Brief reaching training with “sticky mittens” in preterm infants: Randomized controlled trial

ObjectiveTo examine whether a brief reaching training with sticky mittens was effective to improve reaching behavior in newly reaching preterm infants.MethodsIn this randomized controlled trial, twenty four 5-month-old (±16-week-old corrected age) preterm infants were randomly allocated into experimental or control groups. Infants were assessed three times in a single session: pretraining (immediately before training), posttraining (immediately after training), and retention (4 min after the posttraining). During training, infants in the experimental group wore open fingers Velcro covered mittens. Training consisted of one 4-minute session of stimulated reaching using Velcro covered toys. Controls did not receive the training. During assessments, infants were placed in a baby chair and toys without Velcro were offered at their midline for 2 min. Number of total reaches, proximal adjustments and distal adjustments of reaching were primary outcomes. Grasping was a secondary outcome.ResultsGroups were similar in the pretraining. In the posttraining, trained infants performed greater amount of total reaches and bimanual reaches than untrained infants. Greater amount of bimanual reaches in trained infants was maintained in the retention test. Distal adjustments and grasping outcome were not influenced by the training.ConclusionsA brief-term training with open fingers sticky mittens benefited reaching behavior and favored retention of increased bimanual reaches in newly reaching late preterm infants. However, it was not sufficient to influence hand openness and early grasping.     

Age Changes in Interlimb Coupling and the Development of Bimanual Coordination

Changes in interlimb coupling, and their role in the development of bimanual coordination, were studied longitudinally in 6- to 12-month-old infants (N = 6). Infants were observed while they were reaching for simple objects of 2 different sizes. Their use of a uni-versus bimanual strategy for reaching as well as the coupling of their bimanual movements were compared; progress in bimanual coordination of complementary movements was evaluated on 8 different bimanual tasks. The bimanual tasks involved an asymmetrical cooperation between the 2 hands. Although spatiotemporal coupling of bimanual reaching movements did not decrease during the age period studied, infants around 7 months of age used their 2 hands infrequently for reaching. Occurrences of bimanual reaching were particularly low at the session preceding the first bimanual success at a bimanual task. This suggests that the temporal coincidence between greater independence of the 2 hands and progress in bimanual coordination of complementary movements acts in 2 directions: Infants may be more at ease when using their 2 hands in differentiated patterns as the hands move less in synchrony, but, in turn, they may be less likely to move their hands in synchrony as the anticipate mirror manipulations of the object less. The frequency of bimanual reaches increased toward the end of the 1st year. This might have been caused by an increase in the repertoire of bimanual asymmetrical object manipulations and by the fact that the development of bimanual coordination allows infants to manipulate objects with complementary movements even after a bimanual approach toward the object.     

Bimanual reaching across the hemispace: Which hand is yoked to which?

When both hands perform concurrent goal-directed reaches, they become yoked to one another. To investigate the direction of this coupling (i.e., which hand is yoked to which), the temporal dynamics of bimanual reaches were compared with equivalent-amplitude unimanual reaches. These reaches were to target pairs located on either the left or right sides of space; meaning that in the bimanual condition, one hand's contralateral (more difficult) reach accompanied by the other hand's ipsilateral (easier) reach. By comparing which hand's difficult reach was improved more by the presence of the other hand's easier ipsilateral reach, we were able to demonstrate asymmetries in the coupling. When the cost of bimanual reaching was controlled for the contralateral reaching left hand's performance was improved, suggesting that the left hand is yoked to the right during motor output. In contrast, the right hand showed the greatest improvements for contralateral reaching in terms of reaction time, pointing toward a dominant role for the left hand in the processes prior to movement onset. The results may point toward a mechanism for integrating the unitary system of attention with bimanual coordination.     

Reaching skills of infants born very preterm predict neurodevelopment at 2.5 years

The purpose was to investigate associations between quality of reaching for moving objects at 8 months corrected age and neurodevelopment at 2.5 years in children born very preterm (gestational age (GA), 24–31 weeks). Thirtysix infants were assessed while reaching for moving objects. The movements were recorded by a 3D motion capture system. Reaching parameters included aiming, relative length of the reach, number of movement units, proportion of bimanual coupled reaches and number of hits. Neurodevelopment was assessed at 2.5 years by the Bayley Scales of Infant Development III. There were strong associations between infant reaching kinematics and neurodevelopment of cognition and language but the patterns differed: in children born extremely preterm (GA < 28 weeks), planning and control of reaching was strongly related to outcome, while in children born very preterm (GA 28–31 weeks) number of hits and bimanual strategies were of greater relevance. In conclusion, for extremely preterm infants, basic problems on how motion information is incorporated with action planning prevail, while in very preterm infants the coordination of bimanual reaches is more at the focus. We conclude that the results reflect GA related differences in neural vulnerability and that early motor coordination deficits have a cascading effect on neurodevelopment.     

