EHI-10: Edinburgh Handedness Inventory

Reviewed by: Constantin Rezlescu | Associate Professor | UCL Psychology

At a Glance

Items	10 activities (writing, drawing, throwing, scissors, toothbrush, knife without fork, spoon, broom, striking a match, opening a box lid)
Administration time	A few minutes (estimate; not specified in the original paper)
Response format	Hand preference marked per activity in a left or right column; a doubled mark indicates a preference so strong the other hand is never used unless forced (Oldfield, 1971)
Scores	A single Laterality Quotient (LQ), from −100 (strongly left-handed) to +100 (strongly right-handed)
Validated ages	Adults (Oldfield’s 1971 sample comprised about 1,100 young adults)
License	Free for research and clinical use; published in a journal without commercial restrictions (Oldfield, 1971)
Original citation	Oldfield (1971), Neuropsychologia

Introduction

The Edinburgh Handedness Inventory (EHI) is the most widely used standardized measure of hand preference in research and clinical settings. R. C. Oldfield introduced it in 1971; he began with a 20-item list and, after analysing a sample of about 1,100 young adults, eliminated 10 items to arrive at the 10-item inventory shown here (Oldfield, 1971). This 10-item set is Oldfield’s own original inventory, published in the 1971 paper, not a later short form.

The measure is valued for its brevity and for capturing both the direction and the strength of hand preference in a single index. Oldfield’s 1971 article has roughly 11,000 citations in Scopus (Veale, 2014, p. 165), and it remains the common reference point for handedness across neuroscience, psychology, and medical research.

A note on versions: The 10 activities on this page are Oldfield’s original inventory (writing, drawing, throwing, scissors, toothbrush, knife without fork, spoon, broom, striking a match, opening a box lid), the set finally selected in the 1971 paper (Oldfield, 1971, Appendix II, p. 112). Veale’s (2014) Edinburgh Handedness Inventory – Short Form is a different, 4-item instrument (writing, throwing, toothbrush, spoon) with simplified 5-point response options. It is not a 10-item form and is not the version presented here; cite Veale (2014) only if you use that briefer 4-item version.

Understanding Handedness as Neural Organization

Handedness is a basic aspect of human neurological organization, reflecting underlying brain lateralization. It is the preferential use of one hand for skilled motor activities, corresponding to contralateral dominance of the motor cortex. In the general population, roughly 90% of people are right-handed and about 10% left-handed, with a small minority showing mixed or ambidextrous patterns.

Handedness is not simply a binary trait; it lies on a continuum from strong left to strong right preference, with varying consistency across activities. That continuous character is what makes the inventory useful for neuroscience and clinical neuropsychology, where hand preference provides an accessible marker of hemispheric specialization for language and motor control.

Theoretical Foundation

The EHI is grounded in theories of cerebral lateralization and functional hemispheric asymmetry. Its design rests on the observation that hand preference reflects the dominant motor cortex, typically contralateral to the preferred hand. For most right-handers the left hemisphere is dominant for both motor control and language, whereas left-handers show more variable patterns of lateralization.

The inventory recognizes that handedness is not uniform across all activities: some tasks show stronger preference than others, and individuals may show mixed patterns. The Laterality Quotient (LQ) quantifies both the direction of preference (left versus right) and its strength (strong versus mixed). This dimensional approach has been particularly useful in neuroimaging research, where handedness serves as a predictor of, or control for, language lateralization and other functional asymmetries.

📏 Key insight: The inventory’s lasting value is that it converts hand preference into a single continuous laterality quotient, recording not just which hand a person favors but how consistently, which is why it became the common currency for handedness in lateralization research.

Key Features

Assessment Characteristics

• 10 everyday activities spanning fine motor, tool-use, and complex motor actions
• Hand preference marked per activity; a doubled mark records an especially strong preference (Oldfield, 1971)
• A single Laterality Quotient (LQ) captures both the direction and the strength of preference
• A few minutes to complete (estimate; not specified in the original paper)
• Free for research and clinical use

Dimensions Assessed

The inventory yields one quotient rather than separate subscales, but that quotient encodes several facets of hand preference:

• Direction – left versus right hand preference
• Strength – strong versus mixed preference
• Consistency – stable versus variable hand use across the 10 activities

Versions & Adaptations

• Original 10-item inventory (Oldfield, 1971) – the version presented here
• Edinburgh Handedness Inventory – Short Form, 4 items (writing, throwing, toothbrush, spoon), with simplified 5-point response options (Veale, 2014); a separate, briefer instrument, not a 10-item form
• No other standardized forms were identified during verification

Research Applications

• Neuroscience research – brain lateralization and hemispheric specialization studies
• Neuroimaging studies – handedness as a predictor or control variable in fMRI, EEG, and PET research
• Pre-surgical planning – informing language-lateralization expectations for epilepsy and tumor surgery
• Neuropsychological assessment – baseline hand-dominance measurement for cognitive testing
• Developmental and cross-cultural research – motor development and handedness prevalence across populations

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Assess hand preference and calculate your laterality quotient across 10 common activities.

