What is bilateral integration, and why is it a big deal?

Bilateral integration is the ability to use both sides of our bodies together. It is a skill that children typically develop as they grow and gain experiences through play and exploring. Children move on from activities in which both sides of their body perform the same action, e.g. clapping, to more challenging activities in which their arms or legs might be doing different things simultaneously. For some activities, this means that one hand becomes the dominant hand, typically doing the more complex and refined actions, whilst the other hand becomes the ‘helping hand’, e.g. to stabilise the paper whilst writing.

Bilateral integration is a key element for the production of smooth and coordinated gross and fine motor movements needed for all activities. Examples include getting dressed, bottom wiping, using cutlery and handwriting, and many, many more.

Bilateral integration develops as children’s skills develop. It relies on a number of underlying skills, including efficient sensory processing. This means being able to interpret messages from the muscles about their position, movement and force. Children also need good core stability and strong abdominal and back muscles. This in turn enables them to be able to rotate their bodies and reach across their bodies with ease. The effective sequencing and ability to anticipate and plan body movements is also key.

If your child has been seen by one of our Occupational Therapists and challenges with bilateral integration skills have been identified, suggestions to support this may include fun activities that will help to develop their core strength, establish their hand dominance and refine their fine motor skills. 

I like to do games using a large gym ball. Children can sit on it and reach up and across their bodies to pop bubbles or bat a balloon. Rolling over the ball onto outstretched hands and then reaching up and across to collect treasure is also a favourite. 

In handwriting sessions children can draw around their hands, colour them in and laminate these to make a visual prompt to remind them to hold the page with this hand. Creative activities like cutting and sticking can help children to refine and develop these skills too. I like to work using the young person’s interests as much as possible as this helps hugely with motivation and engagement. These ideas can then be shared with parents and school staff to ensure ongoing practice in between sessions.

Practice, as always, is the key to permanence and skill refinement. Have fun exploring!

Rachel White
Children’s Occupational Therapist