Raising a child with an upper limb difference brings many questions. Parents often want clear information, practical guidance, and reassurance that they are not alone.

This page gathers articles, guides, and tools to support families at different stages of the journey. Some resources focus on early questions after diagnosis. Others explore therapy, daily life, and long term well being.

You do not need to read everything at once. Start with what feels most helpful right now and come back when new questions arise.

Parenting series

This series offers thoughtful guidance for parents raising children with upper limb differences. Each post explores one aspect of the journey, including emotional support, physical health, advocacy, and long term well being.

The goal is not to provide a checklist or a perfect formula for parenting. Instead, these posts share ideas that can help families build strong, resilient foundations over time.

👉 Read the Raising a Child with an Upper Limb Difference parenting series

Understanding limb difference & limb loss language

Words matter. The language used to describe limb differences has changed over time and can vary across communities.

This article explains common terms, why some language feels respectful while other language may not, and how families can talk about limb differences in ways that support dignity and understanding.

👉 Read Understanding Limb Difference Language & Terminology

Navigating medical decisions

Interacting with medical professionals can be an important — but sometimes confusing —part of raising a child with an upper limb difference.

Families are often asked to make decisions without always having clear guidance about what questions to ask, what options to consider, or how to interpret different recommendations.

This section is designed to help you feel more prepared and more confident when navigating medical care. It includes guidance on working with physicians and specialists, understanding the role of occupational therapy, and thinking through decisions related to treatment, therapy, and long term care. Many of these insights reflect both clinical experience and lived experience, offering perspective that families are not typically given in medical settings.

The goal is to help you ask thoughtful questions, understand your options, and advocate for your child in a way that feels informed and grounded, not to tell you what decisions to make.

👉 Delve into What Is Occupational Therapy?
👉 Explore Balanced and Nuanced Medical Advice
👉 Read Questions for the Physician or Specialist

Resource directory

Families often ask where to find trusted organizations, support groups, prosthetic resources, and educational materials.

The directory gathers links to organizations and tools that support people with limb differences and the families who love them.

👉 Explore the Resource Directory

Tools for daily life

Children with upper limb differences often find their own ways of doing things. At times, simple tools or adaptations can make everyday activities easier, more comfortable, or more efficient.

This section highlights practical options that can support participation at home, in school, and during play. These resources are not about “fixing” differences, but about expanding access and reducing unnecessary frustration.

👉 Learn about Limb different toys & dolls matter – here’s why
👉 Explore Typing/Keyboarding with an Upper Limb Difference (or two!)

A note for parents

Every child with a limb difference is unique. Families make different choices about therapy, prosthetics, sports, school support, and many other aspects of life.

The resources here are meant to inform and support you as you make decisions that fit your child and your family.

You do not have to figure everything out all at once.

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 Start Here: Resources for Families Raising Children with Upper Limb Differences appeared first on On The Other Hand.

Raising a child with an upper limb difference brings joy, questions, and moments that few people prepare parents for.

Over time, families learn to navigate medical appointments, school conversations, social situations, and decisions about therapy or prosthetics. Along the way, parents also carry emotional work that is not always visible to others.

This parenting series offers practical and compassionate guidance for families raising children with upper limb differences.

The ideas shared here come from lived experience growing up with a hand difference, decades of work as a pediatric occupational therapist, and long involvement in the limb difference community.

The goal is not to provide a checklist or a perfect formula for parenting. Every child and every family is different.

Instead, these posts offer thoughtful suggestions that can help parents support their child’s physical development, emotional well being, and long term resilience.

You may find that some ideas resonate right away. Others may become more helpful later as your child grows.

Take what fits your family and leave the rest.

Parenting tips

This series will grow over time as new topics are added.

Tip #1: Take Care of Yourself

Raising a child with an upper limb difference is a long journey that requires energy, patience, and support. This first post focuses on sustainable parenting and why caring for yourself is an important part of caring for your child.

👉 Read Tip #1: Take Care of Yourself First (Yes, Really You)

Tip #2: Find Your People — Support for Families Raising a Child with an Upper Limb Difference

Parents don’t have to navigate this journey alone. This second post explores how families can find meaningful connection, build supportive community, and navigate relationships with clarity and care.

👉 Read Tip #2: Find Your People — Support for Families Raising a Child with an Upper Limb Difference

A note for parents

Many parents feel pressure to do everything perfectly. In reality, parenting a child with a physical difference is a long learning process.

You do not have to figure everything out at once.

This series is meant to support families as they grow alongside their children.

Explore more resources

👉 Access the Free Handouts
👉 Explore Typing/Keyboarding with an Upper Limb Difference (or two!)
👉 Find out about Limb different toys & dolls
👉 Learn “How to think like an OT”

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

The post Start Here: Parenting Series Landing Page appeared first on On The Other Hand.

Parents and caregivers of children with upper limb differences often say that this is one of the hardest truths to hear: You matter just as much as your child.

It’s tempting to dive all in: to become the researcher, advocate, expert, appointment scheduler, and your family’s emotional glue. You want to give your child, family, everything. 

But burnout is real, and nobody thrives when the parent is exhausted and overwhelmed.

Let’s reframe this: Taking care of yourself is part of caring for your child.

Your feelings are valid
Find community
Pace yourself
Choose the supports that fit your life
Honest conversations to have now
Care for your whole self
Final thought
Want more support?

Here’s what that might look like:

Your feelings are valid

They’re all legitimate: guilt, anxiety, fear, sadness, joy, hope, amazement. Having a safe place to process your feelings isn’t selfish. Needing support also doesn’t mean you don’t love your child. Quite the opposite: sharing with a therapist, counselor, or trusted friend can help your child. In fact, research shows that children born with limb differences are harmed by parents’ depression and anxiety (Martens, et al., 2023). So getting help for yourself can help your child.

Find community

You don’t have to do this alone. Whether it’s an online group, a limb difference family weekend, or just one parent who “gets it,” finding someone to walk beside you makes a huge difference. Connecting with a family whose child shares your child’s limb difference (“hand twin” or “limb twin”) can be helpful both for you and your child.

Pace yourself

You don’t have to know everything all at once. Learn a little at a time, staying just a step ahead of what’s coming next. This is a lifelong journey, not a sprint.

Choose the supports that fit your life

Every family builds support in different ways. Some parents have strong extended family networks. Others rely more on community, friends, or professional support.

It can be helpful to think about support as a menu rather than a single solution. Different families choose different combinations depending on their needs and resources.

Examples of support might include:

• assistance from family or friends
• journaling, reflection, or meditation
• movement, sleep, and nutrition that support your own wellbeing
• therapy or counseling

Honest conversations to have now

Another important form of support involves honest conversations about how responsibilities are shared.

For example, proactively discussing questions with the important people in your life can lessen stress:

• Who attends medical appointments?
• Who manages scheduling and logistics?
• Who handles grocery shopping or meals?
• Who organizes school or social activities?

These conversations can help distribute both the physical and emotional load of parenting.

Care for your whole self

It’s okay to prioritize rest, nourishment, exercise, friendships, and joy. It’s also okay, and often even necessary, to say no to extra commitments.

Some permissions you may need: you don’t have to

• get it all right or do it all perfectly
• be on every board
• attend every event
• carry everything alone

Final thought

Your child needs a present parent, not a perfect one. The fact that you are taking the time to read this already says so much about how you’re doing a beautiful job.

Want more support?

👉 Follow the rest of the Raising a Child with an Upper Limb Difference parenting series on Instagram and read the full series here
👉 Read Understanding Limb Difference Language & Terminology
👉 Access the Resource Directory
👉 Learn about Bullying Part 1: Understanding Exclusion and Social Systems
👉 Delve into Upper body strengthening tools for upper limb difference

Reference

Martens, S. A., Tuberty, S., & James, M. A. (2023). Self-concept development in children with limb differences: A scoping review. International Journal of Orthopaedic and Trauma Nursing, 49, Article 100997. https://doi.org/10.1016/j.ijotn.2023.100997

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

The post Tip #1: Take Care of Yourself First (Yes, Really You) appeared first on On The Other Hand.

Find your people
Support for the whole family
What counts as community?
When support feels complicated
Not every group is the right fit
It’s okay to take breaks
Connection can take time
Final thought
Want more support?

Find your people

When your child is born with a limb difference or acquires one later in life, it can feel like your world has shifted. 

In many ways, it has. But you don’t have to figure it all out alone.

One of the most helpful things families share is the moment they connected with others who truly understood their experience. Maybe it was another parent, a mentor, a teen with a similar limb difference, or even a child who looked like their own.

Community can give hope and perspective. It can remind us that we are not alone, and that our experiences are real, shared, and survivable.

Support for the whole family

Supportive community can benefit more than the child with a limb difference. It can help parents, siblings, and even extended family feel less alone. It can give everyone a sense of belonging and a place to ask honest questions without judgment.

What counts as community?

• Online support groups like Facebook groups or forums
• In-person events or camps like Camp No Limits
• Family weekends like those hosted by Lucky Fin Project
• Social media, curated wisely, can offer connection and representation

You don’t have to attend every event or post online. But if you want support, it’s out there.
👉 Search the Resource Directory for organizations, camps, family weekends, and more!

When support feels complicated

Support can come from many places, including extended family, long-time friends, and new connections within the limb difference community.

Some families report feeling surprised that strangers in limb difference groups offer more understanding than family members or long-time friends. It may seem disappointing that people whom you previously thought were closest to you don’t share your perspective on your child’s limb difference or have different understandings of limb difference. Some may underestimate your child’s abilities, while others may respond with overprotection or uncertainty.

This can be difficult, especially when these perspectives come from relationships you cherished.

It’s okay to be thoughtful about the people and messages that influence your child and who you turn to for support.

Some families find it helpful to:

• limit certain conversations
• set gentle but clear boundaries
• seek out communities that better understand their child’s experience
• take breaks from relationships that feel draining

Not every group is the right fit

Some limb difference events are large and busy, while others are small and intimate. Some groups focus on advocacy, while others center social connections. Try what works for your family, and give yourself permission to leave what doesn’t.

It’s okay to take breaks

While connecting with others can be healing, it can also bring up deep feelings. You might feel tender after an event or overwhelmed by certain stories. This is all normal. You get to engage in ways that feel nourishing, not draining.

Connection can take time

Sometimes families attend an event or join a group expecting instant friendships. While that does happen for some people, it’s not the only way connection develops.

Many meaningful relationships grow slowly, through repeated events, small conversations, or simply recognizing familiar faces over time.

If you attend an event and don’t immediately feel a sense of belonging, that doesn’t mean the community isn’t there for you. Like any relationship, finding your people can take time.

It’s okay to explore at your own pace and allow those connections to develop naturally.

Final thought

Support doesn’t have to come from everyone. It can come from the people who are able to show up in ways that are helpful and respectful. Over time, many families build a circle of support that feels aligned with how they see their child and their future.

Finding supportive community doesn’t solve everything. But it can mean having people to turn to on the hard days and celebrate with on the good days.

Want more support?

👉 Follow the rest of the Raising a Child with an Upper Limb Difference parenting series on Instagram and read the full series here
👉 Access the Resource Directory
👉 Delve into Upper body strengthening tools for upper limb difference
👉 Explore Bullying Part 1: Understanding Exclusion and Social Systems
👉 Read Understanding Limb Difference Language & Terminology

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

The post Tip #2: Find Your People — Support for Families Raising a Child with an Upper Limb Difference appeared first on On The Other Hand.

Families, individuals, and professionals often encounter multiple terms used to describe bodies that look similar but reflect different experiences. This page brings together two related ideas: the types of limb differences and how language and terminology are commonly used. The goals are clarity, not prescribing labels, and support for respectful, thoughtful communication.

Types of limb differences

Limb differences can broadly be described based on when they occur.

Congenital Limb Difference

Congenital limb differences are present at birth. A limb, or part of a limb, may be shorter, formed differently, or absent. These differences develop during pregnancy and are often identified prenatally or at birth.

Children with congenital limb differences typically grow up learning to use their bodies from the beginning with their difference as part of their lived experience.

Acquired Limb Loss

Acquired limb loss occurs after birth. This may happen due to injury, illness, infection, or medical intervention. Individuals with acquired limb loss often have memories and experiences of having two fully formed limbs prior to the loss.

While congenital limb difference and acquired limb loss can look similar, the timing, medical context, and lived experience are often very different.

Why language can feel complicated

People use different words to describe limb difference and limb loss. Language varies across medical settings, communities, and personal identity.

This can feel disorienting for families, especially when different terms are used by different professionals, organizations, or individuals.

Language is not just about anatomy.

Language reflects more than bodies

Terms such as limb difference, limb loss, or amputee often reflect:

• lived experience
• identity
• community
• context

Especially for congenital limb difference, families may hear a wide range of descriptive terms over time. This variation is common and does not mean there is a single correct way to describe every person.

How terms are often used

While usage varies, some patterns are common:

• “Limb difference” is often used in congenital contexts.
• “Amputee” is often used within limb loss communities.

Neither term tells the whole story on its own. The same word may feel accurate and affirming to one person and uncomfortable or incorrect to another.

Meaning depends on the individual using the language.

There is no single “correct” term

There is no one word that fits everyone.

The goal is not perfection. Respectful language is not about memorizing the right terminology—it is about approach.

Using language thoughtfully means:

• listening
• asking when you are unsure
• using the words people choose for themselves

A note for parents

It is not necessary to know everything all at once.

Many parents look back and wish they had learned certain things earlier. That experience is common, especially when raising a child with a disability.

Learning is an ongoing process. Language, understanding, and preferences can evolve over time—and that is okay.

If you are interested in learning more about long-term health considerations, therapy support, or overuse prevention for children with upper limb differences, additional educational resources are available throughout this site.

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

The post Understanding Limb Difference Language & Terminology appeared first on On The Other Hand.

I never had a toy with a limb difference like mine – until just recently. Growing up with a partial hand, I tried so hard to adapt to the limb typical world that it didn’t occur to me that toys with limb differences like mine could be possible. I can only imagine how much my 5 year old self would have loved one of these dolls! 

But of course they’re not only possible – there now are so many incredible options available! Here are the dolls and toys I know about; please message me additional ones through social media so that I can add them to the resources page.

Download the free 2025 Inclusive Toys + Dolls Guide with hot links to the inclusive limb different toys listed below

Name *

First

Last

Name Email

Email *

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!

For children with limb differences, these toys can …
These toys can ALSO …
For children with typical limbs, these toys can …
Where do these toys belong?
How can people who are raising or work with “limb typical” children be allies?
Who makes limb difference toys?
At what age can children benefit from playing with inclusive dolls? 
Transparency
Links

For children with limb differences, these toys can: 

• boost self-esteem – encourage them to embrace their differences
• offer belonging, comfort, & connection – remind them they aren’t alone
• provide representation – help them see themselves positively

These toys can ALSO:

• foster imaginative play that includes their differences
• offer opportunities to practice responding to questions about their limb difference
• open conversations with peers & siblings

For children with typical limbs, these toys can:

• normalize disabilities & differences in body shapes/sizes
• promote acceptance, empathy, & understanding of differences
• serve as powerful tools for inclusion

Where do these toys belong?

Wherever children live, learn, play, & visit, such as:

• daycares
• extracurricular activities
• homes of peers & loved ones
• public libraries, recreational & after care centers
• schools & educational facilities
• summer camps

How can people who are raising or work with “limb typical” children be allies?

• promote inclusive toys with educators, librarians, & program staff
• encourage children to role play asking kind questions

Who makes limb difference toys?

