The 5th Stage Of Body Awareness - Lateral Dominancy

Written and compiled by Melanie Durand And Marene Jooste

Welcome back to our series about body awareness and what you can do to help a child develop all the necessary building blocks necessary for future scholastic success! In our previous blog, we have discussed laterality in more detail.

Today, we are going to talk about lateral dominancy, what it entails, how you can assess it and which activities to do to help a child develop a strong sense of dominancy. Let's jump right in!

Dominancy And The Brain

Over the last decade, there has been a huge emphasis on one's brain hemisphere. Are you a “righty” or “lefty” and what does it depicts for your future – will you be logical and a thinker, or creative and musical? Many therapists also believe that a child begins to show a preference for one of their hands when one side of their brain gains dominance and allows the child to prefer the use of one hand over the other.

To understand more about dominancy, we will first need to have a quick glimpse into the brain and explore some research when it comes to the left and the right side of the brain.

Let's start by looking at the picture above. As you know, the brain is divided into two hemispheres. Here is the interesting part…Though not exclusively, the left hemisphere mostly takes control over the muscles or actions taking place on the right side of the body. The opposite is also true. The right hemisphere mostly takes control over the muscles or actions taking place on the left side of the body.

According to lead author Dr. Jeff Anderson, to use one brain region more than others for certain functions is indeed real. Let us take speech as an example. Speech originates from the left side of the brain for most right-handed people. However, this does not mean that great writers or speakers use their left side of the brain more than the right, or that the “dominant” side of the brain is richer in neurons.

The brain works mostly together as a unit to produce the best results in physical and mental tasks, especially when you need to work through a complex cognitive process. When most of the sensory information coming into the brain comes from the same side, one side of the brain receives the information and communicates it to the proper brain areas. The opposite side of the brain then just provides information to complete the picture. This helps the brain to stay organized with all its information. But how does all of this relate to hand dominance or preference?

Typical Hand Dominance Development in Children

Hand preference starts in the womb when a baby's hand touches his mouth and then he starts to suck his thumb with the help of the sucking reflex. The latest research shows that your handedness (or dominant hand) is not necessarily determined by your left or right hemisphere alone, but more likely by your spinal cord!

Hand preference then continues to develop as a baby starts to grasp objects with his hand. Again, this first starts as an automatic reflex in the womb and can continue until a baby is about 6 months old.

It is interesting to know that during the first few months of life, babies tend to use their left hand. Then a period may follow when you cannot see any preference. Thus, it is perfectly normal for a young baby to use either one of his hands when he needs to pick up a block or reach out for food.

Keep in mind that a baby's preference also depends on whether an object is near the left or right side of his body. (If you place a block near his left side, he will most likely pick up the block with his left hand and not cross over his body to pick it up with his right hand). At about 8 months of age, a baby usually starts to use his dominant hand (in most cases, the right hand).

(Please remember that young babies should use both hands almost equally well. If you notice that your baby has a strong hand preference before 1 year of age, please talk to your pediatrician. It is not always the case, but it can be a sign of a motor delay or neurological problems).

Most children will naturally choose a dominant hand between 2- and 4-years-old. Some children will show a hand preference as early as 15- to 18-months-old and some will not choose a dominant hand until age 5 or 6.

Keeping all of that in mind, it is crucial that a child has a definite dominant hand (and preferably, a dominant foot, ear and eye as well), by the time that they go to "big" school. We want a child's hand to perform tasks “automatically” without thinking about it. This will help to make learning fun and as stress-free as possible.

What Can Influence Hand Dominancy?

Many factors can influence a child's dominancy. This includes sensori-motor experiences, environmental factors and genetics (related to brain hemispheres and your spine). For instance, a child will choose a preferred hand to complete a task based on how well that hand performs the task (or the ability of that hand). If a child has a weak or injured right hand or foot, he will start to use his left hand or foot and vice versa.

Environmental factors can also influence the hand preference of a child. This includes what type of tool or object a child is reaching for. Is this object easier for them to grasp with the left or right hand? Is the object placed on their right or left side? As mentioned before, this may influence which hand they use to reach for and grasp an object.

Factors that can further affect a child's hand dominancy include the strength of the hand, their ability to cross the midline and bilateral coordination of both hands (using both hands together to complete a task.

