Bilateral Co-ordination – What is it?

By June 2, 2022 May 14th, 2023 Occupational Therapy
Child doing activity on gym ball for bilateral coordination in Occupational Therapy Clinic with Occupational Therapist in Bondi Junction and Mascot in Sydney

Bilateral Coordination

What is bilateral coordination and why is it important?

Bilateral coordination, also known as bilateral integration, refers to one’s ability to simultaneously control and coordinate both sides of the body.

Children who have difficulty with bilateral coordination have trouble with fine motor tasks, visual motor tasks, activities or daily living and gross motor activities.

What are the different types of bilateral movements?

There are different types of bilateral movements that a child needs to develop:

  1. Symmetrical movements – This involves both hands or legs performing the same action at the same time (i.e. rolling out playdoh, clapping, jumping with feet together, catching a ball)
  1. Reciprocal movements – These are alternating movements. Both arms or legs need to carry out the same actions, just at different times (i.e. marching, pedalling a bike, pulling rope hand over hand, climbing a ladder)
  1. Asymmetrical movements – This involves one hand taking on the skilled work and the other acting as a support. This is required for activities such as cutting, writing, drawing, threading, and kicking a ball.

 Signs that a child has poor bilateral coordination

 Indicators of poor bilateral coordination are:

  • Difficulty cutting with scissors
  • Trouble with handwriting
  • Difficulty tying shoelaces
  • Unable to dress independently
  • Clumsy
  • Difficulty catching a ball
  • Struggle with gross motor movements and activities


Activities to develop bilateral coordination


  • Hand clapping activities – popping bubbles
  • Threading and beading activities
  • Cutting practice
  • Playdoh and utensils
  • Banging a drum and other musical instruments
  • Building lego
  • Cleaning dishes
  • Dribbling a ball and practicing other ball skills