Scoring and Interpretation

Response Format

In Oldfield’s original inventory, participants mark their hand preference for each activity by placing a mark in a left or right column. A doubled mark signals a preference so strong that the person would never use the other hand unless forced; a mark in both columns signals genuine indifference (Oldfield, 1971, p. 112):

• Left column only: left-hand preference
• Right column only: right-hand preference
• Both columns: genuine indifference (either hand used)
• Doubled mark in one column: a preference so strong the other hand is never used unless forced

The 10 Activities

The EHI is not commercially licensed, so its full item content can be reproduced. These are Oldfield’s original 10 activities (Oldfield, 1971, Appendix II, p. 112):

1. Writing
2. Drawing
3. Throwing
4. Scissors
5. Toothbrush
6. Knife (without fork)
7. Spoon
8. Broom (upper hand)
9. Striking a match (hand holding the match)
10. Opening a box lid

Scoring Procedure

1. Record preference for each of the 10 activities, using the marking convention above.
2. Assign points (modern convention). A common modern reinterpretation assigns each activity a value from −2 to +2 (doubled right = +2, single right = +1, both columns = 0, single left = −1, doubled left = −2). This explicit point table is a later convenience; Oldfield (1971) described the marks and the LQ formula rather than a fixed point table.
3. Compute the Laterality Quotient: LQ = [(R − L) / (R + L)] × 100, where R is the sum of right-hand values and L the absolute value of the left-hand values. This is Oldfield’s own formula: “add all the +’s for each hand, subtract the sum for the left from that for the right, divide by the sum of both and multiply by 100” (Oldfield, 1971, p. 100). The LQ ranges from −100 (strongly left-handed) to +100 (strongly right-handed).

Classification

Oldfield (1971) defined no standard classification bands for the Laterality Quotient, reporting the distribution as decile values instead (Oldfield, 1971, Tables 2 and 3, p. 109). Researchers commonly apply a single threshold (for example, LQ > +40 for right-handers and LQ < −40 for left-handers), with wide variation across studies. Any fixed band scheme should be treated as an arbitrary convention rather than an established norm.

Population Distribution

In Oldfield’s original sample, using a laterality quotient below zero as the criterion for left-handedness, the observed rates were (Oldfield, 1971, Table 1, p. 106):

Sample	N	Left-handers (LQ < 0)	Source
Males	400	10.0% (40)	Oldfield (1971), Table 1
Females	709	5.92% (42)	Oldfield (1971), Table 1
Combined	1109	≈7.4% (82)	Oldfield (1971), Table 1

Oldfield reported no means or standard deviations for the LQ itself, only a frequency distribution and decile tables. He also noted that simple self-report underestimates non-right-handedness: 25.9% of males and 16.6% of females reported some tendency to left-handedness (Oldfield, 1971, p. 99). The widely quoted ~90% right / ~10% left split is broadly consistent with these data, but Oldfield defined no fixed percentage bands.

Interpretation Considerations

• Injury effects: hand injuries may artificially shift reported preferences
• Strong preferences: indicate consistent hemispheric dominance
• Mixed patterns: may suggest more bilateral brain organization
• Cultural influences: some cultures historically discouraged left-hand use
• Developmental factors: handedness is generally established between about ages 3 and 7 (as reviewed by Markou et al., 2017, p. 263)

Research Evidence and Psychometric Properties

Factorial Validity and Reliability (Veale, 2014)

The most direct psychometric evidence comes from Veale’s (2014) confirmatory factor analysis of an online sample of 1,514 respondents. Oldfield (1971) reported no reliability coefficients, so the figures below come from Veale’s 2014 sample.

