Publications by authors named "Dorit Aaron"

10 Publications

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Validity and reliability of the Functional Dexterity Test in children.

J Hand Ther 2017 Oct - Dec;30(4):500-506. Epub 2016 Nov 15.

Shriners Hospitals for Children-Houston, Houston, TX, USA. Electronic address:

Study Design: Clinical measurement study.

Introduction: The Functional Dexterity Test (FDT) has not been validated in children.

Purpose Of The Study: To determine reliability and validity of the FDT in a pediatric population.

Methods: Intraclass Correlation Coefficients (ICCs) were used to calculate interrater and test-retest reliability in typically developing children. Pearson correlation coefficients were used to compare FDT speed with the Jebsen-Taylor Hand Function Test (JHFT) and with 2 activities of daily living tasks to establish validity in children with congenital hand differences.

Results: The FDT demonstrated excellent interrater (ICC, 0.99) and test-retest (ICC, 0.90) reliability. Pearson correlation coefficients exceeded 0.67 for JHFT subsets of fine dexterity and were all less than 0.66 for JHFT subsets of gross grasp. Correlations with the activities of daily living tasks were good to excellent. FDT speeds in TD children exceeded those of children with congenital hand differences (P < .001), demonstrating discriminant validity.

Discussion: Children with congenital hand differences are often treated early in life, making it important to reliably assess hand function of these young children to distinguish developmental change from changes due to interventions. The FDT can reliably measure functional progress over time, help clinicians monitor the efficacy of treatment, and provide families realistic feedback on their child's progress.

Conclusion: The FDT is a valid and reliable instrument for the measurement of fine motor dexterity in children.
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http://dx.doi.org/10.1016/j.jht.2016.08.002DOI Listing
July 2018

Drawing inspiration from children.

J Hand Ther 2015 Apr-Jun;28(2):89-90. Epub 2015 Jan 22.

Division of Biokinesiology & Physical Therapy, Ostrow School of Dentistry and Department of Pediatrics, Keck School of Medicine, University of Southern California, 1540 Alcazar St., CHP 155, Los Angeles CA 90089-9006, USA.

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http://dx.doi.org/10.1016/j.jht.2015.01.006DOI Listing
February 2016

Innovative evaluation of dexterity in pediatrics.

J Hand Ther 2015 Apr-Jun;28(2):144-9; quiz 150. Epub 2015 Jan 22.

University of Southern California, Biomedical Engineering Department and Division of Biokinesiology & Physical Therapy, 3710 S. McClintock, RTH 402, Los Angeles, CA 90089, USA.

Study Design: Review paper.

Introduction: Hand dexterity is multifaceted and essential to the performance of daily tasks. Timed performance and precision demands are the most common features of quantitative dexterity testing. Measurement concepts such as rate of completion, in-hand manipulation and dynamic force control of instabilities are being integrated into assessment tools for the pediatric population.

Purpose: To review measurement concepts inherent in pediatric dexterity testing and introduce concepts that are infrequently measured or novel as exemplified with two assessment tools.

Methods: Measurement concepts included in common assessment tools are introduced first. We then describe seldom measured and novel concepts embedded in two instruments; the Functional Dexterity Test (FDT) and the Strength-Dexterity (SD) Test.

Discussion: The inclusion of novel yet informative tools and measurement concepts in our assessments could aid our understanding of atypical dexterity, and potentially contribute to the design of targeted therapy programs.
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http://dx.doi.org/10.1016/j.jht.2015.01.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4424153PMC
February 2016

Perspectives on glenohumeral joint contractures and shoulder dysfunction in children with perinatal brachial plexus palsy.

J Hand Ther 2015 Apr-Jun;28(2):176-83; quiz 184. Epub 2014 Dec 18.

Shriners Hospitals for Children, Philadelphia, 3551 N. Broad St, Philadelphia, PA 19140, USA.

Shoulder joint deformities continue to be a challenging aspect of treating upper plexus lesions in children with perinatal brachial plexus palsy (PBPP). It is increasingly recognized that PBPP affects the glenohumeral joint specifically, and that abnormal scapulothoracic movements are a compensatory development. The pathophysiology and assessment of glenohumeral joint contractures, the progression of scapular dyskinesia and skeletal dysplasia, and current shoulder imaging techniques are reviewed.
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http://dx.doi.org/10.1016/j.jht.2014.12.001DOI Listing
February 2016

Hand dexterity in children: administration and normative values of the functional dexterity test.

J Hand Surg Am 2013 Dec 1;38(12):2426-31. Epub 2013 Nov 1.

Shriners Hospitals for Children, Houston Hand Therapy, and the University of Texas Health Science Center, Houston, TX; the Department of Statistical Sciences, Cornell University, Ithaca, NY; and Harvard Medical School, Boston, MA. Electronic address:

Purpose: To document normative values from the Functional Dexterity Test (FTD) for typically developing children and to optimize test administration and interpretation.

Methods: A total of 175 typically developing children aged 3 to 17 years participated in the study. Children completed the 16-peg FDT with both hands, and elapsed time was recorded in seconds. Data were analyzed as 16/time, interpreted as speed (pegs per second). A linear regression analysis predicted speed from age and hand dominance.

