Hand under Hand and Hand over Hand
If your child has a visual impairment, she uses her hands to obtain information that typically sighted children gather visually. It may be difficult for children who are visually impaired to fully grasp the details of an object unless they touch it. The senses of touch, hearing, and smell are important sources of information for your child. To help her learn about the world and the things in it, try to involve all her senses when you are playing with her, explaining something, or spending time together during your daily lives. Some examples of activities in which your child will benefit from using her hands to learn include using a measuring spoon to scoop out baking soda when making cookies, pushing a button through a button hole when dressing, or positioning a pair of scissors to cut a line. When you want to show your child how to do tasks such as these, you can use one of two techniques: hand under hand or hand over hand.
When using hand under hand or hand over hand, work from behind your child so that your hands and hers will be moving in the same direction. If she is young, you can sit her on your lap. When she is older, sit behind her or next to her and reach your arms around her.
Before you show your child how to do something using either method, try it yourself with your eyes closed. Pay attention to the steps you are taking to do the activity. Try to pick out things to point out to your child, such as the fact that buttonholes are near the edge of a blouse or shirt.
Most children need multiple demonstrations of a new task to learn it. Since your child may not be able to see another person doing a task clearly or at all, the only demonstration she may receive is the one she feels through the use of hand under hand or hand over hand. Be patient and give her many opportunities to practice a new skill when you are using either technique.
Some children are resistant to trying new activities. They'll pull their hands away and won't want to touch. Try to respect the message your child is giving you if she does this. However, if she is never encouraged to try new things, she won't expand her understanding and interest in the world around her. Another option is to talk with your child's early intervention team, if she has one, about what strategies may work best for your child to get her to try new activities. You might want to lovingly, yet firmly, encourage her to try new activities using either hand under hand or hand over hand guidance.
Hand under Hand
When you use the hand under hand technique, your hands perform the activity while your child's hands rest on top of yours—in this way, your child can feel what your hands are doing. If the activity is new to your child and she is hesitant to try it, she may feel more secure touching your hands rather than the unknown object or activity. Also, because her palms are on your hands, she'll be able to focus her energy on feeling the movements of your hands. She may also feel more comfortable and in control because she can freely remove her hands is she wants to. As you perform the activity, verbally describe what you are doing with your hands.
Hand over Hand
When you use the hand over hand technique to help your child do an activity, you place your hands over your child's hands. Your child is the one who is touching the materials, and your hands guide her as she manipulates the materials to complete the activity. As you find she is able to do small parts of the activity, you can lessen the support your hands are providing by either pulling your hands away or moving them to her wrist or arm—in that way, your hands are ready to come back and lend support if she needs assistance.