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LEFT HAND, RIGHT HAND

IT is still not uncommon, alas, to be asked to see a child who has been labelled as being in some sort of difficulty because he is left-handed, and in some countries attempts are still made to turn left-handers into right-handers. The first message to get over to anyone enquiring about the importance of dominance is that it is normal for a small proportion of human beings to have dominance on the left rather than the right. Some studies have shown an increased incidence of lefthandedness among abnormal populations, and Bishop (p. 569 of this issue) discusses this point. However, the last full review of the subject in this journal appeared in 1972l, and most of the six conclusions Touwen made in that article still stand. His final conclusion was: ‘The often-claimed clinical relationship between neurological or behavioural disorders and mixed or crossed laterality is, at least, highly controversial’. This is not to say that the subject has been neglected during the eight years since Touwen wrote his review. On the contrary, a cursory glance at any citation index reveals the topic’s popularity, but despite the value of some of the normative data that have been collected on the development of laterality and the massive study of abnormal populations, the average reader may well feel that not much new information has appeared. There may be an uneasy feeling that studies of laterality should have importance, but that it is difficult to see a way forward. Bishop had the ingenious thought of looking at the performance of the non-preferred hand, rather than concentrating on the performance of the dominant hand. She sets out her reasons for predicting that there would be more children who are particularly clumsy with the non-preferred hand among the manifest lefthanders than in the remainder of the sample. In looking at this target group of childreii, she found that there was a higher incidence of neurological disorder and significant cognitive impairment. It is interesting that there was not an increased incidence of reported birth-risk factors, and in these days of superior (we hope) perinatal management this does emphasise the fact that there may be other periods during which the central nervous system may be damaged. Bishop has also been able to draw some conclusions about the