Julie M. Campbell

Unimanual to bimanual: Tracking the development of handedness from 6 to 24 months

Manual skills change dramatically over the first two years of life, creating an interesting challenge for researchers studying the development of handedness. A vast body of work to date has focused on unimanual skills during the period from the onset of reaching to walking. The current study sought to connect such early unimanual hand use to later role-differentiated bimanual manipulation (RDBM), in which one hand stabilizes the object for the other hands action. We examined hand use in 38 children over 16 monthly visits using a validated measure for assessing hand preference for acquiring objects when children were 6-14 months old. We also developed a new measure for assessing RDBM preference presented when children were 18-24 months old. The new measure reliably elicited RDBM actions in both toddlers and an adult control group (N = 15). Results revealed that some children show preferences for acquiring objects as infants; these preferences are stable and persist into their second year as new skills appear. Moreover, children with no hand preference during infancy shifted to left or right lateralized hand use as toddlers. Despite a higher incidence of left-handedness compared to adult norms, the majority of children were right-handed by 2 years of age.

Early Handedness in Infancy Predicts Language Ability in Toddlers

Researchers have long been interested in the relationship between handedness and language in development. However, traditional handedness studies using single age groups, small samples, or too few measurement time points have not capitalized on individual variability and may have masked 2 recently identified patterns in infants: those with a consistent hand-use preference and those with an inconsistent preference. In this study, we asked whether a consistent infant hand-use preference is related to later language ability. We assessed handedness in 38 children at monthly intervals from 6-14 months (infant visits) and again from 18-24 months (toddler visits). We found that consistent right-handedness during infancy was associated with advanced language skills at 24 months, as measured by the Bayley Scales of Infant and Toddler Development (Bayley-III; Bayley, 2006). Children who were not lateralized as infants but who became right-handed or left-handed as toddlers had typical language scores. Neither timing nor direction of lateralization was related to cognitive or general motor skills. This study builds on previous literature linking right-handedness and language during the first 2 years of life.

Latent classes in the developmental trajectories of infant handedness.

Handedness for acquiring objects was assessed monthly from 6 to 14 months in 328 infants (182 males). A group based trajectory model identified 3 latent groups with different developmental trajectories: those with an identifiable right preference (38%) or left preference (14%) and those without an identifiable preference (48%) but with a significant trend toward right-handedness. Each group exhibited significant quadratic trends: Those with a right preference increased to asymptote at about 10 months and began decreasing thereafter; those with a left preference increased to asymptote at about 11 months; those without a preference exhibited increasing right-hand use. Since adult handedness reflects different patterns of neural organization which relate to differences in psychological functioning, the observed differences in infant handedness development may relate to differences in the development of infant neurobehavioral organization and functioning. Several methods were used to explore the relation of latent classes to more conventional ways of classifying infant handedness. Classification into handedness groups according to either a monthly z-score or a combination of 4 or fewer months for a handedness index failed to provide reliable estimates of handedness identified by the trajectory analysis. If identified trajectories of handedness development relate to the development of the infants neurobehavioral organization, researchers who assess infant handedness only once in order to relate it to cognitive, social and emotional functioning may risk misclassifying the handedness of as many as 37-45% of infants.

How the development of handedness could contribute to the development of language

We propose a developmental process which may link the development of handedness with the development of hemispheric specialization for speech processing. Using Arbibs proposed sequence of sensorimotor development of manual skills and gestures (that he considers to be the basis of speech gestures and proto-language), we show how the development of hand-use preferences in proto-reaching skills concatenate into object acquisition skills and eventually into role-differentiated bimanual manipulation skills (that reflect interhemispheric communication and coordination). These latter sensorimotor skills might facilitate the development of speech processing via their influence on the development of tool-using and object management abilities.

Different assessment tasks produce different estimates of handedness stability during the eight to 14 month age period.

Using 150 infants (57% males), two common tasks for assessing infant hand-use preferences for acquiring objects were compared for their ability to detect stable preferences during the age period of eight to 14 months. One task assesses the preference using nine presentations of objects; the other uses 32 presentations. Monthly classifications of hand preference for each task were determined by either a commonly used a decision criterion in which one hand is used 50% more often than the other or a criterion based on proportion of hand-use difference that exceeds a conventional alpha probability of 0.05. The seven monthly assessments provided by the two tasks also were examined for latent classes in their developmental trajectories. The two tasks were significantly different for both their identification of latent classes and their monthly classification of the infants hand-use preference. The 32 presentations yielded three developmental trajectories (45% right preferring, 5% left preferring, and 50% no clear preference) whereas the nine presentations revealed only two trajectories (70% right, 30% no preference). The nine presentations task, with the 50% proportion decision criterion, was very generous in classifying right and left-preferring infants at each month but produced greater fluctuations across months compared to the 32 presentation task with an alpha decision criterion. Both tasks revealed that a large proportion of infants are still developing a hand-use preference during this age period. Recommendations are made for examining the development of hand-use preferences and their relation to the development of other neuropsychological functions.

