The form of the control and structure of the mechanism of an artificial hand are important factors which tend to dictate the prosthesis' level of use. Conventional prostheses are simple devices with limited functional range and a control format that requires high levels of user concentration for successful operation. The Southampton Adaptive Manipulation Scheme (SAMS) is a hierarchical control format that allows a larger number of independent motions to be controlled while requiring a smaller degree of user input. The SAMS control has been applied to different hand mechanisms, both custom-made and modified commercial systems. Their application with users shows them to have a performance on a par with, or superior to, other conventional devices. The form of prosthesis control is reviewed and the development of, and clinical experiments with, the Southampton Hand are outlined.