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.     

Linked proximal and distal changes in the reaching behavior of 5- to 12-month-old human infants grasping objects of different sizes

This study evaluates age-related proximal and distal changes in reaching organization for objects of different sizes. To this end, eight objects ranging from 2 to 9 cm diam. were presented to 23 infants ages 5 to 12 months. Proximal control was determined by the relative frequencies of bimanual reaching for large and small objects. Distal control was assessed by hand opening and orientation with respect to an object, and by the proportion of the object being included within hand opening at touch. Five-month-old infants tended to reach bimanually regardless of object size. Starting at 7 to 8 months, infants tended to reach for large objects bimanually more often than for small ones. Only at 11 to 12 months did reaching closely reflect the object’s diameter. The frequency of thumb-index finger angle opening during the approach phase also increased after 7 to 8 months of age, as well as the adjustment of the angle to the object diameter and the proportion of the object within hand opening at touch. Proximal and distal changes appeared coupled at 5 to 6 months, when the few subjects showing evidence of some proximal adjustments to object size were also those who exhibited some distal adjustments. After they started to appear, however, proximal and distal adjustments seemed to be independent, as revealed by the lack of correlation of proximal and distal changes between 7 and 12 months.     

Manual asymmetries in bimanual reaching: the influence of spatial compatibility and visuospatial attention

The goal of the present investigation was to explore the possible expression of hemispheric-specific processing during the planning and execution of a bimanual reaching task. Participants (N = 9) completed 80 bimanual reaching movements (requiring simultaneous, bilateral production of arm movements) to peripherally presented targets while selectively attending to either their left or right hand. Further, targets were presented in spatially compatible (ipsilateral to the aiming limb) and incompatible (contralateral to the aiming limb) response contexts. It was found that the left hand exhibited temporal superiority over the right hand in the response planning phase of bimanual reaching, indicating a left hand/right hemisphere advantage in the preparation of a bimanual response. During response execution, and consistent with the view that interhemispheric processing time (Barthelemy & Boulinguez, 2002) or biomechanical constraints (Carey, Hargreaves, & Goodale, 1996) generate temporal delays, longer movement times were observed in response to spatially incompatible target positions. However, no hemisphere-specific benefit was demonstrated for response execution. Based on these findings, we propose lateralized processing is present at the time of response planning (i.e., left hand/right hemisphere processing advantage); however, lateralized specialization appears to be annulled during dynamic execution of a bimanual reaching task.     

Proximal and distal adjustments of reaching behavior in preterm infants

The authors aimed to investigate proximal and distal adjustments of reaching behavior and grasping in 5-, 6-, and 7-month-old preterm infants. Nine low-risk preterm and 10 full-term infants participated. Both groups showed the predominance of unimanual reaching, an age-related increase in the frequency of vertical-oriented and open hand movement, and also an increase in successful grasping from 6 to 7 months. The frequency of open hand was higher in the preterm group at 6 months. Intrinsic restrictions imposed by prematurity did not seem to have impaired reaching performance of preterm infants throughout the months of age.     

Development of the infant's hand preference for visually directed reaching: Preliminary report of a longitudinal study

The development of hand preference in infancy was investigated longitudinally by using a visually-directed reaching task. Thirty-two infants, equally divided into groups of familial right- and left-handed boys and girls, were tested every 3 weeks from 24 to 39 weeks of age and once again at 52 weeks. Group trends for the development of hand preference were differentiated by familial handedness and sex of the infant. At all ages, test object position (to the infant's right or left) strongly influenced the hand used for reaching. Marked variability both between and within infants demonstrated an instability of early hand preference, an effect that could be appreciated fully only with a prospective longitudinal design. The results thus suggest that the development of hand preference for reaching is highly variable, discontinuous, and related to the interaction of sex and familial handedness.     

A developmental analysis of the relationship between hand preference and performance: II. A performance-based method of measuring hand preference in children

The present study describes a performance-based method of measuring hand preference in children. Three aspects of handedness were considered to be important in developing the paradigm (a) overall hand preference across a number of tasks, (b) consistency of hand use and, (c) the use of the preferred hand in a bimanual task. The new paradigm, termed the WatHand Box Test (WBT), requires participants to perform a variety of unimanual tasks such as, using a hammer, tossing a ball, and opening a lock with a key. To determine the validity of the WBT and examine the developmental trends in hand preference, eighty right-handed children and adults (ages 3-4, 6-7, 9-10, and 18-24 years) performed the WBT. First, the WBT was found to correlate significantly with scores on a standard hand preference questionnaire for the adults. As well, significant developmental trends were noted in hand preference as measured by the WBT. Most specifically, three- and four-year-olds had significantly lower scores on the WBT indicating a less stable pattern of hand preference than in the other three age groups.     

