Bilateral Integration Activities

Bilateral integration activities

Bilateral Integration is an area that kids need for so many tasks…but it’s not a developmental milestone that stands out unless a problem is necessarily noticed. From writing and holding the paper, to holding a art project and cutting with scissors, to zippering a jacket, coordinating both sides of the body in an efficient manner is a skill that is necessary for almost everything we do. Bilateral coordination develops from a very young age. When babies begin to bring both hands together at their mouth, you are seeing coordinated efforts begin. When the infant pushes up on both arms while lying in a tummy time position, the integrated movements of both hands and legs occurs along with strength and control. Here you will find bilateral integration activities that can be incorporated at various ages. Use these bilateral coordination activities to promote coordinated and efficient movements in meaningful activities.

These bilateral coordination activities are creative ways to help kids with bilateral integration needed for fine motor tasks like handwriting, scissor use, and other functional skills.

Bilateral Integration Activities 

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First, let’s talk about some ways that coordinated use of the arms and legs are needed for coordinated movements. These are skills and tasks that can easily be performed by some children. Others, who struggle with motor planning, core strength, posture needs, left-right discrimination, visual motor skills, or many other areas can struggle. It’s easy to see that simply addressing some areas won’t fix the issue when an underlying concern is present.

Tasks that require bilateral integration

Know a child (or adult) who struggles with one or more of the tasks below? Bilateral integration may be a challenge.

  • Writing and holding the paper in a stable position
  • Cutting and holding the paper steady and at an appropriate height
  • Putting on a coat while holding a backpack (or other item)
  • Tying shoes
  • Pulling up pants and not losing balance
  • Putting socks on
  • Jumping jacks with coordinated movements
  • Turning a page and writing or copying work
  • Typing
  • Playing an instrument
  • Reaching for objects
  • Stabilizing an object with one hand while manipulating another object with the other
  • Jumping rope
  • Catching a ball
  • Riding a bike
  • Swimming

To promote the skills needed for these tasks, try some of the activities listed below to promote bilateral integration:

Related Read: Here are are some additional bilateral coordination activities with a winter theme.

Bilateral Integration Activities for Babies

Provide various toys and objects appropriate for young babies. Include bold colored objects including black, white, and red items or contrasting colors, toys, or pictures on a blanket or play mat during tummy time. This black and white board book can be propped up or used while on an adult’s lap.

Provide gentle infant massage during and after bath time, and on all extremities. Here is a resource book on infant massage.

Provide toys and age-appropriate objects for reach and grasp. This banana toothbrush teether has molded handles that make it a great teething item for little ones.

Provide teething toys as baby brings hands together at their mouth.

Provide toys that are appropriate for mouthing that can be held in both hands.

Provide hand-held toys while the child is seated in a high chair. This one has a suction cup base to keep it stable, but has a black and white ring at the base that babies can grasp with one hand while manipulating with the other hand.

Provide toys of various weights when seated upright to provide resistance against gravity and to promote strengthening of the upper extremities. Blocks, rings, sorting toys, or something like this quality teething toy made of heavier materials can be useful to provide variances in weight, while still allowing the baby to manipulate the item.

Provide toys available on a high chair or table surface at various distances to provide opportunities for depth of perception when reaching for toys and bringing them to the mouth.

Continue tummy time while playing in prone to promote strength and stability in upper extremities

Bilateral Integration Activities for Toddlers

Provide toys requiring one hand to stabilize a base while the other hands manipulates an object. Shape sorters are great for this.

Other toys include:

Peg Boards

Blocks- These press and stay sensory blocks are perfect for encouraging one hand to use as a stabilizer and one hand as a

Play Dough

Drawing/coloring- Here is more information on the benefits of coloring.

Bilateral Integration Activities for Preschool

Encourage kids to participate in cooking activities.

Use play dough to cut with scissors and roll out play dough snakes or balls of play dough.

Age-appropriate crafts and craft sets are great for this age.

Play with stickers of various sizes.

Make “snow angels” on a carpet or fluffy blanket

Simon Says is a great game for encouraging novel and varied motor combinations.

Play various song and movement games such as the Hokey Pokey, Farmer in the Dell, etc. Here are movement and song activities that can be used in circle time, warm-ups, centers, or in group activities. All of these move and dance songs promote core strength and stability.

Climb on outdoor play areas at playgrounds and in low trees.

Add sensory! Try this table top bilateral coordination activity to draw shapes.

Draw with both hands! This four leaf clover activity is a powerful one as it covers a variety of skills.

Bilateral Coordination Activities for School-Aged Kids

Folding origami or other paper crafts are great at this age.

Try these gross motor dinosaur themed movements with a DIY game.

Fold paper airplanes.

Work on letter matching and eye hand coordination with a DIY rolling surface toy.

Build with LEGOS or other building toys.

Try craft activities such as beading, jewelry making, or perler bead crafts.

Build and create with Pop Tubes. This bilateral coordination activity is fun.

Weaving activities.

Lacing activities.

Try making this bilateral coordination weaving activity.

Try these bilateral integration activities and coordination ideas to promote use of both hands together in activities such as handwriting, cutting with scissors and so many other tasks!

Last thoughts on encouraging bilateral integration

The best way to encourage and promote integration of both sides of the body? Movement and play! Get the kids active, moving, and experiencing various planes against resistance and with exposure to all types of sensory experiences. The combination of proprioceptive input into a play experience that promotes strengthening in a fun way provides all of the benefits kids need to improve bilateral coordination skills. Add personal interests as the child grows. And finally, have fun!

Use these bilateral coordination activities to promote bilateral integration needed for skills like writing and holding the paper and any activity that uses one hand to manipulate an object while stabilizing with the other hand.