Lastly, if a child's proprioceptive system (or his "muscle system" in layman's terms), struggles to give proper information through to his brain, the child may also struggle to choose a dominant hand or foot. For this reason, children with hypermobility characteristics (being "double-jointed") or low muscle tone, often has a slight delay in hand or foot preference.

Mixed Dominancy Versus Ambidexterity

Will a child have a dominant right foot, eye and ear if he is right-handed? Looking again at the hemispheres, logically it would make sense for all preferences to be on the same side. But this is not always the case.

Some children will write with their left hand, kick a ball with their right foot, put the phone on their left ear and shoot at a target using their right eye. This is called a mixed dominance profile.

Some children may further throw a ball with their left hand, but use their right hand for colouring or writing. In such a case, a child's right hand may be the "better" hand, but because his body is not recognizing this "dominant" feeling for whatever reason, he may use his "not-so-clever" hand to throw the ball. This is called mixed hand dominance, cross-dominance or hand confusion.

Do not mistake mixed dominance for ambidexterity. Ambidexterity is when a person has no definite preference for the use of either the right or left hand. Thus, he can use both hands equally well (or both hands will be equally sloppy).

Why Does A Child Need To Develop Dominancy?

It is very important for children to develop a dominant hand, foot, ear and eye. Developing a preference for one hand to complete a task, allows the brain to make movements automatic.

In other words, the more a child uses one hand for specific movements or classroom tasks, the more opportunity the brain has to refine these movements and make them automatic. This frees up the brain to think about other cognitive tasks instead of focusing on what exactly the hand (or foot, eye and ear) should do.

Think about driving a car or walking around in the house. You do not "think" how you should do it anymore. It just happens automatically. The same goes for dominancy. When it is established, it helps the brain to stay "organized" and will ultimately help a child to process information quicker.

What Are The Complications If Lateral Dominance Is Not Established?

When a child needs to do a task such as snipping, both hands are usually working together. One hand will hold the paper and the other hand will cut the paper. This is known as bilateral coordination and it is important in many school-related tasks.

As mentioned earlier, some children are good at using both hands (ambidextrous). However, it is much better for a child to develop strength and dexterity in one hand. This will help the child to develop accuracy and speed with fine motor tasks, especially handwriting. Thus, it is far better to have a specialized hand to do the job well than two less developed hands.

A child who does not have a strongly specialized left or right hand for a specific task and who switches hands when a specialized hand is required, may struggle to do fine motor activities such as cutting neatly on a line with scissors or writing with a pencil. They may take longer to start working, work more slowly overall and find it difficult to complete their work in time.

A child with mixed dominance may further:

• switch hands to complete a task because they experience fatigue

• have delayed motor development and precision when it comes to fine motor skills

• have gross motor delays involving kicking a ball, jumping on one leg and skipping

• have eye-hand coordination difficulties involving catching, throwing and batting a ball

• experience a moderate level of confusion and frustration as they are unsure of how to make the two sides of their body work together, leading to overall poor hand/foot-eye coordination skills.

According to Integrated Learning Strategies, a mixed dominance can also affect a child more holistically, not just only when it comes to schoolwork. A child with mixed dominancy may:

• show signs of being very emotional (short-tempered, easily hurt or offended, quick to cry, etc.)

• show signs of ADHD (impulsive, easily distracted)

• show signs of obsessive-compulsive behaviors

• get depressed or frustrated easily as they find it difficult to pay attention to lessons.

• find reading, comprehension and writing difficult

• sometimes appear to be ambidextrous, clumsy, incapable to cross the midline, confused, lose objects frequently, and perform poorly on tests.

How To Assess A Child's Dominancy?

There are many ways to screen a child to determine their lateral dominancy. No Harvard degree is needed for this! Adults would want to complete a questionnaire to determine handedness. Other adults may want to follow a more formal route and get tested with the Harris Tests of Lateral Dominance.

For children, there are easy and simple activities that you can do to screen for dominancy. But before you jump right in and assess your child, remember to first observe your child in his most naturalistic environment before moving on to more formal screenings or assessments.

Also take note that a child does not always use his dominant hand in every activity and setting. Lastly, a child's hand dominancy should only be screened when he is using paper that is not stabilized or attached to an easel or clipboard otherwise assistance with his non-dominant hand will not be necessary and you may make an incorrect observation or conclusion.