Attentional asymmetries during concurrent bimanual performance

An asymmetry of attention was observed when subjects attempted to perform concurrent, relatively independent tasks with the two hands: right-handed subjects performed very much better on a dual task which required them to follow the beat of a metronome with the left while tapping as quickly as they could with the right than with the converse arrangement. It is suggested that attentional strategies which have evolved to allow guidance of interdependent skilled bimanual activities are also used when subjects attempt to perform relatively independent concurrent bimanual movements, which are not observed in the naturally occurring motor repertoire. Thus, interactions between hand, hand preference and nature of task are an important factor in dual task performance.     

Unimanual and bimanual tasks and the assessment of handedness in toddlers

The goal of this study was to examine the relations between three different measures of handedness: unimanual reaching, bimanual manipulation and unimanual manipulation. The appropriateness of the task chosen to evaluate handedness was also explored by contrasting different bimanual manipulation tasks for the more or less differentiated (passive\active) roles assigned to each hand. Forty children, between 18 and 36 months of age, were tested in the three conditions. The results show that the degree of bimanual handedness is greater on the bimanual tasks with a strong role differentiation than on the tasks with less differentiation. Bimanual tasks with a strong role differentiation elicited more right‐handedness than unimanual reaching. Among the children who showed handedness in reaching, the correlation between unimanual and bimanual handedness was high, especially for right‐handers. For some tasks, bimanual handedness appeared at the earliest age studied here (18 months), and there was little relationship between bimanual handedness and bimanual skill. In contrast with unimanual reaching, there was no age‐related change in the degree of handedness for either bimanual or unimanual manipulation. There was a bias toward the use of the right hand for unimanual manipulation. It was concluded that grasping is not the best task to employ to look for robust evidence of handedness, and that bimanual tasks offer a better way to estimate handedness in children, as long as the tasks are carefully chosen.     

Hand-use preference for reaching and object manipulation in 6- through 13-month-old infants

Validity, reliability, and stability of separate assessment of hand-use preferences for reaching, object manipulation, and complementary bimanual action were determined for 6 through 13 month-old male and female infants. Only hand-use preferences for complementary bimanual action varied with age. Females had more distinct hand-use preference than males but only for object manipulation. Comparison of hand-use preference among these different sensorimotor skills can provide a richer evaluation of infant handedness status required for systematic study of the development of neuropsychological functions during infancy.     

Does late preterm birth impact trunk control and early reaching behavior?

The aims of the study were to 1) verify the level of trunk control longitudinally and reaching behavior while sitting in two positions in late preterm (LPT) and full-term (FT) infants, 2) determine whether the level of trunk control relates to reaching outcomes. Twenty LPT infants and 36 infants born FT were assessed via three in-lab visits: at 6, 7, and 8 months. At each visit, the Segmental Assessment of Trunk Control (SATCo) and reaching assessment were performed, where the infants were positioned sitting in the ring and at 90° of flexion of hips, knees, and ankles. Accurate manual support to the trunk was provided in each visit. LPT infants presented a lower level of trunk control over time. LPT infants presented a higher percentage of unimanual reaches and successful grasping at 7 months' visit, and a higher number of reaches at 8 months' visit compared to FT infants. The sitting positions did not influence reaching performance. The level of trunk control relates to functional reaching strategies only in FT infants. This study might provide insights for clinicians for understanding the level of trunk control, the importance of reaching behaviors for exploration, and considering these behaviors as strategies for intervention.     

Why do young infants fail to search for hidden objects?

Recent evidence indicates that infants as young as 3.5 months of age understand that objects continue to exist when hidden (Baillargeon, 1987a; Baillargeon & DeVos, 1990). Why, then, do infants fail to search for hidden objects until 7 to 8 months of age? The present experiments tested whether 5.5-month-old infants could distinguish between correct and incorrect search actions performed by an experimenter. In Experiment 1, a toy was placed in front of (possible event) or under (impossible event) a clear cover. Next, a screen was slid in front of the objects, hiding them from view. A hand then reached behind the screen and reappeared holding the toy. The infants looked reliably longer at the impossible than at the possible event, suggesting that they understood that the hand's direct reaching action was sufficient to retrieve the toy when it stood in front of but not under the clear cover. The same results were obtained in a second condition in which a toy was placed in front of (possible event) or behind (impossible event) a barrier. In Experiment 2, a toy was placed under the right (possible event) or the left (impossible event) of two covers. After a screen hid the objects, a hand reached behind the screen's right edge and reappeared first with the right cover and then with the toy. The infants looked reliably longer at the impossible than at the possible event, suggesting that they realized that the hand's sequence of action was sufficient to retrieve the toy when it stood under the right but not the left cover. A control condition supported this interpretation. Together, the results of Experiments 1 and 2 indicate that by 5.5 months of age, infants not only represent hidden objects, but are able to identify the actions necessary to retrieve these objects. The implications of these findings for a problem solving explanation of young infants' failure to retrieve hidden objects are considered.     

