One of the most important things parents and teens need to understand is this:

There is no single, standardized experience for learning to drive with an upper limb difference.

Driving instructors, adaptive driving programs, and Bureau of Motor Vehicles (BMV) staff often approach disability very differently. What one family is told may be completely different from what another family hears, sometimes within the same state.

This post is meant to help families understand the nuance, the long-term implications, and the questions worth asking before making decisions that may affect a teen’s driving future.

Upper limb differences and driving: the big picture
Adaptive driving equipment: helpful tool or long-term commitment?
Steering knobs and license restrictions
State laws vary — sometimes significantly
Talk directly to the BMV or DMV before the road test
The takeaway
Explore more resources

Upper limb differences and driving: the big picture

Teens and adults with shortened, absent, or anatomically different upper limbs drive successfully every day. There are many ways to operate a vehicle safely depending on:

• Which limb is affected (right, left, bilateral)
• Level of limb difference
• Range of motion, strength, and endurance
• Compensation patterns already in use
• The type of vehicle
• Whether adaptive equipment is used

Driving ability is not binary (can vs. can’t). It exists on a spectrum, and most people with upper limb differences fall somewhere in the middle—capable drivers who may or may not need adaptations.

Adaptive driving equipment: helpful tool or long-term commitment?

Adaptive equipment, such as steering knobs, spinner knobs, or modified controls, can be incredibly useful when truly needed. However, families are often not told that using certain devices during a driving test can result in a permanent license restriction.

Steering knobs and license restrictions

A common example is the steering knob:

• A teen may be encouraged (or required) to use a steering knob during the road test
• The BMV may then issue a license stating that the driver must use that adaptive device at all times
• That restriction can follow the driver for years—or indefinitely—unless formally reassessed

What families often don’t realize:
The restriction is not automatically removed if the driver no longer needs the device. In many states, removing a restriction requires additional documentation, medical clearance, a formal reassessment, or even a repeat driving test. For some drivers, that process is straightforward; for others, it can be time-consuming, costly, or discouraging enough that the restriction simply stays in place.

This doesn’t mean adaptive equipment should be avoided. It does mean that families deserve to understand the long-term implications before a device is introduced during a road test.

Important questions to ask before using adaptive equipment during a driving test:

• Is this device required for safety, or is it being suggested out of caution or unfamiliarity?
• If my teen uses this during the test, will it result in a license restriction?
• If so, what is the process for removing that restriction later?
• Who makes that determination—the examiner, the BMV, or a medical professional?

State laws vary — sometimes significantly

Driving regulations related to adaptive equipment are state-specific, and even within a state, interpretation can vary by examiner or office.

One helpful resource is suicideknob.net, which provides a state-by-state overview of laws related to steering (spinner) knobs and other devices. While it’s not an official government site, it can be a useful starting point for understanding what may be permitted in your state and what questions to ask next.

Historically, steering knobs were often restricted to drivers with documented disabilities. Today, in many states, any driver may legally use a spinner knob, regardless of disability status. However, some states still have specific requirements, and others allow them broadly but attach conditions when they’re used during a licensing exam.

This is why it’s so important not to rely solely on what one instructor, therapist, or examiner says.

Talk directly to the BMV or DMV before the road test

Before scheduling a driving test, families should consider contacting someone knowledgeable at their local BMV or DMV, ideally someone who works with medical reviews or adaptive driving cases.

Helpful questions include:

• If a steering knob is used during the test, will that result in a restriction?
• Is there flexibility in how the test is conducted?
• Can a teen test without adaptive equipment if they typically drive without it?
• What documentation is required if adaptations are used or removed later?

Having these conversations ahead of time can prevent surprises and give families more control over the decision-making process.

The takeaway

Adaptive equipment can be empowering, protective, and sometimes essential, but it should be introduced intentionally, not automatically.

Teens with upper limb differences are not a monolith. Some will benefit from adaptive tools long-term; others may use them temporarily or not at all. The goal is to make informed choices that support safety without unnecessarily limiting future options, not to prove independence or avoid supports.

Driving with an upper limb difference is absolutely possible. The path there just requires better information, better questions, and a system that recognizes ability exists on a spectrum.

Frequently asked questions

Can you drive with one hand?
Yes, many people drive safely with one hand while many use compensatory strategies or adaptive equipment when needed.

Do you have to use a steering knob if you have a limb difference?
No. Some drivers choose to use one, but using it during a driving test will result in a license restriction. In most states, you should be able to test without the steering knob (so it isn’t a license restriction) and then use it while driving.

What is a driving evaluation with an occupational therapist?
It’s a specialized assessment that evaluates your physical and cognitive ability to drive and helps determine if adaptive equipment is needed.

Explore more resources

👉 Check out the Free Handouts
👉 Learn about Seeing the whole child with a limb difference: celebrating strengths & supporting struggles
👉 Read Winter Care for Partial Arms and Hands: Skin, Circulation, and Warmth

© 2026. Laura Faye Clubok, MS, OTR/L, On The Other Hand Therapy. All rights reserved.

The post Driving With an Upper Limb Difference: What Families and Teens Need to Know appeared first on On The Other Hand.

