Hand Function 0-7 months: Difference between revisions

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'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>
== Introduction ==
== Introduction ==
Newborns have limited vision leading the majority of their motor and sensory experiences to their surrounding surfaces.  In order to learn about the world around them, they use body to explore and interact.  Spontaneous self-generated movements of the legs and arms provide contact and touch to their environment.  These spontaneous movements support proprioceptive feedback about their posture and where there limbs are in space. <ref>DiMercurio A, Connell JP, Clark M, Corbetta D. [https://www.frontiersin.org/articles/10.3389/fpsyg.2018.02613/full#:~:text=10.3389%2Ffpsyg.2018.02613-,A%20Naturalistic%20Observation%20of%20Spontaneous%20Touches%20to%20the%20Body%20and,First%202%20Months%20of%20Life&text=Self%2Dgenerated%20touches%20to%20the,body%20and%20self%20in%20infancy. A naturalistic observation of spontaneous touches to the body and environment in the first 2 months of life.] Frontiers in psychology. 2018:2613</ref> As infants increase their motor skills, they can better reach and grasp objects in a variety of ways allowing them to engage with caregivers. <ref>LeBarton ES, Landa RJ. [https://www.sciencedirect.com/science/article/abs/pii/S0163638318300626 Infant motor skill predicts later expressive language and autism spectrum disorder diagnosis]. Infant Behavior and Development. 2019 Feb 1;54:37-47.</ref> Reaching enables the infant to bring the hand to the target while the grasp allows the hand to manipulate the toy.<ref>Thomas BL, Karl JM, Whishaw IQ. [https://www.researchgate.net/publication/271535351_Independent_development_of_the_Reach_and_the_Grasp_in_spontaneous_self-touching_by_human_infants_in_the_first_6_months Independent development of the Reach and the Grasp in spontaneous self-touching by human infants in the first 6 months]. Frontiers in psychology. 2015 Jan 8;5:1526.</ref>  Newborns will intuitively grasp objects that are positioned into their hands, while 4 months old can reach for distal objects.  By 12 months, infants can use their arms to facilitate hand grasps that is equal to that of an adult.<ref>Sacrey LA, Zwaigenbaum L, Bryson S, Brian J, Smith IM. [https://link.springer.com/article/10.1186/s11689-018-9259-4 The reach-to-grasp movement in infants later diagnosed with autism spectrum disorder: a high-risk sibling cohort study.] Journal of neurodevelopmental disorders. 2018 Dec;10(1):1-1.</ref>
Newborns have limited vision leading the majority of their motor and sensory experiences to their surrounding surfaces.  In order to learn about the world around them, they use body to explore and interact.  Spontaneous self-generated movements of the legs and arms provide contact and touch to their environment.  These spontaneous movements support proprioceptive feedback about their posture and where there limbs are in space. <ref>DiMercurio A, Connell JP, Clark M, Corbetta D. [https://www.frontiersin.org/articles/10.3389/fpsyg.2018.02613/full#:~:text=10.3389%2Ffpsyg.2018.02613-,A%20Naturalistic%20Observation%20of%20Spontaneous%20Touches%20to%20the%20Body%20and,First%202%20Months%20of%20Life&text=Self%2Dgenerated%20touches%20to%20the,body%20and%20self%20in%20infancy. A naturalistic observation of spontaneous touches to the body and environment in the first 2 months of life.] Frontiers in psychology. 2018:2613</ref> As infants increase their motor skills, they can begin to reach and grasp objects in a variety of ways. <ref>LeBarton ES, Landa RJ. [https://www.sciencedirect.com/science/article/abs/pii/S0163638318300626 Infant motor skill predicts later expressive language and autism spectrum disorder diagnosis]. Infant Behavior and Development. 2019 Feb 1;54:37-47.</ref> The reaching motion enables the infant to bring the hand to the target while the grasping movement provides the hand the opportunity to manipulate the toy.<ref>Thomas BL, Karl JM, Whishaw IQ. [https://www.researchgate.net/publication/271535351_Independent_development_of_the_Reach_and_the_Grasp_in_spontaneous_self-touching_by_human_infants_in_the_first_6_months Independent development of the Reach and the Grasp in spontaneous self-touching by human infants in the first 6 months]. Frontiers in psychology. 2015 Jan 8;5:1526.</ref>   


=== Hands ===
=== Hands ===
Infants use their hands to serve many different purposesDuring the infant stage of 0-7 months the hands function can best be utilised for:
Newborns will intuitively grasp objects that are positioned into their hands but not distant objects.  Around 4 months old infants can begin to reach for distal targetsThe 12 month old can use their arms to facilitate hand grasps equal to that of an adult.<ref>Sacrey LA, Zwaigenbaum L, Bryson S, Brian J, Smith IM. [https://link.springer.com/article/10.1186/s11689-018-9259-4 The reach-to-grasp movement in infants later diagnosed with autism spectrum disorder: a high-risk sibling cohort study.] Journal of neurodevelopmental disorders. 2018 Dec;10(1):1-1.</ref>
 
