Coordination of both hands | Baby's bath Ghana

Picture 1: An example of bilateral coordination.

Task 1: Coloring a shape drawn on paper - Nursery 1 and 2.

Picture 2: Coloring a shape on a paper.

Picture 3: Good bilateral coordination in toddler while drawing [p7].

The inability of the children in Creative Foundation School to use both hands in coloring, and the necessity to teach them how to use both hands showed on a great delay of 2 years in their bilateral coordination.

Task 2: Building with (big) Lego Duplo bricks (Picture 4), Nursery 1 and 2.

Table 1: Building with Lego Duplo.

Table 1 also compares the ability to join 3 cubes of Lego with the ability to color. It appears that:

1. The ability to use the dominant hand comes before the ability to use the non-dominant hand.

2. As the task is more complicated and demands more delicate coordination, the ability to use the non-dominant in a simpler task does not necessarily means that the child has the ability to use his or her non-dominant hand in more delicate tasks.

3. In the specific case of the children from Creative Foundation School the ability to use the non-dominant hand in correctly joining 3 cubes of Lego also demanded the cognitive ability in understanding the middle line of a cube. The ability to use the non-dominant hand while joining the two cubes with the third one came hand with hand with the understanding of the middle line of a cube. However, it is not clear if the higher cognitive level enhanced better bilateral coordination in the Lego task which was more complicated and delicate from coloring a shape on a paper.

Picture 5: Good bilateral coordination in toddler while building with Duplo Legos [p8].

The children in Kindergarten 1 at Creative Foundation School who were one year older than the U.S.A. children, could not join 3 Lego bricks by themselves unless they were shown how to do it and instructed to use both hands endless times. They were up to 3 years of delay in their bilateral coordination development of their hands. This also caused delay in their cognitive development since they could not experience the same things as the children in U.S.A experience at the same age.

Why is bilateral coordination development important, and is there a connection to cognitive ability?

Bilateral coordination refers to the ability to coordinate both sides of the body at the same time in a controlled and organized manner. For example, stabilizing a paper with the non-dominant hand while writing on the paper or cutting the paper with the dominant hand. Good bilateral coordination is an indication that both sides of the brain communicate effectively and share information [114, 117].

Most of our daily activities demand bilateral coordination (bimanual performance). Children who have difficulty in coordinating both sides of their body can have difficulty in completing daily tasks such as dressing and tying shoes, fine motor activities such as banging blocks together, stringing beads, buttoning, visual motor tasks such as drawing, writing, cutting, catching and throwing, and gross motor activities such as crawling, walking, climbing stairs, and riding a bike [114].

Bilateral coordination is also very important in cognitive development. As an infant investigates the world around, he or she interacts with the external environment. Their brain reacts to this interaction inputs. Studies involving neuroimaging have found that increased physical activity promotes the formation of grey matter in the brain (consisting of neuronal cell: bodies cell, dendrites unmyelinated axons, synapse, glial cells and capillaries of blood) [115, 116]. It means that a child that sits idle in one place will be slow in cognition in comparison to a child that explores his or her environment. Inability to use two hands in coordination limits the variety of activities a child can participate in, and therefore limits his or her experience with the environment.

Late experience of the environment, such as in the case of Creative Foundation School children, that were able to build with Lego Duplo bricks using both hands only at the age of 5 to 6 years old, would cause less neural development in comparison to children that already can build with Lego Duplo at age of 2 to 3 years old.

Bilateral exertions (tasks that can be done only by using two hands) demand more neural activation in comparison to unilateral exertions (tasks that can be done using one hand). Greater levels of activation in bilaterally exertions and movements were observed in different regions of the brain: on the surface of the brain = cortical areas, inside the brain=sub-cortical areas, and the cerebellum= hind brain [117].

The possible effect of the hot water massage on bilateral coordination.

