Activities for Your Child:
4 years & up
Everyday Activities
The following activities are intended to encourage the use of both arms/hands at home in activities that a 4+ year old child may already be doing within a day. Not every child will be doing these activities in their day, however choosing even just a few to incorporate into daily routine will be beneficial to the child's carryover of bimanual skills at home.
The everyday activities are divided into the following categories:
Click a white title box to view that category!
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Eating
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Drinking
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Getting Dressed
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Brushing Teeth
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Getting Undressed
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Brushing Teeth
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Reading
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Opening Bottles
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Getting Cleaned Up
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Washing Hands
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Pushing Doors
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Sign Language
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Bimanual Play
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Play with Siblings
Click the button below to view a PDF printable version.
Below are ways that use of both hands can be encouraged during meal or snack time.
Meal Time
Eating
Cooking
Have the child support the bowl with their affected extremity while scooping an ingredient into the bowl with their unaffected extremity. They could also support a bowl with the affected hand while stirring with the unaffected hand or vice versa.
Helping Set the Table
Give the child a role at dinnertime and have them set out the silverware and napkins. They can either hold silverware and napkins in their affected hand and place it on the table with their unaffected hand or hold a handled basket with their affected hand and place with their unaffected hand.
This can also include helping place plates, bowls, cups etc., keeping in mind that plastic items will be the safest option. This can be accomplished by allowing them to carry one place to the table, encouraging them to use both hands.
Grasp/Finger Flexion
Shoulder Flexion
Eating from a snack container
Having the child use one hand to hold a snack bag or cup while using the other to retrieve the food is an easy way to encourage use of both hands at the same time.
Grasp/Finger Flexion
Elbow Flexion
Shoulder Flexion
Eating finger foods
Foods that are cylindrical or long are easy items for your child to practice grasping. Then, either on their own, or with assistance, the child can practice maintaining that grasp while bringing the food to their mouth to take a bite.
Grasp/Finger Flexion
Elbow Flexion
Shoulder Flexion
Eating foods with utensils
Utensils with a cylindrical handle are easier for your child to practice grasping. Then, the child can practice maintaining that grasp while bringing the food to their mouth to take a bite.
Grasp/Finger Flexion
Elbow Flexion
Shoulder Flexion
Helping with Washing Dishes
Have the child help you clean dishes, using their affected hand to hold the dish while the unaffected scrubs it.
Helping with Putting Away the Dishes
Have the child help you unload items like silverware from the dishwasher, using their affected hand to hold the silverware and their unaffected to place it in the appropriate place.
Drinking
Drinking from a two-handled cup
As the child tries to drink, encourage them to use two hands to hold the handles of the cup. The handles on the cup will make this a more appropriate challenge for a child that struggles with grasp.
If the child needs more of a challenge for keeping their hands open, have them hold a cup with no handles, placing both hands around it to drink.
Grasp/Finger Flexion
Elbow Flexion
Shoulder Flexion
Below are ways to encourage use of both hands during your morning routine.
Morning Routine
Getting Dressed
Closing Drawers
Have the child push clothing drawers closed with both hands, assisting as needed while they have both hands placed on the drawer.
Putting on Pants
This is an age-appropriate skill by 4 years of age.
Option 1: Have the child pull up their pants using both hands. They may require cues to place the affected hand on the pants.
Grasp/Finger Flexion
Elbow Flexion
Shoulder Extension
Shoulder Flexion
Putting on pants
Option 2- Adaptive method
Putting on a shirt
This is an age-appropriate skill by age 4.
Have the child push their affected arm through the sleeve before placing it over their head and threading the unaffected arm through.
Option 2: Have the child put the sleeve of their affected arm first. Then have them place their head in, and lastly their unaffected arm.
Grasp/Finger Flexion
Elbow Flexion
Elbow Extension
Shoulder Flexion
Buttoning
Larger buttons (about 1 inch wide) will be easier for the child to manipulate bimanually if they have enough function in their affected extremity. There are also one-handed buttoning techniques and a tool called a button hook that can be utilized (see videos below).
