Hand-Over-Hand Method
written by,
Jean M. Slater, MS
Speech/Language Pathologist
© 2000 Slater Software, Inc.
© 2000 Slater Software, Inc.
www.slatersoftware.com
H
ave you ever told your child to give you something
that is dangerous and he or she ignores you? Have
you asked that he pick up the banana he dropped
on the floor and, again, you are ignored? What do you do?
Do you repeat your request, this time a little louder? Do
you repeat it several times? Do you run after your child,
hoping that he won’t trip with the dangerous object,
and get it out of his hand? Do you give up and pick up
the banana yourself? Whatever you do, the problem is
solved. There is no longer and danger, or the floor is
no longer a mess.
If you have other children without disabilities, their actions
may have been typified as “being disobedient” or “not
paying attention.” Those judgements might lead to other
consequences – scolding, time-out, etc. But with your
child with disabilities, other factors are probably at work.
You child may not understand the words in your request.
Perhaps she has not learned how to “let go” of an object.
It may be even more basic because he doesn’t understand
that you are requesting him to do something. Sometimes
you may not think that he is capable of completing the
request, but you say it anyway, to include him in what’s
going on.
Your child will be expected to follow directions at school.
He or she will learn not to tear other’s papers, not to pull
hair, how to carry a snack to the table, and many other
things. He or she can learn those things at home too. Your
child can learn to follow directions.
M
any skills are taught using the strategy “hand-over-hand.”
This means that another person – usually another adult,
but not necessarily – helps the child follow through on
the directions by literally holding their hand and getting them
to complete the task.
We have all learned by hand-over-hand. Perhaps a batting coach
leaned over your shoulder and helped you position the bat correctly.
Maybe you mother showed you the right way to scrub the floor by
putting her hand over yours to demonstrate how much “elbow grease”
you needed to apply to the job? Many of us have used the hand-overhand technique to teach others. Did you ever help a child learn to ride
a bike by holding his hands on the handlebars to help steady the bike?
How many times have you raised a toddler’s hand to wave “bye-bye”
before that child learned to do it himself? You can probably think of
other examples when you have helped someone, or someone has
helped you, learn a skill by using the hand-over-hand technique.
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© 2000 Slater Software, Inc.
www.slatersoftware.com
T
his is the same thing you will be doing
with your child to help her learn new
skills. The only difference is you didn’t
need hand-over-hand teaching to learn the
skills that you are going to ask your child to
learn. You may be asking your child to turn
a page in a book, open a drawer, find her
toothbrush, climb up into the chair, or get
her coat. To learn these tasks your child
may need your hand-over-hand help and
direction.
Always begin with a direction or a comment.
By using language, you are helping your child
in many ways. You are improving auditory
attention, teaching vocabulary, training a
motor act, helping refine movements, and/or
teaching sequencing and responsibility.
“Take the snack to the
table, Jeannie.” Then help her
grasp both sides of the plate of
crackers and walk to the table.
The adult keeps her hands on
the child’s hands until the task
is completed. (This example
shows the adult giving a direction.)
You say, “It’s time for
a snack,” while the two of you
are standing near a plate of
crackers. Your child does not
reach for the plate, so you grasp
her hands and the plate, just like
in the above example and
help her take it to the table.
(This example shows that adult
giving a comment. It would be
assumed that the child had been
exposed to the snack sequence
several times and may not need
the explicit command, as in the
first example.)
I
have already mentioned that you
precede the task with the words or
directions. It is also very important
that you only give that direction once.
Repetitions usually do not have a
positive effect. Remember, the child
may not be complying for a variety
of reasons, and hearing the direction
more than one time will not significantly
help.
It is also important that you only give
a direction that you are prepared to
act on. If you are comfortable in your
chair, and your child has something
that your spouse needs, and you tell
her to “give it to Mommy,” you must
be prepared to get up, gently turn her
around and help her to get to Mommy.
If you are not willing to get up out of
your chair, don’t give your child the
direction.
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© 2000 Slater Software, Inc.
www.slatersoftware.com
B
efore you know whether or not hand-over-hand
instruction is needed, you need to wait a second
or two for your child to follow your direction.
This is called “wait time” and is very important with
some children. Often a child needs the extra seconds
to understand the direction and begin the motion.
Wait-time may be something that you will have to
practice before you are completely comfortable with
it. As you make the effort to learn the time your child
needs to comply with a direction, you will find that it
is easy to allow her that time.
You have been playing with
blocks, but now it is time to clean up.
“Let’s put the blocks away. Blocks in the
box.” -----wait----- If there is not movement
toward a block or toward the box, put your
hand on your child’s, move to a block,
both of you pick up, take the block to the
box and drop it in. “Good! Picking up
blocks. There are more. Blocks in the
box.” -----wait----- Repeat.
H
and-over-hand is the term used to help your
child learn a new skill or perform a function
that you want him to do. Your child needs your
assistance to be successful with a task. It is not
limited to just tasks that use the hands, but we will
use the term “hand-over-hand.” Sometimes you will
gently turn your child’s head to look out the window,
lift his leg to help guide his foot into his snow boot,
help her climb into the car, or grab him quickly to stop
him in a busy parking lot.
After you have helped your child complete a task, the
final step is to praise and rephrase what he just did.
This reinforces the direction and the action. It also
tells your child that his participation was important
and appreciated.
When helping with the snack,
praise and rephrase what just happened.
“Great! You brought the crackers to the
table. Now everyone can eat.”
Remember, there are four very important
parts of hand-over-hand assistance:
1. Give the direction first. Do not repeat
the direction, and only give a direction
that you are prepared to act on.
2. Allow for “wait time.”
3. Assist you child in completing the direction.
4. Praise you child and rephrase when the
job is completed.
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© 2000 Slater Software, Inc.
www.slatersoftware.com
A
s you become comfortable with hand-overhand teaching, you will notice that your child is
learning new skills. Each skill that is learned
will lead to learning another skill, then another, and
another. There are many opportunities throughout
a child’s day for hand-over-hand help and direction.
Let’s take just one small piece of a dressing task –
putting on a shirt. Assume your child does not help
with this process at all right now. If we can teach
your child a small skill, your task will be easier, your
child will be an active participant, and both of you can
feel you have accomplished something. The scenario
may go something like this:
“OK, sweetie. Time to put on
your Tigger shirt. Arms up. (wait, then
help lift arm(s) up to go in sleeves) That’s
right – arm’s up. Good. Now the shirt
goes over your head. Oh, my, where’s
Betsy? Where’s my darlin’? Pull your
shirt down. (help her get a handful of
shirt) Pull. (wait, both of you pull down
the shirt) There she is. Now you’re all
dressed!”
S
omething to mention that I’m sure you have
already figured out – you do not need to have
your child complete or accomplish a task from
start to finish. Helping him pick up three or four blocks
– while you are picking up that many in one handful
and getting the blocks off the floor – is probably
sufficient probably. When your child is eating, assisting
him to hold the spoon, scoop up food, and take to his
mouth does not have to happen throughout the entire
meal. If this is “new learning” for your child, start the
meal with several hand-over-hand mouthfuls. Then
you can take over and finish the meal.
As your child begins to follow through on his own,
you can remove the total hand-over-hand. You will
start to prompt by touching his elbow, beginning
hand-over-hand but removing your hand before the
task is finished, or guiding only when needed. You
can talk about “fading” the hand-over-hand with your
child’s speech/language therapist.
Hand-over-hand is active, participatory, and educational. Cooperating together is also FUN! – for you,
your child, and the other members of your family.
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© 2000 Slater Software, Inc.
www.slatersoftware.com