Spring Occupational Therapy Activities Packet

Spring occupational therapy activities

Looking for activities to add into therapy sessions, recommend in home programs, or to use in the classroom or home? You probably want ideas that promote developmental skills that kids need for effective and functional skills. That’s why I’ve put together the Spring Occupational Therapy Activities Packet! 


This time of year, one of our more popular products here on The OT Toolbox is our Spring Occupational Therapy packet. The best news is that, this packet has had a major upgrade from it’s previous collection of spring sensory activities.

Spring Occupational Therapy Activities  for kids.



In the Spring OT packet, you’ll now find:

  • Spring Proprioceptive Activities
  • Spring Vestibular Activities
  • Spring Visual Processing Activities
  • Spring Tactile Processing Activities
  • Spring Olfactory Activities
  • Spring Auditory Processing Activities
  • Spring Oral Motor Activities
  • Spring Fine Motor Activities
  • Spring Gross Motor Activities
  • Spring Handwriting Practice Prompts
  • Spring Themed Brain Breaks
  • Occupational Therapy Homework Page
  • Client-Centered Worksheet
  • 5 pages of Visual Perceptual Skill Activities

All of the Spring activities include ideas to promote the various areas of sensory processing with a Spring-theme. There are ways to upgrade and downgrade the activities and each activities includes strategies to incorporate eye-hand coordination, bilateral coordination, body scheme, oculomotor control, visual perception, fine and gross motor skills, and more.



It’s a really popular product on the site this time of year. I’ve doubled the size of this packet and added:

Spring Visual Perception Worksheets- Print these off and slide them into a page protector. Use them to work on visual perceptual skills like form discrimination, visual closure, figure ground, and visual processing skills like tracking, scanning, etc. Use manipulative items to work on fine motor skills with these worksheets such as play dough, slime, Wikki Stix, yarn, craft pom poms, or other items.

Spring Fine Motor and Gross Motor Activities- Add these ideas to therapy home programs to work on pencil grasp or core strength. Use these ideas in therapy warm-ups, or to add movement to a child’s day.

Spring Themed Brain Breaks- Cut up these cards and use them to add movement and motor skills into the classroom or home. It’s a great way to re-charge!

Spring Themed Handwriting Practice Prompts- There are two pages of writing prompts that are ONLY in list form. That means kids don’t need to write out sentences while working on letter formation, spacing and size. They can work on all of the handwriting skills they need in a short list that is interest-based, making it motivational for them. And, the list format is a quick way to sneak in handwriting practice!

OT Homework Sheet- Sometimes, it takes extra practice to make skills “stick”. When parents help in practicing therapy activities, it can make a difference in carryover. You’ll find a done-for-you OT homework sheet to use in weekly homework activities OR for use as a home exercise program!

Client-Centered Worksheet- When our kiddos have a voice in their therapy, carryover and goals can be more meaningful to them. Use this worksheet to come up with Spring activities that meet the needs of a child, while taking into considerations that child’s interests and strengths to make activities meaningful.

Sensory Activities and More- All of these extras were added to the already well-rounded Spring packet that includes activities designed around each of the sensory systems. You’ll find 13 pages of proprioception activities, vestibular activities, tactile activities, oral motor activities, etc. And, they include ideas to extend the activity to include eye-hand coordination, body scheme, oculomotor control, visual perception, coordination, and motor planning.

This Spring Packet has everything you need for the next three months!
You’ll also find several sheets listing tons of Spring activities designed to promote specific areas:

  • Spring Fine Motor Activities
  • Spring Gross Motor Activities
  • Spring Handwriting Practice Prompts
  • Spring Themed Brain Breaks
Use these activities as warm-ups to your therapy sessions, or add them to the homework page below to create a home program. 

Use this Spring Occupational Therapy Activities packet to come up with fresh activity ideas to promote fine motor skills, gross motor skills, balance, coordination, visual motor skills, sensory processing, and more.

The Best thing about the Spring Activity Packet:

One of my favorite parts of the Spring Occupational Therapy Packet is the therapist tool section:

  • Occupational Therapy Homework Page
  • Client-Centered Worksheet

These two sheets are perfect for the therapist looking to incorporate carryover of skills. Use the homework page to provide specific OT recommended activities to be completed at home. This is great for those sills that parents strive to see success in but need more practice time for achieving certain skill levels.

The Client-Centered Worksheet is a great way to incorporate the client’s specific interests and goals so that overarching goal areas and functional goals incorporate interests and personal strengths, achieving that “just right” level of skill.

CLICK HERE to grab the Spring Occupational Therapy Activity Packet for just $7.99.

Finally, included in the Packet are several sheets of visual perception activities. These are worksheets that can be used in so many ways! Laminate them or slide them into a page protector and use them over and over again with a variety of tools such as play dough balls (work those fine motor skills!), pain dabbers, craft pom poms, wikki stix, or dry erase markers. These sheets can be printed off once and used over and over again with the whole caseload, using them in different ways.

  • 5 pages of Visual Perceptual Skill Activities
I’m so excited to get this updated packet out to you. If you’re looking for ways to make therapy planning easy for the next few months, grab your copy here. 

This activity packet is 26 pages long and has everything you need to work on the skills kids are struggling with…with a Spring theme!

Here’s the link again to grab that packet.

Use this Spring Occupational Therapy Activities Packet to work on occupational therapy goals and functional skills with a spring theme.

Spring fine motor activities, spring gross motor skills, visual motor skills, handwriting, sensory processing, and strengthening are just some of the ways to use a spring theme in occupational therapy.
NOTE: This packet is not intended as treatment or intervention. It’s to be used as an educational resource and in conjunction with therapy plans as indicated by a child’s therapist following individualized evaluation. Activities should be completed under supervision by an adult.