Parents can get worried about a lot of things, and slow development of a dominant hand is one of them. Therapists get worried about things too, but the development of dominance is usually not one of them. Except in one situation. And parents can make a bigger impact than they think.
It is generally accepted that handedness is assigned by the brain during fetal development, so most children don’t actively choose which hand they will be using for skilled tasks such as writing. Hand dominance can start to emerge by 12 months in typically-developing infants, but is most commonly seen during the 18-24 month stage. This is when a child learns to use utensils independently for meals and eagerly scribbles with crayons. Children are copying adult actions, and becoming more interested in opening, closing and manipulating small objects that require a dominant hand.
In my career, I have only worked with one child that did not demonstrate clear hand dominance by the age of 5, even after years of therapy. He was an engaging but extensively neurologically-challenged child. His brain may not have had the “hard-wiring” for dominance. His parents chose to train him to be right-handed around 7, and he did become more skilled with his right hand. I tell most concerned parents that their preschooler is likely to develop a dominant hand with targeted activities and daily play that supports it’s emergence.
Then there are the children who have major motor or orthopedic challenges from birth. Brain injury, limb loss, or atypical development of a limb may mean that a child has only one hand that can be effectively used for feeding or writing. This may not be the hand that the brain is wired to select for dominance. A child with these challenges might have to work harder to develop hand skills. Every time he picks up objects, feeds himself a meal, or puts on clothes, he is re-wiring his brain for refined and automatic use of that hand. Parents of children with these challenges should be concerned about mobility, strength, and posture, but effective development of the less-affected or unaffected hand as the dominant side is going to happen with good therapy and lots of practice.
When do I worry?
I get the most concerned with children that actively avoid or aren’t encouraged to participate in the typical play and self-care skills that develop hand control. When I see a 3 year-old child being fed because it is faster and neater for the adult, or watch an adult drawing a truck while a preschooler watches passively, or I see a toddler stand still in front of the TV while being dressed, then I get nervous.
Sometimes it is just easier to feed and dress a child when they are slow or resistant. I hardly ever hear a parent (that is not a Montessori teacher) say that they created a game in which their child had to work to figure something out. Some children are born with a persistent drive, and work hard in the face of a challenge. Most don’t. And some parents don’t realize that holding a bag open during “clean up” is depriving their child of the opportunity to build coordination skills, as well as self-confidence and independence. Sure, it takes longer to pick up all those LEGOs, but building a brain takes time.
If children are not actively encouraged and rewarded for participation, and given great tools that make it fun to work on these skills, they will not have the necessary experiences that train the brain.
If you are worried that your child isn’t showing the emergence of a dominant hand, try creating more and better opportunities. Watch which hand your child prefers for skilled control. That is likely to be the hand she will be writing with in the next few years!