Buttoning and unbuttoning large buttons is age appropriate for a 2-3 year old. Unbuttoning and buttoning all sizes of buttons is age appropriate by 5 years of age.
Tying Shoes
There are one-handed shoe-tying techniques that can be utilized.
Tying shoes is age-appropriate by 6 years of age.
CHASA's Dressing Techniques for Kids with Hemiplegia Resource
Excellent resource for further advice on dressing.
(includes skills for older kids such as buttons and zippers)
CHASA's "I Can Do it Myself!" Booklet
Resource with photos and step by step for putting on and taking off shirt and pants.
(includes skills for older kids as well)
Below are ways to encourage use of both hands during your evening routine.
Evening Routine
Taking off Pants
Have the child pull down their pants using both hands. They may require cues to place the affected hand on the pants.
This is an age-appropriate skill by 3 years of age.
Shoulder Extension
Grasp/Finger Flexion
Elbow Extension
Taking off Shirt
Option 1: Have child take their unaffected arm out first, then pulling it over their head and off of their affected arm. Option 2: Have child grab the back of the neck of the shirt with their unaffected hand and pull it over their head. Then use the unaffected arm to pull the sleeve off the affected.
This is an age-appropriate skill by age 4.
Grasp/Finger Flexion
Elbow Extension
Shoulder Flexion
Brushing Teeth
Have the child open the toothpaste by using their affected hand to hold the tube while using their unaffected hand to manipulate the top.
Grasp/Finger Flexion
Elbow Flexion
Shoulder Flexion
Reading
Allow the child to hold the book with the unaffected hand and turn the pages with the affected hand or vice versa.
Below are ways to encourage use of both hands during bath or shower time.
Bath/Shower Time
Opening Bottles
Allow child to open bubbles and other bottles by using their affected hand to hold the bottle while using the unaffected hand to manipulate the top. They can then use the unaffected hand to squeeze the shampoo into their affected hand to place on their head.
Elbow Flexion
Finger Flexion/Grasp
Shoulder Flexion
Getting Cleaned Up
Encourage child to use both hands to scrub their head and “lather up” their soap by rubbing both hands together.
Elbow Flexion
Finger Extension
Finger Flexion
Shoulder Flexion
Wringing out a washcloth
Have the child help clean up at the end of bath time by grabbing each end of a washcloth and twisting it to squeeze out the water.
Elbow Flexion
Finger Flexion/Grasp
Shoulder Flexion
Pronation/Supination
Miscellaneous
Shopping Cart
While you're grocery shopping have the child either push a kid-sized grocery cart (if the store has these available) or help push the big grocery cart with two hands.
If the child is unable to walk independently, have them sit in the front and encourage them to place both hands on the handles. Race car carts could be especially motivating for kids to place both hands on the wheel to "drive" while you shop. They can even indicate when it is time to "go" by lifting both hands above their head.
Elbow Flexion
Wrist Extension
Finger Flexion/Grasp
Shoulder Flexion
Washing Hands
Encourage child to stretch out arms and open both hands to scrub them together.
You can also sneak in a supination stretch during hand washing by holding the child's forearms to guide them into a palms up (supination) position.
Elbow Extension
Finger Extension
Shoulder Flexion
Pushing Doors Open/Closed
When going from room to room or entering a building, allow child to attempt pushing open the door with both hands, helping them as needed.
Elbow Extension
Wrist Extension
Finger Extension
Shoulder Flexion
Raising up Both Hands to Request Being Picked Up
When your child wants to be picked up, encourage them to raise both hands before you pick them up.
Elbow Extension
Wrist Extension
Shoulder Flexion
Sign Language
Sign language is a great way for your child to communicate with you while also incorporating both hands.
“All done”
Elbow Flexion
Wrist Neutral
Pronation/Supination
Finger Extension
"More"
Elbow Flexion
Wrist Neutral
Finger Flexion
Gardening
Have the child help with gardening tasks. These could include:
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Holding a soil bag open with the affected hand and scooping dirt out of it with the unaffected hand.
