The Development of Handedness


Handedness is typically described as the consistent and more proficient use of the preferred hand for functional and skilled tasks (Annett cited in Henderson and Pehoski, 2006: 161). There are two aspects to handedness, namely direction and degree. The direction simply refers to whether the person is right- or left-handed, whereas the degree refers to how strongly an individual prefers one hand to the other. It is well-known that left-handers generally display less functional asymmetry compared to right-handers, i.e. left-handers use their preferred hand to a lesser degree (Springer and Deutsch, Yahagi and Kasai in Scharoun and Bryden, 2014: 1). The term “handedness” also includes hand preference and hand performance as two measures of handedness. Hand preference refers to the tendency to perform most tasks with one hand rather than the other. Inherent predisposition to handedness is measured by spontaneous untrained hand use and thus does not necessarily mean that the chosen hand is more efficient. On the other hand, hand performance refers to the greater proficiency of one hand over the other in skilled tasks (Henderson and Pehoski, 2006: 161-162).

Handedness is believed to be associated with cerebral dominance (Case-Smith and O’Brien, 2010: 262; Henderson and Pehoski, 2006: 161). The establishment of handedness is considered to be an important indicator of hemispheric specialisation and callosal myelination necessary for development of motor skills, language, and cognitive processes (Henderson and Pehoski, 2006: 161). Unestablished handedness is associated with developmental delay or even pathological conditions, and at times thought to reflect inadequate hemispheric specialisation (Coren, and Gazzaniga cited in Henderson and Pehoski, 2006: 161). The establishment of handedness is essential for the development of high integrated manual and fine motor coordination that enable successful occupational performance (Henderson and Pehoski, 2006: 162). A child who changes hands during tasks such as writing or drawing will likely not develop optimal skill because the preferred hand will fail to specialise to the necessary proficiency (Hurlock cited in Henderson & Pehoski, 2006: 161).

Case-Smith, J. & O’Brien, J.C. 2010. Occupational Therapy for Children, 6th edition. Missouri: Mosby Elsevier.
Henderson, A. & Pehoski, C. 2006. Hand Function in the Child: Foundations for Remediation. Missouri: Mosby Elsevier.
Scharoun, S.M. & Bryden, P.J. 2014. Hand preference, performance abilities, and hand selection in children. Frontiers in Psychology, 5(82). doi: 10. 3389/fpsyg.2014.00082.

What does research tell us about typical development of handedness?

  • 90% of people are right-handed
  • Genetics influence handedness. It has been shown that there is a greater probability of a child with one left-handed parent becoming left-handed, in comparison to a child with two right-handed parents. However, this does not provide explanations for individual development.
  • Hand preference can be reliably detected from as early as 6-months onwards. However, frequent interchange between right and left hand use is observed throughout infancy.
  • Some researchers suggest that the direction of hand preference is set at age 3 years with the degree increasing between the ages of 3 and 7 years and more gradually until the age of 9 years. However, absolute consensus has not yet been reached on the development of handedness.
  • Young children (3 to 5 years) typically demonstrate weaker, inconsistent hand preference tendencies. This is particularly true for left-handed children.
  • It has been found that between the ages of approximately 6 and 10 years children typically select their preferred hand overwhelmingly, even in situations where it is not biomechanically efficient to do so. This is thought to be due to their learnt experience of which hand is more efficient.
  • An adult-like pattern of handedness emerges between the ages of 10 and 12 years when children learn to be less reliant on their preferred hand and the skill level of the non-preferred hand increases.
  • Experience, learning and practice are key components in refining handedness and in particular an individual’s resulting degree of handedness.
  • There is a relationship between the development of handedness and midline crossing. Midline crossing refers to the ability of an individual to reach across their body midline into the opposite body space.
  • Midline crossing is expected to emerge during infancy as a part of the typical progression of perceptual-motor development. The ability to reach into the opposite body space typically begins to emerge between 18 and 20 weeks. It has also been suggested that this period represents a shift from extracallosal to callosal control of interhemispheric communication. The maturation of the corpus callosum is a required prerequisite for development of hand preference and bilateral coordination. The co-existence of delayed development of handedness, midline crossing and bilateral coordination is well documented.
  • Midline crossing is well established by the age of 2 years, however, reaching into the opposite body space is a skill that gradually improves with age. Various methods of postural compensations are typically observed as young children avoid crossing their body midline during visual-motor tasks.
  • Failure to cross the midline by the age of 3 to 4 years may indicate problems with perceptual-motor development that will manifest later in life.