Results: Functional Dexterity Test speed increased linearly in typically developing children by 0.04 pegs/s for each year of age. This rate of increase was the same for dominant and nondominant hands. Dominant hands were faster than nondominant hands by 0.09 pegs/s at all ages. There was no sex difference.

Conclusions: This study provides age-specific normative values for functional dexterity in typically developing children in 2 formats: as a growth chart of FDT speed versus age and as a regression model that calculates expected speed given a child's age and tested hand dominance. Recommended pediatric modifications to the FDT are to use speed (pegs per second) instead of time (seconds) to report results, and to not assess penalties. The norms presented allow clinicians to compare both speed and rate of change over time of pediatric patients with typically developing children, which makes it possible to distinguish developmental change from intervention.

Type Of Study/level Of Evidence: Diagnostic III.
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http://dx.doi.org/10.1016/j.jhsa.2013.08.123DOI Listing
December 2013

Welcome to our world of hand therapy… dare to make waves, dare to adapt!

J Hand Ther 2013 Apr-Jun;26(2):172-4. Epub 2013 Mar 1.

Aaron & Rose Hand Therapy Services, Inc., 2723 Amherst, Houston, TX 77005, USA.

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http://dx.doi.org/10.1016/j.jht.2013.01.002DOI Listing
November 2013

Does hand therapy literature incorporate the holistic view of health and function promoted by the World Health Organization?

J Hand Ther 2011 Apr-Jun;24(2):84-7; quiz 88. Epub 2011 Mar 9.

Aaron & Rose Hand Therapy Services, Inc., Houston, Texas, USA.

The International Classification of Function (ICF), as formulated by the World Health Organization (WHO), is an accepted international standard for categorizing health and disability. We examined the frequency that ICF domains have been included in 788 Journal of Hand Therapy articles and 78 hand therapy articles from other sources using a scoring system based on the WHO ICF definitions. We found emphasis on body functions and body structures, with less emphasis placed on activities, participation, and environmental factors. This trend has remained stable over time despite the emergence of patient-centered disability measures. We recommend that scientists increasingly incorporate all of the WHO ICF domains in their scientific investigations to demonstrate the societal and personal impact of the profession in a language that is understood and appreciated by a wide array of health care users, policy makers, and third-party payers.
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http://dx.doi.org/10.1016/j.jht.2010.12.003DOI Listing
September 2011

Gateway to the world of hand therapy.

J Hand Ther 2010 Jan-Mar;23(1)

President, IFSHT, Raleigh, NC.

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http://dx.doi.org/10.1016/j.jht.2009.09.011DOI Listing
May 2010

Measuring normal hand dexterity values in normal 3-, 4-, and 5-year-old children and their relationship with grip and pinch strength.

J Hand Ther 2003 Jan-Mar;16(1):22-8

Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas, USA.

After surgery for trauma or correction of congenital anomaly, hand function is difficult to evaluate in children because there are no reference norms on children 3 to 5 years old. The purpose of this study was to determine whether reproducible normative values for hand dexterity and grip and pinch strength could be obtained in young children using simple tests that could be administered quickly within the attention span of a 3- to 5-year-old. The Functional Dexterity Test (FDT), a pegboard test validated for adults and older children, seemed to meet our requirements for dexterity. The FDT was administered to a convenience sample of normal children in a prekindergarten school who were grouped according to age: 3-year-olds (n = 17), 4-year-olds (n = 24), and 5-year-olds (n = 22). Hand dominance was determined. The task was demonstrated by 1 of the 2 testers. The child was asked to turn the pegs over in the pegboard without using the free hand or balancing the peg against the chest. Both hands were tested. Grip and pinch strengths were measured in both hands in a consistent manner. All the children were tested with the arm at the side and the elbow at 90 degrees. A dynamometer was used for grip strength and a pinch meter was used to measure key (lateral) and tripod pinch strengths. Means and SDs were calculated for each age group, and the dependent values of dexterity, strength, and dominance were correlated. Dexterity and strength scores were significantly different by age group. A good FDT score in the dominant hand was predictive of a good score in the nondominant hand. Grip and pinch strength correlated poorly with functional dexterity. The normative values established in this study for children in the 3- to 5-year-old range can be referenced for disability estimates and establishing goals for children after surgery or hand injury.
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http://dx.doi.org/10.1016/s0894-1130(03)80020-0DOI Listing
May 2003

Development of the Functional Dexterity Test (FDT): construction, validity, reliability, and normative data.

J Hand Ther 2003 Jan-Mar;16(1):12-21

Functional Hand Therapy Alliance, Inc. Houston, Texas, USA.

Dexterity tests take time to administer; however, the information obtained is an important component of a comprehensive examination of the hand. This article introduces a dexterity test suitable for use as part of routine examination of the hand. The Functional Dexterity Test (FDT) was developed as a measure of dexterity that takes a minimum amount of time to administer, yet provides information regarding the patient's ability to use the hand for daily tasks requiring a 3-jaw chuck prehension between the fingers and the thumb. The test was developed over 20 years. Interrater and intrarater reliability ranges between good and excellent. Construct validity was confirmed in 2 clinical studies. Preliminary normative data were obtained in 6 samples of convenience. Along with statistical data, this article provides equipment standards and instructions.
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http://dx.doi.org/10.1016/s0894-1130(03)80019-4DOI Listing
May 2003
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