The provision of prostheses for children with upper limb deficiency starts at an early age. The roles of the occupational therapist and prosthetist in this programme are described. Casting and fitting techniques applicable to transverse forearm loss and aspects of myoelectric hand prostheses are included. An outline of training methods as related to both parent and child is explained. Higher levels of limb deficiency are covered briefly and the use of alternative methods of electric hand control is included. Finally, a brief summary of distal deficiency is discussed.