Hand Function in the Child: Foundation for Remediation.

Henderson A, Pehoski C, eds. St Louis, MO 63146-3318, Mosby-Year Book Inc, 1995, hardback, 326 pp, illus, $34.95

This book is about the development of hand function in children and the hand's manipulative abilities. The book is unique in that the professional literature in pediatrics has traditionally focused on the development of gross motor abilities.

This work combines a detailed review of the development of hand skills with an overview of neurophysiology, neuropsychology, cognitive psychology, developmental psychology, and therapeutic intervention as it relates to hand function in the child.

The book is intended for those individuals who are interested in the current research and treatment of problems in children's hand skills, yet its content, particularly section 1, is applicable to all practitioners treating patients with hand disorders. The first section amply reviews anatomy and kinesiology of the hand, the cortical control of skilled hand use, sensorimotor aspects of hand and reaching movements, and the role of cognition in hand activities. Anatomical illustrations bring to life some basic aspects of kinesiology of the hand, while figures help depict the pertinent research in the area of motor control.

The second and third sections focus on the development of hand skills and therapeutic intervention in the child. Grasp, release, bimanual skills, and object manipulation are covered in section 2 along with the development of hand dominance and complex areas of graphic skill and self-care. Section 3 is devoted to treating specific pediatric populations such as children with cerebral palsy or Down's syndrome. it also reviews hand skill problems in children and the principles of teaching handwriting.

All of the sections in this book are thoroughly supported and referenced with reviews of pertinent research in the respective areas, although sections 2 and 3 are not as graphically enhanced as the first section. Although the selected chapters on therapeutic intervention are excellent and keep the text focused to the child's hand, I found myself looking for a broader application of these motor behavior and control principles. Even so, I believe there is ample opportunity for a physical therapist to refine and integrate the content of this book and apply it to numerous clinical situations.

The editors of this text have meshed the writings of numerous authors well, and they have organized an expansive field of literature to produce a very readable text. It is organized so that the reader has an understanding of both the foundations and development of hand skills prior to delving into therapeutic considerations. This book is relevant to those clinicians who treat the hand, particularly the child's hand, as that is the subject of the book. it is also, however, apropos to the physical therapy professional and to any clinician who is interested in the science of movement. The book exposes the clinician to this broad behavioral domain while prompting those that treat movement disorders of the upper extremity to consider some of the literature that has not traditionally been considered clinically relevant.

Paul LaStayo, PT, CHT Univ of Florida Gainesville, Fla

Mr LaStayo is an instructor in the department of physical therapy at the University of Florida, and specializes in upper-extremity rehabilitation and research.