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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.

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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 typing these words as they come to my head.

A child with delayed bilateral coordination development may be clumsy and also struggle with certain gross motor activities.

Also, they may frequently try to use one hand for tasks that should require two hands. 


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

Types of Bilateral Movements

There are three types of bilateral movements we perform.

For most of us, we do these movements daily and aren’t even aware of it because it comes naturally 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 are 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

How to Tell if your Child has Poor Bilateral Coordination

how to tell if your child has poor bilateral coordination - #ChildDevelopment #OccupationalTherapy #MotorSkills

If your child has bilateral coordination delays they may also have trouble in school, have poor fine motor skills or gross motor skills.

They may also have poor hand-eye coordination. 

Additionally, you might notice challenges with the vestibular system because bilateral coordination is a component of sensory integration within the vestibular system. 

Some specific behaviors to look out for include: 
  • Trouble stabilizing a piece of paper with one hand while writing with the other.
  • Unable to pedal a bike because they cannot coordinate moving their left and right foot on the pedals.
  • Difficulty with movements like jumping jacks, catching a ball with both hands, swinging a baseball bat.
  • Jerky alternating movements, such as marching, swimming, or beating on a drum.
  • Tries to use one hand for tasks that require two hands. For example, tying shoes, zippering jacket, cutting paper.
  • Unable to pour their own drink without spilling it, or put toothpaste on their brush without making a mess.

Bilateral Coordination Exercises and Activities

There are many ways to help develop bilateral coordination at home.

An occupational therapist can also assess your child’s abilities and suggest ways to encourage the development of any skills your child is struggling with. 

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.

Here are some of my favorite activities, toys, and resources from other bloggers.
  • Pull cotton balls apart or rip pieces of paper to practice using both hands together
  • Roll play-doh with a rolling pin
  • Play with shakers and practice shaking both at the same time and alternating left and right
  • For children whose skills are just emerging, this geometric shape sorter can help
  • Play follow the leader with coordinated movements or use maracas and get your child to copy you while you shake both at the same time, or one at a time. 
  • Air biking: Lay on your back with your legs in the air and pedal your legs like you’re riding a bike.
  • Play hopscotch, twister, hokey-pokey, etc. 
  • 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.  
  • 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 stabilizing 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.

Looking for more resources for your sensory kiddo?

Check out these 40 accommodations for common sensory challenges 


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