Scharoun, S.M. & Bryden, P.J. 2014. Hand preference, performance abilities, and hand selection in children. Frontiers in Psychology, 5(82). doi: 10. 3389/fpsyg.2014.00082.

What activities can be done to assist children with difficulty?

1. Encourage bilateral motor activities!!!!

Practising to coordinate the two sides of the body will promote interhemispheric integration. Refer to our Bilateral Integration Home Activity section for gross motor and fine motor activity ideas to promote bilateral integration.

2. Encourage activities that will facilitate midline crossing:

Caution: If you are unsure of a child’s handedness, focus on the activities below that use both hands simultaneously or reciprocally (i.e. one then the other).

  • Passing, catching and throwing games:
    Simple adaptations can be made to encourage midline crossing. Have the children sit cross-legged on the floor to stabilise their hips and legs to allow for their arms and hands to move freely across their midline. Throw the ball or beanbag slightly from the side, so that the child must turn their upper body to reach for the ball. Do this on both sides and gradually increase the angle from which the ball is thrown to allow for increased midline crossing. Similarly, also place containers to the side of the child for target throwing.
  • Pass the Parcel: Traditional “pass the parcel” type games can also be structured to use both hands for reaching and passing to allow for midline crossing. Children can also be positioned back to back whilst sitting cross-legged on the floor and passing the ball to each other.
  • Simon Says: Include movements that require midline crossing.
  • Play sorting games: Place objects to sort on the left side and containers to place them in on the right side: sort coloured objects, pompoms, marbles, shapes, etc.
  • Squirt gun or spray bottle target shooting: Use both hands to trigger the squirt gun or spray bottle and position the targets so that the child is required to cross their midline. Should they adopt postural compensations to avoid midline crossing, adapt the game that they are kneeling or sitting cross-legged in order to stabilise their hips.
  • Cross crawl pattern: Place hand to opposite knee or foot (Typically develops between the ages of 5 and 6.)
  • Clapping games: Include movements that require crossing of the body midline.
  • Floor play: When playing on the floor, encourage the child to lean on one hand or elbow. Place the toys or games on the side being leaned on. This will encourage the child to cross their midline when playing.
  • Cars on the road: While crawling on the floor push toy cars along a path made with tape or drawn with chalk. Include lots of large turns to encourage midline crossing.
  • “Lazy 8”:Vertical surfaces work best - use a blackboard, whiteboard or chalk on a wall. Ensure that the child is positioned in the centre of the “lazy 8” with one hand on the writing surface for stability. Let the child rub out the “lazy 8” with a large sponge – using both hands and moving the sponge in all directions will also facilitate midline crossing. If the child’s handedness is not clear, let them use both hands to steer a car along the “lazy 8” racetrack.

3. Once the child demonstrates a clear hand preference within a specific skilled task, such as drawing or cutting, encourage them to use their preferred “worker” hand and to use their “helper” hand in a supportive role.

Be careful not to assume that the child who uses their left hand for pencil activities will also cut using their left hand. As we know, left-handers use their preferred hand to a lesser degree. There are many left-hand writers who prefer using their right hand for cutting. As long as they are not swapping hands within a task, it is not considered a “handedness” problem. It should, however, be taking into consideration that the children who perform pencil activities with their left hand, but use their right hand for cutting and gross motor actions (e.g. batting, throwing, etc.) may struggle with pencil control and fine motor development as they do not benefit from the shoulder girdle stability attained through certain gross motor actions and the fine motor strength and endurance attained through cutting. These children should be encouraged to participate in bilateral gross- and fine motor activities that require the two sides of the body to work symmetrically (e.g. frog jumps, bunny hops, star jumps, etc.) or reciprocally (e.g. monkey bars, crab walks, wheelbarrow walks, etc).

Please be advised that the activities suggested within this website are selected to develop and improve specific areas of developmental difficulty. Engaging in these activities only, cannot replace the valuable input and guidance an Occupational Therapist (OT) can provide you with.

In order to benefit optimally from these activities, it is best advised to do these activities with the guidance of your OT. Many parents and caregivers benefit from attending an activity demonstration consultation. Although the activities selected are games that children often play at home or at school, and are generally safe to engage in, the Therapists at this practice cannot be held liable for any injuries occurring while playing any of these games.

Children learn through Play and having fun!! Research has proven that children who have fun are more motivated to learn and have better retention of the learnt skill! Enjoy playing and learning with your child!

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