Lateral manual asymmetries: a longitudinal study from birth to 24 months

Insights Into Human and Nonhuman Primate Handedness From Measuring Both Hands

Handedness is part of our everyday lives, but where does it come from? Researchers studying nonhuman primates and young children have approached this question from different perspectives—evolutionary and developmental, respectively. Their work converges on the conclusion that measurement matters in the science of handedness. Coming to a consensus on assessment will guide future research into the origins of handedness. A candidate behavior for promoting multidisciplinary comparison is role-differentiated bimanual manipulation.

Is Handedness at Five Associated with Prenatal Factors?

The goal of the study was to investigate some of the factors suspected to be related to children's handedness: presentation during the last weeks of gestation and at birth (cephalic or breech), side of presentation (right or left), number of weeks of gestation, season of birth, parents' handedness and sex. We analyzed the relationships between these factors and the child's handedness at five years. Children (n = 1897) from the EDEN cohort participated in the study, among which 1129 were tested for handedness at five. The father's handedness, but not the mother's, was significantly related to the child's hand preference. The percentage of left-handed children was significantly larger when the father was non-right-handed compared to right-handed, and tended to be larger among children in non-left-cephalic presentation compared to left-cephalic presentation. Girls, but not boys, were significantly less lateralized when they were born before 37 weeks of pregnancy than after. Finally, children born in winter or spring were slightly but significantly less lateralized than children born in summer or autumn. All six children who were not lateralized at 5 presented one or several of these factors. These results are discussed in light of the mixed model of handedness.

Measuring infant handedness reliably from reaching: A systematic review

Researchers have utilized reaching paradigms to measure infant handedness for more than a century. However, methods vary widely. Recent research has identified that the number of trials used in assessment is critical with the recommendation that at least 15 trials are necessary to reliably classify infants into handedness categories via statistical cutoffs. As a first step towards establishing best practices for the field, we identified, categorized, and synthesized findings according to trial number from studies that utilized reaching to index handedness in infants across the first two years of life using PRISMA guidelines. Database searches were conducted in PsycINFO, PubMed, and Ovid MEDLINE®. All articles published through May 2018 were included. Additional records were identified through other sources. After removing duplicates, 1,116 records were screened using the online software program Abstrackr. Of these records, 125 full-text articles were further assessed for eligibility, and 87 articles were included in the qualitative synthesis. Results revealed that the majority of papers published since 1890 (70%) do not meet the 15-trial minimum criterion for statistically reliable measurement of infant handedness. Broad themes from articles meeting the measurement criterion and implications for future research are discussed.

Right-handed one day, right-handed the next day?

Although a population bias toward right-hand preference is observed at the early stage of grasping, hand preference fluctuates in infancy. Given these fluctuations, one can wonder whether testing a young infant on a single occasion gives reliable results of its handedness. Very few studies have evaluated short-term test-retest reliability. This was the goal of this study in which 21 infants aged 9-15 months were tested for handedness every day for a total of 5 sessions. The infants were given a classical handedness baby test. Their handedness index (HI) and their category of handedness were compared across sessions. The results show that at the group level the distribution of handedness does not differ significantly across the five sessions. At the individual level, only 19% of infants were categorized as right-handed at all five sessions while 52.4% were consistent in using more one hand than the other across the five sessions (right hand: 47.6%). Most of the fluctuations across sessions occurred between being lateralized and non-lateralized rather than between being right-handed and left-handed. These figures indicate that testing handedness at that age gives fairly reliable results in terms of direction of hand preference, but less so in terms of degree.

A Naturalistic Observation of Spontaneous Touches to the Body and Environment in the First 2 Months of Life

Self-generated touches to the body or supporting surface are considered important contributors to the emergence of an early sense of the body and self in infancy. Both are critical for the formation of later goal-directed actions. Very few studies have examined in detail the development of these early spontaneous touches during the first months of life. In this study, we followed weekly four infants in two naturalistic 5-min sessions (baseline and toys-in-view) as they laid alert in supine from the age of 3 weeks until they acquired head control. We found that throughout the 2 months of observation, infants engaged in a high rate of touch and spent about 50% of the time moving their hands from one touch location to the next. On most sessions, they produced up to 200 body/surface contacts and touched as many as 18 different areas (mainly upper body and floor) both hands combined. When we did not consider the specific areas touched, the rates of touches were higher to the body than to the floor, but the duration of contacts and the most touched areas were higher for the supporting surface than for the body. Until the age of 9 weeks, we found no consistent differences in the rate of touch between head and trunk. Infants also did not display significant differences in their rate of touch between right and left hand or between conditions. However, we discovered that in the earlier weeks, infants engaged more often in what we called “complex touches.” Complex touches were touches performed across several body/floor areas in one continuous bout while the hand maintained contact with the body or floor. Single touches, in contrast, corresponded to one touch to one single body or floor area at a time. We suggest that infants are active explorers of their own body and peripersonal space from day 1 and that these early self-generated and deeply embodied sensorimotor experiences form the critical foundation from which future behaviors develop.

