A Guide to

Bilateral Coordination
By Maria Lagowska with Therapy Materials Vault

Introduction
Bilateral coordination is the ability to coordinate both sides of the body at the same time when
completing a task. Bilateral coordination movements occur when both sides of the brain are integrated
and sharing information with each other effectively. Development of bilateral coordination is necessary
for many motor skills. Gross motor skills, such as walking, skipping, or riding a bike, cannot be completed
without bilateral coordination. Fine motor skills, such as holding paper while cutting with scissors,
buttoning, or stringing beads, require the two sides of our body to coordinate in order to accomplish these
fine motor skills. Many functional skills, such as buttoning, zipping, or tying shoes, require the use of both
hands to accomplish given tasks.
There are two essential skills related to bilateral coordination: crossing the midline and body awareness.
Crossing the midline is the ability to reach across the imaginary midline, a line that divides our body into
right and left sides, of the body during tasks. Reaching for a cup across the table or popping bubbles are
examples of crossing the midline. A child who avoids midline crossing may have difficulty coordinating
both sides of the body. Body awareness is the ability to know where your body is in space. For example,
knowing how high you can lift your leg when climbing stairs or how far you have to extend your arm
to grab a cup of water. Children who have poor body awareness may appear clumsy or uncoordinated.
When children do not have adequate body awareness or midline crossing, they can present with difficulty
coordinating both sides of their body to complete bilateral tasks.

Types of Bilateral Coordination

1. Symmetrical Coordination: This involves using either upper or lower extremities to complete the same
movements at the same time, such as jumping jacks or catching a ball with two hands.
2. Asymmetrical Coordination: This involves using either upper or lower extremities to complete
alternating movements at the same time to complete a task, such as riding a bike or marching.
3. Dominant/Non Dominant Coordination: This involves using one hand to complete a task while the
other hand assists, such as holding the paper with one hand when writing or holding the lace with one
hand and using the other to make a loop when tying shoes.

Importance
Bilateral coordination is important because many of our everyday tasks, such as walking, cutting, or
catching a ball, require us to use both sides of our body. For children, bilateral coordination is crucial for
development of motor skills and moving onto more difficult motor tasks. For an in-depth exploration of
the bilateral coordination developmental milestones, please reference TMV’s Developmental Milestones.

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 Bilateral Coordination
Activities
For age 2
• Pop-beads or interlocking toys (Legos®) - pull apart and push together
• Scooter Board activities - use arms to propel self through an obstacle course or pull self forward
• Tear paper into strips and small pieces to make collages
• Color tiny pieces of paper (hold paper steady with one hand and color with the other)
• Cut with scissors
• Sorting - place objects on one side of the body and container/pile on the other side of the body
• Popping bubbles with two hands

For age 3
• String beads onto laces, pipe cleaners, or dowels
• Lacing/sewing cards
• Wheelbarrow or animal walks
• Open and close fasteners - buttons, zippers, belt buckles, and shoe laces
• Put on socks and shoes
• Pull theraputty with both hands

For age 4
• Play catch with a large ball, or dribble the ball with two hands
• Marching to music while clapping hands at the same time
• Open toothpaste to put onto a toothbrush
• Use a ruler to make a calendar or graph
• Blowing bubbles (one hand on bubbles, one hand on wand)

For age 5+
• Shuffle and deal cards
• Simon Says
• Play musical instruments such as cymbals, drums, triangle, and guitar
• Clapping activities and games (pat-a-cake, Itsy Bitsy Spider)
• March in place, while sitting down, while drawing circles in the air with both hands
• Play hopscotch – the skill of jumping feet apart and together requires coordination of both sides of the body
• 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.
• Open jars and other containers with lids, and factory sealed food items.
• Use a rotary pencil sharpener
• Swimming - splashing, kicking, pulling self along edge of pool using arms, and pulling self out of pool
• Outdoor playground activities - climbing poles and ladders, and swinging
• Riding a bike or scooter
• Tying shoelaces

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 Age 5+: Additional Activities
Gallop

1. Stand with both feet together and your hands at your sides.
2. Move your left foot forward while bringing your right arm slightly forward at the same time.
3. Bring your right foot to your left foot.
4. Repeat the above movements.
5. Repeat with the right foot in order to gallop on the right side.

