Cues to Encourage Effective Arm and Hand Use

Your child has difficulty using one of his/her arms. It’s important to encourage your child to move that arm—and hand—at home. You can provide cues to help increase your child’s arm movement, which will improve your child’s play abilities and self-care skills. This also helps your child become more aware of the affected arm.

Use the following cues at home, and share them with your child’s other care providers, including grandparents, child care workers, teachers, etc.

• When your child is seated, sit next to him/her on the side of the affected arm. That encourages your child to look toward that arm and hand.
• Use positive words to describe your child’s affected hand. For example, say “your left hand,” “your helper hand” or “your super hand” instead of “your bad hand.”
• Praise your child whenever he/she tries an activity using the affected hand. For example, say, “Good job with that right hand!” or “Look at that left hand go!”
• When putting a shirt or coat on your child, put the affected arm through its sleeve first. When undressing, take the affected arm out last. That makes the process easier.

Your child’s therapist can tell you which of the following cues will also be helpful for your child:

• Hand-over-hand assistance: Put your hand on top of your child’s hand to help with movement.
• Tactile cue: Gently touch your child’s arm to help start a movement.
• Demonstration: Using your own hand, show your child how to do certain movements and activities, such as “open hand” and “squeezing hand.”
• Verbal cue: Ask your child to do movements, such as “raise your arm,” or “open your right hand, please.” For our young patients working in “Super Movers” training for constraint-induced movement therapy (CIMT), we encourage phrases such as “Power up that right hand!” and “Use your super hand!”