The developmental concept that the maturation of motor skills proceeds in a proximal to distal direction, and thatdistal movements emerge only after proximal movements have been established has come into question. Neurophysiological and developmental research has suggested that proximal and distal development occur simultaneously, under the influence of two independent neural systems. In order to clarify the questions raised by such opposing viewpoints, twenty-nine normal infants (15 girls, 14 boys), 24 weeks of age, were videotaped reachingfor and grasping a cube deposited in a form-board. The degree of proximal (reach) and distal (grasp) maturity was rated by two independent scorers usinga scale specifically designed for this purpose. Correlation between each rater's proximal and distal scores for each child, evidenced a positive linear relationship (r1 = 0.58, p > 0.001; r2 = 0.79, p > 0.001). It is hypothesised that these results may be indicative of the speed in which the neural centres responsible for proximal and distal function, myelinate and develop functional synapses. Thus, although proximal and distal motor skills mature sequentially, they may nonetheless be contingent upon the controlling influence of two separate neural systems. These findings have implications for occupational therapy treatment approaches.
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