This post is the final in a series that applies the genius empathetic parenting strategy of asking your child when they feel sad, “Do you want to be hugged, heard, or helped?” from Jancee Dunn’s NYTimes column When Someone You Love Is Upset, Ask This One Question, published 4/7/2023.“ In the previous post, we addressed what to say to your child when they choose “helped” and you suspect that their sadness about their limb difference stems from a social-emotional trigger. In this post, we discuss sadness related to physical challenges they may face having a limb difference. Here we explore how to respond when there are activities that they:

• Want to be able to do
• Want to be able to do better
• Want to be able to do more easily
• Want to be able to do with less discomfort or pain

We examine what solutions may address the physical challenges they may be experiencing:

Adaptive Devices
Home Adaptations
Prosthetics & Activity-Specific Devices
School Accommodations
Adaptive Technology
Specialists who can Help Navigate Solutions
Read More in This Series

Adaptive Devices

Devices can help with daily activities, reduce strain, and encourage balanced body development. For example, straps that help with grasp, and adaptive kitchen gadgets. Accessible clothing options include elastic laces, magnetic buttons, slip on shoes, and velcro closures. Check the resources page for suggestions for adaptive aides, clothing options, and cooking gadgets.

Home Adaptations

If you can normalize their use throughout your home, your child may feel less singled out as needing help. An example is replacing round knobs with lever handles for doors and faucets, which are easier to grip, are easier to turn, and often assist both the limb different side(s) and the dominant side.

Prosthetics & Activity Specific Devices

Children with upper limb differences often reject general prosthetics. Children often find activity specific devices work better. For example: devices for hobbies, leisure, or sports (e.g. biking, cooking, doing yoga, etc.).

School Accommodations

There are two basic ways that children with disabilities can be eligible for accommodations or services.

• IEP: An Individualized Educational Plan is for children whose limb difference impact their educational progress, which in some cases can be difficult to demonstrate. Under an IEP, the child receives services to improve their skills and they also may receive accommodations. It is important to note that many services, such as school-based occupational therapy, are considered “related” services, meaning that the child must first demonstrate that their disability adversely impacts their educational progress.
• A 504 plan is used when a student doesn’t need or qualify for direct services and the child receives accommodations only.

Adaptive Technology

Adaptive technology options can help children with upper limb differences increase their typing speed, enable/encourage use of limb different side(s), minimize strain on the side used most, and reduce the long term risk of overuse syndrome. Many good options exist, such as: ergonomic mice, smaller keyboards, voice to text, adaptive computer accessories, one-handed keyboard layouts, and word prediction software. Learn more about adaptive technology options for children with upper limb differences.

Specialists who can help navigate solutions

There are a variety of specialists who have expertise that can help you and your child make informed choices. Here are some good options:

• Occupational Therapists
• Physical Therapist
• Prosthetists
• Educational Advocates
• Assistive Technology Lending Libraries and Librarians

Read the other posts in this series:

• When your child realizes they have a limb difference
• Preparing yourself for when your child feels SAD about their limb difference
• What NOT to say when your child feel SAD about their limb difference
• What to say & do when your child feels sad about their limb difference
• When social-emotional issues cause SADNESS for your child

© 2026. Laura Faye Clubok, MS, OTR/L, On The Other Hand Therapy. All rights reserved.

The post When physical issues cause SADNESS for your child appeared first on On The Other Hand.

In this post, we delve into potential social-emotional causes of your child’s sadness about their upper limb difference. If you haven’t read the previous posts in this series about responding to your child when they are sad about their difference, you can access them below.

• self-awareness
• self-concept
• community connections
• peer interactions
• self-advocacy
• problem-solving
• mental health support
  Read more in this series

Here we continue with the genius empathetic parenting strategy of asking your child: “Do you want to be hugged, heard, or helped?” from Jancee Dunn’s NYTimes column When Someone You Love Is Upset, Ask This One Question, published 4/7/2023. We explore how to respond to your child when they choose “helped.” If you have determined that your child’s sadness mostly about physical issues, stay tuned for the next post!

Before you Respond

A reminder to stop, breathe, and take a moment before responding to your child’s expression of sadness. For us as parents, seeing our children feel sad can be very painful. We typically want to fix it and make it all better, sometimes by putting a positive spin on the situation. In order to truly listen to our children and offer them empathy, we often need first to give ourselves empathy by acknowledging our own feelings, recognizing that it hard for us as parents to hear when our children feel sad. It also can be helpful to take perspective: it’s 100% normal for your child to feel this way.

Self Awareness

If your child’s sadness is about the fact that they were born with or acquired a limb difference, you can straightforwardly ask your child: “do you have questions about your limb difference?” Explaining with facts can be helpful:

• if congenital, explain that their limb didn’t grow before birth
• if acquired (the result of an accident/medical condition), use child-friendly words to convey what happened

Self-Concept

If your child asks the “why” question – “why” this limb difference happened to them – it’s ok to say that you don’t know why they were born this way or had an accident. Many people of faith tell their children “this is how God made you.” 

Community Connections

Role models are important for everyone, even more so for those of us who don’t regularly see others with differences like ours. One of the most incredible and impactful developments of the past decades is the proliferation of ways to connect with the limb difference and limb loss community, whether through social media, camps and family weekends, children’s picture books, podcasts, etc. Depending on your child’s limb difference, finding a child or adult with your child’s exact or a similar difference could potentially be challenging. But there are many thousands of individuals across the globe living with limb difference and limb loss. Ask your child:

• “Would you like to meet other people like you?” 
• “What would you talk about with someone with an arm/leg like yours?”
• “What would you want to do with them?”

Peer Interactions: choosing wisely

As parents, we understandably want our (all of our) children to be surrounded by the love and kindness that we give them and that they both need and deserve to flourish. We also understandably may be terrified that they will be bullied or targeted because of their limb difference, which they obviously did nothing to deserve nor chose. In fact, the number one question of parents of children with limb differences at the various community events I have attended over many years concerns how to protect them from bullying and meanness.

It’s important to teach our children to choose the people whom they like, with whom they click, who are kind, and who make them feel good about themselves. Of course, not everyone is going to be friends with your child. It can be tricky to share this fact, but this is true regardless of having a limb difference or being limb typical. Reminding them that there are many reasons children become friends can be helpful, such as shared interests, similar perspectives or values, or compatible personality traits. It also can be beneficial to share that if they do not develop a close connection with a peer, it may have nothing to do with their difference.