The cortical areas (the external layers) of the brain are most affected by the hot water massage to the head. The hot water applied on the head of a baby causes a cerebral blood flow decreases and hypoxia (deficiency in the amount of oxygen reaching the tissues) in the brain by means of molecular changes [40]. Hypoxia is one of the causes for neural weakening in the cerebrum that if it reaches a permanent situation is called cerebral palsy [118]. One of cerebral palsy symptom is difficulty in bilateral coordination in the arms or/and hands.

One of the items in the Assisting Hand Assessment test for cerebral palsy or unilateral disability, under “arm use section”, is “stabilized by weight or a support test”, that test the need to stabilize paper by placing the non-dominant hand on it while the dominant hand draws on the paper [119]. If the children at the age between 2 and 4 years old from Creative Foundation School would have taken the Assisting Hand Assessment test, they might have given the impression that they are suffering from cerebral palsy or unilateral disability.

The fact that the children used both hands in coloring a shape on paper in Nursery 2, when they were instructed to do so, but failed to join 3 Lego bricks using their two hands, meant that even though they learnt to use both hands in coloring, they could not apply this knowledge to a different and more complicated task of building with Lego bricks

If the children in Nursery 2 and Kindergarten 1 could use, on their own accord, their both hands in coloring a shape on a paper, why could they not use, on their own accord, their both hands in another simple tasks of joining 3 Lego bricks as builder do? And why did it take them additional 1 to 2 years to learn to use their both hands in joining Lego bricks?

The hot water that was applied on their heads when they were newborn babies could have played a role in this.

The children took crayon in their hand and colored a shape drawn on an A4 size paper (Picture 2). Their non-dominant hand was resting beside their body. The problem was that the crayon dragged the paper along with it. It was impossible to color the shape unless the non-dominant hand rested on the paper and stabilized it. At first, when the school started to operate, none of the 18 new pupils used their non-dominant hand to stabilize the paper while their dominant hand was drawing with the crayon. When their non-dominant hand was placed on the paper by the teacher, the children immediately dropped it from the table. After practicing for one year, when the children of Nursery 1 came to Nursery 2 this ability came to them more freely in the sense that they could place the non-dominant hand on the table or the paper when instructed to do so, and the non-dominant hand did not drop immediately but stayed for some time on the paper. However, all through Nursery 2, the teacher had to remind them to use the non-dominant hand in order to keep the paper in one place. When the children were in Kindergarten 1 there was no need to instruct them to use both hands while drawing, they did it on their own initiative. The dominant hand colored and the non-dominant hand stabilized the paper.

Bilateral coordination can be seen already in babies who are a few months old when they pass a toy from one hand to another. No one teaches the babies to do that, they initiate it and do it on their own accord [112]. A true consistent hand preference (right or left hand) develops between the age of 2 and 4 years old (Picture 3). For example: drawing, writing, or painting with the dominant hand, and stabilizing the paper with the non-dominant hand.  Alternatively, using the dominant hand to build tower with blocks, and stabilizing and help keeping the blocks lined up with the non-dominant hand. Together the two hands complete the tasks [161, 163].

bilateral coordination in toddler drawin

bilateral coordination in toddler buildi

Toddlers with a good bilateral coordination are expected to be able to use both hands in building with Legos bricks (Picture 5). There is a range of normality in the development of a child. Building a tower with 8 to 10 bricks is expected before 2.5 years old. By 30 months (2.5 years old), toddlers start building more complex structures, like a bridge or a train. In these more complicated structures, the children must join the Lego bricks with both hands, and should be able to join 3 cubes or more as shown in table 1D and 1E in order to succeed [164].

Children at the age between 3 and 4 years old in the U.S.A. were requested to join 2 and 3 Legos bricks by reconstructing exactly the design they saw in a model. In this task they had to consider the exact distance of the pipes between the bricks (see the pipes on the brick in Picture 4). The task could not have been achieved by using only one hand. The result showed that the 3 bricks were joined inaccurately according to the model. They made a mistake in the distance measured by the number of pipes but did not fail to join the bricks [162].

