Hand awareness, reach and use in play

Typically developing infants will gain incidental awareness of the hands through their early attempts at goal-directed movement (usually circular swiping). For many infants this process is interrupted by:

• Low tone: arms have difficulty reaching against gravity
• High tone: limbs restricted in movement against tone
• Structural difficulties such as bony differences or connective tissue anomalies
• Poor nutrition

Exploration using the hands often begins with 'scratching' movements (opening and closing). These movements help break up early flexion/ fisting and are followed by exploration using more individual finger movements.

• Activation of these hand movements can be encouraged in a number of ways including modelling, tactile stimulation to the dorsum of the hand, constraint therapy and bimanual therapy and through the positioning of the upper limb.
• Textured toys such as a Koosh Ball, baby brush, crinkly toy  or soft toy are perfect for encouraging active finger movement
• The first 6 months is a period of rapid brain development and neural pathway creation. This time period provides the therapist’s best opportunity to develop a repertoire of varied and good quality movement patterns. Working towards equal ability in both hands will provide the baby with the best possible two-handed (bimanual) function.