Bilateral coordination is the ability to use both sides of the body together in a coordinated way. It is also called bilateral integration.

Many childhood and school activities require your child to be able to use both hands together well.

Many kids with delays in this area would rather use one hand alone than both hands together, and may appear awkward or clumsy in certain tasks.

Here are just a few that may be challenging to a child with poor bilateral skills:

Gross Motor Activities

  • Jumping and skipping
  • Riding a bike
  • Catching a ball
  • Beating a drum
  • Pushing/pulling activities

Fine Motor Activities

  • Tying shoelaces
  • Threading beads
  • Using a knife and fork
  • Drawing a line with a ruler
  • Doing buttons
  • Lacing activities
  • Cutting with scissors

There are 3 basic Bilateral Movements:

1.    Symmetrical Movements

Symmetrical movements have each leg or hand doing the same action at the same time, for example rolling out pastry with a rolling pin, or clapping hands.

2.   Reciprocal Movements

Reciprocal movements are actions where first one hand or leg and then the other carries out the same movement in a rhythmical way.

Examples would be pulling a rope hand-over-hand or pedaling a bike.


3.   Leading Hand and Supporting Hand

Sometimes we use one hand to play a supporting role while the other hand does more skilled work, such as cutting with scissors, threading beads or drawing a line with a ruler.

Both hands are working together in a coordinated way, but one is leading and the other is supporting.

Bilateral Coordination Activities

Although symmetrical movements are often easier, your child does not have to master these before moving on to alternating movements – you can combine different kinds of movements through different activities.

A child will usually learn to coordinate the use of the arms before the use of the legs, and obviously, the hardest thing is for a child to use the arms and legs together in a coordinated way at the same time (star jumps/jumping jacks).

So keep that in mind as you try the following activities! Most importantly, have fun with your child!


Pulling hand over hand on a rope is a good way to get the hands working rhythmically together.

Try a Slinky – shifting the hands just enough to get the slinky springs to move back and forth between the hands is great fun.

Encourage your child to roll large balls of playdough between two hands to make smooth balls.

Find some maracas or musical shakers.  Try moving them up and down at the same time or alternately in time to music

Getting legs to move together is hard work. Start by having your child jump over a line and back again, one jump at a time.