been analyzed to validate the Reach Out assessment tool.

Results: The assessment tool has been validated in a total of 231 patients. Significant construct validity of 0.64 (P < .00001, 95% confidence interval = 0.56-0.71, n = 231) for both age groups and diagnostic groups was observed. The Reach Out questionnaire was internally consistent with a Cronbach's Alpha of > 0.8 for most domains in most age groups. Test re-retest scores showed that the questionnaire was reliable with most domains of the questionnaire achieving high scores of reliability (P ≤ .03). We also received positive feedback from participants and parents.

Conclusions: The use of this new tool will help identify both progression and regression of function, allowing a more tailored and holistic approach to treatment in children with conditions affecting the hand and upper limb through the incorporation of International Classification of Disability, Functioning and Health domains. This tool is quicker to complete and can be applied to a wide range of ages and diagnostic groups compared to previous assessment tools.