In addition to manipulating toys, infants 0-7 months old use their hands to serve other purposes.  Hand function use during this stage can be for the following objectives:
# gathering information about their bodies and surrounding surfaces
# gathering information about their bodies and surrounding surfaces
# interacting with objects they encounter
# interacting with objects they encounter
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# body support and postural control<ref name=":0">Versfeld, P. Hand Function 0-7 month old Course.  Physioplus. 2022</ref>
# body support and postural control<ref name=":0">Versfeld, P. Hand Function 0-7 month old Course.  Physioplus. 2022</ref>


As the infant grows during this time period, each step of hand development augments the next stage.  From birth to 6-8 weeks, most hand movements are spontaneous in nature.  As they age from 2-6 months old, they are able to hold visual attention while exploring with their hands.  Lastly, infants 6-8 months old can now manipulate and grasp objects to make things occur leading to goal directed behaviour.<ref name=":0" />
 
As the infant grows during this time period, each step of hand development augments the next stage.  From birth to 6-8 weeks, most hand movements are spontaneous in nature.  As they age from 2-6 months old, they are able to hold visual attention while exploring with their hands.  Lastly, infants 6-8 months old manipulate and grasp objects that lead to goal directed behaviour.<ref name=":0" />


=== Self Touching ===
=== Self Touching ===
During the period of birth to 24 weeks, infants explore with their hands learning about their face, body and surrounding surfaces.  Young infants initially touch with the dorsum of their hands mainly in fists.  Eventually the fist position transitions into a semi-closed position with contact being on the side of the hand and back of the fingers.  Contact during this early period are brief.  As infants move into the 8-12 week period, contact time is increased, exploration is increased, and finger manipulation has begun.  From 12-24 weeks, palmar aspect of the hand is the contact point and touch is more complex.  During this stage hand rotation occurs and fingertip and palms drag alongside surfaces.  
During the period of birth to 24 weeks, infants hand exploration teaches them about their face, body and surrounding surfaces.  Young infants initially touch with their fists on the dorsum of their hands.  Eventually the fist transitions into a semi-closed position with contact being on the side of the hand and back of the fingers.  Contact with the hands during this early period are brief.  As infants move into the 8-12 week period, contact time is increased, exploration is increased, and finger manipulation has begun.  From 12-24 weeks, touch is more complex and the contact point is the palmar aspect of the hand.  During this stage infants can rotate their hands to explore objects.<ref name=":0" />  
 
<nowiki>**</nowiki> spontaneous movements can be affected by the support surface the infant is lying on
=== Spontaneous Movements ===
=== Spontaneous Movements ===
Spontaneous movements are general whole-body movements that are often seen in infants.  These maneuvers can last as long as several minutes to as short as several seconds.<ref>Tsuji T, Nakashima S, Hayashi H, Soh Z, Furui A, Shibanoki T, Shima K, Shimatani K. [https://www.nature.com/articles/s41598-020-57580-z Markerless measurement and evaluation of general movements in infants]. Scientific reports. 2020 Jan 29;10(1):1-3.</ref>  Spontaneous movements of the body help the infant bring their hands into contact with their body, surfaces and within their visual field.  Once an infant focuses on their hands or caregivers, spontaneous movements decrease. Around 10 weeks old, infants can bring their hands into midline.   
Spontaneous movements are general whole-body movements that are often seen in infants.  These maneuvers can last as long as several minutes to as short as several seconds.<ref>Tsuji T, Nakashima S, Hayashi H, Soh Z, Furui A, Shibanoki T, Shima K, Shimatani K. [https://www.nature.com/articles/s41598-020-57580-z Markerless measurement and evaluation of general movements in infants]. Scientific reports. 2020 Jan 29;10(1):1-3.</ref>  Spontaneous movements of the body help the infant bring their hands into contact with their body, surfaces and within their visual field.  Once an infant focuses on their hands or caregivers, spontaneous movements decrease. Around 10 weeks old, infants can bring their hands into midline.   

Revision as of 14:01, 26 May 2022

Original Editor - Robin Tacchetti based on the course by Pam Versfeld
Top Contributors - Robin Tacchetti, Jess Bell, Kim Jackson, Tarina van der Stockt and Ewa Jaraczewska

Introduction[edit | edit source]

Newborns have limited vision leading the majority of their motor and sensory experiences to their surrounding surfaces. In order to learn about the world around them, they use body to explore and interact. Spontaneous self-generated movements of the legs and arms provide contact and touch to their environment. These spontaneous movements support proprioceptive feedback about their posture and where there limbs are in space. [1] As infants increase their motor skills, they can begin to reach and grasp objects in a variety of ways. [2] The reaching motion enables the infant to bring the hand to the target while the grasping movement provides the hand the opportunity to manipulate the toy.[3]

