Format looks good. Keep the font style and size the same in the header as the rest of the paper, and use the words Running head on the title page. Title in the header should be all in CAPS.

The Pediatric Motor Activity Log-Revised:
Assessing Real World Arm Use in Children With Cerebral Palsy
A Literary Review
Mariah Nichols
Psychology 232-01
J. Whitaker
October 27, 2013

Uswatte at el. (Use all the authors names the first time and always include the date) set out to improve, and find the accuracy, of the Pediatric Motor Activity Log-Revised (PMAL-R) when compared to other measurements, such as the Motor Activity Log (MAL), used on adults. The MAL has patients rate their ability to perform 30 activities, designed for use of the upper extremities, with the arm that is more affected. The MAL tends to be more accurate because the patient is reporting the usage versus the caregiver that gives the report in the PMAL-R. “. . .four developments have contributed to the generation of methods for assessing activity of an impaired upper extremity in daily life” (p 149). Constraint-Induced Movement Therapy (CIMT) supports the movement of upper limbs to help improve arm use. CIMT has been proven to be more beneficial than compensatory tactics, and patients using CIMT have shown greater brain plasticity (include name and date, p. 149).
The researchers here wanted to interview the participants in person rather than via a paper survey. This is the way the test was meant to be performed, and they felt as though it would prove to be more accurate. The main goal of this article was to study the convergent validity, the test-retest reliability, and various characteristics of the PMAL-R in children with upper extremity hemiparesis due to CP. Good.
Uswatte et al. had 60 participants in age range from 2-8 years with upper extremity paresis due to CP. They were split up into three main categories. The first was the CIMT Randomized Control Trial (RCT). This group received 6.5 hours of therapy for a total of 15 days, except for the ones put into the control group. The second group was the CIMT Dose-Response Trial where one group of children received 3.5 hours of therapy for 15 weekdays, and the other receives 3.5 hours for 10 weekdays. The third group was the PMAL-R Test-Retest Study where participants received no CIMT between the times the two tests were given. This can be seen in Figure 1 (p 150). Well described.
Guardians of the children rated the children on how well and how often their child could use the more affected arm in accomplishing the 22 tasks listed in the PMAL-R. The HW, or how well, scale was used in measuring the responses. It is referred to as the Arm Use Scale in this research (p 154). This scale was most appropriate because the participants had their less affected arm put in a cast, in order to assure that the child would use the more affected hand. The Pediatric Arm Function Test (PAFT) was also used because it better shows the use of a child’s more affected arm in daily activities. Although it is performed in a lab, the children are not influenced on which arm they are to use during each activity. It should be noted that each test given or performed was video taped to help insure accuracy of the data later recorded. Some items were dropped from calculation in a score when the activity, “[was] physically impossible for a child to do, never carried out in their family, or developmentally inappropriate . . .” (Uswatte et al., 2012). Very good. New paragraph (NP). The mean for the control group did not change between the first and second test given in either the PMAL-R Arm Use scale or the PAFT Limp Preference scale. The mean change for the CIMT group in the PMAL-R was 2.2, and for the PAFT was 27. What was the mean before? These numbers are more meaningful when we something to compare to. Research was also done using a three step PMAL-R instead of the original six, this being done because the six-step structure was thought of as dysfunctional. This was probably due to the way in which it was administered, by paper survey.
Results showed that the original PMAL-R with six steps is stable, accurate, and reliable, which contradicts the original thoughts of Wallen (p 150). However, the PMAL-R with three steps very closely mocked the original. A strong correlation was found between change on the PMAL-R and the PAFT after CIMT. Measuring real world changes using the PMAL-R was valid, but the same is not true for measuring absolute levels of real world more affected arm use. Uswatte at el. say that a possible explanation for this could be, “parents had similar sensitivity to the relative amount of change in arm use due to treatment, but did not share a common frame of reference for rating arm use at baseline” (p 155). Very important observation and potential limitation.
Several listed limitations are given in this particular article. The control group had better use of their more affected arm than children in the CIMT group at the start of Test 1. Another limitation is that the PAFT doesn’t directly measure the use of the more affected arm in daily life. The PAFT was chosen because the limitations were comparatively better than that of the Assisting Hand Assessment (AHA). In the AHA, “tests of motor capacity overestimate spontaneous use of the more affected upper extremity” (Uswatte et al. 2012). This is why the researchers decided the PAFT was a better choice. The authors’ think it would be important to assess how scores on new instruments that become available compare to those of the PMAL-R. Very good.
The study itself wasn’t equally representative. Most of the participants were female, and most were also European Americans. Many studies have shown that development in males and females differ. The same can be said based on genetics in different ethnicities. Also, only 60 participants were apart of this study from around the same area. It couldn’t possibly give a large enough representation. Very good points regarding gender and ethnicity. This would warrant further studies.
The measures used in this study were accurate. Several measures were used to confirm convergence and accuracy. Data was altered when a participant wasn’t able to perform takes due to lack of previous experience or being physically, or developmentally, unable to complete a task. This allows the tests to better judge how well the children actually use their more affected arm in daily life, because they are not penalized for things they cannot do. Good.
The figures and tables provided were very helpful to the reader. They provided more information to the reader, and help the audience view the already stated information in a more solid way. Explanations of processes and methods used made the article simpler to sort through. The information provided shows that the PMAL-R can be used as a solid reference point for future measures that seek to do similar things.
Overall, this article was well written, presented a vast amount of information that was easy to read, and demonstrated research that could be valuable to the field. The information was organized, and the statistics explained in better detail through use of tables and charts. It was very interesting to read through. Anyone interested in learning how children with upper extremity hemiparesis due to cerebral palsy are tested should read this article. Great.

Reference:
Barman, B., Griffin, A., Rowe, J., Taub, E., Uswatte, G., Vogtle, L. (2012). The Pediatric Motor Activity Log-Revised: Assessing Real-World Arm Use in Children With Cerebral Palsy. Rehabilitation Psychology, 57(2), 149-158. doi:10.1037/a0028516