Bilateral Coordination

OT Talk

The ability to use both sides of the body in the performance of a task isn’t something that would often occur to typically functioning individuals. It seems natural to roll the rolling pin with both hands, or hold the jar in one hand while opening it with the other. For those with developmental coordination disorder (DCD), coordinating both sides of the body at the same time – or bilateral coordination – can prove a mammoth task.

Bilateral coordination can refer to situations in which we use both sides of our bodies simultaneously doing either the same movement, opposing movement or reciprocal (alternating) movements. The importance of bilateral coordination – and the impact of its dysfunction – should not be underestimated.  The range of tasks we complete with both sides of our bodies in sync are numerous and often conducted on a daily basis. They include, but are by no means limited to;


  • Tying shoe laces
  • Walking
  • Climbing
  • Stirring food in a bowl
  • Using tools that require two hands
  • Drawing
  • Riding a bike

Definition corner
Technical terms used in OT can be overwhelming at first. This descriptive list is here to help you if you’re unsure of something J

Bilateral coordination (also referred to as bilateral integration): the coordination of both sides of the body in the performance of a task. This can be symmetrical, reciprocal or opposing movements.

Midline: an internalised, intangible line which marks the start and end of each side of the body.

Vestibular processing: interpretation of movement and equilibrioception (balance). Vestibular system processes information about movement and head position.

This particular delay in DCD is often associated with poor vestibular (movement) processing, and can be very pronounced in tasks that require a crossing of the midline. Naturally, difficulties in these tasks can become very frustrating. Luckily, occupational therapy can provide some easy-access activities to help improve your child’s bilateral coordination.

  • Crawling – Crawling is a fantastic activity that promotes the coordinated use of all four major limbs. It’s also an activity that can be incorporated into games devised by the child. For example, try crawling races, or crawling “obstacle courses”.


  • Jumping in sync – get those legs moving together! Jumping with both legs is a great way of training synchronous bilateral coordination. Try games such as jumping over sticks, or “one leg” jumping races.


  • Jumping jacks – with similar benefits to number 2, this activity will also encourage the top half of the body to get in sync.


  • Arts and crafts activities are a great way of developing different roles for each hand. Cutting, colouring, and stencil drawing allow for one hand to stabilise while the other is busy with the task. The same effect can also be availed from opening and closing simple containers.


  • Air biking: Whilst lying on your back, raise your legs and pretend you’re peddling on a bicycle. This provides reciprocal bilateral coordination without the added pressures that often come with actually riding a bike (direction and steering, equilibrated force etc).


If you have queries in relation to the material covered above, consult an Occupational Therapist who can prescribe adapted activities to meet your child’s specific needs.

Natalie Halloran B.Sc. (Hons) Occupational Therapy | OT Network

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Natalie is experienced in the field of intellectual disability and currently practices as a private clinician, providing community based services in a wide variety of settings including schools.

View Natalie’s practice listing on the OT Network

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