Hands[edit | edit source]

Newborns will intuitively grasp objects that are positioned into their hands but not distant objects. Around 4 months old infants can begin to reach for distal targets. The 12 month old can use their arms to facilitate hand grasps equal to that of an adult.[4]

In addition to manipulating toys, infants 0-7 months old use their hands to serve other purposes. Hand function use during this stage can be for the following objectives:

  1. gathering information about their bodies and surrounding surfaces
  2. interacting with objects they encounter
  3. communication purposes
  4. body support and postural control[5]


As the infant grows during this time period, each step of hand development augments the next stage. From birth to 6-8 weeks, most hand movements are spontaneous in nature. As they age from 2-6 months old, they are able to hold visual attention while exploring with their hands. Lastly, infants 6-8 months old manipulate and grasp objects that lead to goal directed behaviour.[5]

Self Touching[edit | edit source]

During the period of birth to 24 weeks, infants hand exploration teaches them about their face, body and surrounding surfaces. Young infants initially touch with their fists on the dorsum of their hands. Eventually the fist transitions into a semi-closed position with contact being on the side of the hand and back of the fingers. Contact with the hands during this early period are brief. As infants move into the 8-12 week period, contact time is increased, exploration is increased, and finger manipulation has begun. From 12-24 weeks, touch is more complex and the contact point is the palmar aspect of the hand. During this stage infants can rotate their hands to explore objects.[5]

Spontaneous Movements[edit | edit source]

Spontaneous movements are general whole-body movements that are often seen in infants. These maneuvers can last as long as several minutes to as short as several seconds.[6] Spontaneous movements of the body help the infant bring their hands into contact with their body, surfaces and within their visual field. Once an infant focuses on their hands or caregivers, spontaneous movements decrease. Around 10 weeks old, infants can bring their hands into midline.

Different support surfaces can affect spontaneous movements of the limbs. Hard, firm surfaces for supine lying tends to place the infants lower extremities in extension with the upper extremities in abduction and elbow extension. This position provides less kicking and spontaneous movement. In contrast, a soft surface places a supine infant in more of a flexed position of the lower extremities with the upper extremities brought into midline near the mouth. In this flexed position, the hands are open and freely able to move to touch each other and the body.

** Reminder: spontaneous movements can be affected by the support surface the infant is lying on

Purpose of spontaneous movements[edit | edit source]

  • muscle strength
  • muscle endurance
  • sensory input
  • maintain steady head in response to upper extremity perturbations
  • shaping of corticospinal tract

*** Preterm and infants with developmental delay have less spontaneous movements

Intentional Reaching and Grasping[edit | edit source]

3-4 months[edit | edit source]

Between 3-4 months, infants will be intentionally reaching for objects to play with especially when it is introduced at midline. Some of the characteristics of intentional reaching are listed below:

  • reaching preceded by visual attention of the toy (allowing them to locate toy in space)
  • hand is open at the beginning of the reach until grasp
  • small, repetitive movements of the fingers provide for exploration of the toy shape and texture
  • lose grasp of toy when no longer within visual field

5-7 months[edit | edit source]

Intentional reach and grasp during the 5-6 month stage is characterised by the following:

  • able to maitain grasp of toy even when not within visual field
  • hold the toy with one hand and use the other hand to explore with their fingers
  • actions are more goal directed
  • grabbing different parts of the toy by use:
    • palmar-grip or
    • thumb-to-forefinger grip
  • pass toy from one hand to the other
  • shake and bang toys
  • when a new toy is introduced, they will drop old toy
  • mouthing of toys


Resources[edit | edit source]


Ref

  1. DiMercurio A, Connell JP, Clark M, Corbetta D. A naturalistic observation of spontaneous touches to the body and environment in the first 2 months of life. Frontiers in psychology. 2018:2613
  2. LeBarton ES, Landa RJ. Infant motor skill predicts later expressive language and autism spectrum disorder diagnosis. Infant Behavior and Development. 2019 Feb 1;54:37-47.
  3. Thomas BL, Karl JM, Whishaw IQ. Independent development of the Reach and the Grasp in spontaneous self-touching by human infants in the first 6 months. Frontiers in psychology. 2015 Jan 8;5:1526.
  4. Sacrey LA, Zwaigenbaum L, Bryson S, Brian J, Smith IM. The reach-to-grasp movement in infants later diagnosed with autism spectrum disorder: a high-risk sibling cohort study. Journal of neurodevelopmental disorders. 2018 Dec;10(1):1-1.
  5. 5.0 5.1 5.2 Versfeld, P. Hand Function 0-7 month old Course. Physioplus. 2022
  6. Tsuji T, Nakashima S, Hayashi H, Soh Z, Furui A, Shibanoki T, Shima K, Shimatani K. Markerless measurement and evaluation of general movements in infants. Scientific reports. 2020 Jan 29;10(1):1-3.