Neurological Assessment of Handedness
The most appropriate neurological test for determining handedness involves inquiring about preferred hand use for multiple skilled activities including throwing a ball, using scissors, knife and fork, and writing, rather than relying on writing hand alone. 1
Clinical Assessment Method
The American Academy of Child and Adolescent Psychiatry recommends a comprehensive inquiry-based approach to determine cerebral dominance for language and verbal memory, which correlates with handedness 1:
Ask about preferred hand for multiple activities:
Writing hand alone is insufficient to determine cerebral dominance for language and verbal memory 1
Standardized Testing Options
When there is doubt about cerebral dominance, standardized protocols are available 1:
- Duke University Medical Center ECT Cerebral Dominance Test or similar protocols may be used in situations requiring formal assessment 1
Important Clinical Context
Understanding the neuroanatomical basis of handedness is critical 1:
- Approximately 70% of left-handed individuals lateralize language functions to the left hemisphere, identical to all right-handed people 1
- 15% of left-handed individuals have bilateral representation of language 1
- 15% of left-handed individuals demonstrate right hemisphere superiority for language function 1
- Irrespective of handedness, only a small number of individuals are right cerebral hemisphere dominant for language 1
Key Clinical Pitfall
The most common error is assuming writing hand definitively determines cerebral dominance. A multi-activity inquiry provides more accurate assessment of true handedness and hemispheric dominance 1.