Manual Ability Classification System (MACS) for Cerebral Palsy

The Manual Ability Classification System (MACS) is a method of classifying how well children with cerebral palsy can use their hands to manipulate objects in the course of day-to-day activities. It should not be used as a stand-in for maximal performance. The scale takes into account how children use their hands in tandem rather than separately.

The MACS seeks to take into account clinically significant distinctions in manual ability in order to provide clear delineations between the tasks that a child can accomplish in everyday life. MACS provides more fine distinction than prior categorizations of mild, moderate and severe impairment. The aim of this classification was to create a metric similar to the Gross Motor Function Classification System (GMFCS), but specifically for hand movement.

Developing a scale for hand function is important for two reasons. The first of these is the complex nature of hand function. Hand function is influenced by considerations such as sensorimotor components, cognition, postural control, visual acuity and motivation. The MACS scale does not try to quantify these underlying factors, but merely to assess how well they work together as a whole. Secondly, hand use is critical for a child’s independence in daily life, at school and during recreation.

The developers of the Manual Ability Classification System have developed numerous MACS resources, including an informational leaflet and a simple flowchart for classification. More information about the system can be found on the MACS website.


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The attorneys at ABC Law Centers Reiter & Walsh, P.C. have devoted their careers to ensuring that children with cerebral palsy and their caregivers obtain proper financial recompense for the medical negligence that caused their cerebral palsy. The firm takes the stance that these errors are preventable, and those who committed errors that led to harm must be held accountable for their mistakes. Our firm has focused only on birth injury and cerebral palsy cases since attorney Jesse Reiter began practicing law in 1987. We have won many cases for our clients, and we hope that you will contact us if you believe you have a case. We are reachable 24 hours a day, 7 days a week via phone at 1-888-419-2229, live chat (as seen to the tab on the left side of this screen) and via our online contact form here.