Dr. M. C. Mathew, Professor and Head, Developmental Paediatrics Unit.
My introduction to early school education was in 1986 when I visited the Pestalozzi Centre in Zurich and the Montessori Centre in Berlin
Let me give you an overview of diverse functions human hands perform during pre-school years.
1. The hand In Exploration
2. The hand In Perception
3. The hand In Co-Ordination
4. The hand In Prehension
5. The hand In Ambulation
6. The hand In Dominance
1. THE HAND IN EXPLORATION
A pre-school child uses the hand to feel his environment. He uses his hand to feel an object, and as he explores the object whether it be round or angular, soft or hard, smooth or rough he enlarges his cognitive skills and stores impressions which he can draw upon to add to his learning instinct. The motoric exploration starts soon after the baby is born. This exploration begins with an awareness of a contact with the mother and other surfaces of the object used for feeding, bath, etc and then moving the palm and the fingers around the object and finally holding it.
As awareness of objects existing in his or her play environment dawns on the child by late infancy. With the initiation of crawling by nine months or so, this exploratory instinct takes a new dimension, when a sensory exploration with mouthing becomes the pattern. It is the hand which aids this process in children with intact vision. This can occur while being fed, bathed, dressed, being held in the arms of adults, sitting or while walking around. The touch is integrated with seeing and hearing and this combination of sensations contribute to the cognitive carpeting of the mind . When the sensory functions are impaired, the perceptions about the hand are limited. A pre-school child who has difficulty with seeing may feel the shape of the ball given to him but may not be able to associate it with the colour or movement of it.
Exploration as a process of primary learning can be hampered when there are restraints or the child is inhibited to explore. Helen Keller required Mrs. Sullivan to explain the sensations she felt so that when the water fell on her hands she could cry out “water” in a moment of comprehension.
Exploration is primary to pre-school learning. The brain is either a store house of integrated information or just a reservoir of isolated facts. As the child explores the environment he builds up a store of facts and also learns to associate these facts with one another and also with related images.
II. THE HAND IN PERCEPTION
The hand is the primary and most sensitive organ of the body for touch. Touch receptors located in the skin relay sensations to the brain which helps the brain to perceive the object. They convey information concerning the object with regard to form (solid, liquid), shape (round, square), size (big, small), texture (smooth, rough, soft, hard, flat), weight (heavy, light), movement (kinetic, static). This information helps the brain to identify the object and perceive its function. The pre-school child learns to interact with the environment by using his hands such as, how much pressure is required to break a stick or how to hold the pencil so the point makes a line on the paper or how to push a button through the button hole or how much effort is required to throw the ball over the net or how to place the bat in the path of a ball so that it makes contact or how much pressure is required to hold a glass without dropping it or how to fold a paper to make a paper boat without crushing it.
These concepts which are discerned through the function of the hands form the basis of perception. The sensations from the hand conveyed to the brain form a mental picture which creates concepts that are stored in the memory. When a child wants to a play ball, he picks up the bat or when she sits at a table she picks up the chappathi and eats it or when she wants to do her homework she picks up a pencil and opens her book - these actions take place almost unconsciously without any anticipatory planning because the concepts have been learnt.
When these perceptions are poorly developed the child may fall often or be prone to accidents. He cannot judge the distance and so he drops the ball thrown to him, when plucking a rose flower she may hold the stem so forcefully that she crushes it. A child with impaired hand perception, subsequently has poor sensory-motor comprehension and performs clumsily.
III. THE HAND IN CO-ORDINATION
The force and direction with which the motor skills are performed is coordinated by the hand. When the child picks up a ball and throws it into a basket, the hand harmonises the action so that there is a smooth and even flow of movement. The hand synchronises all the steps of the movement with the help of the child’s visual and spatial perception so that the ball reaches the basket.
This takes place smoothly when the child receives adequate visual cues. He can make the appropriate movements of approximation and release of the ball and the movement is coordinated by suitable hand movements. What the child feels with his hands instructs him to make the appropriate movement and in the process to discover the function of the object he is handling. The sensory and kinaesthetic dimensions add precision to this process. When a child drops a pebble into a bucket of water he anticipates the rippling of the water. This invites him to drop the pebble into the bucket of water and not outside. When the visual attention or perceptual ability or the sensory awareness are hampered the skills of co-ordination develop poorly.
IV. THE HAND IN PREHENSION
Prehension is the action of picking up objects. The ability for good prehension is a fundamental aspect of dexterity and is one of the primordial early childhood behaviours.
There is graphomotor centre in the motor cortex situated adjacent to Broca’s area, which is located in the left side in right handed people.
The pre-requisite for prehension is MANIPULATIVE MOVEMENTS. ThIs is called SYNERGY. There can be three type of synergy in PREHENSION.
a. Simple Synergy: All the fingers join together in a unified motion to perform the function , such as in squeezing a soft ball.
b. Reciprocal Synergy
Combination of movements in which the thumb and other fingers carry out different movements such as the movements required for the ‘thumbs up sign’ flexion of fingers and extension of thumb.
c. Sequential synergy
The co-ordination of the fingers takes place in sequence. e.g. while washing hands initially the linear movements are made and the rotatory movements of the fingers.
Among these three different types of synergies, in prehension, simple synergy is useful in penmanship, reciprocal synergy in continuous writing and sequential synergy in visual motor co-ordination required in writing.
