Bilateral Integration


Children who present with delays in bilateral integration will have a tendency to use only one hand in an activity, for example they will write with one hand without using the other hand to stabilise the page. They may also struggle with activities which rely on the coordination of both hands, e.g. cutting, tying shoelaces, eating with a knife and fork, as well as bilateral gross motor activities such as riding a bike, skipping and galloping.

It is important that underlying difficulties receive attention first as they have an influence on bilateral integration. These difficulties may be the result of poor processing of the vestibular system, muscle tone, postural adjustment reflexes and other reflexes that have not yet been fully integrated.

Activities for in the car or when travelling

  • Sticker books. Let your child play with a sticker book when travelling longer distances, one hand must support the page of the book while the other hand pulls the stickers off.

  • Playing with magnetic tracing games where one hand must manipulate a magnetic “pen” while the other holds onto the base of the game.

  • Ball in a maze game: Let your children play with games where they must use both hands to manipulate a box so that the ball can run through the obstacle course and land in the hole at the end

  • Popping bubble wrap, hooking and unhooking paperclips, making paperclip chains, playing with Scooby-doo wires or loombands.

  • Slinky:Transfer a slinky from one hand to the other.

Inside and Art Activities

  • Constructional games, e.g. Lego, Zoob, building 3-dimensional models such as planes, cars, dinosaurs etc. using constructional type blocks. Both hands are required to engage in pushing and pulling.

  • When engaging in any art time activity, such as painting, doing stickers, stamps, cutting and pasting, they will always need a “working hand” and a “helping hand” to support the page while working with the other.

  • Doing art activities such as box construction, making collages, mosaic pictures etc. weekly will ensure further development of your child’s bilateral integration.

  • Marble art: Put marbles in paint and then inside a box with even bottom and let then marble roll around in the box. Your child can tilt and move the box around (using both hands) to get the marble rolling and thus painting the full surface of the box.

  • Musical shakers: Hold one in each hand. Try to move them rhythmically up and down at the same time or alternately in time to music.

  • Playdough:
    · Use a rolling pin to roll out dough.
    · Use two hands together to roll long playdough sausages.
    · Use two hands together to roll playdough balls.
    · Practise using a knife and fork together.

Outside Activities

  • Forward roll:

    Watch your child’s neck while they do this. Start with forward rolls on soft surfaces such as the bed, if your child struggles, you can allow them to hold a pillow initially.

  • Jumping activities:

    Let your child jump with both feet in a variation of games, such as hop-scotch or rope skipping games. Work in opportunities to jump forwards, backwards, sideways and over a variety of heights and objects.

  • Trampoline jumping games:

    Let your child jump on the trampoline (small or bigger size). Do starjumps, or try to jump high enough to bounce small balls off the trampoline.

  • Clapping games:

    A variety of clapping games can be played according to the skill level of the class or individual child. For example, simple rhythmic clapping to music or the beat of a metronome can be done with younger children and more complex copying of clapping sequences can be done with older children. Clapping games, such as “The sailor went to the sea”, are good practice and lots of fun.

  • Marching:

    Aim to swing arm opposite to lifted leg.

  • Star jumps

    Well coordinated star jumps typically develop between the ages of 5 and 6 years

  • Angels in the Snow:

    Level 1: For this activity the children must lie on their backs on the floor. Let the children move their arms and legs simultaneously in a “star jump” pattern. Repeat 10 times if no difficulty is experienced. Work towards achieving 10 slow repetitions with no timing and sequencing errors. Can also be done to the beat of a metronome.
    Level 2: Move arms, then legs. The upper and lower limb movements should be distinctly separate. Repeat 10 times if no difficulty is experienced. Work towards achieving 10 repetitions with no timing and sequencing errors. Can also be done to the beat of a metronome.
    Level 3: Move right arm and leg simultaneously, followed by the left arm and leg. The right and left limb movements should be distinctly separate. Repeat 10 times if no difficulty is experienced. Work towards achieving 10 repetitions with no timing and sequencing errors. Can also be done to the beat of a metronome.

  • Animal walks:

    Bunny Hops: Let your child hunch down and then put both arms forward and follow this action up with both legs jumping towards the arms.
    Frog jumps: Let your child jump with arms and legs simultaneously.
    Butterfly: Let your child lie on the floor on their backs. Open and close arms and legs simultaneously. This movement is quite similar to doing “angels in the snow” actions.

  • Playground Activities:

    Monkey bars, climbing, scooters and tricycles

Please be advised that the activities suggested within this website are selected to develop and improve specific areas of developmental difficulty. Engaging in these activities only, cannot replace the valuable input and guidance an Occupational Therapist (OT) can provide you with.

In order to benefit optimally from these activities, it is best advised to do these activities with the guidance of your OT. Many parents and caregivers benefit from attending an activity demonstration consultation. Although the activities selected are games that children often play at home or at school, and are generally safe to engage in, the Therapists at this practice cannot be held liable for any injuries occurring while playing any of these games.

Children learn through Play and having fun!! Research has proven that children who have fun are more motivated to learn and have better retention of the learnt skill! Enjoy playing and learning with your child!

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