Toggle site contrast Toggle Contract

Bilateral intergration and co-ordination

What is bilateral integration?

It’s a neurological process where the sensations from both sides of our body combine or ‘integrate’ together. Bilateral integration is a foundation skill for bilateral co-ordination but not something you can directly see.

What is bilateral co-ordination?

It’s the ability to use both sides of your body together in a smooth, simultaneous and co-ordinated way. There are 2 types.


Both hands and sides of the body do the same movement patterns, for example, clapping, using handlebars to steer a bike, using a rolling pin, or play volleyball.


Two hands or sides do different functions. One hand carries out the major manipulations of the activity and the other hand assists, for example:

  • using a knife and fork
  • holding the page whilst the other hand writes
  • holding paper whilst the other hand cuts with scissors
  • using your legs to peddle a bike.

Why is development of bilateral co-ordination important?

It contributes to establishing a dominant hand and the ability to cross the midline of the body.

Children with difficulty in crossing the midline typically use each hand only on its side of the body. For example, when picking up an object with the non-dominant hand and transferring it to the other hand rather than reach across the midline with the dominant hand. This can make movements look awkward.

Activities to support your child’s bilateral co-ordination development

Bubble pop method

Pop bubbles by accurately clapping hands together.

Variation: blow bubbles to both sides of the body to address midline crossing, tip and balance on a rocking board while clapping, poke bubbles with pointed index fingers.

Ensure your child tracks the bubbles with their eyes.

Balloon fun

Using both hands together, encourage your child to throw the balloon into the air and catch it.

Variation: keep the balloon afloat by repeatedly hitting it with open hands, bat it repeatedly with both hands clasped together in one large ‘fist.’

Ball activities and games

Encourage ball activities that require serving with one hand and hitting with the other, for example, tennis or badminton, bouncing with one hand then the other to various rhythms of increasing speed, and dribbling with alternating hands.

Jumping method

Ask your child to jump with two feet together, forwards, sideways, and backwards.

Variation: try clapping whilst jumping over line or rope. Or play sack races by asking your child to jump with their legs and lower torso in a pillowcase or sack in all directions.

Bouncing equipment

Using a large gym ball, ask your child to sit on the ball with your feet flat on the floor and arms on your lap. Start off by bouncing up and down on the ball then try ‘bounce, bounce, stop’.

Variation: ‘space hopper’, trampoline, or jumping on the bed.


Ask your child to sit on the floor with your feet flat and knees bent, back to back with a friend. Try to push each other over.

Variation: try to stand up by pushing against each other’s back. Ask your child to dig their heels into the ground, in high kneeling, place their palms on their friends’ palms and try to push against each other.