• Plushies + soft dolls
  • A Doll Like Me – custom plush dolls customized to the child’s difference
  • Budsies – custom plush dolls customized to the child’s difference                     
  • Crochet-ABLEs – custom crocheted dolls and animals matched to any limb difference
  • Kikilishop – personalized cloth rag dolls featuring upper and/or lower limb differences
  • Mayana & Friends – a collection of animal plushies representing diverse limb differences
  • Uniquely Me – companion doll to Trace Wilson’s book Uniquely Me
  • Vermont Teddy Bear with theAmputee Coalition – plush bears with limb differences   

• 18″ “realistic” dolls
  • Customized American Girl dolls by A Step Ahead Prosthetics 
  • The Doll for All – boy and girl 18” realistic dolls with 10 upper limb difference options and 4 lower limb difference options
    
• Action figures + character toys
  • Disney® – Nemo has a smaller “lucky fin”
  • LEGO® – Autumn (Friends line) has a partial arm and her sets come with adaptive gadgets
  • Mattel® – Barbie® with a prosthetic leg; part of the Fashionista line

At what age can children benefit from playing with inclusive dolls? 

• the younger the better!
• it’s never too early to make the world kinder & more inclusive

Transparency

I do not do not receive any commissions or kick backs for toy recommendations. Occasionally companies send me free products to try; Mayana & Friends sent me their adorable “Dougie” doll.

Please note that I can no longer find these products that previously were available; they may still be available on Ebay or used:

• “My Life” as a gymnast with prosthetic leg by Walmart
• “Our Generation” with prosthetic leg by Target

Many thanks to the families for sharing photos of their children with their dolls: @kimberly_gallagher and @thehandweredealt

Links

• Links for all of the toys and dolls are on the resources page.
• See this post on Instagram.
• See this post in the “H2L Innovation Station” column in the Hands to Love newsletter.

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

The post Limb different toys & dolls matter – here’s why appeared first on On The Other Hand.

Adapt the technology to the child, not the other way around

Background
Advocating for Your Child
Practice Makes Permanent
Looking Different Can be Hard
Adaptive Technology Options
Keyboard Layouts: QWERTY vs. DVORAK
Mouse Use
External Keyboards
Typing with One Hand
Typing with One Hand and a Partial Hand
Typing with Two Partial Hands
Typing without Hands
What About One-Handed Keyboards?
Custom Keyboard Layouts
My Typing Journey Story
Accessible Accessories
Try Before You Buy
Voice to Text Options
Ergonomics
Taking Breaks from Computer Use
Additional Resources
Quick Links
Important Takeaways

Complete the form below to download a free printable copy of the Adaptive Tech Options for Children with Upper Limb Differences (ULD) handouts, featuring an overview page and a chart with adaptive tech options. You will receive two versions of the chart: digital (with hot links) and printable (less color, so less toner used!). Both handouts link to an Amazon list with recommended products; recommendations for products are for educational purposes only; we don’t endorse or profit from them.

Name Email

Name *

First

Last

Email *

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!

Want to save time? Schedule a consult with me to individualize a technology set up that is best for your child!

Background

While there is now a (limited) body of research on children using computers, there is no research yet specifically on computer use and adaptations for children with upper limb differences (ULD).

So what follows are recommendations based on:

• my personal experience with overuse syndrome
• the experiences of families and adults with whom I’ve worked and spoken
• ergonomics research involving typically developing children and adults

Most of the information below applies regardless of age; however, because upper limb differences can be so varied, unfortunately there is no one-size-fits-all recommendation. Because most children these days use laptops much more often than desktop computers, we focus mostly on laptops. But note that much of the following also applies to home desktop use, which has the advantage of being more configurable. If your child works with an occupational therapist, sharing this information would be helpful.  

Advocating for Your Child

I have heard regularly from parents over the past two decades that there weren’t any specialists with expertise on adaptive tecnology within their school system or school district. Unless your child’s school or district has an assistive technology specialist on staff, you likely will need to be the expert on technology adaptations and advocate for your child. Knowing what grade children begin using technology can be very helpful, as is implementing adaptations as young as possible. But even if your child is older, it’s never too late to reduce strain on their arm(s) and hand(s)!

The most important principle when choosing technology for your child is: as much as possible, adapt the technology to the child, not the other way around. 

Practice Makes Permanent

Most adults with upper limb differences with whom I have spoken report that they were given no accommodations when they learned to type. The same is true of most of the parents of children with ULDs. Those parents who report that their child’s school district offered an “adaptive strategy” for typing with a limb difference all mention the same plan: type the entire keyboard with whatever digits the child has, whether one hand or several digits on either hand.

Can children and adults type with one hand or even several fingers? Absolutely! Some can even type as fast as – or even faster – than two-handed typists! However, the standard layout is much too wide for one hand (especially a child’s) to type on safely for many years, even with a smaller keyboard.

The standard keyboard layout (known as “QWERTY”) was designed for two hands – although it wasn’t designed well for minimizing strain even on ten fingered folks. This is why so many “limb typical” people develop repetitive use injuries such as carpal tunnel syndrome from typing. According to ergonomic research, stretching the fingers to reach inconveniently placed high frequency letters greatly increases the risk of repetitive stress injury for the dominant hand.

So with our children, who may use as few as one or two or fingers, we want to be especially mindful of the wear and tear on the dominant hand, which does almost every other task as well. One-handed typists must type every key using just 4 fingers (the thumb really can’t type more than the space bar). Setting our children up for a lifetime of good bodily health typically requires making some technology accommodations. Because “practice makes permanent” and it is hard to relearn how to type, children with hand/arm differences benefit from learning how to type using an efficient and muscularly healthy motor plan right from the start. The best plan is to consider all of the available options and make the choice that seems best for your child.

Looking Different Can be Hard

But before we even start delving into adaptive technology options, it is important to acknowledge that some children may reject these options. Parents of children with ULD who do not share the difference with their children may feel frustrated or confused when their children reject adaptations that can reduce strain and improve body positioning. Your child’s stage of development and personality can and likely will affect their willingness to try adaptive equipment. It may help to keep in mind that our society rewards “fitting in”, and children who already experience negative attention from their difference may not want to increase the number of ways that they stand out.

For these reasons, introducing adaptations early in a child’s life as a normal part of how they are raised may make them more willing to adopt them. For all of these reasons, the best strategy for children who don’t want to look different may be a more typical computer set up at school and an adaptive set up at home. Of course if your child accepts and even welcomes these options, by all means encourage them to use them at school as well as home!

Adaptive Technology Options

Depending on what your child’s ULD is, there are multiple adaptive techology options to consider for your child, including:

• alternative keyboard layouts + keyboard stickers:
  • one-handed right- or left-handed Dvorak layout
  • two-handed Dvorak layout
  • custom layout
• external ergonomic mouse
• external keyboard
• adaptive accessories
• voice to text

We will explore these options in detail below with a summary of recommendations for the more common types of ULD.

Keyboard Layouts

Here is some background information on the two major keyboard layout options:

• QWERTY:
  The “QWERTY” typewriter layout gets its name from the letters on the left top row of a standard typewriter, which spells “QWERTYUIOP”. When typists used mechanical typewriters, keys would jam if they typed too fast. In the late 1860s, Christopher Sholes of Milwaukee designed a layout that would allow typists to type as fast as possible without jamming the keys by spreading out the high frequency letters across the keyboard. The QWERTY layout became standard for typewriters, and when computers arrived, the layout was transferred to computer keyboards. In the QWERTY system, only 32% of all keystrokes take place on the home row. Computer keyboard keys don’t jam the same way as typewriters once did, so using the QWERTY layout no longer makes much sense, particularly given the prevalence of repetitive use injuries.
  