The influence of a hand preference for acquiring objects on the development of a hand preference for unimanual manipulation from 6 to 14 months

Development of hand preferences for unimanual manipulation of objects was explored in 90 infants (57 males) tested monthly from 6 to 14 months. From a larger sample of 380 infants, 30 infants with a consistent left hand preference for acquiring objects were matched for sex and development of locomotion skills with 30 infants with a consistent right hand preference for acquisition and 30 with no preference. Although frequency of unimanual manipulations increased during 6-14 month period, infants with a hand preference for acquisition did more object manipulations than those without a preference for acquisition. Multilevel modeling of unimanual manipulation trajectories for the three hand-preference groups revealed that hand preferences for unimanual manipulation become more distinctive with age, and the preference is predicted by the hand preference for object acquisition. Infants with a right and left hand preference for object acquisition develop a right and left (respectively) hand preference for unimanual manipulation. However, the majority of infants at each month do not exhibit hand preferences for unimanual manipulation that are unlikely to occur by chance, even by 14 months. The results are consistent with a cascading theory of handedness development in which early preferences (i.e., for acquisition) are transferred to later developing preferences (i.e., for unimanual manipulation).

Infant Hand Preference and the Development of Cognitive Abilities

Hand preference develops in the first two postnatal years with nearly half of infants exhibiting a consistent early preference for acquiring objects. Others exhibit a more variable developmental trajectory but by the end of their second postnatal year, most exhibit a consistent hand preference for role-differentiated bimanual manipulation. According to some forms of embodiment theory, these differences in hand use patterns should influence the way children interact with their environments, which, in turn, should affect the structure and function of brain development. Such early differences in brain development should result in different trajectories of psychological development. We present evidence that children with consistent early hand preferences exhibit advanced patterns of cognitive development as compared to children who develop a hand preference later. Differences in the developmental trajectory of hand preference are predictive of developmental differences in language, object management skills, and tool-use skills. As predicted by Casasanto’s body-specificity hypothesis, infants with different hand preferences proceed along different developmental pathways of cognitive functioning.

Building on What You Have Learned: Object Construction Skill during Infancy Predicts the Comprehension of Spatial Relations Words.

Object construction involves organizing multiple objects into a unified structure (e.g., stacking blocks into a tower) and may provide infants with unique spatial information. Because object construction entails placing objects in spatial locations relative to one another, infants can acquire information about spatial relations during construction activity. To acquire words representing spatial relations, children must link sensorimotor experience to their language system. It is proposed that the development of construction skills during infancy influences knowledge of words indicating spatial relations at three years. Infants who develop early construction skills are expected to comprehend more words describing spatial relations than infants who develop construction skills later. Infants were tested monthly with seven construction tasks from 10–14 months and were tested at three years for their comprehension of spatial relations words. In addition, both the Preschool Language Scales, 5th edition (PLS-5) (three years) and the Bayley cognitive sub-scale (two years) were assessed to examine whether infants with differing construction skills would perform differently on general language and cognitive abilities in infants, as well as spatial words. “High” constructors understood more spatial relations words than “low” constructors, although there were no differences for general language (PLS-5) or cognitive ability (Bayley cognitive sub-scale). Since infant construction skill did not also relate to general language or cognitive ability, rather only to comprehension of spatial words, object construction activity may uniquely afford opportunities for spatial information, which becomes relevant to the development of spatial words.

Toddler hand preference trajectories predict 3‐year language outcome

A growing body of work suggests that early motor experience affects development in unexpected domains. In the current study, childrens hand preference for role-differentiated bimanual manipulation (RDBM) was measured at monthly intervals from 18 to 24 months of age (N = 90). At 3 years of age, childrens language ability was assessed using the Preschool Language Scales 5th edition (PLS™-5). Three distinct RDBM hand preference trajectories were identified using latent class growth analysis: (1) children with a left hand preference but a moderate amount of right hand use; (2) children with a right hand preference but a moderate amount of left hand use; and (3) children with a right hand preference and only a mild amount of left hand use. Stability over time within all three trajectories indicated that children did not change hand use patterns from 18 to 24 months. Children with the greatest amount of preferred (i.e., right) hand use demonstrated higher expressive language scores compared to children in both trajectories with moderate levels of non-preferred hand use. Children with the greatest amount of right hand use also had higher scores for receptive language compared to children with a right hand preference but moderate left hand use. Results support that consistency in handedness as measured by the amount of preferred hand use is related to distal language outcomes in development.

Do hand preferences predict stacking skill during infancy

The cascade theory of handedness suggests that hand preferences develop from a history of cascading and sequentially developing manual asymmetries for a variety of actions. Infants who consistently use their preferred hand for a variety of actions likely would gain proficiency using that preferred hand and, consequently, perform more proficiently on other challenging manual tasks. One such task is object stacking, which has been linked with a number of cognitive abilities. If infant hand preference facilitates the development of stacking skill, then this could provide a link by which early hand preference might affect the development of cognition. From a sample of 380 infants assessed for an acquisition hand preference across 6-14 months, 131 infants were assessed for stacking skill from 10 to 14 months at monthly visits. Four unique handedness sub-groups were identified from the 380-infant sample: left, trending right, stable right, or no hand preference. Each of the four hand preference groups exhibited different trajectories in the development of their stacking skills. Left- and stable right-handers stacked more items than infants with no preference by 14 months, whereas infants with a trending right preference did not. The proportion of preferred hand use (right and left) from 6 to 9 months also predicted an earlier initial onset of stacking skill, whereas the proportion of only right hand use did not. Thus, the development of a hand preference predicts an earlier emergence of stacking skill and may have implications for other domains of infant cognitive development.