Great! Now let's look at the different tests. Start by making sure that you place all materials at your child’s midline (directly in front of the middle of their trunk). Why, you may ask? Well, if a child cannot cross his midline, it will have a direct influence on the outcome of the screening.

Whilst screening your child, also allow your child to choose and switch his hand, foot, eye or ear freely during the next few tests. Make notes of the outcome and screen your child again in a few days, especially if your child was switching either his hand, foot, eye or ear during the screening.

Screening For A Dominant Eye:

Ask your child to look through a toilet roll and find specific objects in the room. Let your child hold the roll with both hands. Notice which eye he is using. You can also draw a small little spider on a piece of paper. Now place the "microscope" over it and hold it for your child. Ask your child to look through the toilet roll and guess which insect you have drawn. Again, notice which eye he is using.

Screening For A Dominant Ear:

Put a watch (or smartphone with a song) on a table. Ask your child to pick up the phone with both hands. Alternatively, you can hold the phone for your child. He should then put his ear against the phone to listen and name the song you are softly playing on your phone. Notice which ear he is using.

Alternatively, you can ask your child to speak to his favourite person on the phone (if he is old enough to understand the concept). Hold the phone in front of your child (in his midline) and let him talk to the person. Do not put the phone on loudspeaker. The objective is for your child to put his ear against the phone to listen to what the other person is saying.

As a last resort, you can whisper a special word or secret in your child's ear. Stand in front of your child, cup your hands around your mouth and wait for your child to turn their ear to listen to the secret word. Again, notice which ear he is using.

Screening For A Dominant Foot:

Put a ball in front of your child, right in the middle of both feet. Now ask your child to kick the ball. Notice which foot he is using. You can also roll a ball down the midline towards your child and ask him to kick the ball back to you. Alternatively, you can ask your child to climb stairs. In both cases, observe which foot he is using.

Screening For A Dominant Hand:

Hold a tennis ball out to your child in front of his midline. Ask him to take the ball and throw it towards a wall. Notice which hand he is using. Also observe which hand your child is using when colouring a picture, brushing his teeth or eating with a spoon. Make sure to place these objects in front of his midline.

It is better to screen for dominancy over a period of time, especially if your child is very young. Also use different objects and screen your child in different environments. If your child has reached the end of Kindergarten and is still switching between hands often for tasks such as scissors or handwriting, this could be a red flag to indicate that he may require more assistance in this aspect of his development.

Professionals such as Kinderkineticists or Occupational Therapists test dominancy in detail using extensive and in-detail techniques to properly score a child's dominance profile. They will also be able to look at the basic motor function of the hand, foot, eye and ear. They will further look at strength, midline crossing, bilateral coordination and other environment factors such as positioning or a lack of experience and exposure to activities.

Feel free to take your child for an assessment if you have done an informal screening and have noticed that your child has not yet established a lateral preference as of yet, especially if he is in a more formal school environment or on his way to "big school".

What Can I Do To Enhance Lateral Dominancy?

A first goal would be for the two hemispheres of a child to communicate with each other and work together - to know who will take control of an activity and who will be the supporting side. One of the activities that are amazing for both hemispheres to work together is crawling! So now is the time to get on your hands and knees, and crawl. Who knows, you might just find some lost objects under the couches or see the world in a new light.

The NHS Foundation Trust recommends that you offer a child plenty of everyday opportunities to participate in developing their hand skills. If a child has not yet established a dominant hand, encourage daily activities that require continued use of one hand without you directing the child which hand or foot to use.

Remember to place materials at the child’s midline (directly in front of the

middle of their trunk), and then allow the child to choose and switch his hand freely during these activities and other activities. Also make sure that the child is sitting with a comfortable and supported posture. His feet should be on the floor with his elbows resting on the table.

Do not emphasize or talk about a dominant and non-dominant hand. Rather allow a child to freely alternate using his hands. After several weeks of daily undirected hand activity, you can observe which hand the child chooses more often or use more consistently for grasping objects. Only when you see a child's preference emerging, can you start to focus on developing the dominant hand (or foot, eye and ear). NEVER EVER force a left-handed child to rather use his right hand or foot!