• DVORAK:
  The “Dvorak” alternate keyboard layout purportedly is more “finger-friendly” than the standard QWERTY layout. August Dvorak invented this layout in 1932 based upon studies of language usage patterns and typing habits. In the Dvorak layout, keys are arranged so that most of the highest-frequency letters are located on the home row, which is the centered position for the fingers. The lowest-frequency keys are positioned farther away, so that typists extend their fingers less often, which significantly cuts down on finger strain. In the standard two-handed Dvorak system, 70% of all keystrokes take place on the home row (compared with 32% for QWERTY (as we saw above). Some proponents claim that the Dvorak layout reduces the incidence of repetitive use injuries.
  • One of the reasons that there has been little research to date on the potential benefits of the Dvorak layout is that most people already know the QWERTY layout. Here is a study that controlled for previous experience with QWERTY comparing speed for one-handed typing using a one-handed QWERTY and one-handed Dvorak layouts. It found that “a clinician working with clients who have lost, temporarily or long term, the use of one hand, would best serve their clients by encouraging them to learn an alternative keyboard layout. Because the layout is built-in to modern operating systems, the cost of provision is minimal, and the time to adapt the computer, and to switch between layouts is a matter of seconds.”
  • The Dvorak layouts are included as standard keyboard settings options on both Mac and Windows operating systems, making them easy to access, and it takes less than two minutes to configure your computer to use them.
  • The Dvorak system includes two ready-made layouts for one-handed typists. So if your child has a limb typical right or left hand, they can use the one-handed layout that corresponds to their hand. Take a look at the Dvorak layouts here.
  • You can purchase labels to cover the key names, which you can easily attach to a laptop or external keyboard.
  • This arrangement is particularly good if the child uses a single assigned laptop at school, so that the child can have the operating system configured to the Dvorak layout.

Mouse Use

Turning to the mouse, it’s important to distinguish between desktop and laptop computers. People typically use an external mouse on desktop computers while on laptops, a touchpad or trackpad is the built-in control for the screen cursor. Research on typically developing children using laptops in schools suggests that an external mouse may be ergonomically preferable to the trackpad on a laptop. However, historically computer mice haven’t had optimal biomechanical design, so frequent mouse use still can lead to strain and pain as people age. While pain or strain usually wouldn’t be so much of a concern for young children, it is more important to be mindful of how children with ULD use their dominant hand – whether or not that hand has a limb difference – because of the additional wear and tear on that limb. If at any point, your child develops overuse pain or strain on either side, it is important to take it seriously and pursue treatment (read about Overuse Syndrome). 

Research has shown that having acclimated to using a regular mouse, many people later are resistant to switching to an adaptive mouse. So introducing a mouse from a young age that works well is ideal, even if the child uses it inconsistently. Some children with ULD use the laptop touchpad or trackpad at school and an external mouse at home.

Depending on your child’s hands, it may be possible to operate the mouse with the affected hand(s), and there are multiple potential options worth considering for an external mouse, such as a small mouse, a vertical mouse, or a trackball. While there are few adaptive mouse options specifically designed for children, some have smaller versions. In order to prevent strain to your child’s arms/hands, it may be worth the hassle of potentially purchasing (and possibly returning) several mice to find a good match for your child’s hand size, range of motion, and personal preference. It also may be worth trying to find two comfortable mice, for example one for home and one for school, to alternate muscle usage in your child’s hands. 

Here are some options: 

• For younger children, miniature mice designed for children 3-7 years old should fit their hands better than larger mice
• For trackballs, many of the the most highly rated versions are for adults
• For vertical mice, there are options at various price points and some are designed for smaller hands
• The free printable copy of the Adaptive Tech Options for Children with Upper Limb Differences (ULD) handout(available at the top and bottom of this post) features a link to an Amazon list I’ve compiled of recommended adaptive technology options that include these mice

External Keyboards

In general, it is worth taking the time to find a keyboard that is comfortable for your child. While some children with ULD prefer the feel of shallow laptop keys, others find them uncomfortable. For children who find laptop keys uncomfortable, I recommend ordering several external keyboards with different depths of keys to find a good fit and returning whatever doesn’t work. When you download the free printable copy of Adaptive Tech Options for Children with Upper Limb Differences (ULD) (above), you will be able to access an Amazon list of recommended adaptive technology options. Here are some of the considerations to keep in mind:

• For children who type one-handed, a smaller external keyboard may cause less strain than on the laptop keyboard
• An 87-key keyboard (no number pad) allows an external mouse to sit closer to the body
• Some keyboards have macro keys that can be assigned to keystrokes that require typing multiple keys simultaneously
• Some children with two-sided limb differences may do better with a split keyboard, where the keyboard is split into two halves, with each arm/hand typing on one half
• Some one-handed typists find that tilting the keyboard makes typing more comfortable
  • A right-handed typist would tilt the bottom left edge of the keyboard down towards the body and the top right edge away from the body
  • A left-handed typist would tilt the bottom right edge of the keyboard down towards the body and the top left edge away from the body
• If your child uses an external keyboard, a simple adjustable laptop stand can ensure that the screen is at the right height for their eyes and encourage upright posture
• Your child may adamantly refuse to use an external keyboard at school but be willing at home; please see section below

Typing with One Hand

If your child has one full (or mostly full) hand available for typing, here are some specific recommendations:

• Two good free keyboard layout options are the left- and right-handed Dvorak layouts, especially if the laptops they use are assigned to them and/or have a dedicated home laptop
• Keyboard labels for whichever layout
• External mouse: ergonomic if possible, at home and possibly at school
• External keyboard: at home if they prefer

Typing with One Hand and a Partial Hand

If your child has use of both one limb typical hand and a partial arm or hand, or if there are some fingers on each hand, there are some additional considerations:

• The two-handed Dvorak layout may be most helpful, especially if your child is assigned their own school or home laptop (see section above), and keyboard labels for the layout
• In addition to the options above, a custom keyboard layout may best optimize their ability to use all their fingers
• Using the Microsoft Adaptive Accessories may enable the partial hand or arm to simplify keystrokes, for example, the Adaptive D-pad button enables a typist to assign “shift + ctrl + V = paste” to a button (see below under Accessible Accessories)
• External keyboards with programmable macro keys offer some of the same functionality

Typing with Two Partial Hands

If your child has one or several fingers on each hand available for typing, here are some specific recommendations:

• Consider the two-handed Dvorak layout, especially if your child is assigned their own school or home laptop (see section above), and keyboard labels for the layout
• External split keyboard (which has separate left and right sides) at home and possibly school
• External mouse: ergonomic if possible, at home and possibly at school

Typing without Hands

As for the previous sections, adaptations will depend on the length of the arm and presence of fingers. With short arms, an external split keyboard may be helpful, attached to a shelf that can rest close to the face to eliminate the need to bend over to reach the keys. Voice to text is a good option. Some individuals may be able to use their feet to type, but special care should be given to ensuring that the screen is enlarged since the keyboard may be at a distance from the body.

What About One-Handed Keyboards?

A number of specialized one-handed alternative keyboards are listed here or you can search for “one handed keyboard”. In addition to their high cost, for many of the them, your child needs to learn a keyboard layout that will not transfer to a standard keyboard. This makes them less generalizable.

Custom Keyboard Layouts

There are several keyboard mapping programs available for download that can be used for this purpose.

CAVEAT:

• It is important to note that unlike the Dvorak layouts above, a custom layout that you design with or for your child will NOT be included as one of the standard keyboard settings options on Mac and Windows operating systems. This means that this custom layout will need to be installed on the operating system every time your child switches computers.
• If it seems that using a custom layout is too risky, it may be worth considering whether it would be possible for the child to type on the one-handed Dvorak layout with the limb typical hand and control the mouse with the partial arm or hand.