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Supporting a pot with the affected hand while scooping dirt into it with the unaffected hand.
Elbow Flexion
Finger Flexion
Shoulder Flexion
Holding a Bucket to Clean Up
Have the child hold a handled bucket with their affected hand while cleaning up or collecting toys with the unaffected.
Helping with Laundry
Have the child help you do laundry by encouraging them to pick up a big pile of dirty clothes and carry them to the washer, or transfer clean clothes from the dryer to their room.
You may also encourage the child to fold their clothes or put them on hangers, both of which require two hands.
Play
Below are ways to encourage use of both hands during play time.
Bimanual Play
Reading
Allow the child to hold the book with the unaffected hand and turn the pages with the affected hand or vice versa.
Blowing Bubbles
Have the child hold a small bubble container with the affected hand while using the unaffected hand to dip the wand and blow bubbles.
Pulling items apart, pushing them together
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Pull tubes
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Snap blocks
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Legos
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Playdough
Have the child push down on cookie cutters or other playdough toys for increase wrist extension.
Crafts
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Stringing
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Ripping paper (tissue paper is an easy material to grasp)
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"Do a dot" or drawing with a marker
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Tracing
Have the child use their affected hand to hold down a stencil while the unaffected hand traces it or have them trace their affected hand
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Cutting paper
"Making Music"
Have the child explore different instruments, whether these are instrument toys or something as simple as two pans or a spoon and a pan. For example, the child can hold one part of the instrument (the pan acting as a drum) with their unaffected extremity while holding the lighter weight spoon (acting as a drumstick) with their affected extremity.
Songs with Hand Motions
Many popular kids songs have two-hand motions associated with them. Have fun singing along while modeling the hand motions for the child to encourage them to imitate you.
These songs might include:
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Wheels on the Bus
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Old MacDonald
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Itsy Bitsy Spider
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Twinkle Twinkle Little Star
This is a video with all 4. Below, songs are available in separate videos.
Old MacDonald
Itsy Bitsy Spider
Twinkle Twinkle Little Star
Wheels on the Bus
Holding onto Swing with Both Hands
While the child is on the swing, have them put their each hand around the chain on both sides.
Riding a tricycle or scooter
Riding a bike or scooter lends easily to the use of both hands by placing a hand on each handlebar.
Yoga
There are a wide variety of poses in the world of yoga. Below are several examples of yoga poses that require two hands or require weight bearing through the arms. Weight bearing is especially beneficial for the development of the child's shoulder, elbow, and wrist (particularly wrist extension).
Cat & Cow
Downward Facing Dog
Warrior 1 and 2
Rainbow
Tree
Upward Facing Dog
Animal Walks
Animal walks or poses can be a fun way to practice use of two hands or weight-bearing which is especially beneficial for the development of the child's shoulder, elbow, and wrist (particularly wrist extension). Animal walks can also provide proprioceptive input (knowing where their body is in space), and increased body awareness for motor planning.
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Bear
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Dog
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Cat
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Crab
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Elephant
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Donkey
Play with Siblings
Passing big ball back and forth, pushing with both hands
Encourage the children to sit on the ground and push a larger ball that requires 2 hands. Make it more fun by challenging them to see how many passes they can get in a row without the ball going out of bounds.
Charades
Play a game of charades, using animal walks or other actions that require two hands.
Simon says
Play a game with one child as Simon or both children as followers and include movements like “simon says lift both hands above your head” or “simon says wave both hands”. You can incorporate yoga poses or animal walks into this as well.
Ring Around the Rosie
With this game, children will naturally have to use both hands to make a circle and then sing the song before all falling down.
Zoom ball
The “Zoom Ball” is a neat way to have two children using both hands at the same time. Each child has two handles to hold which are pulled to make the ball fly from one child to the other.
Twister
With this game, children will be told which hand/foot to put where on the mat. This will not only encourage use of both hands/feet, but also weight bearing through the arms, as they often end up in positions on all four extremities.
Photo Credits
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