Skip

1. Stand with feet together and your arms at your sides.

2. Move forward hopping on your left foot while lifting your right knee and bending your left arm.
3. Switch to step and hop with the opposite foot.
4. Repeat the above movements.

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 Wall Switch

1. Stand one to two feet away from the wall.

2. Place your arms on the wall and stand with your right foot forward.
3. Jump in the air and switch your feet by putting your left foot forward.
4. Repeat the jump and switch movement.

Sit Clap

1. Sit on the floor with your legs spread apart in a V formation. Place your hands on each side of
your left leg.
2. Clap your hands together in the middle while sitting forward.
3. Place your hands on each side of your right leg.
4. Repeat clapping movement from side to side.

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 Stand/Slap/Clap

1 2 3

4
1. Stand up with legs spread shoulder width apart.
2. Bend to the left side and touch the floor with your fingers on each
side of your foot.
3. Come to the starting position and clap hands in the middle.
4. Bend to the right side and touch the floor with your fingers on
each side of your foot.
5. Repeat steps 1 through 4.

Tap Clap Jump

1. Squat down to the floor and tap it three times.

2. Jump up and clap hands above your head.
3. Repeat.

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 Windmills

1 2 3

4
1. Stand with feet shoulder width apart and arms spread out to the side
in a T formation.
2. Bend your body to touch your left foot with your right arm.
3. Go back to the starting position.
4. Bend your body to touch your right foot with your left arm.
5. Go back to the starting position and repeat.

Seated Cross Crawls

1. Sit in a chair with your feet spread shoulder width apart and your arms up in the air.
2. Raise your left knee and tap it with your right hand.
3. Go back to the starting position.
4. Raise your right knee and tap it with your left hand.
5. Go back to the starting position.
6. Repeat steps 2 through 5.

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 Advanced Cross Crawls

1. Stand up straight with your feet together and your arms at your sides.
2. Bring your left knee to your chest and touch it with your right elbow.
3. Bring your feet back together, with your hands at your sides.
4. Bring your right knee to your chest and touch it with your left elbow.
5. Go back to the starting position.
6. Repeat steps 2-5.

Foot Cross Crawls

1. Stand with your feet together and your arms at your sides.
2. Lift your left leg and touch your left ankle with your right arm.
3. Bring your feet back together, with your hands at your sides.
4. Lift your right leg and touch your right ankle with your left arm.
5. Repeat.

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 Back Cross Crawls

1. Stand up straight with your feet together and your arms at your sides.
2. Bend your left knee and kick it back. Touch your left foot with your right hand.
3. Bring your feet back together, with your hands at your sides.
4. Bend your right knee and kick it back. Touch your right foot with your left hand.
5. Repeat.

Switch Cross Crawls

1. Stand up straight with your feet together and your arms at your sides.
2. Lift your left leg and touch your left ankle with your right arm.
3. Bring your feet back together, with your hands at your sides.
4. Bend your right knee and kick it back. Touch your right foot with your left hand.
5. Repeat.

Note: Switch sides.

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 Switch Jumps

1 2 3

1. Stand up straight with your feet together and your arms at your sides.
2. Jump your feet out to the side and touch the floor with your left hand.
3. Bring your feet back together, with your hands at your sides.
4. Jump your feet out to the side and touch the floor with your right hand.
5. Repeat.

Jumping Jacks

1. Stand with your feet together and your arms at your sides.
2. Jump and bring your arms and feet out to the side at the same time.
3. Jump and bring your feet back together, with your hands at your sides.
4. Repeat.

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 Same Side Ski Jumps

1. Stand with your feet together and your arms at your sides.
2. Jump forward with your left leg and bring your left arm up at the same time.
3. Jump forward with your right leg and bring your right arm up at the same time.
4. Repeat steps 2 through 3.