My Typing Journey Story

Like my peers, I learned to type one-handed on the standard QWERTY layout when I was in the 7th grade. Many years later, after I had developed and then mostly healed from the worst of the overuse syndrome in my full hand and arm, I knew that I needed to switch to a more ergonomically designed keyboard layout. Since I have a thumb on my left hand, I also wanted my keyboard layout to enable me to type some low-frequency letters with my left thumb. When I was 30 and newly married, my tech-savvy husband used Microsoft Keyboard Layout Creator to create a custom layout that I modeled on the right-handed Dvorak layout. Here’s what my layout looks like:

Unfortunately, as of the time of this writing, the Microsoft keyboard tool does not work with Windows 11. When I upgraded to the latest Windows, my husband recreated the layout using EPKL. This tool is more difficult to use, but once the layout is created, it has some nice additional features, such as displaying an image of the layout on the screen and much easier portability between computers. If you do not feel so computer-savvy but do want to accommodate the partial hand, consider a visit to your local occupational therapist to help design an efficient individualized keyboard layout, and then to a computer guru to implement it – or schedule a virtual consultation with me.

Just like with the Dvorak one- or two-handed layouts, it can be very helpful to use keyboard labels to cover the key names with a custom layout. Another option is purchasing a keyboard that will allow you to move the keycaps. In particular, most mechanical keyboards will allow you to do this.

Accessible Accessories

Some children with a below-elbow partial arm or hand might benefit from using the Microsoft Adaptive Accessories, which is a family of customizable input devices. These input devices enable keyboard shortcuts, such as replacing “alt-ctrl-V” with a simple button press. These can be used on their own or in addition to an external mouse. One of the options is the Microsoft Adaptive Mouse, for which several free 3D printed designs are available.

Try Before You Buy

The federal government has funded Assistive Technology Centers (ATC) in each state which offer “try before you buy” free adaptive equipment loans. This can be especially helpful for children with upper limb differences that don’t as easily fall into the categories outlined above as one-handed or one-handed plus typists. Depending on where the ATCs are in relation to where you live, you may be able to try the equipment with your child in person. Most ATCs cover shipping for the adaptive equipment to and from houses. Click to find your state/territory ATC.

Voice to Text Options

Many children with ULD benefit from using voice to text, and ideally it should be incorporated in whatever technology accommodations they are using, simply to reduce the amount of written content they need to produce. But it is also important to understand that these programs make mistakes, so it typically is necessary to proof read and use a spell check application to catch errors.

In the early 1990s during my college years, I beta-tested DragonDictate, one of the earliest speech recognition software programs. I was experiencing terrible overuse in my dominant arm and couldn’t type without pain. At the time, the program was glitchy and it made many mistakes. Fortunately, voice to text has come a long way, especially in applications such as smartphones. Microsoft and Google have built-in options for texting and dictation for Google documents, for example.

Ergonomics

By now, you surely are familiar with ontheotherhand.org’s focus on promoting good health for children with hand differences. Which is why we have devoted so much space to considering keyboard and mouse design issues. But underlying these issues is an even more fundamental issue: “ergonomics”, otherwise known as good body positioning. For several years corporations seeking to reduce carpal tunnel syndrome and other repetitive strain injuries among employees have buzzed about ergonomics. But computer ergonomics for children is just beginning to be recognized as essential for instilling in children an awareness of how to take care of their bodies, thereby helping to prevent a whole host of body aches and nasty conditions. Remember once again that children learn habits from a young age, and that children with hand differences need to focus on how they are using their whole bodies, not just their arms.

For excellent general discussions of computer ergonomics for children, visit the Cornell University Ergonomics Website and the Oregon Occupational Safety and Health Division website for great tips on computer station set-up, good computer posture, and practicing good work habits. These sites also have “before and after” pictures of children’s workstations that have been modified to fit their needs.

Taking Breaks From Computer Use

Two elements of working safely at the computer are taking breaks and relaxing tired muscles. Please see a great site with visuals of exercises and stretches for fingers, hands, arms, shoulders, and neck. Try doing these with your child to encourage him/her.

Here’s a list of apps that remind you to take a stretch break.

Additional resources

Two excellent books offer more information about healthy computer use:

Comfort at Your Computer: Body Awareness Training for Pain-Free Computer Use by Paul Linden, published by Pub Group West. This book, written by a black belt in Aikido and Karate with a Ph.D. in Physical Education, covers efficient breathing, improving body awareness, and balancing the muscles of the body while using a computer. Available through amazon.com.

Stretching in the Office by Bob Anderson. This wonderful resource has drawings of stretches that are useful at home or in the office. Available through amazon.com.

Quick Links

• Left-, right-, and two-handed Dvorak layouts are relatively easy to configure on your computer
  
• Microsoft Keyboard Layout Creator enables users to to create a custom layout according to their specifications
  
• Keyboard labels are great for covering the key names for Dvorak or custom layouts

• There are several keyboards ergonomically designed for smaller hands. Download the free handout below for access to a list of recommended adaptive technology options

• A number of specialized one-handed alternative keyboards are listed here. In general, these are not the best options for one-handed children because they require learning a specialized layout that usually doesn’t transfer well to typical keyboards
  
• Microsoft has an Adaptive Accessories line of products that can supplement – or replace – other kinds of input devices like a mouse
  
• Find your state/territory Assistive Technology Center to try options for free

• Cornell University Ergonomics Website and Oregon Occupational Safety and Health Division both have great tips on computer station set-up, good computer posture, and practicing good work habits. These sites also have “before and after” pictures of children’s workstations that have been modified to fit their needs.

• Here is a site with visuals of exercises and stretches for fingers, hands, arms, shoulders, and neck after keyboarding. Try doing these with your child.
  
• Here is a list of apps that remind you to take a stretch break
  
• Two excellent books that can give you more information about healthy computer use are:
  • Comfort at Your Computer: Body Awareness Training for Pain-Free Computer Use by Paul Linden, published by Pub Group West, available through amazon.com
  • Stretching in the Office by Bob Anderson, available through amazon.com
    
• A previous version of this article suggested purchasing an inexpensive device called a mouse bridge, which could be helpful for some folks with upper limb differences. The mouse sits on this raised platform over the numeric keypad. This allows the mouse to be much closer to the resting hand position on the keyboard, thus reducing unnecessary strain on the shoulder when using the mouse. Although this device may be useful for two-handed typists, it is more important for a right-handed typist, who would rest their hand in the middle of the keyboard. However, it may be preferable to purchase a keyboard that doesn’t have a numeric keypad, such as one like the NPET G20 Compact Gaming Keyboard

Important Takeaways

• As much as possible, adapt the technology to the child, not the other way around
• Be aware that some children may reject adaptive tech options because they don’t want to look different at school; encourage use at home
• Because upper limb differences vary so much, it may take some time to devise a set up that maximizes your child’s skills and minimizes strain
• There currently is no research specifically on computer use and adaptations for children with ULD
• The standard keyboard is too wide for one hand (especially a child’s) to type on safely for a lifetime
• For one-handed typing, consider the right- or left-handed Dvorak layout, which is a standard keyboard settings option on Mac and Windows OS operating systems
• For two-handed typing, consider the two-handed Dvorak layout, also standard keyboard settings option on Mac and Windows OS operating systems
• Fingers should not hurt or ache from using a computer; remember that everything your child does over their day is cumulative
• For optimal ergonomics, if using an external mouse, you may want consider an external keyboard & simple laptop stand
• Some children with ULD find typing easier and/or more comfortable on an external keyboard than on the shallow keys of a laptop; some children use a standard laptop at school and an external keyboard at home to reduce strain
• A smaller external keyboard can be easier for one-handed typing and an 87-key keyboard (no number pad) allows the mouse to sit closer to the body
• In addition to their high cost, one-handed keyboards typically require learning a specialized keyboard layout that will not transfer to a standard keyboard, making them less generalizable.
• Research on typically developing children using laptops suggests that an external mouse may be ergonomically preferable to the trackpad on a laptop
• While there are few adaptive mouse options specifically designed for children, some do have smaller versions, such as vertical mice
• In order to prevent strain to your child’s arms/hands, it may be worth the hassle of potentially purchasing (and returning) several mice and external keyboards to find a good match for your child’s hand size, range of motion, and personal preference 
• Alternating between two comfortable mice, such as a track ball and vertical mouse, that use different muscles in your child’s hands/arms can decrease strain; for example, one for home and one for school
• Microsoft has an Adaptive Accessories line of products that can supplement – or replace – other kinds of input devices like a mouse; there are external keyboards with programmable macro keys that serve a similar function

Complete the form below to download a free printable copy of the Adaptive Tech Options for Children with Upper Limb Differences (ULD) handouts, featuring an overview page and a chart with adaptive tech options. You will receive two versions of the chart: digital (with hot links) and printable (less color, so less toner used!). Both handouts link to an Amazon list with recommended products; recommendations for products are for educational purposes only; we don’t endorse or profit from them.

