Hand Function pp 151-161 | Cite as

Hand Function in Children with Congenital Disorders

  • Monique S. Ardon
  • Anneke Hoekstra-Lopez-Villamil


Since hand function is of extreme importance to the developing child, the impact of a congenital difference of the upper limb on the development of hand function needs to be well documented. In this chapter, the normal development of hand function and the impact of the most frequently seen congenital differences of the upper limb are described. Normally, children with congenital hand differences alone overcome their hand function problems very well, sometimes using alternative strategies and sometimes with surgical treatment or with the help of aiding tools.

In the second part of this chapter, the authors provide outcome measures at the ICF-CY levels of body functions and structures, activity (capacity and performance) and participation. Since diagnosis does not predict function, all levels of functioning should be evaluated. In this way, the treatment of each single child is optimised, and you will receive maximum results with well-informed, motivated children and their parents.


Hand Function Developmental Coordination Disorder Pinch Strength Apert Syndrome Bilateral Hand 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Flatt AE. Classification and incidence. The care of congenital hand anomalies. 2nd ed. St. Louis: Quality Medical Publishing; 1994. p. 47–63.Google Scholar
  2. 2.
    Netscher DT, Baumholtz MA. Treatment of congenital upper extremity problems. Plast Reconstr Surg. 2007;119(5):101e–29.PubMedCrossRefGoogle Scholar
  3. 3.
    Swanson AB, Swanson GD, Tada K. A classification for congenital limb malformation. J Hand Surg Am. 1983;8(5 Pt 2):693–702.PubMedCrossRefGoogle Scholar
  4. 4.
    Gupta A, Kay SP, Schecker L, editors. The growing hand. San Diego, CA: Harcourt Brace; 2000.Google Scholar
  5. 5.
    McCarroll HR. Congenital anomalies: a 25-year overview. J Hand Surg Am. 2000;25(6):1007–37.PubMedCrossRefGoogle Scholar
  6. 6.
    Watts AC, Hooper G. Congenital hand anomalies. Curr Orthop. 2006;20:266–73.CrossRefGoogle Scholar
  7. 7.
    Pehoski C. Object manipulation in infants and children. In: Falk K, editor. Hand function in the child: foundations for remediation. 2nd ed. St. Louis: Mosby; 2006.Google Scholar
  8. 8.
    McHale K, Cermak SA. Fine motor activities in elementary school: preliminary findings and provisional implications for children with fine motor problems. Am J Occup Ther. 1992;46(10):898–903.PubMedCrossRefGoogle Scholar
  9. 9.
    Summers J, Larkin D, Dewey D. Activities of daily living in children with developmental coordination disorder: dressing, personal hygiene, and eating skills. Hum Mov Sci. 2008;27(2):215–29.PubMedCrossRefGoogle Scholar
  10. 10.
    Missiuna C, Polatajko H. Developmental dyspraxia by any other name: are they all just clumsy children? Am J Occup Ther. 1995;49(7):619–27.PubMedCrossRefGoogle Scholar
  11. 11.
    Schoenmakers MA, Gulmans VA, Helders PJ, van den Berg HM. Motor performance and disability in Dutch children with haemophilia: a comparison with their healthy peers. Haemophilia. 2001;7(3):293–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Deconinck FJ, De Clercq D, Savelsbergh GJ, Van Coster R, Oostra A, Dewitte G, et al. Differences in gait between children with and without developmental coordination disorder. Motor Control. 2006;10(2):125–42.PubMedGoogle Scholar
  13. 13.
    Geuze RH. Postural control in children with developmental coordination disorder. Neural Plast. 2005;12(2–3):183–96. discussion 263–72.PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    Exner CE. Development of hand skills. In: Occupational therapy for children. Case-Smith J (ed). 5th ed St Louis; 2001 Mosby.Google Scholar
  15. 15.
    Case-Smith J. Hand skill development in the context of infants’ play: birth to 2 years. In: Falk K, editor. Hand function in the child: foundations for remediation. 2nd ed. St. Louis: Mosby; 2006.Google Scholar
  16. 16.
    Lantz C, Melen K, Forssberg H. Early infant grasping involves radial fingers. Dev Med Child Neurol. 1996;38(8):668–74.PubMedCrossRefGoogle Scholar
  17. 17.
    Upton J. Apert syndrome. Classification and pathologic anatomy of limb anomalies. Clin Plast Surg. 1991;18(2):321–55.PubMedGoogle Scholar
  18. 18.
    Twitchell TE. Reflex mechanisms and the development of prehension. In: Connolly K, editor. Mechanisms of motor skill development. London: Academic; 1970.Google Scholar
  19. 19.
    Gesell A, Ames LB. The development of handedness. J Genet Psychol. 1947;70(2):155–75.PubMedGoogle Scholar
  20. 20.
    Krumlinde-Sundholm L, Holmefur M, Eliasson AC. Manual Assisting Hand Assessment, English research version 4.3. Stockholm; 2006Google Scholar
  21. 21.
    Bruner JS. Mechanisms of motor skill development. In: Connolly K, editor. The growth and structure of skill. New York: Academic; 1970.Google Scholar
  22. 22.
    Greaves S, Imms C, Dodd K, Krumlinde-Sundholm L. Assessing bimanual performance in young children with hemiplegic cerebral palsy: a systematic review. Dev Med Child Neurol. 2010;52(5):413–21.PubMedCrossRefGoogle Scholar
