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Type of Measure: (via the MACS website ) The Manual Ability Classification System has been developed to classify how children with cerebral palsy use their hands when handling objects in daily activities. The classification is designed to reflect the child’s typical manual performance, not the child’s maximal capacity. It classifies what children do when using one or both of their hands for activities, rather than assessing and classifying each hand separately. When defining the five levels of the MACS our primary criterion was that the distinctions in manual ability should be clinically meaningful.

Target Population: children with cerebral palsy ages 4-18

Measurement properties and previous use: Validity was established through consultation with parents of children with CP and pediatric rehabilitation specialists; they identified levels of manual ability that were considered meaningful. The MACS has excellent reliability; 0.97 intraclass correlation coefficient (ICC) between therapists, and 0.96 ICC comparing parent and therapist ratings. ( For measuring agreement, the ICC is equivalent to a quadratically-weighted Kappa statistic using Fleiss-Cohen weights.)

Languages: (via MACS download page Chinese, Croat, Danish, Dutch, English, Farsi, Finnish, French, Icelandic, German, Hebrew, Italian, Japanese, Korean, Norwegian, Polish, Portuguese, Portuguese – Brazil, Romanian, Serbia, Slovene, Spanish, Swedish, Turkish, Ukranian.

Authors and Citation: Eliasson AC, Krumlinde Sundholm L, Rösblad B, Beckung E, Arner M, Öhrvall A-M, Rosenbaum P. (2006) The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Developmental Medicine and Child Neurology 48: 549-554.

Additional publications are listed on the MACS publications page

Licence: free to use

Link to measure: MACS materials in several languages

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