{"doi":"10.3390/sym15122161","title":"Hand-Use Preferences for Reaching and Object Exploration in Children with Impaired Upper Extremity Functioning: The Role of Environmental Affordances","abstract":"Infants and young children with weakened or impaired upper extremity functioning often develop a strong hand-use “preference” for reaching and object manipulation. While “preferring” their stronger hand, they often partially or completely ignore their “non-preferred” hand. Such manual lateralization might impede complex object exploration, which would negatively affect children’s cognitive development. The question is whether environmental affordances would significantly affect children’s manifested hand-use “preferences” by promoting the use of the “non-preferred” hand. The current sample included 17 children (5 males; 13.9 ± 8.7 months at baseline) with arthrogryposis multiplex congenita (arthrogryposis). The reaching and object exploration of the children were evaluated longitudinally across a 6-month period with and without the Playskin LiftTM exoskeletal garment (Playskin). Results showed that the use of the Playskin increased both unimanual and bimanual object contact. Also, when anti-gravity support was provided to the arms by the Playskin, children significantly increased the use of their non-preferred hand, which correlated with improved quality of object play—more bimanual object interaction and greater intensity, variability, and complexity of exploration. These findings suggest that hand-use “preference” in children with arthrogryposis is quite malleable during early development. It is likely that children with impaired upper extremity functioning do not “prefer” to use a particular hand but, rather, cannot afford using both hands due to their limited muscular or manual abilities. Importantly, environmental affordances (i.e., anti-gravity support for the arms) might significantly affect the early development of manual lateralization, with potential implications for children’s quality of object exploration and future cognitive development.","journal":"Symmetry","year":2023,"id":381323,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.955,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":861563,"name":"Michele A. Lobo","orcid":"0000-0003-2892-7687","position":1,"is_corresponding":false},{"id":861562,"name":"Iryna Babik","orcid":"0000-0003-0574-4482","position":0,"is_corresponding":true}],"reference_count":112,"raw_metadata":null,"created_at":"2026-07-19T01:17:08.831117Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}