The Determination of Laterality
The Psychological Clinic Copyright, 1934,’Jby Lightner Witmer, Editor Vol. XXII, No. 3 September-November, 1933 :Author: Edwin B. Twitmyer and Yale Nathanson
University of Pennsylvania
The emphasis which has been given to speech correction during the past decade and the attempt to determine etiological factors of stammering cause the periodic revival of the question of cerebral dominance and laterality. A superficial acceptance of certain statistical data gives rise to the theory of changed handedness as a cause of stammering. The incidence of observed stammering at six years in the child and the coincidence of the beginning of organized writing instruction have made too feasible the association. Writing or figure tracing, because there is represented a high level of integration, seems to have become the one diagnostic criterion. This is a serious error. Very early in the life of the child band preference does not decidedly manifest itself. Later, by forty-eight months, a preferred hand does become evident. With prolonged training, although the non-preferred hand improves considerably, it does not approach in motor skill the ability of the preferred hand. It is our opinion that writing as a criterion of laterality is an unfortunate, unscientific and incomplete selection. Not only does writing present but one phase of the neuro-muscular pattern, but imitation, enforced training and insistence on the part of parents to make the child use the right hand, heavily outweigh what would otherwise persist as an expression of native aptitude. To ascertain whether or not change of handedness in writing actually means complete change of function and determine quickly hand preference in children of pre-school age, the authors in 1930 devised a test (T-N-10) the administration of which occupies only a few minutes and in which little apparatus is needed. Thirtyfive hundred school children between the first and twelfth grades were given a simple tapping and aiming test. This was done by placing a 22 mm. circle in the center of a sheet of paper and the 9 141 child was instructed to bring the hand from the side in a full swing attempting to place a mark in the center of the circle in which was a smaller circle 2 mm. in diameter. This was done for each hand ten times. The tapping test consisted of the child making as many dots as possible on a piece of paper for a period of 15 seconds, first with the right hand and then with the left. The children were considered in four groups. Group I, right-handed writers; Group II, left-handed writers who had been taught to write with the right hand; Group III, left-hand writers; Group IV, children who seemed to write with equal facility with either hand. The results showed no significant correlation between right-handed aiming and right-handed writing; however, in the tapping test the preferred hand, whether or not writing handedness had been changed, showed definitely higher results in 87 per cent of the cases. Scholastic standing and penmanship ability were rated, but no significant correlation found, although the left-handed child changed to a righthanded writer demonstrated on the average, poorer writing ability. With pre-school children it was found that a qualitative difference of performance with a pencil favored definitely the preferred hand. It is obvious that other factors must be considered. These other factors are general bodily laterality and visual dominance. Writing hand preference as a criterion of cerebral dominance is certainly inadequate. In pathological cases studied by the authors the involvement of speech and other neuro-muscular functions follow in known manner. The exact cortical contribution of the non-dominant as well as the dominant hemisphere must be approached by an analysis of complete bodily behavior output. In 1931 the authors developed a series of three tests: T-N-50, a questionnaire dealing with laterality of the entire body, head, jaws, arms, legs, etc.; T-N-51, a test to determine auditory acuity and ear preference; and T-N-52, a technique for determining visual dominance.1 In 200 cases tested there is an indication that a consistent dominance does not exist and that eye, ear and body dominance does not necessarily follow to establish a theory of complete cortical dominance. The preliminary survey established the suitability of the tests for use when indicated as part of a clinical examination. T-N-50 dealing with general bodily reaction appears at the conclusion of this paper. These tests are being presented at this time to afford an opportunity for a standard procedure in the 1 T-N-51 and T-N-52 will appear in the next issues of this journal. determination of complete bodily behavior, to ascertain whether there exists cerebral dominance per se, or whether it is a matter of habit, training or unaccounted for muscular development.2 The test consisted of eight mimeographed sheets, S1/^’ X 11”. A separate questionnaire was given to males and females. Those questions which differed on the questionnaire for females are shown at the end of the test. Pages seven and eight, not here included, consisted of one sheet marked “Right Hand,” and the second sheet marked ‘’ Left Hand.’’ In the center of the sheets were drawn two concentric circles, one 20 mm. and one 2 mm. in diameter. The instructions appearing on page six were followed and the scores of mean distance from the center of the smaller circle computed.