Language or music? Environmental influences on infants' handedness from 5 to 12 months

The main purpose of this study was to test the influence of music environment on hand-use preference in infants from 5 to 12 months, compared to speech environment. According to hemispheric specialization, our hypothesis was that infants would reach for objects more with their right hand in a speech context (left hemisphere), and more with their left hand in a music context (right hemisphere). 61 full-term infants aged from 5 to 12 months participated in this study. A prehension task was proposed successively in two sound environments (music and speech) in a counterbalanced order. Left-, right-movement and/or bimanual movements were scored. Results show that whatever the sound context, from 8 months a lateral right bias occurs and increases strongly. However, 5- to 7-months-old infants used more their left hand when they listen to a piece of classical music that an adult speech. Bimanual movements were more frequent at 6 and 7 months than unimanual movements in the speech condition. Results are discussed in terms of manual specialization.

Infant motor activity during sleep: Simultaneous use of two actigraphs comparing right and left legs

Motor asymmetry during the first hours of sleep documented in adults found higher activity in the non-dominant limb. The stage of development at which such asymmetries first appear is unknown. Twenty healthy infants were followed from 7 to 12months of age, at 3-week intervals, comparing motor activity of the right and left legs during sleep using twin actigraphs (AMI). Hour-by-hour analysis of the first seven hours of nocturnal sleep found no consistent difference in activity levels between the right and left legs. Using the standard algorithm for infants, which provides an overall estimate of sleep quality, revealed discrepancies in night waking episodes (Right versus Left) in 33% of the nights. Results pertaining to leg movement suggest that motor asymmetry is not yet present during the first year of life. However, given the large discrepancies in the detection of night waking, further investigation of the developmental course of circadian motor asymmetry is warranted.

Asymmetrical motor behaviour as a window to early leg preference: a longitudinal study in infants 7-12 months of age

This longitudinal study explored leg preference in infancy during half-kneel pulling-to-stand (PTS) and asymmetrical four-point kneeling, which is part of the typical motor repertoire of infants. The special characteristics of the half-kneel PTS as a discrete task, performed in a bilateral context provide the opportunity to explore leg preference during an asymmetrical behaviour. Twenty-seven infants were observed in their homes, every 3 weeks between the ages of 7-12 months. Leg preference was determined by the "lead-out" limb used as the infants pulled to stand from the half-kneeling position (half-kneel PTS). As a complementary measure, the leading leg during asymmetrical four-point kneeling and crawling ("asymmetrical four-point patterns") was used in the 10 infants who developed these patterns. The infants studied showed a general preference for using a leading leg during half-kneel PTS, which was mostly consistent over the study period. A strong correlation was found between leg preferences during half-kneel PTS and asymmetrical four-point patterns. The findings documented functional asymmetry in infant lower limbs during half-kneel PTS and asymmetrical four-point patterns, highlighting the importance of the tasks used to define leg preference.

The contributions of vision and haptics to reaching and grasping

This review aims to provide a comprehensive outlook on the sensory (visual and haptic) contributions to reaching and grasping. The focus is on studies in developing children, normal, and neuropsychological populations, and in sensory-deprived individuals. Studies have suggested a right-hand/left-hemisphere specialization for visually guided grasping and a left-hand/right-hemisphere specialization for haptically guided object recognition. This poses the interesting possibility that when vision is not available and grasping relies heavily on the haptic system, there is an advantage to use the left hand. We review the evidence for this possibility and dissect the unique contributions of the visual and haptic systems to grasping. We ultimately discuss how the integration of these two sensory modalities shape hand preference.