Name *

First

Last

Name Email

Email *

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!

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

The post Typing/Keyboarding with an Upper Limb Difference (or two!) appeared first on On The Other Hand.

Information on Upper Limb Differences

Multiple hospitals across the United States have limb difference clinics, and eight centers are part of the Congenital Upper Limb Differences (CoULD) Registry that tracks patient outcomes over time. The registry’s purpose is to better understand upper extremity function and emotional well-being of children with upper limb differences, and to date, physicians have published multiple research studies on registry patients.

Here are the hospitals that are members of the CoULD registry. Note that while some have adopted the preferred terminology of many members of the limb difference community, others refer to limb differences as “deficiencies” and “deformities.”

Boston Children’s Hospital
Children’s Hospital of Philadelphia, Philadelphia, PA
Gillette Children’s Specialty Healthcare, St. Paul, MN
Nationwide Children’s Hospital, Columbus, OH
Seattle Children’s Hospital, Seattle, WA
Shriners Hospital for Children, Sacramento, CA
University of Utah Hospital & Shriner’s Hospital for Children, Salt Lake City, UT
Washington University & Shriner’s Hospital for Children, St. Louis, MO

Organizations

The Amputee Coalition of America (ACA) is a national, non-profit amputee consumer educational organization representing people who have experienced upper and/or lower amputation or are born with limb differences. The web site features a wealth of information and links, including the Youth Engagement Program (YEP) and Youth Camp, Certified Peer Visitor (CPV) Program, the National Limb Loss Resource Center (NLLRC), regular amputee support group meetings, and an Annual Educational Expo & Conference. On Facebook here and on Instagram here. 

Beautifully Made Community is a support group for individuals or loved ones touched by limb differences or limb loss that focuses on hospital networks. BMC provides resources for new families with limb differences, connections with community, and hosts events in the Boston area. On Facebook here and on Instagram here. 

Enhancing Skills for Life educates, empowers, and connects those living without both arms or more. On Facebook here and on Instagram here. 

Helping Hands Foundation, Inc. is a Massachusetts-based support group which hosts annual events. HHF typically hosts a Winter Event weekend late January/early February in Massachusetts. On Facebook here.

Limb Difference Foundation is a pending 501c(3) non-profit created by individuals with limb differences to support individuals and families with limb differences. The organization focuses on creating connections sharing tools and support with and for others who have limb differences. On Facebook here and on Instagram here. 

Limb Kind Foundation improves the lives of children with limb loss both domestically and internationally, by strengthening the amputee community and providing pediatric prosthetic care. Limb Kind Foundation runs a yearly Adaptive Runway Event in New York for individuals with limb differences. On Facebook here and on Instagram here. 

Lucky Fin Project is a national organization that provides support, education, and connections for families of children with upper limb differences and multiple limb differences. LFP hosts a yearly weekend in Troy, Michigan every July. On Facebook here and Instagram here. 

The Center for Limb Differences at Mary Free Bed Rehabilitation Hospital in Grand Rapids, Michigan, specializes in caring for young patients with congenital and acquired hand, foot and limb differences. Established in 1946, the center was the nation’s first pediatric amputee clinic. The Center for Limb Differences offers prenatal consultations and provides care, offers support, and recommends resources to benefit children from birth through age 18.

Moxie Adaptive focuses on creating spaces to connect and empower those with limb differences. Their mission is to creae space to connect and empower those with limb differences by fostering life-long connections and friendships through shared experiences that boost self-love and conquer personal fears. On Facebook here and on Instagram here. 

International

Aussie Hands, based in Australia, supports children and adults with a hand difference, both congenital or acquired, provides opportunities for networking and exchange of information, and researches initiatives focussing on hand differences. On Facebook here and on Instagram here. 

International Child Amputee Network (I-CAN) is dedicated to promoting education, support, information, and empowerment to traumatic and congenital limb different children and their families. I-CAN works to enhance the quality of life for children and young adults based on the concept of mentors helping families, parent helping parents, and kids helping kids. On Facebook here. 

LimbBo Foundation is a UK based organization that supports children with limb differences and their families. LimbBo hosts chats, links families, and provides the opportunity for children to meet other limb different children. On Facebook here and on Instagram here. 

LimbPower supports amputees, individuals with limb difference, and their families to bridge the gap between hospital rehabilitation and community and school engagement to rebuild lives and improve physical, social and mental well-being. As part of Sport England, LP engages amputees and individuals with limb differences in physical activity, sport, and the arts to improve quality of life and to aid lifelong rehabilitation. On Facebook here and on Instagram here. 

REACH aims to provide families affected by upper limb difference with the opportunity to get together, share experiences and information about what to do, and where to go for advice regarding treatment, and to help them realize that they are not alone. Based in the UK, Reach touches families’ lives from all over the world. On Facebook here and on Instagram here.

Summer Camps

Amputee Coalition Youth Camp is an annual four day long camp in Florida for children ages 10-17 with a limb difference; however, the website has been revised recently and camp information is not currently available.

Camp Candou is a fun-filled six day sleepover camp experience for children ages 7 to 16 with limb differences and their siblings at Jacob’s Island, Ontario, Canada. The camp is part of Camp Maple Leaf, which has run programs for 65 years.

Camp No Limits – No Limits Foundation is a non-profit organization that provides camps for children with limb loss and differences. The camp aims to provide education, mentorship, and support to these children and their families. Camp No Limits fosters a welcoming and supportive community in the hopes of helping all those who attend the camp. On Facebook here and on Instagram here.

Camp Open Arms is a day camp hosted by the University of Maryland Children’s Hospital for children ages 4 to 16 with limb differences and a family day at the end. The camp includes activities such as hiking, water balloon fights, arts and crafts, and visits from local musicians, entertainers, and zoo animals. Camp Open Arms offers a place of acceptance and happiness for children and also for parents and loved ones, who build camaraderie and hope together. On Facebook here and on Instagram here.

Camp Winning Hands is a free overnight camp for children with congenital hand and upper limb differences in Northern California. Campers between the ages of 7 and 17 get the opportunity to have fun and challenge themselves in a safe, supportive environment. Teen Camp is for kids 12 to 17 years old. The Taylor Family Foundation hosts the camp, set in the hills above Livermore, Calif.

Never Say Never Foundation annually hosts Pirate Camp and Amp Camp in Florida. Pirate Camp is a four day long camp for amputees and challenged youth that teaches sailing skills, ocean appreciation, and the importance of overcoming adversity & following dreams. During the five days of Amp Camp, kids fish, hike, swim, and learn about the local wildlife. On Facebook here.

Family Weekends 

Hands to Love hosts an annual Hand Camp in March where families from all across the country gather at Camp Crystal Lake in Starke, FL for a weekend of adventure, camaraderie and relaxation. Hand Camp provides children a safe haven in which to try new activities, meet others who have similar upper limb differences, and just have fun being kids. Hand Camp also allows parents to network with each other, share ideas and experiences, ask questions, be pampered, and relax. On Facebook here and on Instagram here.

Helping Hands Foundation, Inc. typically hosts a Winter Event weekend in January or February in Massachusetts.

Lucky Fin Project hosts a yearly summer weekend for children with upper limb differences and multiple limb differences and their families in Troy, Michigan in July. Dates and information to sign up usually are posted on Facebook here and Instagram here. 

Facebook Groups

Helping Hands (Symbrachydactyly) was started by a mother with a baby that has Symbrachydactyly. 

