Bilateral coordination is the ability to use both sides of the body together in a smooth, controlled and purposeful way. It sounds simple, but it is actually a sophisticated skill that underlies many everyday activities.

Think about cutting with scissors — one hand holds the paper, the other moves the scissors. Tying shoelaces requires both hands doing different things simultaneously. Playing with Lego, catching a ball, climbing a ladder — all of these depend on bilateral coordination working well.

Why Bilateral Coordination Matters

Beyond the specific tasks it enables, bilateral coordination reflects the maturity of connections between the two hemispheres of the brain. When both sides of the brain communicate efficiently, children find it easier to cross the body’s midline — a foundational skill for reading, writing and many physical activities.

Children who struggle with bilateral coordination often appear clumsy, avoid certain activities or tire quickly from tasks that peers manage easily.

Developmental Milestones

Bilateral coordination develops gradually through childhood. Here is what to expect at each stage:

• 12–18 months: Claps hands together, bangs objects on surfaces
• 2 years: Turns pages of a book, holds a cup with two hands
• 3 years: Strings beads, holds paper while drawing
• 4 years: Uses scissors while stabilising paper with the other hand
• 5 years: Cuts simple shapes, manages buttons and zip
• 6–7 years: Ties shoelaces, uses knife and fork together

Keep in mind that these are averages. Some variation is entirely normal. Consistent difficulty across multiple tasks is more meaningful than delay in any single skill.

Signs of Bilateral Coordination Difficulties

If your child:

• Avoids using scissors or manages them one-handed
• Holds paper with the same hand they write with
• Struggles to clap in rhythm or pedal a bicycle
• Has not established a consistent hand preference by age 4–5
• Avoids activities like Lego, craft or climbing

…then it may be worth seeking a paediatric OT assessment.

Fun Activities to Build Bilateral Coordination

The best way to develop bilateral coordination is through play. These activities are enjoyable and genuinely effective.

For Younger Children (2–4 years)

• Drum play: Banging drums or pots and pans with both hands develops rhythmic bilateral movement.
• Tearing paper: Tearing strips of paper or newspaper uses both hands in a coordinated way.
• Stacking blocks: Using one hand to stabilise while the other places blocks.
• Water play: Squeezing and filling containers develops hand strength and coordination.

For School-Age Children (5–10 years)

• Cutting activities: Cutting along lines, then curves, then shapes. Progress from thick card to thin paper.
• Lacing and sewing cards: Threading a lace through holes requires precise bilateral coordination.
• Ball games: Catching, throwing and bouncing with two hands. Clapping games with a partner.
• Skipping rope: Both solo skipping and turning the rope for others builds coordination.
• Cooking and baking: Kneading dough, rolling pastry, stirring — all excellent for bilateral skills.
• Craft activities: Weaving, knitting (with supervision), origami.

Active Play That Builds Both-Sides Skills

• Climbing frames and monkey bars
• Swimming (especially breaststroke and backstroke)
• Riding a bicycle or scooter
• Gymnastics and martial arts

In Malta’s climate, outdoor play is possible year-round — take advantage of it. Physical play is one of the most powerful developmental tools we have.

How OT Can Help

When bilateral coordination difficulties are affecting a child’s daily function or school performance, OT provides targeted assessment and intervention. I identify the specific nature of the difficulty — whether it relates to motor planning, core stability, sensory processing or something else — and design activities to address it directly.

Progress is achievable with consistent practice. Most children make significant gains with a structured programme and good home follow-through.

If you’re concerned about your child’s development, contact us at +356 99872936 or visit wonderkids.mt to book an assessment.

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