ABC, Assessment of Behavioral Components: Analysis of Severely Disordered Posture and Movement in Children with Cerebral Palsy.

ABC, Assessment of Behavioral Components: Analysis of Severely Disordered Posture and Movement in Children with Cerebral Palsy The authors state in the preface of the book that their purpose is to provide an analysis of motor behaviors in children who have cerebral palsy. Their target group appears to be those children with more severe involvement. The authors developed this assessment text mainly for daily care givers, although they state it can be used by physical therapists. The motor behaviors are broken down into smaller components, so that observable changes can be measured.

The assessment text is divided into two main sections. The first section, the instructional manua, includes five short chapters covering the test areas and how to administer them. The first chapter describes cerebral palsy in simple and direct terminology. An overview of the test is provided. The second chapter covers preparation of the child for testing, emphasizing relaxation techniques. The third chapter covers muscle tone and range of motion and how to administer this portion of the assessment. The fourth chapter covers reflex activity and how to administer this area. The fifth chapter covers preparation for the assessment, placing emphasis on relaxing the child during the assessment, allowing plenty of time and motivating the child to respond. Each of these chapters is followed by simple study questions that help to identify the main ideas presented in the chapters. This first section also includes a glossary, an extensive bibliography, and an appendix that covers the reliability and field testing of the assessment. The remaining text is the actual assessment system, which is divided into the assessment of three areas: muscle tone, primitive reflexes, and gross motor development. The format for scoring each behavior includes a written description with an illustration of a "normal" response and a chart that describes or illustrates four levels of observed responses in descending order. The items are scored on a pull-out summary score form and progress chart. The scores are not combined to reach a quotient. Instead each item is scored individually; the score sheet provides a graph illustrating changes observed over a series of test occasions.

I commend the authors of this text for taking on the task of assessment of muscle tone within the contest of range of motion. At the least, this portion of the test provides a baseline for therapists; however, I found the whole assessment to be less than useful. I repeatedly found myself wondering whether I would choose to use this assessment. Its drawbacks are many, including the difficulty of matching the many and varied responses available from the child to the four responses described in the scoring system, the excessive time needed to administer the test, and, finally, the narrow outlook of an assessment that assesses the child with cerebral palsy on the basis of gross motor and reflex behavior alone.

I believe that combining a more global developmental assessment, such as the Hawaii Early Learning Profile or the Denver Developmental Screening Test, with the more traditional reflex testing as described by Mary Fiorentino would more accurately help to assess and describe progress than this particular format. I cannot recommend this text to physical tehrapy practitioners.