Crossing Midline Activities

Crossing midline activities

In this blog post, we are covering all things crossing midline activities…but what is crossing midline?? We’ll get into that too, as well as some fun ways to develop midline crossing skills and specific exercises that kids (and all ages) can do to support development of this motor skills task that is huge in the way of gross motor coordination.

Crossing midline is one of those motor skills we do constantly throughout the day, but never really give a second thought. And that automaticity of motor movements is a good thing, too! Imagine processing the action to use one hand to pull a door open. Imagine the time it would take to shower, dress, put on and tie your shoes if you had to process through the action to move your hands fluidly across the middle line of your body.

As therapists, we hear “crossing the midline” all the time.  Have you ever wondered what the big deal is?  Why is crossing the midline so important?  In this post we will delve into what crossing the midline is, what causes issues, and how it impacts daily function, especially schoolwork.

Before we get started, if you are doubting the validity of crossing the midline, tie one hand behind your back and go about your day.  How much did you reach across your body to get something?  You reached across, diagonal, up and down to interact with your environment.  While a two-handed person does not do this much crossing the midline, there is still a fair amount.

Crossing midline activities and exercises for crossing the midline.

What is Crossing Midline?

Crossing midline refers to moving the body (hand/arm/foot/leg across an imaginary line that runs vertically down the center of the body to the other side (and vise versa). Additionally, crossing midline also refers to twisting the body in rotation around this imaginary line, as well as leaning the upper or body across the middle of the body.

Let’s break it down further:

Midline of the body is an imaginary line that drops from the middle of the head, straight down over the nose, to the belly button and divides the body into left and right sides.  Imagine a line that starts at the middle part of your hair and runs straight down your forehead and ends at the core of your abdomen. This imaginary line effectively divides your body into a symmetrical (mostly) left side and a right side.

Crossing the midline” is a simplified way to indicate that part of the body moves over that imaginary line. This can look like 3 different aspects of movement:

  1. Reaching an arm/hand or foot/leg across the middle of the body to the other side of the body (Example: Reaching the right arm across the body for an object placed on a table to the left side)
  2. Rotating the body around the midline in a rotary motion in order to twist at the hips. This can look like putting your hands on your hips and rotating your upper body around at the abdomen (Example: reaching for a seatbelt involves reaching the hand and arm across the midline but it also involves twisting at the hips)
  3. Leaning the upper body over the middle line as in doing a side crunch. The head and shoulders move over the middle of the body (Example: Bending sideways at the waist while getting dressed or reaching while sitting for an object that’s fallen to the floor)
What is crossing midline and why is it important to a child's development?

Crossing the midline is a motor skill that requires using both hands together in a coordinated manner (bilateral hand coordination) allows kids to cross midline during tasks. This bilateral coordination ability is deeply connected to crossing midline.

Why is Crossing Midline Important?

Midline crossing is a developmental ability that is important for so many fine motor and gross motor tasks. This relates to functional skills in a major way. When a child has difficulty with crossing midline, they will demonstrate challenges in practically every functional task.

When a child does efficiently cross the midline, they can use their dominant hand in skilled tasks.  They develop a dominant hand and the other extremity becomes the assisting hand.  They can manipulate objects in the world around them through all planes. They can demonstrate sensory integration by motor skills with vestibular, proprioceptive, and visual input.

In particular, crossing the midline offers vestibular input. Moving the head from center plane shifts position of the inner ears. When bending, twisting, and moving from center, the vestibular system is at work.

When the child does not cross the midline, they tend to use both hands equally in tasks like handwriting, coloring, and cutting with scissors. They may demonstrate awkward movements by moving the body to position itself so they don’t need to cross the middle line.

Challenges with this motor skill impact learning, social skills, play, and self-care.

In particular, we might notice sensory motor challenges at different age levels. For example, for children aged 3-5, we might see specific midline red flags that impact learning and play. We cover this specific age group in our blog post on Crossing Midline Activities for Preschoolers.

Child crossing midline to place one hand on opposite knee

Crossing Midline Occupational Therapy Asessments

Occupational therapists perform individualized evaluations and assessments of underlying skills as they impact functional performance in every day tasks. Because of this, crossing midline is an essential skill that will be observed and looked for in every OT evaluation.

Occupational therapists can complete a standardized evaluation, but most often, their skilled abilities will enable them to identify when crossing midline is a problem through play and interaction during the evaluation process.