The determination of dominant ear and eye function requires laboratory apparatus and is, therefore, not so easily accomplished. The authors are insistent that dominance, particularly for activities at higher levels of integration, should be determined early in the life of the child. Some children who have not had an opportunity for actual writing do not, therefore, present a real picture of hand preference in writing. For such children the questionnaire material applicable can be employed by the examiner and the observations properly recorded by him. A child who demonstrates left-handness, particularly in the finer motor skills, should not have his handedness changed. Changing handedness places an obstacle in the way of motor acquisitions, although the relation of changed handedness to stammering is not of greater importance than would be any other set of disturbing circumstances. Superimposing on the organism not too well stabilized, an additional burden makes propitious the occasion for some disturbance in behavior output. This disturbance in behavior output may or may not assume the form of stammering. It is dependent on whether or not stammering is a “minoris locus resist entiae, an aspect of the residual diathesis.” 3 The findings of functional dominance are worth serious investigation with all children and especially in cases of children who encounter difficulties in school in spelling, reading or writing. The establishment of a technique to determine definite eye, ear and 2 Clias. A. Selzer. Lateral Dominance and Visual Fusion, 1933, Harvard Monographs in Educ. No. 12, Harvard Univ. Press, Cambridge, pp. 119. This monograph contains a presentation of existing theories, a battery of tests and
bibliography.
3 Edwin B. Twitmyer and Yale Nathanson. Correction of Defective Speech, 1932, Phila., P. Blakiston’s Sons & Co., Inc., p. xv. bodily laterality as a criterion for the persistence in training of the preferred side should eliminate the serious error of whimsical change and make possible certain school adjustments where these are indicated. The investigation of eye, ear and bodily laterality, should indicate whether or not (I) there is a complete cerebral dominance, (II) whether cerebral dominance obtains only for certain levels of behavior, anatomically and by virtue of complexity, (III) whether the manifestation of laterality for certain functions is the result of habit or training, and (IV) what degree of correlation exists for eye, ear and general bodily laterality. (Page 1) Lateral Dominance?Questionnaire (Males) T-N-50 N ame Age Race N ationality OccupationDate Time required Do you consider yourself Right Handed or Left Handed? The answers given by you constitute an integral part of the scientific data of an important problem. Intelligent and serious cooperation is expected of you. Observe these brief instructions: I. Underscore the Word Which Answers the Question, e.g. Yes No or Right Left II. Whenever You Can Not Answer a Question, or it is not Applicable to Your Case Make a Cross, e.g. Yes X No III. If Both Words are Applicable Underscore Both, e.g. Yes No or Right Left (At the end of this questionnaire appears the word Comments and a space is provided for suggestions or other addenda.) 1. Cutting paper or cloth with a scissors which hand do you use? Right Left 2. In filing your nails can you manipulate the file equally well with both hands? Yes No Do you move the file with the right hand and move the left hand against the file? Yes No Or, Do you move the file with the left hand and move the right hand against the file? Yes No 3. When sharpening a pencil which hand holds the knife? Right Left 4. Close your eyes and clasp (fold) your hands. Which thumb is uppermost? Right Left 5. In which hand do you hold the comb when combing your hair? Right Left 6. Do you transfer the fork to your right hand after you have finished using your knife? Yes No 7. With which hand do you make erasures (on paper)? Right Left 8. With which hand do you insert a key in the door and unlock it? Right Left 9. If you have any characteristic gesture such as stroking your cheeks or nose or running your hand through your hair which hand do you use? Right Left 10. Do you bite your nails? Yes No (Page 2)
If you do bite your nails, is there a preferred hand? Which? Right Left
12. Do you know, if as a young child you sucked your thumb? Yes No If you did was it the Right Left 13. In using a shoe horn, which hand do you use? Right Left 14. When smoking which hand usually holds the cigarette? Right Left 15. Do you wear rings on the right hand? Yes No Do you wear rings on the left hand? Yes No Do you wear rings on both hands? Yes No 16. Which do you think is your stronger hand? Right Left (When opportunity permits examiner will take five readings on dynamometer.) 17. Have you noticed any difference in the size of your hands? Yes No Which is larger? Right Left 18. Have you ever suffered an injury to one of your hands which necessitated additional use of the other? Yes No (If your answer is “yes” kindly indicate briefly details?type of injury, degree of seriousness and period of incapacity.) Write your answer at the end of the questionnaire under Comments.
