Hand-eye coordination is the ability of the vision system to coordinate the information received through the eyes to control, guide, and direct the hands in the accomplishment of a given task, such as handwriting or catching a ball. Hand-eye coordination uses the eyes to direct attention and the hands to execute a task.
Vision is the process of understanding what is seen by the eyes. It involves more than simple visual acuity (ability to distinguish fine details). Vision also involves fixation and eye movement abilities, accommodation (focusing), convergence (eye aiming), binocularity (eye teaming), and the control of hand-eye coordination. Most hand movements require visual input to be carried out effectively. For example, when children are learning to draw, they follow the position of the hand holding the pencil visually as they make lines on the paper. Between four and 14 months of age, infants explore their world and develop hand-eye coordination, in conjunction with fine motor skills. Fine motor skills are involved in the control of small muscle movements, such as when an infant starts to use fingers with a purpose and in coordination with the eyes.
Infants are eager to move their eyes, their mouths, and their bodies toward the people and objects that comfort and interest them. They practice skills that let them move closer to desired objects and also move desired objects closer to themselves. By six months of age, many infants begin reaching for objects quickly, without jerkiness, and may be able to feed themselves a cracker or similar food. Infants of this age try to get objects within their reach and objects out of their reach. Many infants are also able to look from hand to object, to hold one object while looking for a second object, and to follow the movements of their hands with their eyes. At this age, most infants begin to poke at objects with their index fingers. After six months, infants are usually able to manipulate a cup and hold it by the handle. Many infants at this age also begin to reach for objects with one arm instead of both. At about eight months of age, as dexterity improves, many infants can use a pincher movement to grasp small objects, and they can also clap and wave their hands. They also begin to transfer objects from hand to hand, and bang objects together. Hand-eye coordination development milestones are as follows.
Birth to three years
Between birth and three years of age, infants can accomplish the following skills:
- start to develop vision that allows them to follow slowly moving objects with their eyes
- begin to develop basic hand-eye skills, such as reaching, grasping objects, feeding, dressing
- begin to recognize concepts of place and direction, such as up, down, in
- develop the ability to manipulate objects with fine motor skills
Three to five years
Between three and five years of age, little children develop or continue to develop the following skills:
- continue to develop hand-eye coordination skills and a preference for left or right handedness
- continue to understand and use concepts of place and direction, such as up, down, under, beside
- develop the ability to climb, balance, run, gallop, jump, push and pull, and take stairs one at a time
- develop eye/hand/body coordination, eye teaming, and depth perception
Five to seven years
Children between five and seven years old develop or continue to develop the following skills:
- improve fine motor skills, such as handling writing tools, using scissors
- continue to develop climbing, balancing, running, galloping, and jumping abilities
- continue to improve hand-eye coordination and handedness preference
- learn to focus vision on school work for hours every day
Hand-eye coordination problems are usually first noted as a lack of skill in drawing or writing. Drawing shows poor orientation on the page and the child is unable to stay "within the lines" when using a coloring book. Often the child continues to depend on his or her hand for inspection and exploration of toys or other objects. Poor hand-eye coordination can have a wide variety of causes, but the main two conditions responsible for inadequate hand-eye coordination are vision problems and movement disorders.
Vision impairment is a loss of vision that makes it hard or impossible to perform daily tasks without specialized adaptations. Vision impairment may be caused by a loss of visual acuity, in which the eye does not see objects as clearly as usual. It may also be caused by a loss of visual field, in which the eye cannot see as wide an area as usual without moving the eyes or turning the head. Vision impairment changes how a child understands and functions in the world. Impaired vision necessarily affects a child's hand-eye coordination, as well as cognitive, emotional, neurological, and physical development by limiting the range of experiences and the kinds of information to which the child is exposed.
Movement disorders are characterized by impaired body movements. They have a variety of causes. An example is ataxia, characterized by a lack of coordination while performing voluntary movements. The problem may appear as clumsiness, inaccuracy, or instability. Movements are not smooth and may appear disjointed or jerky. Another example is hypertonia, a condition marked by an abnormal increase in muscle tension and a reduced ability of a muscle to stretch. Whatever their origin, movement disorders almost always prevent the normal development of hand-eye coordination.
When a child is between one and two years old, parents should start encouraging activities that allow the child to learn how to use hands to manipulate objects and learn how different things fit together. These activities are extremely important for the development of hand-eye coordination, which is itself crucial for the overall physical development of the child. Some toys are designed to assist hand-eye coordination development. They usually involve "fitting things together," but parents can also use simple kitchen cups or bowls. Letting children play with these objects teaches them how to fit objects together. Jigsaw puzzles are also good hand-eye coordination developers, as are blocks or tower toys that encourage playing and coordination. These toys help children learn what items can fit on top of each other and which ones will stack easily. By the time children reach two or three years of age, they are ready to start throwing things and wanting to catch them. These play activities are a great way to improve hand-eye coordination. Most child development professionals believe that the best thing parents can do when trying to improve hand-eye coordination in their children is simply to let them play with a variety of toys on their own.
When to call the doctor
Parents of preschool children should be alert for signs of abnormal visual development or coordination
Ataxia—A condition marked by impaired muscular coordination, most frequently resulting from disorders in the brain or spinal cord.
Binocular vision—Using both eyes at the same time to see an image.
Convergence—The natural movement of the eyes inward to view objects close-up.
Fine motor skill—The abilities required to control the smaller muscles of the body for writing, playing an instrument, artistic expression and craft work. The muscles required to perform fine motor skills are generally found in the hands, feet and head.
Gross motor skills—The abilities required to control the large muscles of the body for walking, running, sitting, crawling, and other activities. The muscles required to perform gross motor skills are generally found in the arms, legs, back, abdomen and torso.
Hypertonia—Having excessive muscular tone or strength.
Motor skills—Controlled movements of muscle groups. Fine motor skills involve tasks that require dexterity of small muscles, such as buttoning a shirt. Tasks such as walking or throwing a ball involve the use of gross motor skills.
Visual acuity—Sharpness or clearness of vision.
See also Bayley Scales of Infant Development.
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American Academy of Pediatrics (AAP). 141 Northwest Point Boulevard, Elk Grove Village, IL 60007–1098. Web site: <www.aap.org>.
American Occupational Therapy Association (AOTA). 4720 Montgomery Lane, PO Box 31220, Bethesda, MD 20824–1220. Web site: <www.aota.org>.
American Psychological Association (APA). 750 First Street, NE, Washington, DC 20002–4242. Web site: <www.apa.org>.
Child Development Institute (CDI). 3528 E Ridgeway Road, Orange, California 92867. Web site: <www.cdipage.com>.
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Monique Laberge, Ph.D.