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Bilateral Coordination – What It Is, How to Improve It

What’s inside this article: Description of bilateral coordination, types of bilateral movements, signs your child has poor bilateral coordination, and lastly, ways to develop and improve bilateral coordination.

Disclaimer: This post contains affiliate links


This post is part of a 10-part series on the sensory systems. Each part will contain a table of contents to help you easily navigate through the entire series.

Table of Contents:

  1. Introduction – The Sensory Spectrum
  2. The Tactile System
  3. The Auditory System
  4. The Visual System
  5. Proprioception
  6. Vestibular System
  7. Interoception
  8. The Olfactory System
  9. The Oral-Motor System
  10. Bilateral Coordination

What is Bilateral Coordination? How do you Improve It?

Bilateral Coordination is the ability to use both sides of your body in a coordinated fashion. Many activities in school and throughout childhood (and life) require bilateral coordination.

Developing bilateral coordination is important.

The fact that I have bilateral coordination is the reason why I can sit here and write this post with both my hands on the keyboard and type these words as they come to my head.

Signs of Poor Bilateral Coordination

The signs of poor bilateral coordination all relate to struggles with tasks and movements requiring both sides of the body. These include:

  • Difficulty coordinating both sides of the body smoothly (e.g., jumping jacks, riding a bicycle)
  • Struggles with tasks requiring the use of both hands together (e.g., tying shoelaces, cutting with scissors). They may try to perform these tasks with one hand instead.
  • Poor fine motor skills
  • Difficulty establishing a dominant hand may switch hands frequently during activities.
  • Trouble with tasks that require sequential movements (e.g., climbing stairs, skipping)
  • Poor performance in sports or activities involving coordination, like catching a ball or swimming
  • Difficulty with rhythmical activities, such as dancing or playing musical instruments
  • Challenges with fine motor tasks that need both hands to work together, like buttoning clothes or zipping a zipper
  • Challenges with the vestibular system because bilateral coordination is a component of sensory integration within the vestibular system. 
  • Problems with spatial awareness, leading to clumsiness or frequent bumping into objects
  • Struggles with tasks that require crossing the midline of the body, such as drawing a line across a page without switching hands

Types of Bilateral Movements

There are three types of bilateral movements we perform.

Most of us do these movements daily and aren’t even aware of the skill required because it comes naturally or automatically to us.

However, for a child struggling with bilateral coordination challenges, these types of activities may require intense focus to complete, or they simply may not be able to perform them at all.

1. Symmetrical Movements 

These are movements where both arms, or legs, must perform the same movement at the same time, and with an equal amount of force. 

Symmetrical Movement Examples:

  • Using a rolling pin
  • Jumping jacks
  • Clapping your hands
  • Pushing or pulling with both hands
  • Skipping rope

2. Reciprocal Movements

These are movements where actions are carried out first by one hand or foot, and then the other, in a rhythmic way.

When bilateral coordination is poorly developed these movements will look jerky instead of smooth or your child will be unable to perform them at all. 

Reciprocal Movement Examples:

  • Riding a bike
  • Crawling
  • Climbing a ladder
  • Hopping from one foot to another

3. Leading Hand and Supporting Hand

Coordinating your leading hand and supporting hand actions together is required for tasks where you need to stabilize an item with one hand while your dominant hand does more skilled work. 

Example of bilateral coordination - a girl cutting a piece of paper with scissors.

Both hands are equally important in completing the task because, without adequate stabilization from one hand, the other hand will not be able to perform the work correctly.

Leading Hand and Supporting Hand Examples:

  • Cutting with scissors
  • Writing on a piece of paper
  • Tying your shoes
  • Sewing
  • Adding beads to string or pipe cleaner

Bilateral Coordination Exercises and Activities

An occupational therapist can assess your child’s abilities and suggest tailored ways to encourage the development of any bilateral coordination skills your child is struggling with. However, there are many ways parents can help their children develop bilateral coordination at home.

As it turns out, it’s difficult to find resources online related specifically to improving bilateral coordination.

However, the key to developing any lagging skill is – practice, practice, practice. The more times your child does something successfully, the more that skill will develop and improve.

Choose activities your child is likely to do well at as you begin practicing and developing their bilateral coordination. It’s important to ensure your child doesn’t feel discouraged, as this may make them want to give up practicing. Move on to more challenging movements as this skill develops.

Here are some of my favorite activities, toys, and resourcesfor developing bilateral coordination:

  • Playing Catch: Throwing and catching balls of different sizes helps coordinate hand-eye movements and the use of both hands together.
  • Riding Bicycle: This activity requires synchronized leg movements and balancing, which engages both sides of the body.
    • Can’t ride a bike yet? Try air biking: Lay on your back with your legs in the air and pedal your legs like you’re riding a bike.
  • Jump Rope: Skipping rope involves timing, rhythm, and the use of arms and legs in a coordinated manner.
  • Swimming: Different swimming strokes require coordination of arms and legs moving in specific patterns.
  • Arts and Crafts: Activities like cutting with scissors, gluing, and drawing require the use of both hands, with one leading and the other supporting.
    • These scissors from ALEX toys automatically re-open after each cut. You can use these as skills emerge to make the task of cutting easier until your child can better coordinate and stabilize the paper and cutting on the line.
    • Kids DIY sewing kit – This is perfect for practicing leading hand and supporting hand activities. The holes for sewing are pre-punched as a guide to help your child.
  • Dance and Movement Games: These encourage children to use both sides of their body in a mirrored or synchronized way.
    • Simon says
    • Follow the leader
    • Hopscotch
    • Twister
    • The Hokey-Pokey
    • Tug-o-war
  • Playing Instruments: Helps develop coordination of hands doing different tasks simultaneously.
    • Play with maracas or shakers together, getting your child to copy your movements.
    • Register for lessons to learn an instrument that interests your child.
  • Toys: Many toys help kids develop bilateral coordination
    • Use a toy broom and dustpan and practice sweeping cotton balls or pom-poms into the dustpan with one hand while stabilizing with the other hand.  
    • Building blocks, legos, magnetic tiles, etc. encourage using both hands in a coordinated way to build things.
    • Video games and hand held game consoles
    • Bop it
  • Both of my workouts created for kids: 7 Minute HIIT, and the 8 Minute Morning Workout, can help improve bilateral coordination because several of the moves require various types of bilateral coordination.
  • From the OT Toolbox: Clover bilateral coordination and visual motor integration clover – This blog is amazing because everything is explained so well and from an occupational therapist’s point of view. It offers a lot of insight into all things sensory.
  • Another from OT Toolbox: Pop Toob activity
  • The Inspired Treehouse:  Hand Clapping Games for Kids
  • From Your Therapy Source: Lacing Activities for Children
  • From MissMancy: Twist and Turn Activity
Child using DIY sewing kit to make a stuffed rabbit, helping build bilateral coordination

Bilateral coordination is an essential developmental skill that impacts a child’s ability to perform everyday activities, from simple tasks like tying shoelaces to complex actions like participating in sports.

If your child is showing signs of poor bilateral coordination, you should speak to their pediatrician or an occupational therapist who can provide tailored advice for building this important skill.

However, by incorporating symmetrical movements, reciprocal movements, and activities that engage both the leading and supporting hand, parents and educators can support children in developing stronger bilateral coordination. This not only aids in their physical development but also boosts their confidence and independence in performing daily tasks.

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