Bilateral Integration

Buttering toast, skipping with a rope, cutting with scissors… These are all tasks that require the use of bilateral integration.

Bilateral integration is the ability to use both sides of the body together in a coordinated way. This can be either as a symmetrical movement where both hands work together at the same time or in an alternating movement.

Bilateral integration is essential for your child being able to complete fine motor (small hand and arm movement) and gross motor (bigger body movement) tasks.

How bilateral integration skills develop

Since they were born, your little miss or mister learnt to use both sides of their body in stages.

As babies, they started using both hands together when performing the same action, such as doing the 'happy baby' yoga move (grasping the left foot in their left hand and right foot in their right hand while lying on their back).

Junior then graduated to tasks that keep one hand still while the other moves, such as shaking a rattle with a single hand.

Later, they began using both hands at the same time, each doing something different like holding the teddy in one hand while the fingers on the other hand explored teddy’s facial features.

How do I know if my child is having difficulty with their bilateral integration?

Your little one may have bilateral integration difficulties if they do any of the following:

  • Appear not to have a dominant (preferred) hand
  • Swap hands during tasks
  • Avoid using one side of the body
  • Tire quickly or become increasingly frustrated in tabletop activities
  • Lean to one side when doing tabletop activities
  • Show difficulty in doing tasks that require two hands (e.g. tying their shoelaces, using a knife and fork, scissor tasks, ball skills)
  • Struggle with construction games (e.g. Lego), cutting tasks, threading
  • Have difficulty playing musical instruments (e.g. hitting a drum with two drumsticks)
  • Struggle with hopping or jumping

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Fun Activities

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Ways you can help your child with their bilateral integration

Do you think little miss or mister would benefit from working on their bilateral integration skills? Have a go at the following fun activities:

  • Playing with playdough (e.g. moulding shapes, cutting with implements, decorating)
  • Building with blocks
  • Cooking (e.g. holding a bowl and stirring with the other hand)
  • Puzzles
  • Threading activities (e.g. with beads, macaroni)
  • Screwing/unscrewing nuts and bolts
  • Ball games that involve catching and throwing with two hands and batting (e.g. cricket)
  • Singing songs that involve actions such as clapping
  • Playing musical instruments such as triangles and tambourines
  • Pulling nesting cups apart and putting them back together
  • Blowing bubbles and reaching with both hands to pop them
  • Tearing strips of paper and pasting them with glue to make a collage
  • Stringing beads or dried pasta to make jewellery
  • Cutting and pasting



Some additional tips for improving your child’s bilateral integration

Whenever you can, remind junior to use their non-dominant hand as a 'stabiliser' (to hold the item steady) when holding paper to cut, draw or write.



You can also put a stamp/star at the top left corner of the page for right-handers or the top right corner of the page for left-handers to remind little miss or mister where to put their stabilising hand.

Or you can even just trace your child's hand on the appropriate corner to help prompt them.

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Combined Videos

Combining several foundation skills, our PlayBiz Play-a-Long videos run for 10 minutes or so. We’ve carefully ordered the activities so they enable your youngster to have an optimal learning experience and develop the skills they’ll need for school by joining in the ‘teachable moments’. Picture a fun and educational TV program like PlaySchool crossed with an occupational therapy session that’s chock full of tailor-made strategies. Ready, steady, learn! Please note: The Play-a-Long videos don’t need to be viewed in any particular order.