If you wear a wrist watch on which arm is it worn? Right Left
20. If you carry your watch in your vest pocket which hand do you use to withdraw it to see the time? Right Left 21. Close your eyes and fold your arms. Which arm is uppermost? Right Left 22. If you are eating an apple or pear in which hand do you hold it? Right Left 23. With which hand do you deal cards? Right Left In the event only one hand is habitually used does the other render any appreciable assistance? Yes No 24. When using a hammer, which hand is used? Right Left When using a saw, which hand is used? Right Left 25. Which hand is used when winding a clock? Right Left Which hand is used when winding a watch? Right Left 26. With which hand do you throw a ball? Right Left 27. If someone throws a ball or other small object to you with which hand do you attempt to catch it? Right Left 28. If an object is within a few feet of you, nearly equidistant from either hand, with which hand do you reach for it? Right Left (Page 3) 29. If an object is considerable distance from you with which hand do you reach for it? Right Left 30. In lighting a cigarette or cigar which hand holds the match or lighter? Right Left 31. With which hand do you press an electric light switch button? Right Left 32. In lighting an electric light, which is accomplished by pulling a cord suspended at some height, which hand do you use? Right Left 33. Which hand do you employ in painting with a brush? Right Left 34. In which hand do you hold your book when reading? Right Left 35. If you have finished reading a book which is lying on a table or desk with which hand do you close it? Right Left 36. With which hand do you tip your hat? Right Left 37. With which hand do you button your vest or coat? Right Left 38. With which hand do you hold the farther end of a billiard cue? Right Left 39. With which hand do you throw a ball when bowling? Right Left 40. In batting a baseball which hand is nearer the hitting part of 41 w+?e a i , . ? Right Left 41. With which hand do you play tennis; Right Left 42. In chopping wood which hand is closer to the cutting end of the axC!> Right Left 43. In drinking a glass of water, other than at meal time, which hand is used to hold the glass? Right Left 44. In tying a four-in-hand tie which hand is used to hold the longer end? Right Left 45. Which hand do you use in brushing your teeth? Right Left 46. With which hand do you lather your face? Right Left 47. With which hand do you shave? Right Left 48. Which sleeve do you put on first when putting on your coat? Right Left 49. Which hand is uppermost when sweeping with a broom? Right Left 50. Which arm do you use to carry light bundles? Right Left 51. With which arm do you carry a relatively heavy suitcase? Right Left (Page 4) 52. Which arm has greater muscular development? Right Left (Where any injury or disease has affected either arm kindly indicate facts briefly under Comments.) 53. In which hand do you carry a cane? Right Left In which hand do you carry an umbrella? Right Left 54. In the space provided below make as many dots as you possibly can with your right and left hand, as designated, for fifteen seconds. Put score in space provided for it. Left Hand ScoreRight Hand ScORE55. Close your eyes and cross your legs, which leg is uppermost? Right Left 56. With which foot do you keep time to music? Right Left 57. Which shoe do you habitually put on first? Right Left 58. Which stocking do you habitually put on first? Right Left 59. With which foot do you kick a football? Right Left 60. In jumping which foot is extended? Right Left 61. In using a shovel requiring added pressure of your foot, which foot you you employ? Right Left 62. Which foot is larger? Right Left 63. Have you any foot or leg defect or injury? Yes No Which? Right Left (Indicate under Comments, nature of foot or leg defect or injury.) 64. Do you wear glasses? Yes No (Page 5) 65. Which is your better eye? Right Left (In event of blindness in either eye or other serious defect give particulars under Comments.) 