Sometimes children seek acceptance from peers who are unkind and unwelcoming. As a parent, you can steer your child towards making good friends by telling them about the dynamics you have observed in their interactions. For example, you might share that while you have noticed that Peter frequently has said unkind words about their difference, you have heard their friend Jenny being kind to them on several occasions.

Finally, it is important to be mindful of how welcomed your child feels in various environments, such as school, extracurriculars, religious settings, or gatherings with extended family. While you certainly don’t want to cater everything to your child all the time (and nor would it be good for them if you were to do that!), getting a sense of whether particular environments or teams are welcoming vs. unwelcoming or value inclusivity vs. do not value inclusivity is important.

Self-Advocacy

As parents and caregivers, we can help our children choose and identify healthy outlets for their feelings. You can ask your child: “what makes you feel better when you’re sad?” Some children color, cook, dance, draw, jump, make videos, role play, run, see a friend, take photos, write stories, etc.

You may also ask them: “Is there something else you can do to help yourself?” or “Is there something else someone could help you with?”

Problem-Solving

After they have identified what they or someone else might do to help them with the current situation, you can encourage agency by asking your child: “What do you want to do next? Do you want to pursue one of the options you brainstormed?” Problem-solving and self-advocacy are key life skills! Your ongoing support can empower your child to pursue what they need.

Mental Health Support

Sometimes our children need outside help and support from a qualified mental health professional. It is not a reflection on your parenting or your relationship with your child if they reach a time or point when they feel more comfortable talking with an outside provider. You can ask your child if it might be helpful for them to talk about what they’re going through with someone who has special training. The easiest place to start might be your child’s school, as many schools have a counselor. But if you have health insurance that covers counseling, that also might be a good option, as it may provide more privacy for your child.

Read the other posts in this series:

• When your child realizes they have a limb difference
• Preparing yourself for when your child feels SAD about their limb difference
• What NOT to say when your child feel SAD about their limb difference
• What to say & do when your child feels sad about their limb difference
• When physical issues cause SADNESS for your child

©2024. Laura Faye Clubok, MS, OTR/L, On The Other Hand Therapy

The post When social-emotional issues cause SADNESS for your child appeared first on On The Other Hand.

Empathic parenting: a best practice
Helped, heard or hugged?
Before you respond
When you respond: offer choices
When they choose HUGGED
When they choose HEARD
When they choose HELPED
Offer a wide welcome for feelings
Read more

Empathic parenting: a best practice

Over the 25 years that I have been working with children as an occupational therapist and the 21 years that I’ve been raising my two children, I’ve read dozens of parenting books, looking for approaches and strategies that would support children’s emotional intelligence. Incorporating the use of empathy by far has had the most profound effect on my clients’s and my own family’s emotional health and well-being. While it’s challenging for researchers to study parenting strategies, in my personal and professional opinion, using empathy in raising children is a “best practice.” 

After implementing these concepts and practices in my own life and teaching them for many years to the parents of my pediatric clients, I have started to apply them to raising children with limb differences. As a child growing up with a hand difference, here are the empathetic practices and approaches that would have nurtured me when I was sad about my difference as a young one.

Helped, heard or hugged?

When we respond to our children when they feel sad with empathy, love, presence, and warmth, they get to feel seen and heard. This strategy isn’t mine – Jancee Dunn wrote in a NYTimes column (dated 4/23) about this genius empathetic parenting strategy of asking your child: “Do you want to be helped, heard or hugged?”

Before you respond

If possible, take a moment to pause and breathe. Is seeing your child sad painful? Do you want to make it all better? Give yourself empathy: acknowledge your own feelings, recognize that this is hard for you too. It also may help to take perspective; it’s 100% normal for your child to feel sad about their difference.

Consider what would be best for your child in this moment. Offer simple choices to your young child or guess what you think they need/want. Ask your older talking child their preferences, offering empathy, love, presence, and warmth.

When you respond: offer choices

Ask your child, “What would you like first? Do you want to be HELPED, HEARD, or HUGGED?” These work in any order. It’s ok if you have time for just one or two. We will delve into these in reverse order.

When they choose HUGGED

Use physical connection:

• get close to your child
• sit your child on your lap
• hold their different limb
• encourage them to snuggle a favorite doll or stuffed animal
• if time allows, savor this precious moment of connection

If you have time, you can offer choice again: “Would you like to be heard or helped?”

When they choose HEARD

Invite communication:

• Be fully present
  • Put down your phone & step away from distractions
  • Physically get down to their eye level
• Respond with gentle acknowledgement
  • say: “mmm” or “oh sweetie”
  • nod your head” 

Invite their feelings:

• Thank them for sharing
  • “I’m so happy you told me how you feel”
• Use “feelings & needs” cards: this is a tool to help children identify how they feel & what they want. Ideally introduce these in advance. You can make or buy a set.
  
  

Demonstrate you understand:

• Use reflective listening
  • “I hear you say that you feel mad & don’t want help”
• Empathize: “of course …”
  • “of course you want to open the jar” 
• Offer an impossible wish
  • “Do you wish you could use your light saber to …” 

When they choose HELPED

Analyze the Situation 

Is your child’s sadness mostly about social-emotional or physical issues related to their upper limb difference?

Social-emotional issues could be about:

• self-awareness
• self-concept
• community connections
• peer interactions
• self-advocacy & problem-solving
• mental health concerns

Physical issues could be about a physical aspect your child might want help with. Are there activities that they:

• Want to be able to do
• Want to be able to do better
• Want to be able to do more easily
• Want to be able to do with less discomfort or pain

Solutions may include:

• adaptive devices
• home adaptations
• prosthetics
• school accommodations
• technology

We will delve into greater detail about these social-emotional or physical issues related to their upper limb difference in another post.