Hand preference status and reach kinematics in infants

Infants show age-related improvements in reach straightness and smoothness over the first years of life as well as a decrease in average movement speed. This period of changing kinematics overlaps the emergence of handedness. We examined whether infant hand preference status is related to the development of motor control in 53 infants ranging from 11 to 14 months old. Hand preference status was assessed from reaching to a set of 5 objects presented individually at the infant's midline; infants were classified into 'right preference' or 'no preference' groups. Three-dimensional (3-D) recordings were made of each arm for reaches under two distinct conditions: pick up a ball and fit it into the opening of a toy (grasp-to-place task) or pick up a Cheerio® and consume it (grasp-to-eat task). Contrary to expectations, there was no effect of hand preference status on reach smoothness or straightness for either task. On the grasp-to-eat task only, average speed of the left hand differed as a function of hand preference status. Infants in the no preference group exhibited higher left hand average speeds than infants in the right preference group. Our results suggest that while behavioral differences in the use of the two hands may be present in some infants, these differences do not appear to be systematically linked to biases in motor control of the arms early in development.

Efficacy of baby-CIMT: study protocol for a randomised controlled trial on infants below age 12 months, with clinical signs of unilateral CP

Background

Infants with unilateral brain lesions are at high risk of developing unilateral cerebral palsy (CP). Given the great plasticity of the young brain, possible interventions for infants at risk of unilateral CP deserve exploration. Constraint-induced movement therapy (CIMT) is known to be effective for older children with unilateral CP but is not systematically used for infants. The development of CIMT for infants (baby-CIMT) is described here, as is the methodology of an RCT comparing the effects on manual ability development of baby-CIMT versus baby-massage. The main hypothesis is that infants receiving baby-CIMT will develop manual ability in the involved hand faster than will infants receiving baby-massage in the first year of life.

Method and design

The study will be a randomised, controlled, prospective parallel-group trial. Invited infants will be to be randomised to either the baby-CIMT or the baby-massage group if they: 1) are at risk of developing unilateral CP due to a known neonatal event affecting the brain or 2) have been referred to Astrid Lindgren Children’s Hospital due to asymmetric hand function. The inclusion criteria are age 3–8 months and established asymmetric hand use. Infants in both groups will receive two 6-weeks training periods separated by a 6-week pause, for 12 weeks in total of treatment. The primary outcome measure will be the new Hand Assessment for Infants (HAI) for evaluating manual ability. In addition, the Parenting Sense of Competence scale and Alberta Infant Motor Scale will be used. Clinical neuroimaging will be utilized to characterise the brain lesion type. To compare outcomes between treatment groups generalised linear models will be used.

Discussion

The model of early intensive intervention for hand function, baby-CIMT evaluated by the Hand Assessment for Infants (HAI) will have the potential to significantly increase our understanding of how early intervention of upper limb function in infants at risk of developing unilateral CP can be performed and measured.

Trial registration

SFO-V4072/2012, 05/22/2013

Brain reorganization as a function of walking experience in 12-month-old infants: implications for the development of manual laterality

Hand preference in infancy is marked by many developmental shifts in hand use and arm coupling as infants reach for and manipulate objects. Research has linked these early shifts in hand use to the emergence of fundamental postural-locomotor milestones. Specifically, it was found that bimanual reaching declines when infants learn to sit; increases if infants begin to scoot in a sitting posture; declines when infants begin to crawl on hands and knees; and increases again when infants start walking upright. Why such pattern fluctuations during periods of postural-locomotor learning? One proposed hypothesis is that arm use practiced for the specific purpose of controlling posture and achieving locomotion transfers to reaching via brain functional reorganization. There has been scientific support for functional cortical reorganization and change in neural connectivity in response to motor practice in adults and animals, and as a function of crawling experience in human infants. In this research, we examined whether changes in neural connectivity also occurred as infants coupled their arms when learning to walk and whether such coupling mapped onto reaching laterality. Electroencephalogram (EEG) coherence data were collected from 43 12-month-old infants with varied levels of walking experience. EEG was recorded during quiet, attentive baseline. Walking proficiency was laboratory assessed and reaching responses were captured using small toys presented at mid-line while infants were sitting. Results revealed greater EEG coherence at homologous prefrontal/central scalp locations for the novice walkers compared to the prewalkers or more experienced walkers. In addition, reaching laterality was low in prewalkers and early walkers but high in experienced walkers. These results are consistent with the interpretation that arm coupling practiced during early walking transferred to reaching via brain functional reorganization, leading to the observed developmental changes in manual laterality.