BoHA certification

The Both Hands Assessment (BoHA) is a test developed to evaluate hand function in children with bilateral cerebral palsy aged 18 months to 18 years. It is an extension of the Assisting Hand Assessment (AHA) and is intended for children with spastic, dyskinetic or ataxic bilateral CP with hand function at MACS levels I to III. The BoHA measures how effectively children use both hands together in bimanual activity and quantifies the asymmetry between the two hands.

The BoHA is scored from a 15-20 minute video-recorded, semi-structured play session. Sixteen (16) items are scored on a four-point scale: eleven (11) unimanual items are scored separately for each hand and five (5) bimanual items receive one shared score. This course teaches BoHA Version 1.2. A course manual and a computer-based score form are provided.

The course is conducted in four steps:

1. Pre-forum tasks (self-directed). Participants download and print the course manual, order an AHA 18-18 test kit and review the pre-course reading on the CPTeaching Learning Management System (LMS).

2. Three online forums (live). Participants learn about the constructs underlying the BoHA, the test items and how to score them using the detailed item criteria. The forums also cover the test procedure, including how to conduct the play session and which toys to use, with practice scoring of children from video recordings.

3. Scoring calibration (self-directed, within 4 weeks after Online forum 3). Participants individually score five (5) calibration cases on the CPTeaching Learning Management System (LMS) and receive feedback on their scoring. Satisfactory results on the calibration cases are required for certification.

4. Administration reliability (self-directed, within 3 months after Online forum 3). Participants administer and video record their own BoHA play session with a child from their practice, upload the video and complete a self-reflection process. Feedback on the play session is provided.

If participants do not complete these steps within the required time frame, they will not meet the requirements for BoHA certification and will need to register and attend another course.

Who should attend

Occupational therapists and physiotherapists who assess and treat children with bilateral cerebral palsy.

Course objectives

On completion of this course, participants will be able to:

1. Explain the construct of the BoHA and the psychometric evidence that supports its use.

2. Set up, conduct and video record a BoHA play session according to the test procedure.

3. Score a BoHA play session reliably according to the criteria in the manual (BoHA Version 1.2).

4. Interpret BoHA results, including asymmetry between the hands, and communicate them to families and colleagues to guide intervention and measure change.

Course requirements

To complete the self-produced BoHA administration, you must have access to an AHA 18-18 test kit and at least one (1) child with bilateral upper limb impairment. The AHA 18-18 test kit can be ordered by course participants from www.cpteaching.com.

Prerequisites: Nil.

Please do not register for this course if you:

1. Do not have access to at least one child with bilateral upper limb impairment to complete the BoHA administration reliability procedure.

2. Do not have access to an AHA 18-18 test kit.

3. Have planned leave or other factors that will impact on your ability to complete all steps outlined above within the time frames specified.