SCPE tools, reference documents and classifications

The GMFCS, BFMF, MACS, MRICS, Viking Speech Scale, among others are considered to be key elements in the description of a child with CP:

  • Motor development using GMFCS criteria for gross motor function grading, BFMF and/or MACS criteria for functional grading of the upper limbs
  • Cognitive development according to IQ and ICD10 codes
  • Communication according to Viking Speech Scale
  • Visual and hearing functions
  • Epilepsy


Gross Motor Function Classification System (GMFCS)

The GMFCS describes functional abilities, the need for mobility devices and to a lesser extent quality of movement.

Bimanual Fine Motor Function (BFMF)

BFMF is a scoring system for fine motor function. It is an assessment which takes into account symmetrical or asymmetrical involvement of the upper limbs. It can be obtained directly or retrospectively out of medical records.

Manual Ability Classification System (MACS)

The MACS system reports the participation of both hands in different activities. It is obtained through direct clinical examination and only with difficulty retrospectively.

MRI classification system (MRICS)

The MRI classification system (MRICS) was developed to harmonize classification of magnetic resonance imaging (MRI), based on pathogenic patterns as proposed by the SCPE network. (Link to RTM MRI manual coming soon!)

More information is available in the SCPE MRICS article:
Himmelmann K et al. (2017), MRI classification system (MRICS) for children with cerebral palsy: development, reliability, and recommendations. Dev Med Child Neurol, 59: 57-64, doi:10.1111/dmcn.13166.

Viking Speech Scale (VSS)

The VSS has been developed to classify children’s speech production. The ease with which children can make themselves understood using other methods of communication is scored using different scales.

I. Speech is not affected by motor disorder.

II. Speech is imprecise but usually understandable to unfamiliar listeners.

Loudness of speech is adequate for one to one conversation. Voice may be breathy or harsh sounding but does not impair intelligibility. Articulation is imprecise; most consonants are produced, but deterioration is noticeable in longer utterances. Although difficulties are noticeable, speech is usually understandable to unfamiliar listeners out of context.

III. Speech is unclear and not usually understandable to unfamiliar listeners out of context.

Difficulties controlling breathing for speech – can produce one word per utterance and/or speech is sometimes too loud or too quiet to be understood. Voice may be harsh sounding; pitch may change suddenly. Speech may be markedly hyper nasal. A very small range of consonants are produced. The severity of the difficulties makes the speech difficult to understand out of context.

IV. No understandable speech.


How to score: to score children’s usual speech performance i.e. what they usually do, not what they can do.

Score the level to which children are understandable to strangers and unfamiliar conversation partners. People familiar with the children (e.g. parents, teachers) will have "tuned in" to children’s speech, recognise words because of their repeated use in context and may understand the children better than most other listeners.