Non-dominant hand.

The children in Nursery 1 and 2 learnt how to join big Lego bricks (see a sample in Picture 4).

Nursery 1 (N1): The children learnt to join the big bricks Lego one on top of the other (Table 1, A). They used their dominant hand while their non-dominant hand was resting against their body.
Nursery 2 (N2): The children learnt to join 3 bricks as builders do when they build a wall (table 1 D). Since they tended to use their dominant hand alone, they could not put two bricks next to each other in a straight line (table 1 B). They were instructed to use the non-dominant hand and they were helped by the teacher. Using the non-dominant hand was not an easy task for them, and for some of them it was very difficult. However, once they were able to put the two bricks in a straight line, they removed the non-dominant hand from the table and tried to join a third brick on top of the two bricks with only the dominant hand. None of the children initiated the use of both their hands. Since they use the dominant hand alone, those who succeed to join the 3 blocks could not join the third brick in the middle (Table 1 C). The concept of the middle of a brick (shown with a red line in Picture 4,Table 1 C and 1 D) was very difficult for the children In Nursery 2 to understand, even though it was pointed out and demonstrated to them how to join the bricks again and again (Table 1 C).
Kindergarten 1 (K1): The pupils could master joining 2 Lego bricks with a third one as required using both hands (table 1 D). However, they could do it only by following the instructions of the teacher. Therefore, it was not clear if the children understood what the middle of a brick is or followed an action learnt by heart.
Kindergarten 2 (K2): Only at this age, the children correctly joined 3 bricks of Lego Duplo on their own accord (Table 1 E). Since they could join different numbers of bricks to form a wall, using both hands, and joining the bricks correctly in the middle, we could assume that the children in Kindergarten 2 finally not only had bilateral coordination but also understood the concept of 'middle'.

This boy is in Primary 1 in one of the rural areas of Ghana. He uses both hands when writing in an exercise book. The dominant right-hand writes while the non-dominant left hand is placed on the exercise book to prevent it shifting from one side to another. If the boy would write on a sheet of paper and he uses only the dominant hand, as he presses with the pencil on the paper, the paper will move with the pencil and the boy will not be able to write.

Coordination of both hands: Nursery 1, 2 and Kindergarten 1, 2.
(Nursery 1 = 10 children, ages: 2 to 3 years old. Nursery 2 = 8 children, ages 3 to 4 years old.) (Kindergarten 1 = 7 children, ages: 4 to 5 years old, Kindergarten 2 = 7 children, ages: 5 to 6 years old)

Abstract.

Bilateral Coordination of both hands is the ability to use the two hands (dominant and non-dominant) together at the same time to perform a task that cannot be done with one hand. The children from Nursery 1 up to Kindergarten 1 demonstrated poor bilateral coordination. The children in Nursery 1 were not able to color a shape on a paper while using their non-dominant hand to stabilize the paper so it would not shift with the crayon. Only in Nursery 2 this ability was more natural to them. However, they had to be reminded all the time to use their non-dominant hand to support the paper. In Kindergarten 1 it was difficult for the children to join three Lego bricks as builders do. Toddlers who are 2 years old are expected to use both hands in performing a task such as drawing, using the non-dominant hand to support the paper. What is not yet distinct is which hand will be the dominant hand.

The hot water applied to the head of a baby causes cerebral blood flow to decrease. This results in hypoxia (lack of oxygen) that can end in neural weakening in the cerebrum. A permanent neural weakening is called cerebral palsy. One of cerebral palsy symptoms is the difficulty in bilateral coordination of the arms and hands.

Picture 4: A sample of the Lego Duplo brick the children used for their Lego's tasks.

Research on the practice of massaging the head of a baby with hot water and ointments in Ghana. By Dzamesi Yael (Ph.D. in Science Education)

Non-dominant hand.

Picture 4: A sample of the Lego Duplo brick the children used for their Lego's tasks.

Contact: Dr. Yael Dzamesi (Ph.D.)