• 10-item factor structure: the full 10-item inventory did not fit a single-factor model well (CFI .84, RMSEA .145 under robust maximum likelihood), largely because writing and drawing are nearly collinear (r ≈ .97) and the broom, knife, and box-lid items carry high residual error (Veale, 2014, Table 2, p. 170)
• 10-item reliability (Veale’s sample): Cronbach’s α = .95 and Raykov’s composite reliability = .95 (Veale, 2014, Table 2, p. 170)
• 4-item Short Form: a separate 4-item Short Form (writing, throwing, toothbrush, spoon) achieved good fit and high reliability: Cronbach’s α = .93, Raykov’s composite reliability = .93, factor-score determinacy = .97 (Veale, 2014, Table 2, p. 170)
• Agreement between versions: laterality quotients from the 4-item Short Form correlate with the 10-item inventory at Spearman’s r = .90 (r² = .94) (Veale, 2014, p. 173)
• Factorial invariance: the 4-item Short Form showed metric and scalar invariance across regions (USA vs. Australia/New Zealand), age groups, and levels of education, with generally acceptable invariance across genders (Veale, 2014, Table 5, p. 171)

Neuroimaging Correlates

• Language lateralization: right-hemisphere language dominance rises with left-handedness, from about 4% in strong right-handers to 15% in ambidextrous individuals to 27% in strong left-handers, as measured by functional transcranial Doppler (Knecht et al., 2000, as reported in Markou et al., 2017, p. 259)
• Motor cortex asymmetry: consistent with structural MRI measurements of motor-cortex size (Amunts et al., 1996)

Genetic and Developmental Research

• Heritability: in the largest twin-family study to date (54,270 individuals from 25,732 families), additive genetic effects accounted for about a quarter of the variance in handedness, 23.64% (95% CI 20.2–27.1%), with the remainder due to non-shared environment; this is consistent with a 35-study meta-analytic estimate of 25.9% (Medland et al., 2009, p. 334)
• Twin correlations: monozygotic co-twin correlations for hand preference (about .24) exceeded dizygotic correlations (about .07–.15), indicating a modest genetic contribution rather than high concordance; there was no difference in left-handedness prevalence between MZ and DZ twins (Medland et al., 2009, pp. 334–335)
• Developmental emergence: handedness is generally established between about ages 3 and 7 in the general population (as reviewed by Markou et al., 2017, p. 263)
• Prenatal factors: the fetal-testosterone hypothesis proposed prenatal hormonal influences on handedness, but it is largely unsupported by later evidence: the large Medland et al. (2009) twin analysis found no hormonal-transfer effect (no prevalence difference between same- and opposite-sex twin pairs) (Medland et al., 2009, p. 334), and Markou et al. (2017, p. 261) note the hypothesis has been challenged

Cross-Cultural Evidence

• International samples: prevalence data pooled across many countries indicate broadly comparable left-handedness rates (Papadatou-Pastou et al., 2020)
• Cultural consistency: left-handedness rates (7–10%) are relatively stable across cultures despite historical stigma (McManus et al., 2010)
• Regional invariance: Veale’s (2014) 4-item Short Form showed factorial invariance across regions (USA vs. Australia/New Zealand), age, and education within a single English-language online sample; Veale did not test translated language versions (Veale, 2014, Table 5, p. 171)

Clinical Population Studies

• Stroke patients: reliable classification of pre-morbid handedness (Bishop, 1990)
• Autism spectrum: a meta-analysis found elevated atypical handedness; individuals with ASD are 2.34 times more likely to be mixed-handed (36.1% prevalence), 2.49 times more likely to be left-handed (18.3% prevalence), and 3.48 times more likely to be non-right-handed (45.4% prevalence) than typically developing individuals (Markou et al., 2017, p. 258)

Usage Guidelines and Applications

Primary Research Applications

• Neuroscience studies controlling for brain lateralization patterns
• Cognitive research examining language and spatial-ability relationships
• Neuroimaging studies using handedness as a predictor or control variable
• Developmental psychology tracking motor development and lateralization emergence
• Cross-cultural research investigating handedness prevalence across populations
• Genetic studies examining heritability and family patterns of lateralization

Design Considerations

• Define handedness cutoffs explicitly in protocols (for example, LQ > +40 for right-handed), since no standard bands exist
• Prefer the continuous LQ over categorical splits where the hypothesis allows; it retains more information and statistical power
• Account for the ~90:10 right-to-left distribution when planning sample sizes for left-handed subgroup analyses
• Document hand-injury history and any childhood training to use the right hand

Cultural Considerations

• Historical cohort effects: older adults may show forced right-handedness from childhood training (Papadatou-Pastou et al., 2020)
• Cultural stigma: some cultures historically discouraged left-hand use for eating or writing
• Activity relevance: ensure all 10 activities are culturally familiar and practiced
• Translation quality: use validated translations rather than ad hoc translation

