Description
What is it?
MACS is a classification system that describes how children and youth (ages 4-18) with cerebral palsy (CP) use their hands to handle objects during everyday activities. MACS was developed in 2002 by a group of researchers across multiple disciplines from Canada and Sweden.
Since its development, MACS has been translated into more than 25 languages, including French, Spanish, German, Italian, Greek, Japanese, Korean, Serbian, Turkish, and Traditional Chinese, making it one of the most widely used manual ability classification systems for children with cerebral palsy worldwide.
Inspired by Gross Motor Function Classification System (GMFCS), MACS strives to capture hand function as independent from gross motor function. A different method of classification is necessary for this because we cannot assume that improvements in hand function occur in the same manner or pace as improvements in gross motor skills. Our research group focused on developing a system that is more meaningful and descriptive for families than traditional “mild”, “moderate”, and “severe” classifications.
MACS contains five levels as well as guidance for distinguishing between the levels. The levels include:
- I – Handles objects easily and successfully.
- II – Handles most objects, but with somewhat reduced quality and/or speed of achievement.
- III – Handles objects with difficulty; needs help to prepare and/or modify activities.
- IV – Handles a limited selection of easily managed objects in adapted situations.
- V – Does not handle objects and has severely limited ability to perform even simple actions.
This tool was designed to be completed by someone who interacts with the child frequently such as a parent, therapists, or the child themselves. In doing so, MACS reflects the hand function of the child when they are engaging in regular activities and movement, rather than in ideal circumstances.
MACS is provided as a downloadable PDF that includes the complete tool and instructions for use.
Preview
A sample page of the Manual Ability Classification System (MACS) can be found below.
For more information, please visit the MACS resource page.
Authors: Eliasson AC, Krumlinde Sundholm L, Rösblad B, Beckung E, Arner M, Öhrvall AM, Rosenbaum P.