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Quality of Upper Extremity Skills Test (QUEST)

The Quality of Upper Extremity Skills Test is an outcome measure designed to evaluate movement patterns and hand function in children with cerebral palsy. The QUEST is both reliable and valid.

A license is required to use the QUEST. The license, which includes the QUEST manual and assessment form, can be purchased from the CanChild e-store. 

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Reference for the manual: DeMatteo, C., Law, M., Russell, D., Pollock, N., Rosenbaum, P., & Walter, S. (1992). QUEST: Quality of Upper Extremity Skills Test. Hamilton, ON: McMaster University, CanChild Centre for Childhood Disability Research.

More information about the QUEST:  The purpose of the QUEST is to evaluate quality of upper extremity function in four domains: dissociated movement, grasp, protective extension, and weight bearing. Validation studies have been completed with children with cerebral palsy, aged 18 months to 8 years.

  • 36 items assessing dissociated movements, grasp, protective extension, and weight bearing.
  • Three reliability studies have been completed with children with cerebral palsy.
  • Observer reliability of the QUEST and its domains ranges from 0.51 to 0.96 with all coefficients except one greater than 0.70.
  • Test-retest reliability of QUEST and its domains ranges from 0.75 to 0.95.
  • Concurrent validity with the Peabody Developmental Motor Scales (PDMS) - fine motor is 0.84.
  • Correlations between QUEST domains and subscores of the PDMS range from 0.58 to 0.84.
  • The grasp domain correlates highly with all areas for the PDMS while protective extension is lower.
  • Construct validity with therapist's judgement of child's level of hand function - 0.72 for left hand function, and 0.58 for right hand function.
  • Correlation between chronological age and QUEST score was 0.33.
  • QUEST was responsive to changes in quality of movement after upper extremity casting in a study of 72 children with cerebral palsy.
  • Percentage score is calculated.
  • Administration requires 30 - 45 minutes.
  • QUEST is a reliable and valid measure for evaluating quality of movement in children with cerebral palsy.
  • Items are related to quality of movement, not to chronological age.
  • It is administered within a play context.

DeMatteo, C., Law, M., Russell, D., Pollock, N., Rosenbaum, P., & Walter, S. (1993). The reliability and validity of Quality of Upper Extremity Skills Test. Physical and Occupational Therapy in Pediatrics 13(2), 1-18.