Offer a wide welcome for feelings

Allow whatever feelings arise for your child and offer them accompaniment as they feel. Offering a wide welcome to feel whatever they feel and accompanying them fully with your presence shows you accept them FULLY – not just when they’re happy. It also helps them manage “big feelings” when you’re not there.

Read the other posts in this series:

• When your child realizes they have a limb difference
• Preparing yourself for when your child feels SAD about their limb difference
• What NOT to say when your child feel SAD about their limb difference

© 2026. Laura Faye Clubok, MS, OTR/L, On The Other Hand Therapy. All rights reserved.

The post What to say & do when your child feels SAD about their limb difference appeared first on On The Other Hand.

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Parental conditioning

Many of us were conditioned to respond to children in ways that aren’t the best for them. Some of the following responses are less helpful in the moment than using reflective listening and offering empathy. Many of us heard these from our families of origin. Knowing why they can be harmful can empower us.

When children feel sad, it’s common to misuse these “strategies” as an intial response

Avoid dismissing & minimizing

Telling them NOT to feel how they feel is harmful – not helpful. For example: don’t feel sad” – “you can’t be angry!” Even if you don’t mean to, dismissing/minimizing teaches that you are uncomfortable when they have “big feelings” and that “big feelings” are too scary, so best to avoid them.

Avoid fixing, rescuing, & giving advice

Trying to “make it all better” is harmful – not helpful. These “strategies” teach kids that solving a “problem” is more important than taking time to express feelings. Here are some examples:
“But you are beautiful!”
“Icecream will make you feel better!”
“Just do this next time”

Avoid “you’re so strong!”

Telling kids “you’re so strong” doesn’t make them strong, such as: “You’ve got this – you are so strong!”
“You’re strong” teaches kids that their feelings are invalid (because if they were truly “strong,” they wouldn’t feel this way)

Avoid unreasonable expectations

Telling them they can do everything is harmful, for example: “You can do anything if you try hard enough”
This is because everyone has limits. “You can do everything” teaches them that their limits are their “fault”; parents usually don’t expect “typical” kids to do everything.

Avoid toxic positivity

This isn’t the time to say how great their difference is, such as: “Your nubby is so great: think of all the things you can do with it!” Toxic positivity teaches kids not to share because others will think they are complaining that people don’t want to hear when things are hard.

Avoid cliches & platitudes

Simplistic responses shut down conversations. For example, “Your difference is what makes you amazing” Cliches and platitudes may be comforting to parents, but may invalidate your child’s feelings.

Complete the form below to download a free printable copy of What NOT to say when your child is sad about their limb difference

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By providing your email address, you agree to receive occasional email correspondence from On The Other Hand. Don’t worry: we will never share your email with any other entity and we will never spam you!

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Read the other posts in this series:

• When your child realizes they have a limb difference
• Preparing yourself for when your child feels SAD about their limb difference
• What to say & do when your child feels sad about their limb difference

© 2026. Laura Faye Clubok, MS, OTR/L, On The Other Hand Therapy. All rights reserved.

The post What NOT to say when your child feels SAD about their limb difference appeared first on On The Other Hand.

Background

On social media, parents often share about the hard moments when their children feel sadness about their limb difference for the first time. Before offering suggestions for supporting children during these difficult moments, I wanted to examine this situation from the parents’ perspective. All children experience sadness about aspects of their life. Is sadness about having a limb difference different from other kinds of sadness? What is it like for parents to hear that their child feels sad about their limb difference? What kinds of support do parents need so that they can meet their children where they are? In delving into sensitive subjects like this, I hope that these posts, even though they can be tough to read, enable parents to gain perspective on important aspects of raising a child with a limb difference that aren’t always addressed.

Planning ahead so you can respond in a positive way

At some point your child will feel sad about their limb difference. It can be hard to prepare yourself for this moment, but planning ahead can help you to respond in a positive way. You may feel a full range of emotions: anger, anxiety, calm, fear, grief, guilt, regret, sadness, or overwhelm.

It’s totally normal to feel conflicted

On the one hand (nub?), it may feel like a big deal to hear that your child feels sad about their difference. It also can be painful. On the other hand (nub?), you may feel like you’re making a fuss over nothing. Many parents go through this, so what’s the big deal?

Anticipating the moment that your child feels sad

Everyone is different, so however it is for YOU is OK. There’s no one “right” way to handle this. Can you allow yourself to feel however you feel? It might vary from seeming like a big deal to not a big deal. Can you give yourself empathy? Ask yourself what your closest friend would say to you. How would they offer you unconditional love and support? Speak to yourself the way your closest friend would, or better yet, can you call that friend now?

In the actual moment that your child feels sad

It may be hard to separate your feelings from your child’s. Being aware of this may help you avoid projecting your feelings onto your child, notice if you’re being hard on yourself, and listen to your child tell you what they’re feeling.

What else might you need?

Perhaps permission to do something later for YOURSELF? Here are some possible needs, even if you have to schedule self care time:

• To express: cry, journal, laugh, reach out for support, or scream
• To create: build, cook, craft, weld
• To move: dance, run, walk, do yoga
  

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Complete the form below to download a free printable copy of Preparing yourself for when your child feels SAD about their limb difference

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Read more

Read the other posts in this series:

• When your child realizes they have a limb difference
• What NOT to say when your child feels SAD about their limb difference
• What to say & do when your child feels sad about their limb difference

© 2026. Laura Faye Clubok, MS, OTR/L, On The Other Hand Therapy

The post Preparing yourself for when your child feels SAD about their limb difference appeared first on On The Other Hand.

