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. The classification is determined based on observations from a person who knows the child well. It takes into account how children use their hands in tandem rather than separately.

MACS provides a more fine distinction than other categorizations of mild, moderate, and severe impairment of hand function. 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 MACS scale is divided into five levels (2):

1. Handles objects easily and successfully; limitations in hand movements only apparent in speed and accuracy.
2. Handles objects, but with somewhat reduced quality and/or speed of achievement; certain activities are difficult, but more can be done independently.
3. Handles objects with difficulty; needs help to prepare and/or modify activities; slow and inaccurate performance of activities when trying them independently.
4. Handles a limited selection of easily-managed objects in adapted situations; completes parts of activities with limitations, requires support and assistance.
5. Does not handle objects and has severely limited ability to perform even simple actions; needs assistance for all activities.

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.

The attorneys at ABC Law Centers: Birth Injury Lawyers have devoted their careers to ensuring that children with cerebral palsy and their caregivers obtain proper financial compensation if their cerebral palsy was caused by medical negligence around the time of birth (a birth injury). 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.

• Cerebral palsy (CP)
• What tests are used to diagnose cerebral palsy?
• Treatments and therapies for cerebral palsy
• What causes cerebral palsy?

1. Manual Ability Classification System for children with cerebral palsy 4-18 years. (n.d.). Retrieved July 19, 2019, from http://www.macs.nu/
2. MACS Manual Ability Classification System for Children with Cerebral Palsy 4-18 Years[Pamphlet]. (2010). Http://www.macs.nu/files/MACS_English_2010.pdf.