Bilateral Coordination

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Bilateral coordination is the ability to use both sides of the body together in a coordinated way. It is also called bilateral integration.

The quick links below will take you to the information and activities on this page. Have fun!



When Do Kids Use Bilateral Integration?

Many childhood and school activities require your child to be able to use both hands together well.

Many kids with delays in this area would rather use one hand alone than both hands together, and may appear awkward or clumsy in certain tasks.

Here are just a few that may be challenging to a child with poor bilateral skills:

Gross Motor Activities

  • Jumping and skipping
  • Riding a bike
  • Catching a ball
  • Beating a drum
  • Pushing/pulling activities

Fine Motor Activities

  • Tying shoelaces
  • Threading beads
  • Using a knife and fork
  • Drawing a line with a ruler
  • Doing buttons
  • Lacing activities
  • Cutting with scissors

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3 Basic Bilateral Movements

1) Symmetrical Movements

Symmetrical movements have each leg or hand doing the same action at the same time, for example rolling out pastry with a rolling pin, or clapping hands.

2) Reciprocal Movements

Reciprocal movements are actions where first one hand or leg and then the other carries out the same movement in a rhythmical way.

Examples would be pulling a rope hand-over-hand or pedaling a bike.

Reciprocal movements are also called alternating movements.

3) Leading Hand and Supporting Hand

Sometimes we use one hand to play a supporting role while the other hand does more skilled work, such as cutting with scissors, threading beads or drawing a line with a ruler.

Both hands are working together in a coordinated way, but one is leading and the other is supporting.

During handwriting, if a child does not stabilise the paper with the non-writing hand, then writing can be less efficient. (Parush et al, 1998)

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Vestibular System and Bilateral Integration

The vestibular system (which is situated in the inner ear and helps the brain to process movement information) plays a vital role in a child's physical development.

Children with poor vestibular processing may well have delayed bilateral integration abilities.

For this reason, many occupational therapists use specific movement activities in their therapy sessions to stimulate the vestibular system before carrying out activities to boost bilateral coordination skills.

Examples that you can use at home are:
Jumping on a trampoline, rolling on the grass, going down a slide, and doing somersaults.

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Bilateral Coordination Activities

Although symmetrical movements are often easier, your child does not have to master these before moving on to alternating movements – you can combine different kinds of movements through different activities.

A child will usually learn to coordinate the use of the arms before the use of the legs, and obviously, the hardest thing is for a child to use the arms and legs together in a coordinated way at the same time (star jumps/jumping jacks).

So keep that in mind as you try the following activities! Most importantly, have fun with your child!


Catching a ball is good for bilateral coordination, but if mom has to keep chasing missed balls, it can get pretty tedious!

Here is a great way to help your child practice ball skills without chasing after missed balls all day long: suspend a ball in a net as shown in the photos below, and your child can practice pushing and catching the ball with both hands!

I use a net bag, the kind that you get fruit and veggies in.

Pop a ball in and knot it to a length of rope.

The rope needs to be long enough to get the ball level with your child’s chest.

Suspend the ball from any horizontal pole or even from a hook in a doorway.

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More Bilateral Activity Ideas

Pulling hand over hand on a rope is a good way to get the hands working rhythmically together.

Try a Slinky – shifting the hands just enough to get the slinky springs to move back and forth between the hands is great fun.

Encourage your child to roll large balls of playdough between two hands to make smooth balls.

Try some of my other playdough ideas to boost coordination skills.

Find some maracas or musical shakers (like these ones on Amazon). (this is an affiliate link)

Try moving them up and down at the same time or alternately in time to music.

Getting legs to move together is hard work. Start by having your child jump over a line and back again, one jump at a time.

Increase the number of jumps as your child improves at keeping feet together!

A Zoom Ball is an awesome toy that gets your child to open and close the arms symmetrically, to make the ball "zoom" back and forth on the string.

Have you tried Bear Paw Creek's Stretchy Band?

When a group of kids are making the band move around in a circle, hand over hand, they are getting a good bilateral workout, as well as crossing their midlines.
Get 10% off if you use the coupon code otmom at checkout on their site.

The above contains affiliate links - I may receive a small commission if you purchase an item through my links.

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Bilateral Coordination E-Book

The above activities are just a small sample of the variety of activities that you will find in my Bilateral Coordination Activities E-book.

There are lots and lots of fun activities you can do at home to boost your child's bilateral coordination skills.

View the e-book now!

(This book forms part of my bundle deal)

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Related Pages


Parush, S.; Levanon-Erez, N., Weintraub, N. Ergonomic factors influencing handwriting performance. Work 11(1998) p295-305

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