Why do we need to use two hands for writing? After all, you only need one hand to hold a pencil. Well, did you ever injure your non-dominant shoulder or wrist? Without a hand to steady the paper and move it accurately as you write across a page, an adult will write like a preschooler or worse. When you write, you are using one hand for writing and the other for balance, posture, paper stabilization and paper placement. Bilateral hand coordination begins before a child’s first birthday and develops through early childhood. Without it, handwriting is certain to be a challenge.
So many kids that struggle with crawling and walking as infants and young toddlers will continue to have difficulties using both hands together as preschoolers. Occupational therapists like myself often observe that that they are not using one hand as a “prime mover” ( grabbing, reaching and writing) and the other hand as a “stabilizer”, i.e. holding a container or paper in a skilled manner. What does it look like to stabilize a container with skill? The container is held using just enough force and with the opening angled to allow the other hand to fill it without dumping the contents out. Take a look at my post Better Posture and More Legible Writing With A “Helper Hand” to explore why that stabilizer hand placed on the table is essential for good handwriting. Problems with bilateral control are often seen with children with ASD, SPD, and many neurological issues such as low muscle tone, but bilateral control delays can exist without any formal diagnosis.
Most handwriting programs, such as Fundations, do not pay much attention to the underlying physical skills needed for legible handwriting. Handwriting Without Tears does an excellent job of teaching educational staff to remember the physical aspect of handwriting. Children ideally need good bilateral coordination BEFORE they begin hard-core handwriting instruction, not after. If a child has identified neurological or developmental challenges that contribute to limited bilateral coordination, working on these skills are essential to prevent compensations and delays in handwriting.
As an OT working with kids over 4, when those basic bilateral control and grasping skills should have been achieved, I have to decide whether to spend precious time in every session on handwriting or on the basic abilities (coordination, strength, visual-perceptual, and sensory processing) that support handwriting. Usually, I end up doing both, building target skills with intensive and complex treatment plans while I am working on handwriting instruction that gets kids up to speed as quickly as possible.
I am going to guess that if some of my toddlers and preschoolers in treatment had received more daily home and school practice with the following activities, I would have more time to teach great writing strategies. For every parent that has asked me for some effective methods for early bilateral control skills, here you go:
- Do not hold or stabilize toys too much for them while playing. Let them figure out that they need the other hand to steady a soft but large object or container. Kids will often ask adults to hold a bag for them during clean up. Your response? Place their “helper” hand effectively on the bag and direct them to use the other hand to pick things up. You did help, but you didn’t enable more dependency. Safety first, so always support a container that could shatter or injure them if it dropped and broke. But if the contents of a safe container spills? That is another lesson in coordination to be learned by the child. Encourage and reward a good clean-up effort!
- Provide good containers that demand bilateral skills. My Ziploc post Develop Pincer Grasp With Ziploc Bags also develops bilateral coordination during snacking (one of my favorite times of the day!). Another fave? Store little toys in the cosmetic bags with nice big zipper pulls that the department stores include with free-gift-with purchase events. Ladies, if you love makeup as much as I do, you have a pile of these in a drawer somewhere. If not, the local drug store probably has a selection. When a container is soft and collapses, it is a greater challenge to stabilize and open. Challenge is good.
- Encourage your child to turn the pages of a book while holding the book on their lap when sitting on the bottom step of the stairs or a low bench. With the book resting on their lap with one hand holding it, there will be no chance for the floor to hold the book, or for you to do it. If it is a really heavy or large book, either give them one finger’s wobbly assistance under the book, or pick a lighter/smaller book. Some of my clients would rather let me hold the book, so I try to have something in my hands to prevent them from asking for assistance rather than working hard. I cheer them on, and make sure they have great books to look at every time!