Bilateral Coordination – Why Two Hands Are Better Than One

As an Occupational Therapist in Malta, I often notice that children who struggle with tasks like cutting with scissors, tying shoelaces, or catching a ball have something in common — difficulty using both hands together in a coordinated way. This is called bilateral coordination, and it is one of those foundational skills that underpins so much of what children do every day.

Bilateral coordination is the ability to use both sides of the body together in a controlled, organised manner. It might sound simple, but it requires the brain’s two hemispheres to communicate effectively — and when this communication is disrupted, everyday tasks can become surprisingly difficult.

What Does Bilateral Coordination Look Like?

There are three main types of bilateral coordination, and children need all three to function well:

• Symmetrical movements: Both hands doing the same thing at the same time, such as pushing a rolling pin, clapping, or catching a large ball
• Alternating movements: Hands or feet taking turns in a rhythmic pattern, such as climbing a ladder, drumming, or pedalling a bicycle
• Dominant-assist movements: One hand leads while the other supports, such as holding paper while cutting, stabilising a jar while unscrewing the lid, or holding a fork while cutting with a knife

Signs Your Child May Have Bilateral Coordination Difficulties

Children with poor bilateral coordination may not have an obvious diagnosis, but you might notice patterns such as:

• Avoiding two-handed tasks: Preferring to do everything one-handed or swapping hands frequently
• Difficulty with scissors: Struggling to hold the paper and cut at the same time
• Trouble with self-care: Challenges with buttons, zips, tying laces, or using a knife and fork together
• Delayed hand dominance: Not establishing a clear preferred hand by age 5-6
• Difficulty crossing midline: Avoiding reaching across the body, switching hands instead
• Challenges in sport: Struggling with catching, throwing, skipping, or swimming
• Messy handwriting: The non-dominant hand not stabilising the page, causing the paper to slide

Why Does Bilateral Coordination Matter?

Almost every meaningful activity in a child’s day requires bilateral coordination. Getting dressed in the morning, eating breakfast, writing at school, playing sport during break time, and participating in craft activities all depend on both hands working together. When this skill is underdeveloped, children may fall behind their peers, become frustrated, or start avoiding tasks altogether.

Bilateral coordination is also closely linked to crossing the midline — the imaginary line down the centre of the body. Children who struggle to reach across their midline often have difficulty with reading (tracking words across a page), writing (moving the hand fluidly across the paper), and coordinated physical activities.

How OT Builds Bilateral Coordination

At WonderKids, we use fun, engaging activities to develop bilateral coordination skills. Our approach is always play-based and tailored to your child’s specific needs. Activities might include:

• Climbing and swinging: Using both arms together to grip, pull, and stabilise on suspended equipment
• Drumming and rhythm games: Practising alternating movements in a motivating, musical context
• Craft activities: Tearing paper, threading beads, lacing cards — all requiring one hand to hold and the other to manipulate
• Ball games: Catching, throwing, and bouncing with two hands
• Midline crossing exercises: Activities that encourage reaching across the body, such as painting on a large surface or playing clapping games
• Resistance activities: Pulling apart construction toys, rolling dough, or wringing out sponges

Activities You Can Try at Home

Parents in Malta can support bilateral coordination development at home with simple, everyday activities:

• Cooking together: Stirring, rolling, kneading, and pouring all require two-handed coordination
• Water play: Squeezing sponges, pouring between containers, and wringing out cloths
• Outdoor play: Climbing at the playground, riding a bicycle, or playing catch
• Construction toys: LEGO, Duplo, or magnetic tiles require both hands to build

If your child struggles with tasks that require both hands working together, an occupational therapy assessment can help identify whether bilateral coordination is a contributing factor. Contact WonderKids on +356 77048650 or at info@wonderkids.mt.