Reliability and validity of the Test of In-Hand Manipulation in children ages 5 to 6 years.

The Test of In-Hand Manipulation (TIHM; Case-Smith, 2000) is a five-task test that uses a 9-hole pegboard to examine 2 key components of in-hand manipulation: rotation and translation with stabilization. The authors used Rasch modeling to examine the TIHM's construct validity, interrater reliability, and test-retest reliability in 45 typically developing children ages 5.5 years to 6.5 years. A version of the test, revised using Rasch modeling, was found to have evidence for adequate construct validity and excellent interrater reliability. However, test-retest reliability over a 2-week retest period was not supported. The TIHM demonstrates potential as a clinically useful assessment of in-hand manipulation. The test does not examine all aspects of in-hand manipulation, however, and it may have limited sensitivity to the performance of finger-to-palm and palm-to-finger translation. Further validation of the test is needed before the TIHM can confidently be used in occupational therapy practice.