Lucky Fin Project (see above) and there is an LFP chapter for each state, e.g. LFP Michigan Chapter

Sports Camps

Camp No Limits is a non-profit organization 501 (c)(3) providing camps for children with limb loss and differences. The camp aims to provide education, mentorship, and support to these children and their families. Camp No Limits fosters a welcoming and supportive community in the hopes of helping all those who attend the camp. On Facebook here and on Instagram here.

Nubability Athletics hosts a variety of nationwide sport camps for youth athletes who are congenital, traumatic or medical amputees from around the world. On Facebook here and on Instagram here.

Podcasts and YouTube Videos @

A Little Limb Different Podcast was created by Kelsey Ryan (@kelseyy.ryan) and Savannah Stuard (@theonearmsavvy), both of whom were born with upper limb differences. Over 9 episdes, they cover all the hard topics for limb different girls living in a two handed world. On Facebook here and on Instagram here.

Disarming Disability was started in 2019 by Nicole Kelly and Dr. Sarah Tuberty. During the two seasons that the podcast has aired, Nicole and Sarah interview experts on disability and discuss a range of topics. Check out their reading list! On Instagram here and Apple podcasts here.

Hands in Motion, the podcast of the American Society of Hand Therapists, interviewed Dr. Sarah Tuberty about her lived experience growing up with a congenital upper limb difference. She shares how language and terminology around limb differences has evolved and how therapists and providers can create networks of support for patients and families as they navigate the limb difference journey.

Parenting Children with Limb Differences Podcast (PCWLD) is a supportive platform where hosts Ali and Kari offer experiences, tips, resources, compassion, empathy, humor, understanding, and validation. I was honored to be a guest on two episodes, 9/16/24 and 9/19/24! On Facebook here and on Instagram here.

Stump Kitchen was created by Alexis Hillyard. Stump Kitchen showcases the interesting and ‘Stumptastic’ ways Alexis uses their body when they cook. On Facebook here and on Instagram here. 

We’re Not Stumped Podcast, is the brainchild of Mike Bolland, who was born without a right hand. Over 5 seasons (and still going!), Mike has interviewed dozens of individuals with upper and lower limb differences and limb loss, as well as family members of amputees and prosthetic/support providers. On Facebook here.

Adaptive Aids

Please note that other than for EazyHold, I do not receive any commissions or kick backs for the product recommendations below, but I have received some of these products at no cost to evaluate.

EazyHold Universal Cuff is an adaptable, hygienic, and multi-purpose adaptive product that enables individuals with upper limb differences of all ages to grasp items with their affected sides. On Facebook here and on Instagram here. Please note that as an “affiliate” for EazyHold, I receive a small commission for sales made through this referral.

Form5 creates adaptive devices for the limb difference community created by members of the limb difference community, such as the Bike Arm Adapter (patent pending). Interdisciplinary teams of specialists regularly host fabrication workshops to create innovative medical and recreational devices. Form5 also cultivates a community of individuals with limb differences through its Nub Club. On Facebook here and on Instagram here. 

RangeMaster’s StretchStrap is a great tool for children and adults with limited grasp ability who want to be able to enhance their range of motion when stretching because the dual sided strap includes non-stretch webbing on one side and elastic stretchable loops on the other.

StayPutMat is a non-slip drawing mat & writing aid that can be used with any letter-size paper. The StayPut Mat™ may be very helpful for children with upper limb differences who benefit from assistance in stabilizing their paper. The magnetic frame secures the paper while the non-slip frame backing eliminates movement on the table surface. The mat is portable, durable, and easy to use. Educators are eligible for a free StayPut Mat with any order.

Books and Articles

Limb Love Library promotes awareness of limb differences and encourages open discussions about all kinds of differences in our communities. Their partnership program provides carefully selected books, educational resources, and ongoing support to create more inclusive learning environments. On Facebook here and on Instagram here. 

The Hand Book: An Informational Guide for Parents of Children with Hand Differences, by Nina Lightdale-Miric, MD and Sarah Tuberty, OTD, OTR/L, follows readers through their personal journey of understanding the science of hand differences. It offers support to cope with the news of a child’s hand difference at birth, make medical decisions, enroll children in school, prepare children for living independently as an adult, and everything in between.

In Singlehandedly: Learning to Unhide and Embrace Connection, inspirational speaker, author, executive coach, and consultant Ruth Rathblott, tells her story of the exhausting and often lonely years she spent overachieving and trying to hide her disability before she learned to unhide. Ruth’s journey of self-discovery and process of finding self-acceptance is riveting. Ultimately, she discovers the gift of her difference and builds greater connections with people with and without disabilities.

“Born Different, Treated Differently: Changing the Narrative Around Disability Awareness
Tips to put an end to bullying” was written by Madelyn Hubbs, born without her left arm and a Shriners Hospitals ambassador, public speaker, and future OT!

Clothing

Please note that I do not receive any commissions or kick backs for the product recommendations below; I have personally tried these brands/items: MimiTENS and 10 Seconds ® Proline MultiSport Stretch Laces but not the others.

Brooklynn’s Bows is a collection of cute and stylish hair bows created by Krystal Pelletier, mother of Brooklynn Jean, who was born with an upper limb difference. In addition to receiving the bows, purchasers will contribute towards a future prosthesis for Brooklynn. On Facebook here and on Instagram here.

Em13race is an adaptive clothing company that makes products spefically designed for people with upper and lower extremity limb differences. Founded by Alexia Michitti, who used her personal experiences to create the products, they are offered in sizes youth through adult XXXL. On Facebook here and on Instagram here.

Knit for Unique Fit matches knitters with families to provide custom made knit gloves for children with hand and arm differences. Families share the dimensions of their children’s hands and volunteers create the mittens! The online group was created and is administered by Rena Rosen, founder of Art of Compassion. On Facebook here and on Instagram here. 

Liberare‘s all-female team sells easy-on bras and underwear featuring the HeroHold™ Closure that can be fastened with one-hand. On Facebook here and on Instagram here. 

MimiTENS is a Canadian based company that offers special mittens for children with limb differences. The mittens stay on with no strings attached and they feature long, stretchy cuffs that reach the elbow. If you order a pair of mimiTENS for a child with a limb difference, they will add a special flat mitten for free. On Facebook here and on Instagram here. 

Springrose sells adaptive bras and underwear with Velcro and magnetic closures. The bras can be put on one-handed, regardless of size. On Facebook here and on Instagram here. 

10 Seconds ® Proline MultiSport Stretch Laces are my favorite elastic laces set because I find the toggle easy to use and they come in a variety of colors.

Cooking

Very Smart Ideas, created by limb difference advocate, digital creator, and actor Gigi Verrey, offers yummy recipes as well as home and garden tips and products for accomplising every day tasks with one hand. On Facebook here and on Instagram here. 

Stump Kitchen is a playful and whimsical creation of limb different blogger and educator Alexis Hillyard. Using playful, intricate cosplay characters, Alexis cooks tasty gluten free vegan recipes using her stump as a kitchen tool. On YouTube here, on Facebook here, and on Instagram here. 

Prosthetics

Please note that I do not receive any commissions or kick backs for the product recommendations below.

Different Heroes is dedicated to celebrating limb differences and those making a difference in the life of someone different. DH raises funds to send children to with limb differences camps, promotes international adoption of children with limb differences, and has distributed hundreds of 3D-printed prosthetics to children around the world. On Facebook here and on Instagram here. 

Hanger Clinic, with over 900 locations across the country, creates customized upper and lower extremity prostheses for people of all ages. On Facebook here and on Instagram here. 

The Helping Hand Project creates 3D printed specially designed, cost-free recreational prosthetic devices. They also strive to foster a sense of belonging by organizing community events that unite children with limb differences, reassuring them that they are never alone. HHP is made up of several chapters located at universities throughout North Carolina. You can complete a device inquiry form and attach pictures of your child’s limb difference. On Facebook here and on Instagram here. 

