The Problems with Hand-Over-Hand

Please note: an updated version of this is available at

Last week, I made an infographic called "The Problems with Hand-Over-Hand" and shared it on my Facebook page.

I've had a few requests from people who couldn't find it on Facebook - and so I've put it up here for easier access.


Thanks to everyone who contributed to the original infographic and also to everyone who has participated discussion about it online. Particularly Kate Ahern and the members of AAC Through Motivate, Model, Move out of the way. There's been lots of robust discussion online so please check it out if you are interested in this topic.

And Carol Aguiar converted it to an Instagram post which I have just shared on my Instagram account.

Spread the word. Share this post!

Comments (4)

  1. Trude Burnett


    Thank you, thank you, thank you for this amazing Infograph. As educators we must always be aware of our boundaries and our students boundaries and what messages we may unintentionally be sending. Let's empower our students by gaining consent first!

  2. Mary Alexandra


    I wish people would think individually about our children who use AAC and not paint them with the same brush. I have worked with children who have fine motor delays, difficulty copying others, and children who need a bit of gentle guidance in connecting the dots and making the communicative transaction occur. At times, the child will guide my hand towards the symbol, and I quickly switch from their hand over mine to hand-under-hand so they get to push the symbol. I am neurodivergent myself, and you could have me observe someone modeling vocabulary on the device until the cows come, home but I would need some one actively and gently guiding me, in the least intrusive way possible, to help me figure out how what my active role is in the modeled exchange. Many of my kiddos are the same and I find it's in the art of balancing providing enough models and reacting to a child's individual learning profiles that makes the most difference. For some, that's modeling on it's own and for others, for some gentle guidance is needed and appreciated. I have never 'made' a child communicate but I have helped them figure out the missing piece. You can still be respectful of a child's boundaries and provide some physical support. Using AAC is a new skill and children learn in different ways. I always combine what I read in academic research with what I have experienced as a skilled clinician, in the real world, and the results are always the same: there is no cookie cutter method to helping a child improve their communication skills.

    • jane


      HI Mary, thanks for writing about your personal experiences and sharing your opinion. I strongly believe that hand-over-hand is restrictive practice and have seen it used far too often to "persuade" students to say things that they don't want to say. So - I will continue to advocate for it not to be used. I am also a very experienced clinician who works in the real world and I haven't needed to use hand-over-hand for years. I did use to use it, and like you I was convinced it was an essential part of my toolkit. However, since then, I have been lucky enough to work with a broad range of individuals who have taught me a wide range of strategies that I can use instead - and since these are not restrictive in any way they are the ones I will continue to use and to advocate for.



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