Tag Archives: hand dominance

Taping The Paper To The Table For Your Child? Stop!

Many young children between 2 and 5, especially children with low muscle tone or postural instability, will struggle with bilateral control.  In preschool, one way to notice this is to see the paper sliding around the table while a child colors.  The common response of teachers (and parents) is to tape the paper down.  Oops!  This  eliminates any demand for both hands to work together.  Bilateral control only develops if it is needed and practiced.

The better approach, the one that makes the brain work and builds a child’s skills, is to make it even more slippery while making the activity more fun.

Why?  This child,’s brain, as described, needs more information about what is going wrong with the activity.  You can use heavier paper, stickers in a book that need accurate placement, or fun glittery markers.  Really, anything that makes a child care more about placing marks accurately.   I select the smoothest table surface available.  Glass coffee tables are a fave at home.  The alternate choice is a bumpy surface, something that will be slightly uneven and make the paper move more with each stroke.

I have some older kids that really struggle but can use a visual cue.  I make a mark on their paper and tell them to put their “helper hand” – the one not coloring- on this mark.  This is sometimes helpful, but it is limiting the extent that this hand is providing optimal postural support.

Yup, support.  The hand that holds the paper is also performing another function.  It is stabilizing the child’s body so that the dominant hand can execute a skilled movement.

So….no more tape on that paper, OK?

Is My Child Right or Left-Handed? How Handedness Emerges, And How You Can Influence Development

 

Wok and Roll!

Playing Wok ‘n Roll with Edison Chopsticks!

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!

 

Is My Child Ambidextrous?

I answer this question from parents about once a month, on average.  Here is the better question: Is my child developing age-appropriate grasp?

The statistics are against your child being ambidextrous:  only about 1% of people are truly ambidextrous.  Being able to hit a ball equally well with either arm is valued on a team, but when they sit down for supper, switch hitters probably don’t use both hands equally to twirl their spaghetti.  But….children who have poor core stability often do not reach across the center of their body and switch hands to reach what they need.  Children who have motor planning or strength/stability issues will switch hands if the become fatigued or frustrated. None of these children are truly ambidextrous. They are compensating for delays and deficits.

Studies I have read on the development of normal hand dominance suggests that some children are seen as having emerging hand dominance (consistent and skilled use of one hand rather than the other) as early as 12 months.  You know those kids; they pick up cereal bits with their thumb and index finger at 9 months and pop them into their mouths individually as if they were sitting at a bar with a bowl of peanuts and a beer!  They delicately hand you the bit of string they found while crawling, and are already trying to unzip your purse.  Those kids.  It is more common to see emerging hand dominance in the 18-24 month range.  Developmental issues often delay this progression, and issues such as cerebral palsy can result in a child whose neurology would be expressed as right-dominant requiring more left-dominance due to hemiplegia.  That’s right:  hand dominance is biological, not learned, and very likely inherited to some degree.

IMG_0934

terrific safe scissors for little hands!

In my professional career, the greatest predictor of age-appropriate grasping skills has been not core stability or even muscle tone, but exposure and interest.  I work with a child that is legally blind since birth, and his grasping skills are very delayed.  His exposure is biologically limited.  He cannot see what his fingertips are doing, and since he has some vision, he is not doing what totally blind children usually do. They increase their tactile exploration of objects because they don’t have any visual information, and in doing so, end up with generally good refined grasp and control.  This child has slowly developed his skills with carefully chosen and strongly emphasized activities in therapy.

Low muscle tone makes it difficult for infants to develop effective opposition, the rotation and bending of the tip of the thumb opposite to the tip of the index finger.  It is common to see opposition to the tip of the middle finger.  The stability offered by that finger’s placement between two fingers at knuckle-level, plus less rotation needed, explain that quite clearly.  Sadly, the middle finger doesn’t have the refined movement of the index finger, so control is lacking.  They tend to use a fist for gripping toys, and often end up dropping or breaking their goldfish crackers.  These kids often actively dislike using their hands in a skilled manner.  “Read me a book or let me run around” rather than “Give me tiny snacks and beads to string”.  If it is true pattern of avoidance and frustration, it isn’t simply a preference.  It’s an issue.

Wok and Roll!

Playing Wok ‘n Roll with Edison Chopsticks!

How can parents support the development of hand skills at all ages?

  • Infants under 12 months:  Provide safe and desirable things to pick up.  Bits of food that aren’t choking hazards.  Toys with tags firmly sewn on.  Toys with parts that spin and have textures to explore.  Show your interest and delight in this exploration.
  • Toddlers:  Even more opportunities and enthusiasm.  Let them scribble on magnetic boards, use food as fingerpaint, and introduce utensils as early as safe.  Us lots of containers that need to be opened, closed and held for filling and emptying.  Check out Easy Ways To Build Bilateral Hand Coordination for Writing for more ideas.
  • Preschoolers:  Don’t tape down that paper!  Teach the  use of the “helper hand” Better Posture and More Legible Writing With A “Helper Hand” if it isn’t being used, and double-down on toys that require both hands.

What are your best methods for refining grasp and dominance?  All you teachers, therapists and parents out there, please comment and add your ideas!