Which Hand??

Many parents become concerned when their child enters preschool and does not have well-established hand dominance. Hand dominance may be present as early as age 3-4 but may not be fully established until age 7. It is never a good idea to pick a dominant hand for the child and encourage that he or she perform all tasks solely with that hand. The following developmental stages help a child to develop hand dominance. These stages include: • Symmetrical bilateral integration – using both arms/hands to perform the same action at the same time such as pushing, pulling, clapping, etc. • Reciprocal bilateral integration – when one arm is doing the exact opposite of the other arm such as when crawling, or when the arms swing when walking, climbing, etc. • Asymmetrical Bilateral Integration – when the arms/hands are performing two different actions at the same time such as when stringing beads, screwing nuts and bolts, lacing string, etc. This stage is the beginning of one hand learning to be more of the “helper hand” and one hand becoming more of the “worker or dominant hand”.

Often we have to work with children at one of these stages or level of development in order to help facilitate the development of a dominant hand. Sometimes a child may be delayed in passing through these stages due to issues other than just maturity. Some children may not have enough upper body strength yet which may account for why the child tends to switch hands continuously when engaged in a task such as coloring due to fatigue or limited endurance.

Some children may not have developed the ability to cross the midline of their body, which is can be due to limited balance. If the crayon is on their left side they will pick up the crayon with their left hand and begin coloring. If the crayon is on their right side they will do the same thing with their right hand.  Sometimes we may have a child wheelbarrow walk or engaged in a bilateral fine motor task while swinging on a platform swing or sitting on the therapy ball or laying on his/her tummy depending on his/her need. Pinpointing the cause for lack of hand dominance helps to determine the appropriate intervention.

What you can do:  Present any items that a child might be playing with at the midline or center of his or her body, then whatever hand he or she uses to pick up that item try to hand them use it until they put the item down, then present the second time again at midline and see what happens.