How to Promote Bilateral Hand Skills

What are Bilateral Hand Skills?

Bilateral means both sides. Between 3 and 6 months of age babies develop the abilities to bring their right and left hands toward the middle of the body so that they can touch or clasp. This is the beginning of bilateral hand skills. Of course, these skills further develop as babies learn to clap, hold objects with both hands and stabilize an object such as a ring stack while placing a ring on top.

Prepare babies to use hands together by

  • positioning baby on her side using a cushion. This makes it easier to bring the hands together
  • offering objects from baby's left and right sides- alternating to promote body awareness.
  • positioning to put weight on both hands so that baby receives heavy pressure sensory stimulation (as shown in the photo above)
  • attaching auditory wrist toys and move baby's hands together and apart while listening to sounds
  • assisting baby to grasp a sensory object such as a vibrating tube with both hands

When a Child Uses only One Hand.....

A child may avoid using one side of the body or one hand due to a nerve injury such as Erb's Palsy that occurs during birth or a brain disorder such as stroke or cerebral palsy.  In addition, children with a sensory processing disorder (SPD) may avoid

  • stabilizing toys with one hand while manipulating them
  • crossing midline.
  • have decreased muscle tone,  hand strength and coordination-often seen in children with dyspraxia

Consult with your physician who may recommend an occupational and/or physical therapy assessment.

Adapting Activities to Require Using Hands Together

Its really difficult to do the following unless you use both hands!

  1. Hold onto a handle while squatting on a horse (as shown in above photo)
  2. Pull objects attached with Velcro from a large container or board
  3. Push objects inside a tight container opening
  4. Hold, carry or manipulate large and/or heavy materials.
  5.  Stretch objects apart

The following video demonstrates a client who typically avoids using his left hand. However, he will use it to stabilize the board to remove shapes and then stabilize the container to insert them. 

The young lady shown in the following video is still learning that she needs to stabilize a container in order to insert objects. She is also developing bilateral hand skills as she pulls the plastic pieces apart before inserting them.

Finally, the last video demonstrates a variety of fun activities that may help children or adults to develop bilateral hand skills. I've been making "Velcro Bottles" for over 30 years and they are still my favorite "go-to" activity because clients often love the sound and sensation experienced when ripping Velcro.

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