The Reliability and Validity of the Quality of Upper Extremity Skills Test

The Quality of Upper Extremity Skills Test (QUEST) was developed to overcome limitations of currently available measures of hand function. This measure evaluates quality of upper extremity function in four domains: dissociated movement, grasp, protective extension, and weight bearing. It is designed to be used with children who have neuromotor dysfunction with spasticity and has been validated with children from 18 months to 8 years of age. Recently, a multi-centre trial evaluating the effect of neurodevelopmental therapy (NDT) and upper extremity casting on improvement of hand function in children with cerebral palsy was completed. Data collected during that study were analyzed to examine the validity and responsiveness of the QUEST. Consensus meetings were held with therapists who have used the QUEST, reliability testing was completed and a manual of test administration was written. The results of these studies indicate that the QUEST is a criterion referenced measure with good interobserver and test-retest reliability. The QUEST correlates strongly with another measure of hand function, the Peabody Developmental Fine Motor Scales. The QUEST is useful as a measure to describe upper extremity quality of movement and to use in planning intervention programs.