What parents often ask me
By the time your child is a toddler
Before they are able to talk
How you can help
What to avoid 
What will they say when they can talk? 
Be ready to hear about their pain
Important takeaways
Quick Links
Download the free handout
Read more

Download a free printable copy of the What to do when your child realizes they have a limb difference!

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What parents often ask me

Parents often ask two things:

• What do I wish my parents had known when I was a child?
• How has my thinking changed over the years?

They also want to know how to support their children with differences. I’m here to help answer those questions.

By the time your child is a toddler

Most toddlers with limb differences already know something is different about them. They’ve noticed how people respond to them, and they’ve heard how you talk about their difference. Many families use a nickname like “lucky fin,” “nubby,” or “small hand.” Others may have asked your child, “What happened to their hand/arm/foot/leg?”

Before they are able to talk

Your child is listening. They understand more than just words. They pick up on tone of voice, facial expressions, and body language. They may feel both good and hard emotions about their difference, even if they can’t say it yet. They might show frustration or sadness through behavior or body language.

How you can help

You can help your child feel seen, safe, and loved. Try these ideas:

• Use simple language to name feelings. When your child is crying, say something like:
  “Oh sweetie, I see you’re crying. Would you like a hug?”
• Talk about their limb difference in a positive way—especially in front of others.
• Stand up for your child. Don’t let others decide what your child can or can’t do, whether your child is present or not.

Reading picture books that include characters with limb differences can also help. These stories remind your child they’re not alone—and that they can do what matters to them. You can find book suggestions here.

You may also want to connect with support groups or attend family events. These spaces let children meet others like them and build confidence. Check out Resources for ideas.

What to avoid 

Your child should not have to prove themselves to anyone. Statements like:
“Bet they didn’t think you could do that!”
can make your child feel like they have to earn approval from others. Children thrive when they feel proud of what they do—not just when they impress someone else.

What will they say when they can talk? 

Parents are often surprised by the things young children say. Some children proudly explain:
“I do that with nub!”

Others may repeat something they’ve heard:
“Nubby looks funny.”

They may express love, sadness, confusion—or all of these.
“Me love lucky fin!”
“I sad—no foot, just nubby.”

Be ready to hear about their pain

It can be painful to hear your child express sadness or frustration. But these feelings are normal. Your child is learning to understand their body and identity.

You can prepare by practicing responses with a partner, friend, or therapist. That way, when your child says something hard, you feel less caught off guard.

Some real examples from parents:

• “Why I have to be born like this?”
• “Will my hands/feet be big when I’m 5?”

Important takeaways

• By toddlerhood, most children already notice they are different
• Even before talking, they understand a lot through tone, body language, and experience
• Talk positively about their difference and name emotions when you see them
• Stand up for your child’s abilities—don’t let others decide what they can or can’t do
• Picture books and community events help children feel seen and connected
• Avoid language that makes your child feel like they need to “prove” themselves
• Be ready for your child to say both sweet and hard things
• Practice ahead of time so you can respond with love and confidence

Quick Links

• Read blog post Choosing High Quality Picture Books for Your Child with a limb difference
• Check Resources for dolls you can customize to have a limb difference like your child’s and for organizations that host events where your child can connect with others like them

Download a free printable copy of the What to do when your child realizes they have a limb difference!

Name *

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By providing your email address, you agree to receive occasional email correspondence from On The Other Hand. Don’t worry: we will never share your email with any other entity and we will never spam you!

Download the free handout!

Read the other posts in this series:

• Preparing yourself for when your child feels SAD about their limb difference
• What NOT to say when your child feels SAD about their limb difference
• What to say & do when your child feels SAD about their limb difference

© 2026. Laura Faye Clubok, MS, OTR/L, On The Other Hand Therapy. All rights reserved.

The post When your child realizes they have a limb difference appeared first on On The Other Hand.

Most parents are choosy about which books they read to their children, and for good reason! As a parent, you want to choose high quality books that align with and reinforce your values and steer clear of books that teach messages that you prefer to avoid. That’s being a savvy parent! The same is true of the growing library of books for children with limb differences. I encourage you to watch read alouds on YouTube of any books you consider purchasing. 

It is vitally important that children see themselves represented in books. While some children with limb differences are confident, outgoing extroverts, others are shy, studious, and quiet introverts. There can’t be a one-size-fits-all approach to representing children who have different personalities and differences.

In addition, it is important to watch for ableist and “you can do anything” messages. While these can be well-intentioned, they also can lead to pressure to achieve/perform/prove competency. A quick caveat that focusing one’s praise too much on accomplishments can lead to issues such as the Overachiever Trap.

Questions to consider about books for children with limb differences:

• Does the book imply or explicitly state that children with limb differences are required to work extra hard to make up for their difference?
• Are children with limb differences required or encouraged to prove their competence?
• Are children with limb differences portrayed as having a range of feelings? Do the adults and/or peers validate these feelings? For example, is the child allowed to feel sad about not being able to do something or not having the same body parts as everyone else? 
• Are children with limb differences expected to do everything independently and without help, or are they offered appropriate and needed accommodations and support?
• Does the book share ableist messages such as children with limb differences are superheros whose skills surpass those of their peers?
• Put yourself in your child’s shoes; does the story inspire you? Comfort you? Answer your questions? Share a valuable life lesson?

Here are some of the books I recommend:

• Awesomely Emma: A Charley and Emma Story (Charley and Emma Stories Book 2)
• Baking Up a Storm by Jessica Parham
• Different is Awesome by Ryan Hack
• Goldie’s Tasty Tacos (The Able Fables) by Dr. Nicole Julia
• Uniquely Me by Trace Wilson
• What Happened to You? by James Catchpole, Karen George (Illustrator)
• You’re So Amazing! by James Catchpole (Author), Lucy Catchpole (Author), Karen George (Illustrator)

I would love to hear what books resonate for your child. Let me know here.