Multiple measures of hand-use lateralization in the ring-tailed lemur (Lemur catta)

Evaluated a free-ranging matriline of 13 ring-tailed lemurs (Lemur catta) from videotaped records for lateralized hand use with 2 tasks and 4 measures: food reaching, feeding posture, duration of food holding, and manipulation of food between mouth and hand while eating. Binomial z scores determined 7 lemurs to be left preferent in reaching, 3 right, and 3 ambipreferent. Ideographic analyses suggested possible sex-linked and early experience twin effects. When compared to right and ambipreferent lemurs, left reach preferent lemurs used the left hand more but bimanuals grasped less in food holding and also engaged in less hand-mouth food manipulation. The tendency to manipulate food was not correlated with bimanual holding but was inversely related to left hand holding and directly related to right hand holding. These patterns are discussed as possible precursors of human bimanual manipulation.     

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).     

Re-examining structural constraints on the initiation of bimanual movements: the role of starting locations, movement amplitudes, and target locations

Structural constraints affect the coordination of bimanual movements in ways that have been taken to suggest that the specification of different movement amplitudes is subject to strong intermanual interference effects. Most experiments taken to support this notion, however, confounded variations of movement amplitudes with symmetry in starting locations and variations in target location. The present experiment was designed to further investigate the relative influence of the parameters starting location, movement amplitude, and target location on bimanual movement coordination. Participants performed simultaneous reaching movements with the left and right hand from same and different starting locations to same and different target locations. On each trial, two movements could match on none, one, or all of the parameters. We assessed the influence of each parameter by comparing conditions in which only a single parameter matched between the two hands with conditions in which all parameters differed. The reaction-time data revealed some challenging results for previous studies: (1) same starting locations significantly delayed movement initiation; (2) specifying movement amplitudes had virtually no effect on movement initiation, whereas (3) selecting same target locations significantly benefited the bimanual responses. These findings cannot be taken to support the notion that amplitude specification affects the initiation of bimanual movements. Rather, they support the notion that the initial starting locations of the two hands and the selection of target locations decide about the ease with which we perform bimanual reaching movements.     

Co-ordination of bimanual movements in a centrally deafferented patient executing open loop reach-to-grasp movements

Many everyday tasks require that we use our hands co-operatively. For tasks where both hands are required to perform the same action, a common motor program can be used. But, where each hand must perform a different action, some degree of independent control of each hand is required. In this paper we examine the co-ordination of bimanual movement kinematics in a female patient recovering from brain injury involving anterior regions of the parietal lobe of the right hemisphere, which has resulted in a dense hemianaesthesia of her left arm. A particular focus of this paper is the co-ordination of bimanual movements for reaches executed without visual feedback. Specifically we present new data, which quantify the synchronisation of patient D.B.'s hands by comparing their relative time lag at the start and the end of her bimanual reaches. The results are discussed with particular reference to the role played by limb proprioception in the planning and control of prehension movements.     

Perturbations in Action Goal Influence Bimanual Grasp Posture Planning

The authors examined the effects of perturbations in action goal on bimanual grasp posture planning. Sixteen participants simultaneously reached for 2 cylinders and placed either the left or the right end of the cylinders into targets. As soon as the participants began their reaching movements, a secondary stimulus was triggered, which indicated whether the intended action goal for the left or right hand had changed. Overall, the tendency for a single hand to select end-state comfort compliant grasp postures was higher for the nonperturbed condition compared to both the perturbed left and perturbed right conditions. Furthermore, participants were more likely to plan their movements to ensure end-state comfort for both hands during nonperturbed trials, than perturbed trials, especially object end-orientation conditions that required the adoption of at least one underhand grasp posture to satisfy bimanual end-state comfort. Results indicated that when the action goal of a single object was perturbed, participants attempted to reduce the cognitive costs associated with grasp posture replanning by maintaining the original grasp posture plan, and tolerating grasp postures that result in less controllable final postures.