66. In sighting with a gun which eye do you use? Right Left 67. In working with a microscope which eye do you use? Right Left 68. Can you wink with either eye with equal facility? Yes No 69. If you habitually wink with one eye, which eye do you use? Right Left 70. To which ear do you hold the telephone receiver? Right Left 71. Which is your better ear? Right Left (In event of any ear defect kindly indicate briefly particulars under Comments.) 72. If you smoke do you habitually keep pipe, cigar or cigarette on Right 1 Left I of Mouth Center J 73. With which side of your mouth do you chew food? Right Left (If you have suffered the loss of teeth on either side or have any other dental condition kindly indicate briefly the nature of the condition under Comments.) 74. On which side of your head do you part your hair? Right Left Center 75. In what position do you sleep? Right Side? Left Side? Back? Abdomen? 76. Were you ever operated on for appendicitis? Yes No (If “yes,” age years.) Do you have any heart condition? Yes No 77. With which hand do you write? Right Left 78. Which hand do you habitually use to draw large objects as on a blackboard? Right Left 79. In drawing large objects (as on a blackboard) can you use both hands with nearly equal facility? Yes No 80. Was your handedness ever changed (in school or at home)? Yes No (If “yes” indicate briefly at what age and how, under Comments.) 81. Is your “Minor Hand” clumsy and awkward for most operations? Yes No 82. Did you ever stammer for any length of time? Yes No (If “yes” indicate briefly under Comments degree of seriousness, age, and if you have recovered, what measures were employed.) 83. What is the handedness of your mother? Right Left 84. What is the handedness of your father? Right Left (Page 6) 85. Is there any Left-Handedness in your immediate family? Yes No (If “yes” indicate under Comments, relationship.) 86. Are any of your uncles, aunts or grandparents Left Handed? Yes No (If “yes” indicate under Comments, relationship.) 87. Write below with your right hand, your name (use pencil). 88. Write below with your left hand, your name (use pencil). Comments Stand up and place Sheet A on a table or desk directly in front of you (top of table or desk should be about at your waist level). Place a pencil in your Right Hand and drop your hand to your side. At intervals of four seconds bring the pencil up quickly with a full swing of the arm and try to place a dot as nearly as possible in the centre of the smaller circle. Repeat this until ten trials have been made. Then with the Left Hand repeat the exercise on Sheet B. Finish Both Sheets, A and B, then measure the distance of the ten dots on Sheet A from the smaller circle and divide by ten. Do the same for Sheet B for the Left Hand. Mark scores on sheets where indicated. Make measurements in millimeters.
The questionnaire for females differs from the questionnaire for males by the substitution of the following questions: 20. If you use lip stick, with which hand do you apply it? Right Left 30. When ironing, which hand is used? Right T fw 36. With which hand do you cut bread? Right T 37. With which hand do you button your coat? Right Left 38. Which hand do you use to powder your nose? Right Left 39. With which hand do you sew? Right Left 40. Which hand holds the needle when threading it? Right Left 42. On which arm do you wear bracelets? Right Left 44. In which hand do you hold the spoon to stir when cooking? Right Left 46. In which hand do you hold a scrubbing brush? Right Left 47. When lighting a gas stove, which hand strikes and holds the match? Right Left 53. In which hand do you carry your purse? Right Left In which hand do you carry an umbrella? Right Left 59. Which leg can you kick higher? Right Left 72. If you smoke do you habitually keep a cigarette on Right ] Left f of Mouth Center
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