  23. 23.
    Exner CE. Development of hand skills. In: Occupational therapy for children. Case-Smith J (ed). 5th ed St Louis; 2001 Mosby.Google Scholar
  24. 24.
    WHO. International classification of functioning, disability and health (ICF). Geneva: World Health Organization; 2001.Google Scholar
  25. 25.
    Amadio PC. Outcome assessment in hand surgery and hand therapy: an update. J Hand Ther. 2001;14(2):63–7.PubMedCrossRefGoogle Scholar
  26. 26.
    Aaron DH. Pediatric hand therapy. In: Falk K, editor. Hand function in the child: foundations for remediation. 2nd ed. St. Louis: Mosby; 2006.Google Scholar
  27. 27.
    Coster W, Khetani MA. Measuring participation of children with disabilities: issues and challenges. Disabil Rehabil. 2008;30(8):639–48.PubMedCrossRefGoogle Scholar
  28. 28.
    Mc Manus V, Corcoran P, Perry IJ. Participation in everyday activities and quality of life in pre-teenage children living with cerebral palsy in South West Ireland. BMC Pediatr. 2008;8:50.PubMedCentralPubMedCrossRefGoogle Scholar
  29. 29.
    Ho ES, Clarke HM. Functional evaluation in children with congenital upper extremity malformations. Clin Plast Surg. 2005;32(4):471–83. v.PubMedCrossRefGoogle Scholar
  30. 30.
    de Kraker M, Selles RW, Schreuders TA, Hovius SE, Stam HJ. The Pollexograph: a new device for palmar abduction measurements of the thumb. J Hand Ther. 2009;22(3):271–6. quiz 7.PubMedCrossRefGoogle Scholar
  31. 31.
    Molenaar HM, Selles RW, Zuidam JM, Willemsen SP, Stam HJ, Hovius SE. Growth diagrams for grip strength in children. Clin Orthop Relat Res. 2010;468(1):217–23.PubMedCentralPubMedCrossRefGoogle Scholar
  32. 32.
    Molenaar HM, Selles RW, Willemsen SP, Hovius SE, Stam HJ. Growth diagrams for individual finger strength in children measured with the RIHM. Clin Orthop Relat Res. 2011;469(3):868–76.PubMedCentralPubMedCrossRefGoogle Scholar
  33. 33.
    Amirjani N, Ashworth NL, Gordon T, Edwards DC, Chan KM. Normative values and the effects of age, gender, and handedness on the Moberg Pick-Up Test. Muscle Nerve. 2007;35(6):788–92.PubMedCrossRefGoogle Scholar
  34. 34.
    Buffart LM, Roebroeck ME, Pesch-Batenburg JM, Janssen WG, Stam HJ. Assessment of arm/hand functioning in children with a congenital transverse or longitudinal reduction deficiency of the upper limb. Disabil Rehabil. 2006;28(2):85–95.PubMedCrossRefGoogle Scholar
  35. 35.
    Wright FV, Hubbard S, Naumann S, Jutai J. Evaluation of the validity of the prosthetic upper extremity functional index for children. Arch Phys Med Rehabil. 2003;84(4):518–27.PubMedCrossRefGoogle Scholar
  36. 36.
    Arnould C, Penta M, Renders A, Thonnard JL. ABILHAND-Kids: a measure of manual ability in children with cerebral palsy. Neurology. 2004;63(6):1045–52.PubMedCrossRefGoogle Scholar
  37. 37.
    Skold A, Hermansson LN, Krumlinde-Sundholm L, Eliasson AC. Development and evidence of validity for the Children’s Hand-use Experience Questionnaire (CHEQ). Dev Med Child Neurol. 2011;53(5):436–42.PubMedCrossRefGoogle Scholar
  38. 38.
    Keller J, Kafkes A, Kielhofner G. Psychometric Characteristics of the Child Occupational Self Assessment (COSA), part one: an initial examination of psychometric properties. Scand J Occup Ther. 2005;12(3):118–27.PubMedCrossRefGoogle Scholar
  39. 39.
    Bagley AM, Molitor F, Wagner LV, Tomhave W, James MA. The Unilateral Below Elbow Test: a function test for children with unilateral congenital below elbow deficiency. Dev Med Child Neurol. 2006;48(7):569–75.PubMedCrossRefGoogle Scholar
  40. 40.
    Sanderson ER, Scott RN. UNB test of prosthetic function: a test for unilateral amputees [test manual]. Fredericton: Bioengineering Institute, Univ New Brunswick; 1985.Google Scholar
  41. 41.
    Law M, Baptiste S, Carswell A, McColl MA, Polatajko H, Pollock N. Canadian occupational performance measure. 3rd ed. Ottawa, ON: CAOT Publications ACE; 1998.Google Scholar
  42. 42.
    Turner-Stokes L, Williams H. Goal attainment scaling: a direct comparison of alternative rating methods. Clin Rehabil. 2010;24(1):66–73.PubMedCrossRefGoogle Scholar
  43. 43.
    King GA, Law M, King S, Hurley P, Hanna S, Kertoy M, et al. Measuring children’s participation in recreation and leisure activities: construct validation of the CAPE and PAC. Child Care Health Dev. 2007;33(1):28–39.PubMedCrossRefGoogle Scholar
  44. 44.
    Bult MK, Verschuren O, Jongmans MJ, Lindeman E, Ketelaar M. What influences participation in leisure activities of children and youth with physical disabilities? A systematic review. Res Dev Disabil. 2011;32(5):1521–9.PubMedGoogle Scholar
  45. 45.
    Bradbury E. Psychology. In: Gupta A, Kay SPJ, Scheker LR, editors. The growing hand: diagnosis and management of the upper extremity in children. London: Mosby; 2000. p. 21–3.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Monique S. Ardon
    • 1
  • Anneke Hoekstra-Lopez-Villamil
    • 2
  1. 1.Rehabilitation Medicine and Plastic & Reconstructive SurgeryErasmus Medical CentreRotterdamThe Netherlands
  2. 2.Rehabilitation MedicineErasmus Medical CentreRotterdamThe Netherlands

Personalised recommendations