Measuring Advanced Motor Skills in Children With Cerebral Palsy: Further Development of the Challenge Module

Purpose: Since previous testing of the Challenge Module revealed that response scales should assess performance speed as well as skill accomplishment, this study sought to develop empirically based dual-criterion (accomplishment and time) response options. Methods: Challenge items were tested with a convenience sample of 34 children who were typically developing (4-10 years) to obtain time cut-points that could be applied to children/youth with cerebral palsy. Median/lower quartile item performance times were calculated within younger (<7.5 years) and older child (>= 7.5 years) groups, and used as benchmarks for response option cut-points. Children's scores were recalculated using these cut-points to verify that differences in younger and older children's abilities and times were captured. Results: Mean scores were 48.9% and 87.2% for younger and older groups, reflecting expected developmental progression. Further response revision captured high-level movement control older children exhibited. Conclusion: The revised Challenge measures skill accomplishment, speed, and quality.