Development of Bilateral Coordination for Feeding Skills | The OT Toolbox

Development of Bilateral Coordination for Feeding Skills

Below, you will find information on development of bilateral coordination needed for feeding skills in kids who are challenged with using both hands together in a coordinated manner. Development of bilateral coordination skills is necessary for improved self-feeding in toddlers and improves through the childhood years.

When children learn to feed themselves and become more independent with self-feeding tool use with finger foods, utensils, or cups, development of bilateral coordination is one aspect that is necessary. When we think about self-feeding, problems can arise based on a variety of areas. Upper extremity coordination is one of those aspects that are evaluated and addressed when self-feeding difficulties are present. When thinking about development of self-feeding, consider the following issues related to bilateral coordination difficulty and try using some of the bilateral coordination activities based on development of bilateral coordination to improve feeding skills.




Discover typical development of bilateral coordination in feeding skills in kids, which are needed for improved independence in self-feeding.


Why is bilateral coordination important? 

When bilateral coordination or bilateral integration is intact and progressing appropriately through development, it is an indicator that both sides of the brain are communicating effectively and sharing information during functional tasks. 

Younger toddlers and babies can be observed using both hands in play as they pick up objects in their line of sight. However, they typically will pick up items with the hand that is closest to the object or toy. 

As toddlers progress in development, they will begin to establish a dominant hand and crossing midline. This ability to utilize a dominant hand and a non-dominant hand in activities indicates a maturation of the brain and lateralization in functional tasks, which is very important for motor planning, directionality, and visual motor skills. 

In fact, impaired bilateral coordination skills can lead to difficulty in the classroom.

Development of bilateral coordination in self-feeding depends greatly on the child's developmental level. The baby who is learning to place dry cereal in their mouth will be vastly different level than the child who is scooping soup or cutting a piece of chicken. Development of fine motor skills and visual motor skills have an impact on coordination of the hands in self-feeding.

What makes up bilateral coordination?

In fact, there are three components of bilateral coordination:
Symmetrical movements
Reciprocal movements
Dominant hand/supporting hand movements

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What does development of bilateral coordination look like in feeding skills?


Development of bilateral coordination occurs at every stage of childhood:

Newborn Self-Feeding

At the newborn stage, reflexes dominate movements. Babies aged 0-3 months will root, suckle, and swallow in feeding activities. This stage progresses as vision and motor control develop.

Development of  Bilateral Coordination in Feeding Skills at 4-6 Months

In this stage, development of coordination between the eyes and motor skills are just developing. The child explores with their eyes, hands, and mouth and will start to reach for objects purposely around four months. Accuracy of hand use is limited.

Development of Bilateral Coordination in Feeding Skills at 6-9 Months

At this stage, the child is typically sitting up with or without support. The child's hands are often times used in grasp with a clenched or a fist-like grasp. The child will begin to separate the thumb from the rest of the fingers to use a gross grasp on objects. Babies at this stage will typically place everything in their mouth, using both hands together in symmetry. The child will hold a bottle or cup with assistance, placing both hands on the cup/bottle, but are not able to hold the cup or bottle on their own.

Development of Bilateral Coordination in Feeding Skills at 9-12 Months

The child is able to sit upright without support and develops proximal stability, allowing for increased development of distal extremities. In this stage, babies are developing pincer grasp and thumb opposition skills. This stage brings the ability to hold one object in each hand such as two blocks. The baby will be able to bring both hands together at the same time. Children will be able to begin finger feeding skills around 9 months as they bring dry cereal foods to their mouth with a scraping motion.

Finger isolation on both hands begins as they poke foods and explore textures with their hands. Children will use both hands to smear food and bring soft foods such as wet foods like a cereal mix or applesauce to their mouth. The child will be able to hold a cup with both hands and bring it to their mouth.

The child will start to hold a spoon with a gross grasp, but without a dominant arm. At this stage, grasp of the spoon occurs with a palmer grasp. The child will not hold the bowl or plate with their non-assisting hand.

Development of Bilateral Coordination in Feeding Skills at 12-15 Months

In this stage, the child begins to dip their spoon into foods. They will have more accuracy with dipping as opposed to scooping foods. The spoon is help seith a digital grasp and the child will likely switch hands while holding the spoon. The child will lift and drink from a cup with one hand.

A scooper bowl with suction base can be  help with scooping development and bilateral coordination at this stage.

Development of Bilateral Coordination in Feeding Skills at 15-18 Months

The child is able to support the bowl with one hand while scooping with a spoon. Children can hold a small cup and pick out pieces of dry cereal or snacks. Fine motor skills are developing quickly.

Development of Bilateral Coordination in Feeding Skills at 18-24 Months

The child will typically be able to drink from a cup with accuracy and with one hand. There will be more coordination of the cup and accuracy, with less spillage. At this stage, the child will use a dominant hand in self-feeding and will begin to supinate the forearm when scooping with a spoon, resulting in greater accuracy.

Development of bilateral coordination for feeding skills is essential for accuracy and improving independence in self-feeding in kids.

Development of Bilateral Coordination in Feeding Skills at 24-36 Months

During this stage, the child's dominant hand is more established and the child can support with the non-dominant hand with greater accuracy. There will be greater control of forearm supination sor that the palm is facing upward when scooping. Typically, the child is able to self-feed without assistance.

Development of Bilateral Coordination in Feeding Skills at 3-4 Years

The child will begin to use a fork with improving accuracy. They can use a straw and hold the cup with one or both hands. The child will use both hands together with improving coordination in self-feeding.

Development of Bilateral Coordination in Feeding Skills at 4-5 Years

Children will be able to use a knife to spread butter or peanut butter with the dominant hand while holding the plate or bread with their non-dominant hand. Beginning use of child-friendly knives is appropriate. They will press with the knife rather than chopping or slicing.


Development of Bilateral Coordination in Feeding Skills at 5-6 Years

Children will use a fork and spoon accurately. They will be able to scoop, poke, and stab with a fork using appropriate positioning and without use of the non-dominant hand to support the plate. The child will begin to use a knife to cut foods.


Development of Bilateral Coordination in Feeding Skills 6+ Years

The child will be able to cut meat with a knife with increasing accuracy and ability. As they develop, the child will increase coordination with knife and fork use in a coordinated manner. Spilling of cups and foods decreases with age and development.

Attention in feeding tasks develops as children progress through the various stages, too. This makes a big difference in accuracy as well.


Development of bilateral coordination skills in feeding occurs throughout childhood.