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Monday 20 November 2017
Derbyshire Healthcare NHS Foundation Trust
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Encouraging use of the affected hand 

Trying to get a child to use their affected hand when the non-affected one is so much more efficient is difficult and they need a lot of encouragement. However, if the child’s function in that hand is to improve, they must be encouraged to use it and practice certain difficult movements.

Consistency works best and setting out basic ground rules as early as possible is advisable.

Activities:

  1. When carrying the child, hold them so their non-affected arm is against the adult so that they have to use their affected hand to reach for people / toys etc.
  2. Hold the affected hand whilst offering objects to the non-affected hand, let go once you have done this and allow the child to transfer the object to their non-affected hand to save frustration.
  3. Put bracelets, hair scrunchies, mittens, socks, over the non-affected hand and leave them on for the child to pull of with their affected hand when they are ready.
  4. Stick stickers on the back of the non-affected hand for the child to pull off with the affected hand.
  5. Draw little faces on the palm of the affected hand for him to look at. Or, draw the faces on the finger-tips.
  6. Always give biscuits or any finger food to the child’s affected hand. You may have to take the hand and place the biscuit in it at first but should expect him to begin to reach for it. If the food is not crumbly hold his non-affected hand and encourage him to take the food to his mouth with his affected hand.
  7. Make turn taking rules during one to one play i.e. “This hand’s turn first, now this hand’s turn”.
  8. Play “give me games”, encouraging the child to reach out and put a toy into your hand or take a toy from your hand. Allow the child to turn take with the hands and the adult should do the same with theirs.

 

Encouraging Opening and Shutting of the Hand

  • Some children need to be taught this and you will need to physically help them to begin with when encouraging use of the affected hand.
  • Dropping the wrist so it is bent down will straighten the fingers and help the hand open.
  • Lifting the wrist so it is extended will tighten the fingers for a good grasp.

 

Using Two hands

This can be quite difficult to encourage as children soon learn to cope with just one hand, and in the early years when play and daily activities are quite simple, they do not experience the frustrations of not being able to use two hands as much as older children.

Some of the ideas below may help overcome these difficulties for part of the day and make two - handed use more natural and fun! (If your child is not using two hands at all, start with the activities below which encourage use of the two arms such as clapping and ball games).

Activities:

  • Start with games / songs which encourage the use of 2 hands together such as “pat – a cake”, “lets all clap together”, “wind the bobbin” etc.
  • Give large toys which cannot be picked up with one hand or one hand and teeth i.e. Playing with large dolls/teddies. These also include toys with no parts jutting out from them, toys to push, toys with an inside which can be explored etc. Boxes and paper bags are quite good.
  • Banging things together such as bricks, pot lids or musical instruments such as cymbals.
  • Swimming.
  • Obstacle courses in soft play environments where two hands are needed for balance. Give things to the child which are likely to need the use of two hands i.e. beakers rather than cups with handles.


N.B. Try to avoid holding objects for the child unless they are really not going to achieve the task after first making an attempt to do so.