When should my child have a dominant hand?

This is one of the most frequently asked questions pediatric occupational therapists hear from parents of children born without limb differences or other neurological/physical conditions affecting hand use. When should I know whether or not my child is a righty or a lefty?

The short answer is that children should have a well-established dominant hand by age 5. This means that they primarily use one hand for one-handed fine motor activities such as writing, coloring, and feeding. By age 5, children should have developed adequate strength and bilateral integration to consistently use one hand for these tasks without needing to switch hands, showing a clear preference for one side. Children age 5 or older who have not yet developed a clear hand preference may be experiencing underlying difficulties with postural endurance and control, and/or difficulties with crossing midline.

If you notice that your child frequently switches hands during an activity, he or she may be experiencing fatigue. This can lead to alternating hand use during an activity to give one side of the body a break to rest. If this is happening on a daily basis and during age-appropriate activities, this difficulty with strength and endurance is considered to be abnormal. Difficulties with hand strength alone are rare (see our blog post about the development of fine motor control) – if your child is exhibiting signs of fatigue during fine motor activities, they may benefit from occupational therapy services addressing their core strength and proximal stability, in addition to their utensil grasp and manual dexterity.

Another common explanation for switching hands during tasks is difficulty with crossing midline. Do you notice that your child tends to do things on the right side of his or her body with the right hand, and do things on the left side of his or her body with the left hand? By age 5, children should automatically cross the midline of their body with both arms. Some children who have underlying difficulties integrating both sides of their body (often related to vestibular processing challenges) do not automatically develop this skill, and tend to operate their body as two separate halves, rather than using the two sides together as one unit. If your child is having difficulty with crossing midline, you may notice that he or she tends to switch which hand holds the eating utensil depending on the location of the food they are trying to retrieve, or tends to switch which hand holds the pencil or crayon depending on which side of the paper they are writing on or coloring.

Is my child just ambidextrous?

Probably not. Did you know less than 1% of the population is truly ambidextrous? It is very unlikely that a child who doesn’t show a consistent hand preference is truly ambidextrous. This is actually more likely to be a red flag for underlying challenges with bilateral integration, which can be related to difficulties with learning skills such as reading, writing, and math later on.

What about lefties?

Lefties are sometimes the exception to the rule. Your child may show signs of left-handedness for most activities, but have a few “splinter skills” that they perform right-handed (ex: cutting, throwing a ball). This is often the case for lefties trying to survive in a right-handed world! This is not necessarily a concern, as long as most activities are completed with a dominant hand, and your child is consistent with which activities are the exception to the rule.

How can I encourage my child to develop a dominant hand?

It is natural that young children will experiment with using both hands for the same task when they are young. As they get closer to 5 years old, we can help them figure out which hand is dominant by monitoring their hand use within an activity. Do not let your child switch hands once they’ve started a task. If they begin coloring with their right hand, great! Make sure the left hand works on holding the paper and doesn’t take over the crayon until the coloring page is finished. If they pick up the crayon with their left hand tomorrow, don’t worry! Just don’t let them switch to the right hand within the same activity. Inhibiting switching hands within a task will help your child figure out how to cross their midline and gradually build up their endurance for fine motor tasks, reducing the need to switch hands over time. This will help them figure out if they are a lefty or a righty!