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

Glazebrook, Cheryl M. PT, PhD; Wright, F. Virginia PT, PhD

doi: 10.1097/PEP.0000000000000035
Research Article

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.

The authors describe the process of revising the Challenge Module and report that the Challenge now measures skill accomplishment, speed, and quality.

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

Correspondence: F. Virginia Wright, PT, PhD, Bloorview Research Institute, 150 Kilgour Rd, Toronto, ON M4G 1R8, Canada (

Grant Support: This study was supported in part by the Physiotherapy Foundation of Canada, and Bloorview Research Institute, Toronto, Canada.

The authors declare no conflicts of interest.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins and the Section on Pediatrics of the American Physical Therapy Association.