Learn more

• Access the Free Handouts
• Check out Limb different toys & dolls matter – here’s why
• Follow the Raising a Child with an Upper Limb Difference parenting series on Instagram
• Learn about Bullying Part 1: Understanding Exclusion and Social Systems
• Delve into Upper body strengthening tools for upper limb difference
• Read Understanding Limb Difference Language & Terminology

© 2026. Laura Faye Clubok, MS, OTR/L, On The Other Hand Therapy. All rights reserved.

The post Choosing High Quality Picture Books for Your Child appeared first on On The Other Hand.

Intro
My daughter Brittany was born missing both her hands and part of her arms below the elbow. She has always been independent, but now she faces true independence. As I reflect on her middle school through high school years (ages 13 through 17), I would like to share with you some of the things we have learned, as well as her challenges and triumphs.

Transitioning from Elementary to Middle School
Going from elementary school (K through 6th grades) to middle school (7th and 8th grades) was a major transition for Brittany. Most children are nervous about the new environment both because in middle school they switch classes and they are not familiar with the school’s layout. Brittany’s concerns went beyond that. For the first time in 7 years, she would be entering a school where she would be meeting new kids. We weren’t sure how students would react towards her. Quite frankly, I was more nervous than she was. As she was approaching the end of the elementary school, I began to toughen her up. We talked about how to respond to kids who say unkind things, and we discussed the fact that not all kids’ disabilities can be seen. Fortunately, she did not have any significant negative feedback during those years.

Shortly after school started, I requested a meeting with her teachers, mostly because I didn’t want her teachers to “walk on eggshells.” I wanted them to understand that she was not to be treated “special”, that she would ask for help if needed, and that they could feel free to ask her any question they had on their minds. I emphasized that she would not be insulted or feel awkward by their questions. This meeting helped the teachers to relax and be comfortable around Brittany, and also allowed them to ask me any questions they had.

Tackling Logistics: Carrying Heavy Books
One of the problems Brittany experienced was carrying her books. The books that she had to take home were quite heavy on her back and caused her back pain. Not having hands to hold them in front of her, all the weight was on her back. As a result of the meeting with her teachers, Brittany was given a second set of books to keep home so she would not have to carry them back and forth to school.

As time marched on, Brittany attended various dances the school had, interacted with other students with no problems, and lived life like a “normal” teenager. My only frustration with the school was that they did not place her correctly in math class. Her math grades were excellent, yet she wasn’t placed in Algebra in 8th grade. Since I thought the school knew what they were doing plus Brittany was a little nervous about taking Algebra, I decided not to say anything. BIG MISTAKE!!! As a result, she was bored in her high school math classes. Since she is going to focus on engineering in college, she lost the opportunity to take calculus in high school, which was a set back for her. My advice to all parents is: if you feel your child can do the work, then challenge the school and fight for your child. You don’t realize how much your child’s placement in high school can affect her opportunities in college. Since that time, the same school tried to place my son incorrectly in high school. I challenged his middle school, I won, and my son is doing excellent in high school.

Life Beyond School
Life outside school became more complicated and challenging. Prior to Brittany’s 16th birthday, my husband and I began to teach her to drive. We found that she had no problem securing the steering wheel and moving the stick from park to drive. Soon I was teaching her along with the driving school. Like many parents, my hair got grayer and my foot kept reaching for what I called “the invisible brake” on the passenger’s side. The education portion of driver’s education was no problem – it was the driving portion that could have been a problem. We were very fortunate that the woman who owned the driving school had worked with various students with disabilities and was willing to go out with Brittany to see how she did. We were quite thankful that we gave her driving experience prior to her sessions with her instructor. This experience helped boost Brittany’s confidence, especially since she was nervous driving a different car that did not have the same kind of steering wheel she had. Her steering wheel had multiple bars going from where the horn is to the wheel, allowing Brittany to move the wheel from the inside. The steering wheel in her instructor’s car did not have the same configuration, which made driving a little more difficult. By the time driver’s education was over, Brittany did very well and was ready to take the test. The department of motor vehicles said that she had to go through the handicap division. We were totally opposed to this because they would classify her and try to evaluate her for special devices on the car. She was quite capable of driving without special devices, and we felt that she shouldn’t be restricted to driving with devices. We contacted the owner of the driving school. She then contacted someone she knew at DMV who was able to take Brittany for her test. As a result, she got her license without disability restrictions. My advice to anyone going through this is to make sure that the driving school has worked with kids with disabilities and is supportive of them. If you have that, the owner will go the extra mile for you if you need it.

Another important factor is making sure your child drives everywhere during the time he has his permit. Brittany was much more seasoned than many of her friends. We took her on the highway, the back roads, and anywhere else we had to go. As a result, she was quite comfortable reading signs, going where she needed to go, and even getting lost at times.

Another consideration was the car she had to drive. We put a cover on the steering wheel that had ridges so that it was easier for her to hang onto the wheel. We had to make sure she could reach the ignition, could manipulate the console, reach the radio, and handle her seat belt. Some cars were more of a challenge for her than others.

