Assessment of in-hand manipulation by occupational therapists in paediatric practices in South Africa

Introduction: Assessment of in-hand manipulation is fundamental to guide treatment for children with fine motor delays. Limited literature is available on how South African occupational therapists assess in-hand manipulation. This study aimed to describe which current in-hand manipulation assessment methods are used and what the preferences of occupational therapists in all areas of paediatric practices are regarding a suitable instrument. Methods: Quantitative cross-sectional study design with a non-probability, purposive sampling method was used. Participants completed an EvaSys survey system online questionnaire. Results: Two-hundred-and-ninety-two (n=292) occupational therapists registered with the HPCSA participated. Limited familiarity (n=50; 17.1%) with the formal assessment instruments described in literature was reported. The informal assessment methods most commonly used were subjective observation of tasks (n=287; 98.3%) of scholastic tasks (n=261; 89.4%) and play tasks (n=255; 87.3%) for children between the ages of five to six years (n=273; 93.5%). Preferences supported a descriptive instrument accompanied by a user manual that is administered under 15 minutes, in multiple languages, and with attention to the quality of movements and compensatory techniques used by the child. Conclusion: Results showed that the current and preferred assessment methods used by occupational therapists might provide guidance for the future development of a contextual, relevant in-hand manipulation instrument for paediatric practices in South Africa.