Opposite Side Ski Jumps

1. Stand with your feet together and your arms at your sides.
2. Jump forward with your left leg and bring your right arm up at the same time.
3. Jump forward with your right leg and bring your left arm up at the same time.
4. Repeat steps 2 through 3.

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 High Skips

1. Stand with your feet together and your arms at your sides.
2. Move forward hopping on your right foot while lifting your left knee toward your chest and raising your
right arm.
3. Repeat the movement on the opposite side.

High Step March

1. Stand with your feet together and your arms at your sides.
2. Kick forward your left leg and touch your left foot with your right arm (maintain a straight leg).
3. Kick forward your right leg and touch your right foot with your left arm (maintain a straight leg).
4. Repeat steps 2 through 3.

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 Trunk Twist

1. Sit on the floor with your knees bent and your legs crossed.
2. Lift your legs up from the floor.
3. Extend your arms and twist the body to reach the right side.
4. Extend your arms and twist the body to reach the left side.
5. Repeat steps 3 through 4.

Mountain Climber

1. Start in a plank position with your hands flat on the floor directly under your shoulders and your toes on
the floor.
2. Kick in your left knee to your chest.
3. Jump and kick in your right knee to your chest.
4. Repeat steps 2 through 3.

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 Side Sit Ups

1 2

3 4

1. Lay flat on the floor on your back with your arms at your sides and your knees bent.
2. Raise your torso off of the floor and extend your arms to the left side of your legs.
3. Lower down, bringing your head and shoulders to lay flat on the floor.
4. Raise your torso off of the floor and extend your arms to the right side of your legs.
5. Lower down, bringing your head and shoulders to lay flat on the floor.
6. Repeat.

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 Cross Crunch

1 2

3 4

1. Lay flat on the floor on your back with your arms at your sides and your knees bent.
2. Raise your torso off of the floor and bring your left knee to meet your right elbow.
3. Lower down, bringing your head and shoulders to lay flat on the floor.
4. Raise your torso off of the floor and bring your right knee to meet your left elbow.
5. Lower down, bringing your head and shoulders to lay flat on the floor.
6. Repeat.

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 Swimmer

1. Lay flat on your stomach on the floor with arms and legs extended.
2. Raise your left foot and your right arm off of the ground at the same time.
3. Lower your left foot and your right arm back to the ground.
4. Raise your right foot and your left arm off of the ground at the same time.
5. Lower your right foot and your left arm back to the ground.
6. Repeat steps 2 through 5

Crawl Lift

1 2

3 4

1. Begin with your hands and knees on the floor in a table top position.
2. Extend your left arm forward and your right leg backwards at the same time.
3. Return to a table top position.
4. Extend your right arm forward and your left leg backwards at the same time.
5. Return to a table top position.
6. Repeat steps 2 through 5.

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 Braiding

1 2 3

1. Stand up straight with your feet together and your arms at sides.
2. Cross your right foot in front of your left foot.
3. Step your left foot next to your right foot in a neutral standing position.
4. Cross your right foot behind your left foot.
5. Step your left foot next to your right foot in a neutral standing position.
6. Repeat steps 2 through 5 as you move in a sideways direction.

Note: Switch sides.

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 References
Developmental milestones. (2020, February 5). Chicago Occupational Therapy.
https://chicagooccupationaltherapy.com/developmental-milestones/
The ultimate guide to bilateral coordination skills. (2017, October 1). Your Therapy Source.
https://www.yourtherapysource.com/blog1/2017/10/01/bilateral-coordination-skills/
Ways to improve bilateral coordination in pediatric occupational therapy. (2017, February 21). Chicago Occupational
Therapy - Discover Why Parents Choose Us. https://chicagooccupationaltherapy.com/articles/bilateral-
coordination-and-how-pediatric-occupational-therapy-can-help/
What is bilateral coordination and why is it important? (2014, August 6). Child’s Play Therapy Center.
https://www.childsplaytherapycenter.com/bilateral-coordination-important/#:~:text=The%20following%
20activities%20are%20helpful,blocks%2C%20pop%2Dbeads%2C%20Legos

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