Taking on Responsibility
Life definitely changed after driving. Brittany was handling money more frequently because she was going out with her friends to restaurants, movies, the shopping mall, and the grocery store. Yes … I did say the grocery store. One of Brittany’s weekly chores was to make out a grocery list and do the grocery shopping. This activity served several purposes. It made her conscious of store prices, taught her a skill that she would be using when living on her own, allowed her to experience challenges at a time when I was able to advise her, and got her out into the public. Her presence in the public was not only beneficial to her, but also to the public. On one occasion, a woman saw her shopping and approached her. She stated that she was so happy to see her and asked Brittany if she could give her a hug. Brittany did not know her, yet she agreed. Brittany didn’t understand at the time what had happened, but I suspect that the woman either had a child or grandchild with a disability and seeing Brittany must have given her the faith that the child was going to be okay. On another occasion, I happened to go with Brittany to the grocery store and noticed that the deli employees and the fish employees were all saying hello to her. When Brittany went to another part of the store, a gentleman from the deli counter told me how amazing Brittany is, and that I should be very proud of her. Our children were given to us for many reasons, some of which, I believe, are to instill faith in others and make people appreciate what they have.

Handling Money
Regarding the handling of money, we found that a man’s bifold wallet was best because it opened wide and was long enough to balance on a counter so that she could flip through the dollars. She never liked handling change, so she would let that drop to the bottom of her purse. I have made other suggestions to her for managing the change, but the bottom of the purse is what worked for her.

Eating Out
When Brittany went with us out to dinner, we always would cut her food. So that she wouldn’t get embarrassed, we would swap plates, cut her food, and then swap the plates again. This worked well when we all went out to dinner as a family, but now that she was becoming independent, she needed to eat independently. Some foods she was able to cut, and she was comfortable asking some friends to cut her food for her. When she was in a situation where she didn’t want friends to do it, she would ask the waiter/waitress to have the food cut prior to it being served. This eliminated any embarrassing situations, and also allowed her to order whatever she wanted without being concerned if she was able to cut it or not.

Money Matters
The next challenge was shopping at the mall. Since I didn’t function well as a bank, I felt that it was time that I set her up with a checking account and ATM card. Although she wasn’t yet 18 years old, I was able to setup a checking account as long as my name appeared jointly with hers. By doing this, I was able to teach her about money management, how to balance a checkbook, how to use the ATM machine, and also how to use the ATM card to make purchases and pump gas. Brittany earned allowance by doing chores at home, money by working over the summer, and she received money from birthdays and holidays. This gave her an opportunity to control her spending and understand the consequences of spending too much. Thanks to the Internet, I was able to login to the bank’s website and observe her spending so that she didn’t get herself into trouble. The only problem she ran into was with our bank’s ATM machine. It wasn’t what we call, “Brittany friendly”, because the slot the card goes into has an indentation where the card must be pushed in and pulled out. She had no trouble pushing it in but couldn’t pull it out. She avoided using that bank’s ATM. However, we did come up with a solution: we attached one of those small black paper clips that fold down over paper. We clipped it onto the card, which allowed her to remove it independently. I also notified the bank, because by law the ATM is supposed to be accessible to all people with disabilities. Brittany’s disability happens to be one they didn’t plan for.

Chores
Along with grocery shopping, Brittany had to alternate setting the table, doing the dishes, emptying the small garbage cans, and doing her laundry. The purpose was to allow her to earn money, which enhanced her money management skills, and for her to learn life skills. Seeing the challenges our children experience at home allows us to assist our children with adapting, correcting mistakes, and recognizing their limitations if there are any. Once children move out, it is difficult for parents to advise, since they aren’t there to witness. For example, teaching Brittany to do laundry before she went to school was challenging; she had trouble reaching the clothes at the bottom of the top-load washer. She would have to get a step stool and then put her head in the washer to grab the clothes. I am sure there are devices she could use to get the clothes out, but this worked for her. It also taught her – and us – that a front-loading washer is more practical. Handling the front-loading dryer was no problem.

Emptying the garbage cans was also difficult, because she had to put the entire garbage can into the waste bag. She was unable to hold the bag with one hand while emptying with the other. Again, this was another life skill that she had to figure out.

To help with the dishes, Brittany had to work the sponge to clean them in the sink so that she could put them in the dishwasher, and then she had to stand on chairs to put them away when the load was clean. Once again, she did it her way and got them cleaned. If the dishes that didn’t go in the dishwasher weren’t cleaned well enough, she would have to do it again with me watching so I could determine where she was having the problem.

Summing Up
Much has happened during this time period and we all learned a lot. I share all of this with you to reinforce the importance of communicating with teachers, fighting for your children, and teaching your children valuable life skills before they leave home. Leaving home is a major transition and will provide many challenges. The fewer new challenges that they have to deal with, and the more things they are familiar with, the easier the transition will be for them. As far as the parents … nothing is easy when your child leaves home and nothing can prepare you for it. So enjoy having them home, because before you know it, you will be walking in my shoes.

Contacting Me
If anyone is interested in speaking with me directly, I can be reached in the evenings at 203 925-0446 or via email at LKTofinchio@aol.com. Brittany and I have had 18 plus years of challenges in our lives, and we wouldn’t change a thing! We would be happy to assist you in whatever way we can. My best to all of you.

The post Teenage Years appeared first on On The Other Hand.

Intro
In this essay, I discuss some of the triumphs and challenges that my daughter Brittany has experienced as a congenital bilateral, below elbow amputee. In other words, my daughter Brittany was born missing both her hands and part of her arms below the elbow. Brittany is now 19 years old. The years I am going to reflect on are from age 6 through age 12. When Brittany began elementary school she started in the first grade. She attended kindergarten through the daycare center, which will be covered in another article.

School Experience
Before Brittany was ready to move on to first grade, I met with the elementary school principal. I shared with her Brittany’s experiences and my concerns. As a result, the principal allowed me to observe each first grade class to determine which teacher I felt Brittany would work well with. The principal gave me her recommendation but also allowed me to make my own assessment. We both agreed on the same teacher. This teacher was quite innovative and open minded, which are what you need for a child who has to adapt to her environment.

