The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability
2006/06/19 by Ann‐Christin Eliasson, Ann-Christin Eliasson, Lena Krumlinde-Sundholm +7 · 2,204 citations
Medicine · Psychology · #Cerebral Palsy and Movement Disorders #Cerebral palsy #Content validity #Developmental psychology #Diplegia #Family and Disability Support Research #Gross Motor Function Classification System #Infant Development and Preterm Care #Intraclass correlation #Medicine #Physical medicine and rehabilitation #Physical therapy #Psychiatry #Psychology #Psychometrics #Reliability (semiconductor) #Spastic diplegia #Tetraplegia
paper · doi:10.1017/s0012162206001162
published in Developmental Medicine & Child Neurology 48(07), 549 (Wiley)
openalex publication_date 2006/06/19 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/05
Abstract
The Manual Ability Classification System (MACS) has been developed to classify how children with cerebral palsy (CP) 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 the collaborative use of both hands together. Validation was based on the experience within an expert group, a review of the literature, and thorough analysis of children across a spectrum of function. Discussions continued until consensus was reached, first about the constructs, then about the content of the five levels. Parents and therapists were interviewed about the content and the description of levels. Reliability was tested between pairs of therapists for 168 children (70 females, 98 males; with hemiplegia [n=52], diplegia [n=70], tetraplegia [n=19], ataxia [n=6], dyskinesia [n=19], and unspecified CP [n=2]) between 4 and 18 years and between 25 parents and their children's therapists. The results demonstrated that MACS has good validity and reliability. The intraclass correlation coefficient between therapists was 0.97 (95% confidence interval 0.96-0.98), and between parents and therapist was 0.96 (0.89-0.98), indicating excellent agreement.
Citations
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