Ways to Improve Bilateral Coordination in Pediatric Occupational Therapy

Bilateral coordination is our ability to use both sides of our bodies at the same time in a coordinated way. This means using our bodies to do the same thing on each side (e.g. rolling a rolling pin), bipedal movement (e.g. walking), or using different movements (e.g. using one hand to cut paper with scissors while the other holds the paper).

What does a delay in bilateral coordination look like?
If a child has typically developing bilateral coordination, it is a good indication that both sides of their brain are communicating and sharing information together. Children who experience delays in bilateral coordination have more difficulty sharing that information. Delays can result in trouble crawling, walking, tying shoes, drawing, or other activities that involve fine motor skills and hand-eye coordination. Children with delayed bilateral coordination might even appear clumsy or uncoordinated. If a child is experiencing these delays, they may be referred to a pediatric occupational therapist. During pediatric occupational therapy sessions, the child will work on improving the skills needed to complete daily activities (or occupations).

What kinds of activities can help improve a child’s bilateral coordination?
There are many activities that parents and/or pediatric occupational therapists can use to help children improve bilateral coordination. These activities can include simple symmetrical movements, alternating movements, and body awareness exercises. All of these activities are versatile and can be practiced in a range of environments, from a clinical occupational therapy session to a child’s play room at home.
Some simple symmetrical movement activities include playing catch and blowing bubbles. Playing catch is a great exercise for building coordination. As children throw the ball back and forth, they are encouraged to catch the ball with both hands and keep their eye on the ball. This not only helps with their bilateral coordination, but also with visual tracking skills and hand-eye coordination. When playing with bubbles, blow them into the air and have the child try to pop them with both hands. Also try to change the direction of where you blow the bubbles. Once the child has become more comfortable with popping the bubbles with both hands, the parent can encourage the child to start popping them with their right and left hand separately.

Activities that involve alternating movement include playing the drums, riding a tricycle (or bicycle), or swimming. While playing the drums, try to encourage the child to play with both hands and to copy the rhythm. Riding a tricycle or bicycle helps the child learn alternating movements from pedaling. If the child is not ready for a tricycle or bicycle yet, they can practice with an air bike, meaning that the child will lay on their back with their feet up in the air. If this is the first time they are trying this activity, it might be helpful for you to model pedaling before they do so. The child will then start pedaling in the air (on their own), just like they would on a real bike. Swimming is probably one of the best activities for helping children with bilateral coordination, as this activity requires continual use of both arms and legs. Swimming is also a great activity for strengthening core muscles, which are used to build better posture.

Body awareness activities can include games, such as ‘Simon Says,’ ‘Hokey Pokey,’ wheelbarrow walking, and animal walking. In games like ‘Simon Says’ and ‘Hokey Pokey,’ the child can improve coordination by following the directions within the song. Each game has repetitive movements that require the child to know where their body is in relation to the space around them (also known as proprioception) and uses symmetric and alternating movements. Wheelbarrow walking helps the child understand how their legs, arms, head, and trunk move; animal walking is great for the same concept. Children can have fun mimicking gorillas, bears, inch worms, snakes, and crabs, while also building pivotal skills.

Would you like to learn more about bilateral coordination and pediatric occupational therapy?

Contact Chicago Occupational Therapy to learn about the range of services we provide for children in Chicago including occupational therapy, ABA therapy, speech therapy, and a therapeutic preschool program.

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