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Bilateral Coordination

Bilateral coordination refers to the ability to coordinate both sides of the body at the same time in a controlled and organized manner. For example, holding a piece of paper with one hand while cutting with the other hand.

Bilateral Coordination shows us how our brain is talking to our body. The right side of our brain controls the left side of our body then the left side of the brain controls the right side of our brain; we can see if a child has dominance to one side and how the brain is working in coordination with the body.

Signs of poor bilateral coordination include:

  • Difficulty with tying shoes

  • Difficulty with dressing

  • Difficulty with jumping jacks

  • Delayed gross motor skills such as crawling, walking and/or climbing stairs

  • Difficulty riding a bike

  • Difficulty with climbing such as rock wall or ladder

Crossing Midline is one of the main steppingstones to bilateral coordination. Crossing Midline refers to the ability to spontaneously cross over the midline of the body during motor completion/ functional tasks- moving one hand, foot, or eye into the space of the other hand, foot, or eye (i.e., sitting with legs crossed, scratching the opposite elbow, successfully intersecting lines to draw a cross- without switching hands, reading left to right, etc.).

Babies and toddlers may use both hands equally and initiate picking up or interacting with an object with whichever hand is closer (i.e., if the item is on the left side of the table, he will likely use the left hand, if it the object is on the right side, he will likely use the right hand).

However, by 3-4 yrs. of age a child should typically have mastered the skill of “crossing midline.” Establishing hand dominance (a “worker hand” vs. a “helper hand”) is an indicator that the brain is maturing, and lateralization is occurring- this is strongly correlated with the ability to cross midline.

Signs of difficulty crossing midline include:

  • Difficulty establishing hand dominance

  • Difficulty With coloring, connecting the dots and handwriting

  • Difficulty understanding directionality or rights vs left

  • Difficulty with gross motor task such as reaching across body for toys and climbing play structures

Body Awareness is another important aspect of bilateral coordination. Body awareness refers to the ability to know where your body is in space without necessarily using vision (i.e., how high to lift your leg when climbing stairs, etc.); it involves proprioception, which is feedback from muscle and joint sensations. Children who do not have adequate body awareness may appear a bit clumsy, be cautious with movement or fearful with feet off ground (tossing in air, swinging, etc.), seek (or avoid) deep input or be too rough with peers/ toys (wrestling, crashing, carrying/ pushing/ pulling heavy objects). Subsequently, children who do not have a good sense of where their body’s/ body parts are in space can present with difficulty coordinating both sides of their body to complete bilateral tasks (i.e., putting on socks and shoes, throwing/ catching a large ball with 2 hands).

Signs of poor body awareness:

  • Always seem to be leaning on objects or people

  • “Clumsy” Always bumping into things

  • Loves to get big and deep hugs

  • Seems to have a hard time with pressure and force of grasping objects

Printable Resources:

Pointer Dog
Download PDF • 74KB

The Randolph Shuffle
Download PDF • 102KB

Resource: Children Play


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