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Bilateral Integration – Crossing the Midline

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Bilateral integration is the process of learning to use the opposite sides of the body and brain to perform everyday activities. Although the activities and skills required to perform tasks that build bilateral integration appear physical in nature, they also activate the two hemispheres of the brain preparing the brain to tackle higher order thinking and learning skills as your child enters his academic career.

How Do Children Learn Bilateral Integration?

There are a number of steps or milestones that children attain during normal development that lead to full bilateral integration.

Symmetrical Bilateral Integration: During infancy and toddlerhood children perform symmetrical tasks. This includes learning to play patty-cake where both sides of the body perform the same task. Other symmetrical tasks include jumping with both feet together, clapping or banging on pots and pans. You may notice your little one splashing in water by hitting the surface of the water with both hands using an identical motion.

Reciprocal Bilateral Integration: Once a child masters symmetrical bilateral integration, he will move on to tasks involving reciprocal movements from each side of the body. The task performed on one side of the body will be opposite the task performed on the other. Arms and legs will swing or perform in an opposite motion. Examples of reciprocal bilateral integration include learning to crawl, walk, climb stairs, skip and other activities that require opposite movements from the arms and legs. In older children this includes pedaling a bike or climbing a ladder.

Asymmetrical Bilateral Integration: At this stage the child has typically developed a dominate hand and will use it to perform a task while the non-dominant hand or foot performs a different task. Initially, asymmetrical bilateral integration involves using the dominant hand to perform the task while keeping the non-dominant hand steady, such as putting toothpaste on a toothbrush or stabilizing a coloring paper with one hand and coloring with the other. As the child develops more advanced asymmetrical bilateral integration skills, he can then tackle tasks like buttoning and zipping his clothing or tying his shoes. This also includes cutting with scissors.

Crossing the Midline Bilateral integration: Once a child has established the first three stages of bilateral integration, he is ready to move on to crossing the midline. This means he is able to cross an imaginary line that divides the two sides of the body to perform a task. This stage is vital to learning to perform cognitive tasks that require the use of both hemispheres of the brain. Some examples of activities that cross the midline include: touching the left shoulder with the right hand, touching the right hand to the left toe, and other physical activities that require the hand or foot on one side of the body to perform a task on the opposite side. It also includes reaching across the imaginary midline to color a paper, pick up toys or cards in a game, or to write the letters of the alphabet.


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Why is Crossing the Midline So Important?

Crossing the midline shows that the two sides (hemispheres) of the brain are able to communicate efficiently. This allows your child to access the information and attributes from both sides of the brain. The left hemisphere is traditionally considered the center for logical and factual information while the right hemisphere is the center for feelings, language and creativity. When these two hemispheres communicate well, your child can perform the tasks required for reading, writing and mathematical reasoning. In addition, failure to cross the midline may make it difficult for a child to track writing across a page in reading and may hinder his ability to complete worksheets or complete patterns or recognize sequences that carry across a page.

Can You Correct Problems with Crossing the Midline?

Yes. Many children respond favorably to activities that build their skill at crossing the midline. These include physical exercises, like touching the opposite hand to the toes, touching the opposite shoulder with his hands and touching the opposite elbow to a raised knee. It even includes learning to do the old chorus line dance where opposite legs are raised and cross the midline to music. Other activities include pen and paper tasks, such as drawing a line to match objects from columns of either side of the page. A therapist is often useful in teaching your child to build strong bilateral integration skills, but you can do activities at home too.


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