If the skills of exploration, perception, and co-ordination are hampered, this may lead to poor penmanship and untidy writing. It is neither because of carelessness or laziness that a child with impaired prehensile skills has poor hand writing. Visual spatial dysgraphia, motor dysgraphia, apraxic dysgraphia and executive dysgraphia are the consequences of inadequate development of prehensile hand function.
V. THE HAND IN AMBULATION
What the feet are to the child when he takes his first steps, the hands are to the child when he is falling. They are held out in appropriate positions to hold on to objects and to protect him from falling. They developreciprocal movements to assist in the process of ambulation. The swinging movements of the arms with every forward movement of the legs help in balance.
By three years most children develop synchronised walking, which is because the easy movement of hands and body while walking. Good posture and ambulation include the development of reciprocal movements, swinging movements and synchronized movements
There is considerable dysfunction in pre-school children if there is asymmetry of motor development caused by flat feet, hyper mobile joints, floppy muscles and dysfunctions of motor coordination.
Some children excel in sports, gymnastics, dance, acrobatics. They are able to integrate body and hand movements to develop smooth and easy flow of movement. This process of development continues during the pre school years. The hand function is central to the development of a stable and dynamic gait.
VI. THE HAND DOMINANCE
Handedness is the preference for one hand for eating, writing and performing daily activity. Handedness varies from person to person and from time to time in some. Some people may be left handed (3-4%), while others are right handed (66%). The remaining are bimanual. Handedness is related to the development of the cerebral hemispheres.
The two cerebral hemispheres differ in their predominant functions. The right hemisphere is responsible for non-verbal communication, lateral thinking and problem solving skills. The left hemisphere is responsible for speech, writing and processing of information. And yet it is not necessary that those who are left handed, should have the right hemisphere as the dominant hemisphere. Besides looking for hand preference, it is also necessary to look for dominance of eye, ear and leg. It is possible to determine if the pattern of dominance is fully right sided or mixed by the time the child is four or five years old.
The question is often asked what happens if the left handed dominance is interfered with and the child is compelled to use the right hand. Suppression of the dominant side can cause dysfunction of speech, writing etc., If we force the left handed child to use his right hand, he may have less right – sided skills. There may also be rivalry between the right and left hemisphere. Parents must be encouraged to look for the early signs of dominance and allow them to develop.
The author concludes…
The human being is the symbol of the highest order of integrated function of the brain. The infant brain follows a developmental pattern preset to suit the neuro-developmental sequences of early childhood. The face and hand together have the maximum representation in the motor and supplementary cortex. Those who suffer various forms of insult to the cortex may end up having diminished hand function. The physician needs to be alert to test for the skills of the hand and encourage early intervention if there is suspicion of delayed organisation of the skills of hand.
INTERACTION THROUGH PLAY
The child of 4-6 weeks smiles in response to a look or a touch - the social smile. The child of 4-6 months is ready to interact socially and is responsive to recognition and engagement with others. There is a desire for communication.
Some of the suggested dreasons why parents play with children
·fun way of learning for a child
·enjoyable educational involvement with children.
·constructive way of spending time.
·exploring together constructively.
·way of making child feel important.
·natural to children, unwinding to parent.
·play can be a healing experience.
·way of allowing child to express emotions.
1. PLAY STIMULATES DEVELOPMENTThere is a movement from visual engagement to physical engagement using hands and legs. Appropriate toys -colourful objects- rattles and sound makers - soft toys.
If the external environment is stimulating the child thrives and without a play based environment the child is deprived.
2. PLAY BUILDS RELATIONSHIPS.
Attachment relationship is cemented by play. Maria Montessori introduced a natural form of learning using play materials. Play-based learning process. Learning by doing.
Social aspects of play are present in every form of play
COMMON FORMS OF PLAY
A. Simple Play
·Earliest form of play to increase cognitive levels.
·Parent dominant , child passive.
·introduces child to listen, observe, attend.
·improves cognitive dimension of child.
B. Individual Play
· Child plays on his\her own.
· develops initiative and builds independence.
· develops imagination and creativity.
· improves attention span and concentration.
C. Interactive Play
· Can be introduced around one year of age
· Participation from child is essential in this participatory play.
· Introduces child to turn - taking. Around 8-10 months the child shows signs of readiness for turn-taking and by 10-15 months it is explicit in most children.
· Parent can initiate pre-learning skills like attention, compliance, social responses, co-operation
In an older child interactive play can help the child develop
·CONCEPTS -
·DISCRIMINATION - shapes, sizes, colour, texture....
·DETAIL APPRECIATION
·REPRODUCTION
·CREATIVITY.
D. Make Believe Play
· Explore the fantasy world of child through make-believe play.
· Develops intuitive functions of child like imagination and creativity, art, music.
· Fantasy is a right-sided function of brain. Left sided functions like logic, reading, memory develop earlier.
E. Social play
· The child is ready for social play after he is steady on his feet - around 2 years.
· Most out-door play is good for social development
Also develops fine and gross motor co-ordination.
F. Family Play
· Alongside PRAYING together PLAYING together keeps the family together.
· Both outdoor play and various indoor games are very healthy family activities.
USE OF TOYS
·Discretion is called for in the use of toys. Used selectively and appropriately they can be valuable tools.
·Toys are for playing with and not for keeping in the show-case.
·Choice of toy and age and interest appropriateness are crucial.
