Bilateral Integration Activities | The OT Toolbox

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.