Limitations and Cautions

• Self-report measure: relies on accurate self-perception and memory
• Activity-specific: handedness may vary by activity domain not fully captured
• Over-categorising mixed handers: the 10-item inventory tends to over-classify people as mixed-handed; eliminating high-error items (as in Veale’s 4-item Short Form) reduces this (Veale, 2014, p. 173)
• Developmental changes: handedness in young children may still be developing
• Pathological left-handedness: some left-handedness results from early right-hemisphere injury

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Legal and Copyright Information

Copyright and Usage Responsibility: Check that you have the proper rights and permissions to use this assessment tool in your research. This may include purchasing appropriate licenses, obtaining permissions from authors/copyright holders, or ensuring your usage falls within fair use guidelines.

The Edinburgh Handedness Inventory is free for research and clinical use. The original scale was published in an academic journal without commercial restrictions. Researchers and clinicians may use the measure without seeking specific permission, though proper citation of the original work is required.

Proper Attribution: When using or referencing the 10-item inventory shown here, cite the original development:

Oldfield, R. C. (1971). The assessment and analysis of handedness: The Edinburgh inventory. Neuropsychologia, 9(1), 97-113.

If (and only if) you use the separate 4-item Short Form, also cite:

Veale, J. F. (2014). Edinburgh Handedness Inventory – Short Form: A revised version based on confirmatory factor analysis. Laterality, 19(2), 164-177. (This is a 4-item instrument — writing, throwing, toothbrush, spoon — not a validation of the 10-item inventory.)

External Links and Resources

• Handedness – Wikipedia
• Brain Lateralization – Wikipedia

References

Primary Development:

• Oldfield, R. C. (1971). The assessment and analysis of handedness: The Edinburgh inventory. Neuropsychologia, 9(1), 97-113. https://doi.org/10.1016/0028-3932(71)90067-4

Four-Item Short Form (a separate, briefer instrument):

• Veale, J. F. (2014). Edinburgh Handedness Inventory – Short Form: A revised version based on confirmatory factor analysis. Laterality, 19(2), 164-177. https://doi.org/10.1080/1357650X.2013.783045

Neuroimaging and Brain Lateralization:

• Knecht, S., Dräger, B., Deppe, M., Bobe, L., Lohmann, H., Flöel, A., Ringelstein, E. B., & Henningsen, H. (2000). Handedness and hemispheric language dominance in healthy humans. Brain, 123(12), 2512-2518. https://doi.org/10.1093/brain/123.12.2512
• Amunts, K., Schlaug, G., Schleicher, A., Steinmetz, H., Dabringhaus, A., Roland, P. E., & Zilles, K. (1996). Asymmetry in the human motor cortex and handedness. NeuroImage, 4(3), 216-222. https://doi.org/10.1006/nimg.1996.0073

Genetics and Development:

• Medland, S. E., Duffy, D. L., Wright, M. J., Geffen, G. M., Hay, D. A., Levy, F., van-Beijsterveldt, C. E., Willemsen, G., Townsend, G. C., White, V., Hewitt, A. W., Mackey, D. A., Bailey, J. M., Slutske, W. S., Nyholt, D. R., Treloar, S. A., Martin, N. G., & Boomsma, D. I. (2009). Genetic influences on handedness: Data from 25,732 Australian and Dutch twin families. Neuropsychologia, 47(2), 330-337. https://doi.org/10.1016/j.neuropsychologia.2008.09.005

Reviews and Cross-Cultural Prevalence:

• Papadatou-Pastou, M., Ntolka, E., Schmitz, J., Martin, M., Munafò, M. R., Ocklenburg, S., & Paracchini, S. (2020). Human handedness: A meta-analysis. Psychological Bulletin, 146(6), 481-524. https://doi.org/10.1037/bul0000229
• McManus, I. C., Moore, J., Freegard, M., & Rawles, R. (2010). Science in the making: Right hand, left hand. III: Estimating historical rates of left-handedness. Laterality, 15(1-2), 186-208. https://doi.org/10.1080/13576500802565313

Clinical Applications:

• Markou, P., Ahtam, B., & Papadatou-Pastou, M. (2017). Elevated levels of atypical handedness in autism: Meta-analyses. Neuropsychology Review, 27(3), 258-283. https://doi.org/10.1007/s11065-017-9354-4
• Bishop, D. V. M. (1990). Handedness and developmental disorder. Blackwell Scientific Publications. (no DOI)