Koalaa prosthetics offers products for all ages that support partial hand and below elbow limb differences. They offer a wide range of interchangeable tools which attach to prosthetic sleeves for various activities such as yoga, surfing, cycling, or playing guitar. Koalaa has a strong community and provides a peer-to-peer service that supports users and their families throughout their limb difference journey. On Facebook here and on Instagram here. 

Toys

Please note that I do not receive any commissions or kick backs for the product recommendations below. Occasionally companies send me free products to try.

A note on the toys featured below: their prices range from low cost to quite pricey; there are boy and girl versions for some, but not all; some are customizable for the limb difference or there are multiple options (e.g. upper vs. lower limb) while others are available with one specific limb difference.

Action Figures

Lego® created a figurine with an upper limb difference named Autumn: “Curious and adventurous, Autumn cares deeply about the planet and loves sharing her experiences with her friends. She was born without the lower part of her left arm – not that she lets this get in her way of exploring nature.” Follow Lego on Instagram here.

Barbie® with prosthetic leg

Plush dolls and stuffies

• A Doll Like Me that uses donations from their global community to ensure that dolls can be provided to families at no charge. The dolls are custom made to match a child’s physical difference, whether that is a facial, limb, or other kind of physical difference. On Facebook here and on Instagram here. 
• Budsies makes custom plush handmade dolls with hypoallergenic stuffing that promote inclusivity, build confidence and a positive self-image, and celebrate children’s uniqueness! Families can upload a child’s photo or drawing. On Facebook here and on Instagram here. 
• Crochet-ABLEs are crocheted dolls that can can be customized for specific limb differences. They have partnered with the Lucky Fin Project to offer discounted dolls. Families interested in one should message on Instagram.
• Kikilishop makes a plush Amputee Doll that can be personalized for boys and girls. The doll’s legs, arms, feet, and hands all are customizable, and personalization with the child’s name is optional. On Facebook here and on Instagram here. 
• Mayana & Friends are whimsical plush limb different animals, proudly made by a Filipino-Canadian family raising a child with a congenital upper limb difference. The brand’s mission is to celebrate and normalize differences. There are five options, some with upper and some with lower limb differences. On Facebook here and on Instagram here. 
• Uniquely Me – companion to book by Trace Wilson
• Vermont Teddy Bear Company makes Limb Loss & Limb Difference Bears (from home page, click “Bears That Care” tab)! The bear can be customized to have a limb difference (upper, lower, or both). Additionally 20% of the proceeds go to the Amputee Coalition.

18″ realistic dolls with limb differences:

• A Step Ahead Prosthetics customizes American Girl® dolls for children with limb loss. These dolls are especially good for children who have an arm or leg stump and/or wear prosthetics (the company does not customize for hand differences). The company modifies American Girl® dolls sent to them by families and will add a custom-designed prosthetic limb (or limbs) to match the child if preferred. Follow on Instagram here. 
• The Doll for All are realistic 18″ action dolls that are customizable for limb differences. Check out Evie, who has a lower limb difference and Max who has an upper limb difference. On Facebook here and on Instagram here. 

Exercise

http://www.yogakids.com/
http://www.childrensyoga.com/

Occupational Therapy

Occupational theapy for upper limb difference
American Occupational Therapy Association (AOTA)
Hand Therapy Certification Commission (HTCC)
American Society of Hand Therapists (ASHT)
The Association of Children’s Prosthetic-Orthotic Clinics (ACPOC)

Typing

Typing/Keyboarding for Kids, Teens, and Adults with Hand/Arm Differences – download the free handout!
Dvorak keyboard layout info
Microsoft Keyboard Layout Creator
Microsoft Accessible Accessories are adaptive input devices compatible with Windows 10 and 11 designed to enable children and adults with upper limb differences to assign common keystroke combinations to buttons.
Cornell University Ergonomics Website
Oregon Occupational Safety and Health

I am continuously updating these resources. If you would like to contribute resources to this page, kindly contact us.

© 2025. Laura Faye Clubok, MS, OTR/L, On The Other Hand Therapy

The post Resource Directory appeared first on On The Other Hand.

In contrast, some older adults with limb differences have shared that when they were younger, hand specialists told their parents to expect that they likely would have difficulty with everyday tasks such as driving a car, participating in sports, performing self-care tasks, or typing. 

In both of these cases, the doctor unfortunately is missing the mark due to lack of information and incomplete understanding of possible long-term effects of limb differences. Most parents not only can handle detail, nuance, and uncertainty, but they typically prefer to have issues laid out on the table ahead of time rather than discover later that the rosy or doom-and-groom predictions they were given were inaccurate. 

By contrast, an older friend recently received a diagnosis of a hiatal hernia from a gastrointestinal specialist. When discussing what she could expect, the doctor’s response was that it might never cause her problems, or that it might cause certain symptoms. He then reviewed interventions that could be taken, should those symptoms occur. 

So the physician was neither saying that everything was likely to go wrong, nor that everything would go right. Instead, they laid out the possibilities along with a decision tree: perhaps you won’t have a problem, or perhaps you will. If you do have a problem, here are the types of problems you can expect, and if you encounter those problems, here the steps you might take.

Why is it that the GI doctor is able to give this kind of nuanced response with a decision tree, but the hand specialist could/did not?

At the very minimum, hand specialists should be able to advise families with some certitude that over the course of the child’s growing up, there likely will be some degree of social emotional issues for both the child and the adult and recommend resources and websites that address those issues. More immediately, the physician can focus on functional issues, predicting the ways that the child likely will use the affected side(s). They can mention that if for some reason the child does not naturally incorporate the affected side into their movement patterns, occupational therapy could be very helpful, in addition to certain kinds of adaptive equipment. 

Beyond that, the physician can suggest that while the child will be able to do many things, there likely will be some things that they find more difficult than do other children. In those situations, adaptations may suffice, whether with or without adaptive equipment. In addition, the physician should be able to advise parents that they will want to watch what compensations the child uses for the missing digits or partial arm, both on the affected and unaffected sides, so that they do not compromise the biomechanical integrity of the stabilizing muscles. That is, the body is designed to be symmetrical and it is important for parents to understand from their child’s young age that compensations on both the affected and unaffected sides can have long-term consequences. Of course, this is a bit of a tricky thing because usage patterns get set early in the body and become ingrained, but they don’t always show their effects until much later in time. Unfortunately, by the time parents may become aware that the child has developed ways of using their body that cause strain, long-term damage may have already been done, potentially causing pain, functional limitations, and/or overuse syndrome. At that point, it can be very difficult to retrain the brain/body to reduce the strain.

Of course, with the exception of the social emotional issues, many of the above issues are possibilities, not certainties. But not allowing parents to understand potential aspects of the life long trajectory of adapting to a limb difference does them a significant disservice. 

Maybe it’s unreasonable to expect that a hand surgeon on a consultation with the parents of an infant will be able to go into this amount of detail, but at the very least they should be able to refer parents to online and print resources. Perhaps a team approach would be preferable, where the parents would have follow-up visits with a nurse, social worker, or occupational therapist to review some of these issues. But at the very least, the hand specialist should be able to do better than deliver an oversimplified message to the family: “Forget he has it, allow him to do everything he wants, never limit him.”   

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

The post Balanced and Nuanced Medical Advice appeared first on On The Other Hand.

• What caused the limb difference?
• Is the difference part of a larger syndrome?
• What are some functional problems that my child is likely to encounter?
• What can we do to help our child develop and improve function?
• What types of medical interventions might be helpful? What are the benefits versus downsides of those interventions? 
• If there are significant downsides, would you do this intervention for your own child? 
• What other kinds of therapies could we pursue?
• Does your office have a list of mentor families whose children have undergone similar interventions or who have similar hand/arm differences so that we can ask about their experiences?
• How often should we arrange follow-up appointments/check ups?
• Is there a local support group affiliated with this facility and do you know how often they meet?

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

The post Questions for the Physician/Specialist appeared first on On The Other Hand.