When doing math, Brittany was given an abacas for counting since the children normally use their fingers. Brittany could have also taken off her shoes and socks and used her toes, but she chose not to.

When it was time for cutting paper, Brittany used adaptive children’s scissors. This was the only adaptive device she needed for school. The school purchased the scissors from Sammons Preston Rolyan. This company has a tremendous selection of adaptive tools such as kitchen utensils, desk tools, bathroom accessories, and so on. You can see the products in their catalog at www.sammonspreston.com. Over the years, we purchased a variety of things on our own, such as knives, forks, cutting board, and adult scissors to name a few.

When Brittany went into third grade, one of the art projects was to make a knitting ball. The students competed to see who could make the largest ball. Because fingers were required for this project, Brittany’s art teacher worked with her husband and created a wooden device that allowed Brittany to be able to knit. We were overwhelmed by the art teacher’s determination and kindness. Brittany was so excited that she was able to participate. It is particularly rewarding to see the interest teachers take in their students at such a young age. We were grateful and appreciative that Brittany had such wonderful teachers.

The other challenge we had was finding a lunch box Brittany could use. She didn’t like the metal lunch boxes and the thermal bags were too narrow for her to get both her arms in to get the food out. We looked around for some time, and finally found a cloth lunch bag that was wide enough for both her arms to fit in.

Clothing and Shoes
For some time, Brittany wore pullover shirts and sweaters, stretch pants, and Velcro shoes because she was unable to button and tie laces. One day she asked to wear jeans. I explained to her that it is important that she be independent. If she wanted jeans, she needed to be able to manipulate a zipper, snap when needed, and button the top button. We provided her with educational dolls that had all those things for her to practice. When she felt she was ready, I took her shopping and told her that if she was able to put the jeans on herself, zipper and snap or button the top button, then she could have the jeans. As a result of her determination, she was able to accomplish this. She was ecstatic, and from that day forward, she never wore stretch pants again.

Her next request was to get sneakers with laces. Once again, I explained to her that she could get a pair if she was able to tie her sneakers. My husband and I worked with her the best we could to show her what to do. The rest was for her to figure out, and she did. Between using her mouth and arms she was able to do it. To this day I couldn’t begin to explain how she does it – but she does.

As a result of her accomplishment, the elementary school kindergarten teacher asked her if she would show the kindergarten class on a Friday how she tied her shoes. Brittany was so proud to do this. The teacher emphasized to the class that if Brittany could do it so could they. By the following Monday, 50% of the students who couldn’t tie their shoes before came able to tie them

Additionally, to keep Brittany comfortable in her clothes, we regularly visited the tailor. He shorted the sleeves on her sweaters, jackets and shirts. He did such an outstanding job that you would have thought the clothes were made that way. The only restriction Brittany had was that she couldn’t wear clothes that had zippers and buttons in the back.

Sports and Games
At home, Brittany was determined to learn how to ride a bike. This was quite a challenge, since she could not grip the handle bars. We never found anything that she could fit her arms into, but what we were able to do was to swap the handle bars the bike came with, with another set that curved closer to the body so that Brittany could reach them. She took a number of falls but was able to steer and eventually ride a two wheeler. Her riding days didn’t last too long because when she would hit a bump, the wheel would jump and she did not have the control that most kids have to keep the bike steady. As a result, she fell more times than desired. Eventually she did give it up.

From first grade through high school Brittany played soccer. This was a great sport for her, since she didn’t need to use her arms. She loved the sport, it provided team interaction, she did well at it, and it was a great boost to her self esteem.

One of the things Brittany liked to do with friends was to play cards. There were so many games that involved cards. We found a card rack in the Sammons Preston Rolyan catalog that allowed Brittany to place all her cards in the rack where other children would hold them in their hand. To this day, when she plays cards, she still uses the rack.

After School and Summer Camp
Having to work full time, I needed after school care for Brittany and to enroll her in summer camp. She attended excellent programs. They provided sports activities, field trips, and arts and crafts. The great thing about these programs is that it kept her interacting with other children, it allowed her to adapt to whatever she needed to do, and the counselors were great working with her. As with her school programs, I met with the counselor staff ahead of time to advise them and reinforce the importance of Brittany asking for help. I emphasized that they should feel comfortable asking her questions without feeling like they would offend her.

Emotional “Why me?”
As Brittany moved into the 5th and 6th grades, she became more conscious about her dress and appearance. There were times when she would be upset or cry about not having hands, not being able to do what everyone else did, and not being able to wear certain clothes that she liked. When these times happened – which were very few and far between – I would hold her and tell her that it is okay to feel bad or angry. And believe me, there were times when I wanted to cry with her. I also explained that feeling bad wasn’t going to change things, so it was okay to feel bad “today” but tomorrow was a new day. I also explained how lucky she was to have her elbows and that life would have been more challenging without them. We talked about children in wheelchairs and other children who were worse off. Usually this helped her appreciate what she did have versus what she didn’t. As she got older, we talked about the positive impression she has made on others and how she makes other people appreciate what they have.

Summary
One of the things I found to be important in Brittany’s development is communication. Communication was important with the people who would be interacting with her and communicating with Brittany. I always reinforced to others that they should feel comfortable asking Brittany any question, and that they would never offend her by their questions. I also emphasized that she wasn’t to be treated special and the importance of her being independent. At the same time, I reinforced to Brittany the importance of her being independent and that if she needed help, she needed to ask for it.

As I mentioned in my last article, if anyone is interested in speaking with me directly, I can be reached in the evenings at 203 925-0446 or via email at LKTofinchio@aol.com. Brittany and I have had 19 plus years of challenges in our lives, and we wouldn’t change a thing! We would be happy to assist you in whatever way we can. My best to all of you.

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