Quality of Upper Extremity Skills Test (QUEST)

The QUEST looks at how a child with cerebral palsy moves their arms and hands — not what tasks they can complete, but the quality of the movement itself. That focus is deliberate: a child can get a toy to their mouth using a pattern that will not carry them further, and a task-completion measure would miss that.

Four domains are observed during play. Dissociated movement asks whether the child can move one joint independently of another rather than in a whole-limb pattern. Grasp covers how objects are held. Protective extension covers whether the arms come out to catch a fall. Weight bearing covers propping and pushing up. Each domain converts to a percentage, and the four average into a total from 0 to 100.

• Shirley Ryan Ability Lab Overview

Licensing Notes: Published by CanChild. Use requires accepting a license agreement, governed by the laws of Ontario, with ownership retained by McMaster.

Learn More: Domains can be administered selectively — clinical convention allows omitting weight bearing or protective extension when a child's gross motor limitations mean the items cannot be attempted, and the total is averaged over the domains actually given. The reported minimal clinically important difference is 4.89 points on any domain.