Proximodistal development refers to the growth pattern found in infants and young children that starts with the torso and then emanates outwardly. It explains how gross motor control of the limbs are developed before fine motor control found in the hands and fingers.
Over the first years of life, more refined control of the limbs, followed by the hands and fingers then allows for more advanced skills to develop.
Cephalocaudal development refers to a similar progression of growth that occurs from head to toe. For example, neck and should muscles will develop before the lower limbs. This allows the infant to turn and lift their head, as is required for seeking nourishment from the mother.
Proximodistal Development Examples
- An infant may be able to grasp an object placed in their hand, but they are unable to grasp an object on their own because they don’t yet have enough control over their fingers.
- Although an infant may want to reach for an object they can see, their arm just flails back and forth because they don’t have enough control over its movement.
- An eight-month-old baby can sit-up, but can’t yet stand on their own because their leg muscles are still not strong enough.
- As a baby tries to stack rings for the first time, their arm often overshoots to the left and right repeatedly. Eventually, they can stop their arm at the right spot and release their grasp of the ring.
- A three-year-old colors by moving their arm back and forth and grasping the crayon with a fist-like grip.
- When being tossed a ball, most first graders will outstretch their arms and try to cradle the ball to catch it.
- Most young children can run forward in a straight line, but they will be unable to run laterally without tripping and falling down.
- A first-grader cannot throw a ball overhand with any sense of direction, but a second-grader can hit a large target.
- A six-year-old is able to hold a pencil correctly by using only three fingers: thumb, index, and middle finger. But when they write, they still do so by mostly moving their entire hand.
- A child 6 years old is able to bounce a ball with both hands while standing still, but can’t using just one hand.
Case Studies of Proximodistal Development
Prehension is the act of grasping. It is one of the earliest actions of a newborn. They will instinctively grasp whatever makes contact with their palm, and their grip can be surprisingly strong.
Piaget (1956; 1965) identified at least 5 stages of prehension.
Stage 1 is an involuntary grasp reflex, while stages 2 and 3 result from a raw coordination between the infant’s visual and motor cortexes.
As Piaget described in the detailed notes of his children’s behavior “…the glance already follows the hand movements but the latter are not governed by the former” (p. 102).
“It is not yet possible to speak of coordination between vision and prehension, since the child knows neither how to grasp what he sees…nor how to hold before his eyes that which he has grasped…” (p. 106).
The neural pathways that connect the visual system to the limbs via the spinal cord are developing rapidly, but are still many weeks away from controlling the hands and fingers.
This is an example of how proximodistal development is progressing steadily towards control over the limbs before the hands and fingers.
2. The Tummy Roll
Babies need to spend time on their tummies during the first several months of their lives. This is referred to as tummy time. It helps develop their neck and shoulder muscles and facilitates exploration of the environment.
Most babies will start rolling over around the age of 4 months, going from laying on their back to the tummy. This is a key developmental milestone as the muscles in the torso become stronger. The infant learns to twist their torso in conjunction with the movement of the limbs.
In the above video, you can see how the infant attempts to coordinate the movement of their limbs and twisting of their torso to manage a complete roll to their tummy. The control of the limbs is still quite immature.
As proximodistal development reaches the limbs more extensively, the tummy roll will become progressively easier to accomplish.
It may not sound like much, but the tummy roll allows the infant to explore the environment from a different visual perspective and is a key step towards crawling.
3. Feet First Object Exploration
It is commonly assumed that children prefer to use their hands to reach for an object. This makes perfect sense given that the hands are so dominant in object exploration and manipulation throughout the lifespan. It also makes sense from a cephalocaudal point of view; the hands develop before the feet.
In a novel test comparing cephalocaudal versus proximodistal predictions, Galloway and Thelen (2004) constructed a specially designed seating apparatus that would allow infants to reach for an object with their hands or feet
“In two experiments, we provided infants with equivalent opportunities to reach for toys with their hands and with their feet. ‘Feet-reaching’ preceded hand reaching by a month or more” (p. 108).
Although surprising, the authors offer a compelling explanation for infants preferring to use their feet over their hands.
“…due to hip joint anatomy, the leg may be softly constrained to move less freely in lateral workspaces … Without this anatomical constraint, the arm moved freely through a wide range of motion, which increased the degree of control required to place the hand on the toy” (p. 110).
4. Bone Growth In The Developing Hand
The hands are the primary instruments that humans utilize to manipulate their environment. We use them in nearly every aspect of our lives, from personal grooming and hygiene, to preparation and consumption of meals, to scrolling through videos on social media. And of course, work related tasks such as writing reports and designing PowerPoint presentations.
Despite this reliance, the hands are relatively slow to develop. Young children have great difficulty holding writing instruments such as a pencil, which is so crucial for learning how to perform one of the most important skills in their educational journey.
Take a look at the above video which shows the growth of bones in the hand for adults and young children. At the .38 second mark, you can see that the young child’s hand contains a lot of cartilage.
This is what makes it so difficult for them to hold a pencil properly and have the necessary control over the movement of their fingers required for writing.
5. Catching A Ball
There are a lot of physical and intellectual skills that young children need to develop in kindergarten and early primary grades. In terms of physical skills, being able to catch and throw a ball are some of the most challenging. Although ideally we catch the ball with our hands, this is not where we start.
Because young children do not have enough control over their hands and fingers yet, we start by teaching them how to catch a ball with their arms first.
The above video shows a teacher instructing her kids to catch the ball with their arms. She shows them how to outstretch their arms, let the ball hit their hands, and then curl the arms towards the torso.
The next step is to help the kids get used to using their fingers to catch. Since this is so difficult, she has the kids practice while they are sitting down and letting them catch a rolling ball instead of one that has been tossed.
It’s important to start with easy steps for children in this age group. They need to have their confidence built-up so they keep trying.
While most of us are familiar with human growth progressing from head to toe (i.e., cephalocaudal development), proximodistal development refers to growth from the torso and spinal cord outward.
This pattern of growth is manifest in babies being able to grasp objects reflexively, if placed in their palm, but not yet have enough control over their limbs to reach for an item with any degree of accuracy.
Other examples include babies being able to sit-up before standing, or place a ring on a tube by engaging in large arm movements.
As children get older, more bones in their hands begin to form and they are able to grasp a pencil with their thumb and fingers. However, they still color or write by engaging in large arm movements instead of moving their wrists and fingers.
Angulo-Kinzler, R. M., Ulrich, B., & Thelen, E. (2002). Three-month-old infants can select specific leg motor solutions. Motor Control, 6, 52–68.
Galloway, James & Thelen, Esther. (2004). Feet first: Object exploration in young infants. Infant Behavior and Development, 27, 107-112. https://doi.org/10.1016/j.infbeh.2003.06.001
Piaget, J. (1956; 1965). The Origins of Intelligence in Children. International Universities Press Inc. New York.
Selin, A. S. (2003). Pencil Grip: A Descriptive Model and Four Empirical Studies. Turku, Finland: Åbo Akademi University.