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Typical Hand Development
Four to six month old babies gradually develop skills to bring their hands toward the midline or center of the body to playfully clasp them together. The “midline" is an imaginary vertical line running down the center of the body dividing it into right and left halves. Between six and nine months of age babies typically bring the hands together to manipulate toys, clap, reach with one hand across the body’s midline and transfer toys. This progression of hand skills leads to the gradual development of a hand preference and abilities to learn complex fine-motor skills such as coloring or cutting with scissors.
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Promote Crossing Midline
Children with disabilities may avoid crossing midline (CML). A child might pick up an object with the hand closest to it and then transfer it to the other hand for use. This is one sign of a possible sensory integration disorder that may interfere with developing coordination. Parents and teachers can promote developing hand preference in special needs children by helping them CML during gross and fine motor activities such as the following:
- Provide a box of bean bags placed on the right side of the child to toss into a box placed on the floor near the left side. Then reverse sides so that the child tosses with the left hand toward the right.
- Play games where children imitate body postures that CML such as touching right hand to left ear, left hand to right foot, right hand to left hip etc.
- Scatter cards on the table-asking the child to line them up in numerical order with the right hand. Then repeat with the left hand.
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Promote Bilateral Hand Skills
One of the best way to promote developing hand preference in special needs children or any child is to present materials at midline and provide activities such as the following that require using both hands together:
- Propelling a scooter board with hands
- Crawling through tunnels
- Wheel barrel walking (hands are on floor with ankles held)
- Toss large balls, bags or other objects
- Using heavy or large objects such as sand bags made out of long socks that are too difficult to grasp with only one hand
- Hand activities that require force such as building with clay
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Activities to Promote Skill in One Hand
Encourage older children (five years and older) to think about which hand seems to do a better job during activities such as spreading jam on bread or writing and encourage using that same hand consistently. Resistive activities that take force such as connecting a building brick onto a tower or mixing cake batter are great because they provide sensory feedback. Provide lots of other activities such as the following that require stabilizing with one hand. This will help children determine which hand they prefer using for skilled tasks:
- Pushing eyes, nose and mouth on Mr. Potato Head
- Removing stickers from backings
- Lacing boards, nesting cups and stringing beads.
Given encouragement to engage in lots of activities that promote using both hands, crossing midline and stabilization with one hand-children with autism and other developmental disabilities may develop the abilities to stabilize paper with the non-preferred hand during the years of increasingly complex paper and pencil tasks.