Seeking Ideas for Child with no Clear Hand Dominance

Hand dominanceRobin, OT, posts:

DEAR ERI COMMUNITY: Help please! I am working with a 5 soon to be 6 (may 25) kindergarten student. Despite the many academic challenges he faces he clearly has no established dominance . Based upon all my observations he is equally efficient with both hands when it comes to handwriting (which is poor as one would expect).He does not demonstrate any lower extremity dominance either . I am very unclear as to how to proceed with use of writing tools. Based upon a recent observation when drawing a family portrait(again very immature) he started all but 2 of his 6 pics with his left hand but in all 6 switched to his right hand. This happens consistently, but sometimes he starts with his right hand. Any suggestions, resources would be greatly appreciated!! I am really worried about this little guy. He is in half day AM kindergarten now with PM in sub separate , going to 1st grade in Sept.

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9 Responses to Seeking Ideas for Child with no Clear Hand Dominance

  1. Amanda says:

    Try using cross crawl exercises, crossing midline activities, upper extremity weight bearing (I have them in a hands/knees creeping position usually to complete a quick FM task), and FM tasks while prone. Hope this helps!

  2. nancy says:

    I often come across this with my students. I watch them during their functional daily tasks, esp feeding to see watch hand they start with, which one they use for utensils and finger foods. When they play with items which hand is primary. Then I know which hand to focus on for school related tasks writing/cutting. I hope this helps.

  3. Brooke Thomas says:

    I would start by checking if the child is able to cross midline in both directions and efficiently (no compensating with turning their body). I would also have the child complete bi-manual activities such as wind up toys where one hand is the worker hand and one is the stability hand and see if there is a pattern to what they prefer. Also, when the child is writing I would always present the writing utensil at midline and have the child choose what hand they are going to use. Have them stick with that hand throughout a task is order to build up enough strength and not need to switch. There is a great website that have lots of articles and pictures for this topic. Here it is:

    Hope this helps!

  4. Dolores Cook, C.O.T.A. says:

    I went to 2 seminars in the past week. At both seminars, the lecturers said that nowadays, hand dominance is not definitive until 7 years of age. I couldn’t believe what I was hearing. When I went back to work on Monday, I relayed this information to two of our new graduate O.T.Rs. They both informed me that was what they were taught. I also treat a child that uses both hands equally well during writing tasks. He will be going into kindergarten in September, and I worry for him, as you worry for your boy, too. I’m sorry I can’t be of more help to you. If you find an answer to your problem, please email me with the solution. Thank you.

  5. Mary Ann laielli says:

    Good morning. In reply to your inquiry about hand dominance, does this child readily and easily cross midline? Is the child frequently shifting positions in the chair to keep a paper on one side of the body or the other? This could be an indicator that he/she is not crossing midline. When presenting any writing implements or objects, always offer them at midline and track which hand is used more often to pick them up. Then, facilitate that emerging dominance. Hope this helps.

  6. Mandy says:

    Comment from Andria
    I was just wondering which hand the little guy eats with? That may give an indication to dominance. Also, have you tested eye dominance? We have to remember that true dominance isn’t actually solidified until 6 yo and he may be delayed.

    Practicing for 15 years
    Graduated from Columbia University with a Masters of Science degree

  7. Nancy S says:

    I agree with the other people that have posted answers about working on midline crossing and activities like cross crawling or other brain gym activities. I would add that I would really work on heavy work proprioceptive activities so he feels his own body well enough that he can make an informed decision on which hand is more skilled. I also would carefully check his muscle tone on the two sides by comparing how much range of motion he has in external rotation at the shoulders. The arm with less rotation and therefore more tone is usually the side that should be dominant. I also agree that not everyone has dominance established at that age.

  8. Mandy says:

    Comment from Linda:
    I am a PT so this is not exactly up my alley but I have a thought. If he is generally weak, that could be the reason he is switching so much so I would try some general bilateral strengthening exercise. My thinking is that once his strength has improved enough, he will chose a dominant side. Try some kid yoga exercises where he is weight bearing into his hands. I often try to get low tone kids to move through 3 different yoga moves fluidly repeating each one 3 times. Throwing a weighted ball or just placing it from the floor onto a high mat above the childs head. Just some ideas. Good luck

  9. robin says:

    I wanted to thank everyone for their helpful comments. I tried paying special attention to self feeding. Imagine my surprize when I was observing him eating cafeteria lunch(rigatoni and chicken parm) with his fingers!!! he refused to use a utensil. However he did seem to prefer his left hand. I also set him up with pretzel snacks. One at a time at his midline. Literally split, 50/50, right and left. Sometimes he would reach with both hands.I hadn’t considered that overall strength or diminished upper body strength might also play a part, so that idea is helpful. Can someone tell me the best way to evaluate eye dominance?. He is going to be 6 on May 25th and is about as far away from showing a preference, never mind a dominance.
    Thanks again for everyone’s help, it is greatly appreciated.

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