Bilateral Coordination – Challenges and Strategies to Improve Development

Signs of Bilateral Coordination Challenges and 15 Strategies to Improve Bilateral Coordination Development

Bilateral Coordination – the ability to use both sides of your body in a coordinated fashion. Many activities in school and throughout childhood require bilateral coordination so development 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 clumsyand also struggle with certain gross motor activities. Also, they might frequently try to use one hand for tasks that should require two hands. 

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

Three Types of Bilateral Movements

There are three types of bilateral movements we perform. For most of us, we do this 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 the task. 

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 smooth movements will look jerky 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 are required to stabilize an item with one hand, while your dominant hand does more skilled work. 

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:

  • Writing
  • Drawing a line using a ruler
  • Using scissors
  • Cutting food with a fork and knife
  • Putting beads on a string
  • Sewing
  • Opening a jar
  • Doing up buttons, snaps and zippers on clothing

Signs Your Child Is Struggling with Bilateral Coordination

Signs your child is struggling with Bilateral Coordination / 15 Activities for improving bilateral coordination / #MotorSkills #SensoryProcessing #SPD #Autism #ADHDKids #SensoryDiet #ToddlerDevelopment

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. 

You may also notice challenges with the vestibular system because bilateral coordination is a component of sensory integration within the vestibular system. 


Related: The Vestibular System & 25 Vestibular Input Activities 


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 the left foot and right foot on the pedals
  • Trouble performing activities such as jumping jacks, jumping rope, catching a ball with both hands, swinging a baseball bat
  • Struggles with alternating movements, such as marching, swimming, beating a drum
  • Trying to do an activity using only one hand that requires two hands. For example, tying shoes, zippering a zipper, cutting paper, etc.
  • Unable to pour themselves a drink without spilling it, or to put their toothpaste on their own toothbrush without making a mess.

Strategies to Improve Bilateral Coordination

Bilateral Coordination / 15 Activities for improving bilateral coordination / #MotorSkills #SensoryProcessing #SPD #Autism #ADHDKids #SensoryDiet #ToddlerDevelopment

There are many ways to work on 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.

Here are some of my favorite activities, toys, and resources of 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
  • Regularly practice of activities that require bilateral coordination. Skills can be taught they just may take additional time compared to peers.
  • Play hopscotch, twister, the 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.
  • 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 on all things sensory.
  • Another from OT Toolbox: Pop Toob activity
  • The Inspired Treehouse:  Handclapping Games for Kids
  • From Your Therapy Source: Lacing Activities for Children
  • From MissMancy: Twist and Turn Activity

Looking for more resources for your sensory kiddo? Check out these 35 accommodations for common sensory challenges 


One thought on “Bilateral Coordination – Challenges and Strategies to Improve Development

  1. Love this post!!! This was our first indicator that something wasn’t typical with our son as he couldn’t walk, eat solids, or drink from a straw until he was nearly 18 months old (he accomplished all three within a 10 day time period just before he turned 18 months and when he started it was like he had been doing it the whole time). This was soon followed by fine & gross motor delays that concerned his doctor (and us) at his 4 year check up which started us down the evaluation road where I’m hoping we will finally have an answer next month after finishing evaluations with a psychiatrist last month. A few times into this journey ADHD has come up but his teachers and I don’t feel that’s really the main issue or even an issue at all. Your story about your son bringing in the wrong meal felt like I was reading about one of my own son’s meltdowns word-for-word. While our son doesn’t have fixated interests, other than the color green, he does get stuck on having certain items with him, but those rotate out every few days or so. And don’t get me started on the dentist and haircuts, I feel like those experiences would bring most moms to tears (I just save mine for later). He’s 7 and started a new school this year as they felt he no longer needed as much intervention at school and it’s been a bumpy road. Hopefully we will get answers next month that amount more to him just having sensory issues and needing emotional/behavioral plans & supports. Thank you for such a great site!

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