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Pediatr Phys Ther. 2014 Summer;26(2):201-13. doi: 10.1097/PEP.0000000000000035.

Measuring advanced motor skills in children with cerebral palsy: further development of the Challenge module.

Author information

University of Manitoba (Dr Glazebrook), Winnipeg, Manitoba, Canada; Bloorview Research Institute and Department of Physical Therapy, University of Toronto (Dr Wright), Toronto, Ontario, Canada.



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.


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.


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.


The revised Challenge measures skill accomplishment, speed, and quality.

[Indexed for MEDLINE]

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