Bilateral Coordination

April 25, 2018

To start our journey into developmental skills we are going to start with one of the first developmental skills to mature, bilateral coordination. Bilateral coordination refers to the ability to the ability to coordinate movements of the right and left side of the body at the same time or in alternating movements.  When you push a grocery cart or stroller you have to use your arms with the same pressure, if you are unable to innately complete bilateral coordination you will push harder on one side than the other and the cart or stroller will not go straight.  This is using the sides of your body coordinated at the same time.  Another example is buttoning a button or tying a shoe, you use both side of the body but in different ways.  If you do not have adequate bilateral coordination you will be unable to complete these tasks.

Many motor skills including man gross motor and fine motor skills rely on the proper development of bilateral coordination.  It is important to start here and ensure your child is able to complete bilateral coordination without difficulty prior to moving on to their developmental tasks when addressing many delays including but not limited to handwriting, gross motor, motor planning, dressing, fine motor, and self feeding deficits.

There are 3 types of bilateral coordination

1.)Symmetrical Coordination-Using 2 extremities to do the same thing at the same time such as jumping jacks, jumping rope, or catching a ball with 2 hands.

2.) Asymmetrical  Coordination- Using 2 extremities to do alternating movements at the same time to complete a task such as swimming, biking, climbing stairs or a ladder, and marching.

3.) Dominant/Non Dominant Coordination- Using one hand to complete a task while the other assists, commonly utilized in fine motor skills including but not limited to writing, cutting with scissors, stringing beads, tying shoes, completing fasteners, and coloring.

Bilateral coordination is also closely linked to one of the sensory systems responsible for calming down and organizing our brain, the vestibular system. As we move input from the vestibular system helps guide the movements of our extremities and coordinate them.  Children with vestibular dysfunction often also exhibit dysfunction in bilateral coordination skills.

Another skill involved in bilateral coordination is crossing mid-line, that is the ability to move an extremity across the mid-line of the body, this is imperative to developing fine motor skills such as writing, coloring, and scissor skills.  A child with inability to cross mid-line will often switch hands and not demonstrate a dominance because they have poor bilateral coordination. This will hold back developmental significantly.  It is normal to switch hands and not cross mid-line until between 3 and 4 years old, after that age it is important to focus on bilateral coordination in addition to fine motor to resolve crossing mid-line and hand dominance concerns.

Below is a list of simple activities to work on bilateral coordination at home.

1.  Marching to music and clapping hands at the same time.

2.  Cross crawls – touch your right hand to your left knee and then the left hand to your right knee.  Repeat touching the opposite feet.

3.  Traditional jumping jacks

4.  Cross Country Jumping Jacks – place right arm and right leg forward jump and switch left arm and left leg forward.  Try opposite sides – place right arm and left leg forward jump and switch left arm and right leg forward.

5.  March in place sitting down while drawing circles in the air with both hands

6.  Try a task using both hands or both hands and feet at the same time – ie: dribbling a ball with both hands, kicking a ball and dribbling a ball.

7.  Play hopscotch – the skill of jumping feet apart and together requires coordination of both sides of the body

8.  Perform motor activities to the beat of a metronome

9.  Jumping activities – jumping rope, jump up and clap hands, jump up and touch your heels behind your bottom, jumping activities through a floor ladder, etc.

10.  Animal walks that use both sides of the body – ie: crab walk, bear walk and crawling

11. Scooter board activities the belly using Both arms or both arms and legs.

12. Hand clapping games crossing mid-line in a rhythmic pattern.

Also please find a link from last week post regarding games to promote increased bilateral skills.

Bilateral Skills

Our OT’s do a great job of helping children to develop bilateral coordination. If you have any question or concerns please do not hesitate to contact us!


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