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HAT Clinician Education Videos

Welcome to the Hypertonia Assessment Tool (HAT) eLearning platform. Within this educational tool, you will find short videos that demonstrate how to administer and score the HAT using positive case examples.

A login is not required to access the eLearning platform. However, we recommend that you download the HAT User Manual before watching the videos.The HAT Manual can be downloaded from Flintbox.

HAT Educational Videos

Hat Administration

Before Administrating the HAT:
  1. Children should be between 4 to 19 years of age and have hypertonia (increased resistance to passive stretch of the muscle) in at least one limb.
  2. Determine the limb you will be assessing (you can assess all limbs with hypertonia, but do each limb separately and generate a HAT score for each limb).
  3. The child/youth should be supine on the examining table in comfortable, unrestrictive clothing with their hand or foot of the limb you are examining bare (e.g. out of splints and socks). If possible, their hands should be placed gently on their upper abdomen.
  4. Place a roll under the child’s knees and a pillow under the child’s head.

Hypertonia Logo         CP Net logo

Administration of the HAT:

NOTE: Complete ALL 7 items on one extremity before moving to the next hypertonic extremity. It usually takes less than five minutes to complete the HAT assessment on one limb. Items are listed in the suggested order of administration.

Scoring of the HAT:

The HAT consists of seven items in total: 2 spasticity items, 2 rigidity items and 3 dystonia items. Each item is scored using a yes/no format. The presence of at least one item of the subgroup confirms the presence of the subtype of hypertonia and the presence of items from more than one subgroup identifies the presence of mixed tone.

We would like to thank Dr. Anne Kawamura, Dr. Shauna Kingsnorth, Ashleigh Townley, Dr. Darcy Fehlings and Lauren Switzer for their support in developing this educational tool. Additionally, we would like to thank our sponsoring institution, Holland Bloorview Kids Rehabilitation Hospital; our research funders, Holland Bloorview Kids Rehabilitation Hospital Foundation and the National Institutes of Health; and our eLearning Platform funders CP-NET, in partnership with the Ontario Brain Institute.

We value your feedback! Please address all correspondence and commentary about the HAT tool to:

Dr. Darcy Fehlings
Holland Bloorview Kids Rehabilitation Hospital
150 Kilgour Road
Toronto, ON, Canada M4G 1R8

The HAT was developed by: Fehlings, D., Switzer, L., Jethwa, A., Mink, J., Macarthur, C., Knights, S., & Fehlings, T.