Enhancing Prehension in Infants and Children

Abstract

Learning to reach for and manipulate objects requires considerable neuromotor control and flexibility. Through environmental and object exploration individual neuromotor strategies expand, and prehensile skills improve, as infants and children overcome constraints. Infants and children with prehensile deficits often have difficulty exploring objects and the environment, thus, may not sufficiently develop the strategies needed to expand their prehensile skills. This article reviews neuromotor factors that influence prehension development, discusses limitations to prehensile function and provides guidelines that can be used to examine and enhance prehensile behaviors in infants and young children based on a task-oriented approach addressing impairments, motor strategies and function.

Very early upper limb interventions for infants with asymmetric brain lesions

“…Both bimanual and unimanual reaching with early strong hand preference at four to six months of age can be considered to be a strong sign of early hemiplegia (Golomb et al, 2001). Studies of infants who have sustained an early perinatal stroke from 4 to 7 months corrected age have suggested that until reach to grasp behaviours have emerged, an asymmetry may not be clearly evident so that a hemiparesis may not be confirmed (Duff and Charles, 2004;Duff and Gordon, 2003).…”

Early reach to grasp development of infants with asymmetric brain injury on the Grasp and Reach Assessment of Brisbane (GRAB)

“…209 Studies of infants who have sustained an early perinatal stroke from 4 to 7 months corrected age have suggested that until reach to grasp behaviours have emerged, an asymmetry may not be clearly evident so that a hemiparesis may not be confirmed. 186,187 Critical periods of typical upper limb motor development…”

“…60 Studies of infants who have sustained an early perinatal stroke before four to seven months corrected age have suggested that until reach to grasp behaviours have emerged, an asymmetry may not be clearly evident and hemiparesis not confirmed. 186,187 Early intervention for infants at risk of developing congenital hemiplegia is considered to be very important, however, standard rehabilitation programs generally commence after six months of age due to delayed detection. A further consideration regarding the timing of commencement of intervention is that important phases of brain reorganisation may have already occurred.…”

“…has been reported in a small number of studies. [176][177][178]186,187 Other studies have compared reach to grasp development of preterm infants or infants with stroke to healthy, term-born infants aged two to seven months. 109,177,181 Movement quality and anticipatory strategies during reaching for moving toys using kinematic analysis has been reported previously.…”

“…177 Earlier detection of emerging asymmetries during upper limb (UL) motor development in infants at risk of UCP would enable earlier diagnosis and timely referral to early intervention. 58,187 …”