Congenital abnormal development requires an appropriate fitting when the infant reaches 6 months. This is very important for the development of the infant. The earliest possible fitting has two advantages: On the one hand the symmetry of the body is retained through compensation; on the other hand the small child needs both arms and hands as supports for crawling and discovering the world. A child up to the age of two is in a sensorimotor phase and is developing his or her senses and movement functions. In this respect, a child benefits immensely from the fitting of a prosthesis at this time. For dysmelia children (with a congenital abnormal development on one side), the missing arm can be simulated by a bandage with the appropriate weight – a cover that is pulled on to the residual limb. Here, too, care and preparation of the residual limb are very important. However, children with congenital abnormal developments suffer neither from phantom pain nor from oversensitivity of the residual limb. After an initial fitting with a so-called plastic hand, a cable-controlled or myoelectrically controlled prosthesis can be used. It is easy to learn to control the gripping function of the cable-controlled prosthesis. Many parents however reject this type of fitting on aesthetic grounds. An attractive, functional and high-quality alternative is offered after the child has reached the age of 2, when they can be fit with a myoelectrically controlled arm prosthesis . Small children under the age of 4 best learn how to use the prosthesis playing games. Everyday life, hobbies, dexterity games and reaction training can be used playfully to induce older children to do occupational therapy. Two-handed activities are especially important for movement. Weaving, sewing on buttons, tying shoes, throwing rings and sandbags, letting go of rope and gripping towels are only a few examples of exercises suited for children. Popular, everyday children’s games can also be used in a therapeutically sensible way. The inventiveness of the occupational therapist knows no limits. Everything that is fun for children can be included.