Think about how many everyday tasks use both hands, or both sides of the body, at the same time. Holding a cup steady while pouring. Pulling up pants. Cutting with scissors while the other hand turns the paper. Climbing stairs one foot after the other. Catching a ball.
The ability to do this smoothly is called bilateral coordination. Most of us never think about it, because once it develops, it runs in the background. For some children, though, getting both sides of the body to work together takes more effort, and that can show up in surprising places: getting dressed, writing, mealtimes, sports, and play.
Here is what bilateral coordination is, how it usually develops, what it can look like when a child finds it harder, and simple, play-based ways to support it at home.
What is bilateral coordination?
Bilateral coordination means using both sides of the body together in an organized, controlled way. Sometimes both sides do the same thing, sometimes they take turns, and sometimes each side does a different job at the same time.
It depends on several systems working as a team:
- Balance and movement sense. The inner ear (the vestibular system) helps the body stay steady and know where it is in space.
- Body awareness. Signals from muscles and joints (proprioception) tell your child where their arms and legs are without needing to look.
- Vision. The eyes guide where the hands and feet go.
- Communication between the two sides of the brain. Each side of the brain controls the opposite side of the body, so the two sides need to share information quickly.
When these systems are in sync, a child can catch a ball, zip a jacket, or ride a scooter without having to think through every move.
How bilateral coordination develops
These skills build in a loose sequence through early childhood. Every child moves through them at their own pace.
- Both sides doing the same thing. Clapping, holding a big ball with two hands, pushing up on the floor during tummy time, jumping with two feet.
- Both sides taking turns. Crawling, walking, climbing stairs, pedaling a tricycle, marching. The left and right sides move in an alternating pattern.
- Each side doing a different job. One hand does the main work while the other helps. Think of one hand holding the paper while the other colors, or one hand holding a jar while the other twists the lid.
- Crossing the middle of the body. Reaching across the body with one hand, like a right hand reaching toward the left foot to put on a sock. This supports smooth movements across a page when reading and writing.
- A preferred hand. As these skills come together, one hand usually settles in as the “doer” for skilled tasks like drawing, eating, and throwing, while the other becomes the helper. Right or left does not matter. What matters is that a pattern develops over time.
What it can look like when it is harder
Some children need more time and support with bilateral coordination, including many children with autism, ADHD, sensory processing differences, low muscle tone, or developmental coordination differences. None of this is about effort or laziness. Their bodies are working harder to organize movement.
You might notice:
- Your child seems clumsier than other kids their age, or bumps into things often.
- Crawling was skipped or brief, or walking came later.
- Switching hands often during drawing, eating, or play, without a clear preferred hand by the early school years.
- Avoiding or getting frustrated with two-handed tasks like buttons, zippers, shoelaces, opening containers, or using a knife and fork.
- Using only one hand for tasks that need two, like letting the paper slide around while coloring.
- Trouble with jumping jacks, skipping, galloping, catching, or pumping on a swing.
- Turning the whole body, or switching hands, instead of reaching across the body.
- Avoiding arts and crafts, or finding scissors and other tools hard to manage.
Every child has some of these moments. What matters is whether the pattern keeps showing up and whether it is getting in the way of things your child wants or needs to do.
Play ideas to support bilateral coordination at home
The best practice does not feel like practice. Follow your child’s interests and turn these into games. Keep it short, keep it fun, and stop while your child is still enjoying it.
Both sides together
- Push a heavy laundry basket or a big box across the room.
- Squish, roll, and flatten play dough with both palms.
- Jump on a trampoline or hop like a frog with feet together.
- Toss and catch a large, soft ball or a balloon.
Taking turns
- Crawl through a tunnel or under a “bridge” of couch cushions.
- March, stomp, or drum along to music.
- Climb playground ladders and stairs.
- Ride a scooter, tricycle, or balance bike.
One hand works, one hand helps
- String big beads or cereal onto a pipe cleaner.
- Open and close containers to find a hidden treat or small toy.
- Tear paper into strips for a collage, then glue it down.
- Help in the kitchen: stirring while holding the bowl, spreading with a butter knife, peeling a clementine.
- Cut along thick lines with child-safe scissors while the other hand turns the paper.
Crossing the middle
- Draw big rainbows or figure eights on a large paper taped to a wall or on the sidewalk with chalk.
- Play “sticker reach”: place stickers on one side of your child’s body and have them peel them off with the opposite hand.
- Pass a beanbag around your waist, or play Simon Says with cross-body moves.
For more ideas sorted by skill and by the materials you already have at home, visit OTPlan.com.
A few tips for parents
- Follow your child’s lead. If your child loves trains, string “train cars.” If they love cooking, start in the kitchen. Interest builds persistence.
- Do not force a hand. Let your child’s preferred hand show up naturally. Left-handed is just as good as right-handed.
- Set up for success. Stabilize what you can. Tape paper to the table, use a non-slip mat under a bowl, and choose bigger, easier-to-grasp materials at first.
- Celebrate effort and small steps. “You held the paper still the whole time” means more than “good job.”
- Do not push before your child is ready. These skills develop over time. The goal is to make movement feel good, not to drill.
When to reach out to an occupational therapist
It can help to talk with a pediatric occupational therapist if bilateral coordination challenges are making daily life harder for your child, such as getting dressed, eating, writing, or joining in at the playground, or if your child is becoming frustrated or avoiding activities they used to enjoy.
An occupational therapist looks at what is happening underneath, including balance, body awareness, strength, and how your child takes in and organizes sensory information. Therapy is play-based, so your child builds these skills through swinging, climbing, building, and creating. A good therapist also shares ideas with your family, so the progress carries over to home and school.
How we can help
At Tumble N’ Dots in Irvine, all of our occupational therapists are sensory integration trained. We work with children from birth through age 12 and their families throughout Orange County, using child-led, play-based sessions that support coordination, confidence, and the everyday skills that matter most to your child.
If you are wondering whether your child could use some support, we would love to show you around. Schedule a tour of our clinic and see how we work.
This article is general information for parents and is not a substitute for an individualized evaluation.