To help develop hand dominance, you can do the following games with the child as suggested by the NHS Foundation Trust:

• Large scribbling on the chalkboard or drawing on mural paper that is on an easel or taped to the wall or floor

• Hammering wood that is clamped to a surface

• Pounding a large ball or clay with one hand until it is flat

• Swinging a ball on a string above head

• Throwing small balls or beanbags with one hand.

Further examples or activities to include when a dominant hand is chosen:

• Drawing, writing, or painting with one hand, stabilizing paper with the other.

• Cutting with one hand, stabilizing and turning paper with the other.

• Using one hand to build towers with blocks, stabilizing and helping to keep blocks lined up with the other.

• Tracing or scribbling over templates, holding writing implement with one hand while stabilizing paper with the other.

• Opening containers, such as jars or plastic containers with lids that require stabilization with one hand and action with other.

In addition to the above, any activities that increase lateral awareness or knowledge of a difference between the right and left sides of the body as discussed in our previous blog, will cause a child to feel how their one side is different from the other side. These activities also encourage children to use the preferred hand and leg. Switching sides, such as practicing a movement with the right and then the left hand, will defeat the purpose of helping a child to choose his dominant hand. Cheatum and Hammond have some specific lateral preference activities that can be done at home to help with lateral dominancy:

Jack-and-Jill Relay (4 years and older)

This is a wonderful activity to play during those hot summer days. Fill three buckets with +- 3 liters of water. Place all three buckets behind a line (can be anything to indicate this is the starting point). Make another line 2 meters away (can be further for older children). This can either be done individually or as a race between friends. The child must pick up the bucket with their preferred / dominant hand and carry the bucket all the way past the finishing line. Put the bucket down, run towards the starting line again and fetch the second bucket with the same hand. Complete by fetching the third bucket with the same dominant hand. The game is not to spill any water while carrying the buckets.

One-Arm Tug-of-War (5 years and older)

Mark a 1-meter line on the floor. Two friends should stand opposite the marked line. Both use their dominant hand, they hold on to each other’s wrists on the preferred dominant hand. Ready, steady, GO! They must pull each other to see who can pull their friend over the line. No jerk movements are allowed. Only pull for 20 seconds. If someone is not pulled over the line after 20 seconds, the game starts again. This can be repeated as long as no one gets hurt.

Paper-Ball Soccer-Drills (5 years and older)

Make a ball out of paper (A4 paper that is wadded up into a ball). Mark your starting line. Place 4 cones in a straight line 0,5 meter – 1 meter apart from each other. The “goal box” will be 1 meter away from the last cone. The goal box will be marked with two cones that are 1,2 meters apart. Each child will receive a paper ball. They need to push/dribble the ball with their feet while walking like a crab (on the ground with their hand placed behind them, knees bent, feet flat, and their bottoms lifted off the floor). They need to kick the ball around the cones (zig-zag) and when they come to the goal box, they need to score by kicking with their dominant foot.

Thumb Wrestling (6 years and older)

This is a game played in pairs. The children sit opposite each other by a small enough table that they can reach each other’s hands. The dominant hands are placed on the table. With the thumb facing up (thumbs up position), their hook their fingers together. Now they have to try and push the friend’s thumb down by using their thumb.

Conclusion

A child needs to establish dominancy before going to a formal school setup. However, NO child must ever be forced to use one hand, foot, eye, or ear as dominancy becomes wired into the brain By forcing a child to use their non-dominant hand, foot, eye or ear as their dominant, will only result in complications at a later stage in their development.

Trying to force a child to learn to use his non-dominant hand will also lead to frustration and a lack of confidence. It further prevents him from performing tasks to the best of his ability, which can further lower his self-esteem.

Remember, everybody can bake a cake, but no one needs to use the same method or ingredients. So rather encourage a child to play as much as possible and provide the guidance to help him establish his own dominancy or preference (even if it is left). All that a child need is the assistance and help of a loving parent to give them courage and boost their self-esteem.

We trust that the above-discussed information will help both you and your child. If you are concerned about your child's dominancy, please speak to a paediatric therapist or contact us for more information. The good news is that a child is more than just his dominancy. He can still become a teacher, dancer, computer programmer, pilot or salesperson — the sky is the limit!

In our next blog, we will talk about more about a child's midline and the crossing thereof. Until then, happy moving moments!