Hand-Under-Hand Prompting

By: C. J. Fields

Why Hand-Under-Hand Prompting?

A child who cannot see or hear, or who lacks a considerable amount of these senses, must be given a way to compensate for the missing information that these senses usually provide. Most commonly, it is the hands that take over the function of the eyes and ears for a child who is deafblind. When a sense is used a great deal, the brain is able to process information from that sense more efficiently. In individuals who are deafblind and use their hands extensively, areas previously devoted to visual or auditory processing have been shown to reconfigure for the processing of tactile information. Therefore, it is imperative that adults who work with children with deafblindness begin to develop the use of these children's hands as early as possible. Because the hands of a person with deafblindness are so important - functioning as tools, sense organs, and voice - it is crucial for edu-cators, parents, and friends of children who are deafblind to become especially sensitive to the child's hands. One evidence-based method of engaging the hands of a child with deafblindness is to use hand-under-hand prompting when assisting the child with a task or activity.

What is Hand Under Hand Prompting?

Hand-under-hand prompting refers to physical prompting that involves the adult facilitator guiding a child's hands from underneath (not over top) the child's hand. By using hand-under-hand prompting, the child is not forced to comply, but can move his or her hands at will. This process is less intrusive than manipulating the student's hands, which is especially beneficial for children with deafblindness who are often tactilely defensive. The hand-under-hand approach also allows the child who is deafblind to:

  • have more control
  • play a more active part in tasks and in learning
  • focus on objects being touched rather than exclusively on the facilitator’s hands
  • retain access to the world
  • the hand-over-hand approach, in contrast, is equivalent to blindfolding a sighted child—the child who has no sight needs his/her hands to access the world. 

The hand-under-hand approach is appropriate in all contexts when supporting a child with deafblindness, including but not limited to:

  • using physical prompting to demonstrate an activity to the child
  • demonstrating/teaching tactile signing
  • jointly exploring items by touch
  • using on-body signing

Important Points to Remember When Using Hand-Under-Hand Prompting

When you as a parent or service provider use the hand-under-hand technique, your hands perform the activity while your child or student's hands rest on top of yours - in this way the child can feel what your hands are doing. If the activity is new to the child and the child is hesitant, he or she may feel more secure touching your hands rather than the unknown object or activity, and so introduction of the object or activity may need to be gradual. Also, because the child's palms are on your hands, the child will be able to focus his or her energy on feeling the movements of your hands. With hand-under-hand prompting, it is common for the child to feel more comfortable and in control due to the fact that the child can move his or her hands freely if so desired. Remember that if the child you are working with does have some hearing capabilities, it is also important to pair the hand-under-hand prompting with a verbal description of the activity or task tin which you are engaging with the child.


  • American Foundation for the Blind. (2013). Hand under Hand and Hand over Hand. Retrieved on June 28, 2013
  • Downing, J. (2010). Academic instruction for students with moderate and severe intellectual disabilities in inclusive classrooms. Thousand Oaks, CA: SAGE
  • Miles, B., & Lane, H. (2003). Talking the language of the hands to the hands. The National In-formation Clearing House on Children Who Are Deafblind. 1-12.
  • Royal National Institute of Blind People. (2013). Supporting the child with the hand-under-hand approach. Retrieved on June 28, 2013