The Manual Ability Classification System (MACS) is a five-level scale used to classify how children with cerebral palsy use their hands to handle objects in daily activities. It focuses on the child’s ability to manipulate objects rather than specific movement patterns.
- Level I: Handles objects easily and successfully.
- Level II: Handles most objects but with reduced quality or speed.
- Level III: Handles objects with difficulty and needs help preparing or modifying activities.
- Level IV: Handles only a limited selection of easily manageable objects.
- Level V: Does not handle objects independently and requires significant assistance.
MACS helps clinicians, therapists, and families understand a child’s functional hand use and guide therapy and support strategies.
Accessing the MACS:
You can access detailed information about the MACS, including its levels and guidelines, on the official MACS website:
Additionally, the full MACS document is available for download here:
Pros of the MACS:
- Standardized Classification: Provides a consistent framework for assessing and communicating about hand function in children with CP.
- Reliability and Validity: Extensive research supports its reliability and validity across various settings and populations.
- Age Appropriateness: Designed specifically for children aged 4 to 18 years, with a Mini-MACS version available for younger children aged 1 to 4 years.
- Clinical Utility: Assists in goal setting, treatment planning, and tracking progress over time.
- Parental and Therapist Input: Incorporates perspectives from both parents and therapists, ensuring a comprehensive assessment.
Cons of the MACS:
- Limited Age Range: Primarily validated for children and adolescents; its applicability to adults with CP is less established.
- Focus on Typical Performance: Classifies usual performance rather than maximal capacity, which may not capture a child’s full potential.
- Cultural Sensitivity: May require adaptation for use in diverse cultural contexts to ensure relevance and accuracy.
- Not for Detecting Change: Designed for classification purposes and may not be sensitive to small changes in manual ability over time.
For a comprehensive understanding and access to the MACS materials, visit the official website: