Most 3- or 4-year-old children have difficulty following my directions when I test biceps strength during a neurologic exam. Here's a trick I find helpful: Have the child make fists with both hands, place one fist on each cheek, and move his (her) elbows close to his body. Then tell him not to let you take his fist off his cheek while you pull on his arm. My patients enjoy this "game" and love to show me how strong they are.
Stacy B. Pierson, MD St. Petersburg, Fla.
