Content validity of the Handwriting Assessment Battery (HAB-v6) for use with adults with acquired brain injury (ABI): An international Delphi study.
Christiana D'Cunha, Lauren J Christie, Annie McCluskey and 1 others
PMID 39900496WHAT IT FOUND
Experts judged the HAB-v6 relevant for assessing adult handwriting after ABI, but did not agree on the dots drawing subtest.
They recommended adding vertical lines and number copying, and revising sentence copying.
Key findings
01Five of six existing HAB-v6 subtests achieved high consensus for importance, while the dots drawing subtest did not reach consensus.
02The panel reached high consensus to add a vertical line drawing subtest and a number copying subtest, and to modify sentence copying to require correct capitalisation.
03The panel reached high consensus to keep the self-generated shopping list subtest for speed.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study used expert opinion from a small panel, not adults with ABI or therapists using the tool in routine care. Only English-speaking experts were invited, so handwriting practices in other languages and cultures were not represented. The dots drawing subtest did not reach consensus, so its place in the assessment remains unclear. The Delphi process checked content relevance, not whether scores are reliable, responsive, or useful for predicting handwriting outcomes. Some round two questions combined speed and legibility. This made it difficult to interpret consensus for each domain separately. The proposed additions and scoring changes are recommendations for a future version, not changes already made to the free HAB-v6.
Declared interests
One author is an original developer of the HAB. The tool is freely available online, and the paper reports no patent or financial gain.
The easy way to misread this
Do not read the consensus ratings as proof that the HAB-v6 improves handwriting after ABI. This was expert opinion about assessment content, not a tested intervention.