Hand dominance is a concern often identified by caregivers and teachers in referrals for occupational therapy.
They ask when should they worry? What should they do to encourage development? Should they pick one hand and push their child to use it? Of course there is no single answer, as every child is an individual developing at his or her own rate.
In general, dominance usually develops anywhere from the age of three to about six and a half years, although preference may be seen emerging in the younger years. Left handedness occurs in approximately 10 per cent of the population.
It is also not uncommon for children to switch hands during tasks while dominance is developing.
This can occur for many reasons: experimentation, fatigue, tool placement or difficulties completing movements that cross over the middle of their body. The ability to cross midline typically develops at a young age, so if you are noting challenges in this area it would be advisable to seek out the support of your health care provider.
Additionally, 16 per cent of us have cross laterality; meaning hand, eye, foot and ear dominance may be mixed between sides of the body. Don't assume that a child's hand dominance will coincidence with other dominances.
There are many ways to facilitate the development of hand dominance. Firstly start with ensuring the child is seated at an appropriate sized table or desk allowing a good base of support.
Secondly follow two general rules:
1. Place the item to be used at midline. Do not force a child to use a certain hand
2. Allow the child to use the item with whichever hand or foot they like. With experience and repeated exposure, the child will begin using the hand or foot that is most successful and efficient for them.
It is also important to be conscious of the items we give them to use. For example, ensure that you use universal scissors if your child is demonstrating a possible left preference. Using right-handed scissors is more difficult for a lefty because the orientation of the blades makes snipping very difficult and blocks vision.
Infuse daily routines with as many two-handed tasks as possible to encourage discovery of hand dominance, learn to use the hands together while performing different tasks and to stabilize objects. Remind the child to use their "helping hand."
Play ball games, rip paper, string beads, cereal and pasta, build with blocks and Lego, play with toy tools and play dough. Also encourage bilateral use in other aspects of the daily routine including fastening zippers and buttons, stirring and pouring activities in the bathtub, sandbox or kitchen.
It is important to note that some children face additional challenges or disabilities and dominance may not emerge in a typical manner. In this case consider consulting your child's physician, as well as your child's occupational therapist for further assessment and recommendations supporting the development of functional skills.
