Bimanual behaviours in children aged 8–18 months: A literature review to select toys that elicit the use of two hands

Toys that provoke the use of both hands are required to develop a test of bimanual performance in children 8–18 months with unilateral cerebral palsy (Mini-AHA). To choose the toys, a conceptual model based on perception–action theory and object use was used to guide a literature review. Evidence was sought for three critical relationships identified in the model which help determine bimanual performance: (1) the child–toy relationship, (2) the child–task relationship, and (3) the toy–task relationship. Evidence for both typically developing children and children with unilateral CP in this age range was sought. Thirty-five papers provided information about one or more of the relationships in typically developing children. No evidence was found for children with unilateral CP. Synthesis of the evidence from these three relationships informed toy selection for this new assessment.

► Children aged from 8 months use a variety of bimanual actions when exploring toys.
► Specific toy characteristics provoke different bimanual play responses.
► Specific toys can be used to assess bimanual skills of children with unilateral CP.
► Toys selected now require validation for use with children with unilateral CP.