When you are watching for midline crossing, you should observe kids playing in normal situations.  A child will demonstrate a tendency to avoid crossing midline in activities or tasks, but if “set up” to cross the midline (i.e. setting items to the left of the body and asking them to reach over the midline with their right hand), they will typically be able to complete the requested movement pattern, but not carry over the action in a normal situation.

If they have difficulty with crossing midline, a child will switch hands during handwriting because both hands get practice with pencil manipulation.  

The child might rotate their whole body instead of twisting at the trunk or shift their weight in a task rather than leaning the upper body over the midline.  

You can often times observe a tendency to avoid midline crossing in activities such as kicking a ball, throwing beanbags, switching hands in coloring, difficulty with putting on pants and shoes independently, and difficulty with visual tracking and reading.

Crossing the midline exercise for child

Crossing Midline Activities

So, what do you do when crossing the midline is an issue? There are many ways to support the development of this skill.

The ideas listed below are fun ways to play and develop motor skills by crossing midline, however they have a sensory component too.

We mentioned above the aspect of vestibular input and proprioceptive input that occurs in crossing the midline. These midline activities have those sensory motor considerations through play.

  • Rotate the body in a twisting motion.
  • Bend the upper body side to side.
  • Play Simon Says. Use these therapy Simon Says commands to get you started.
  • Play hand clapping games
  • Thread lids on a long string – Position string and beads or lids at different placements to encourage crossing the midline.
  • Wash a large wall with big swooping arm motions.
  • Erase a large chalkboard.
  • Scoop balloons in a water bin.
  • Wash a car.  Encourage the child to use large circular motions with the sponge.
  • Kick a ball.
  • Yoga
  • Dinosaur Gross Motor Game
  • Brain Gym Bilateral Coordination activities
  • Toss bean bags -Encourage upper body movement! Bend through the legs, turn sideways, reach back behind you, rotate side to side…encourage vestibular input by bending and rotating.
  • Squirt gun activities at targets.
  • Play with magnets on the garage door.
  • Play Twister.
  • Slow motion cartwheels- Place both hands on the floor to the side, kick legs over. By doing the cartwheel in slow motion, the body is forced to move sequentially, adding midline crossing at the trunk.
  • Hit a ball with a bat.
  • Use pool noodles to hit a ball- think hockey and hitting the ball into a target on the floor
  • Play catch with rolled socks- Use a bucket or bin to catch the rolled socks. They will fly high, low, left, and right!
  • Play flashlight tag.
  • Catch lighting bugs or butterflies.
  • Show the child how to write their name in the air with large arm movements.
  • Bend over at the waist and swing the arm side to side, in large circles, and in figure 8 motions.
  • Play with scarves to music.
  • Move a ribbon wand to music.
Midline march. Crossing midline gross motor activity to help with handwriting, and bilateral hand coordination skill.

Crossing the Midline Exercises

I love this crossing midline exercise below, because it has a ton of different movement options with one fun activity.

We had fun one winter day with a few crossing the midline exercises, including marching, crossing arms over, and stomping out some wiggles.

Our midline march activity was a marching parade with “Stop Stations”.  We marched along to music and when I turned off the sound, the kids had to do a midline exercise.    

The midline exercises included:

  • Place left hand on right knee
  • Place right hand on left knee
  • Stand and bend to touch the opposite foot
  • Standing and place right elbow on left knee
  • Standing and place left elbow on right knee
  • Crunches with touching right elbow to left knee
  • Crunches with touching left elbow to right knee
  • Cherry picker crunches- lay on the back slightly bent forward at the hips so the upper body is off the ground. Move a ball or small toy from the right side to the left side.

Because we were doing these midline exercises to music that quickly stopped and started, the thought process was quick. The kids had to quickly complete the exercise without much forethought.

This quick start and stop activity allowed them to practice crossing midline without over-thinking about the action.

Child crossing the midline with hand on knee
Child crossing midline with hand on opposite knee

Fine Motor Crossing Midline Exercises

Crossing the midline can be done on a small scale, too. This activity is similar to the midline marching activity described above, but it uses paper, pencil, and small colored dots such as stickers or a small circle drawn with markers.

  1. Draw dots on the left margin of a paper using colored markers or colored stickers. There should be one of each color going down the left margin.
  2. Draw dots using the same colors going down the right margin. Use each color only once.
  3. Turn on music. The student can draw to music on the center of the page using their pencil or markers.
  4. Turn off the music. When the music stops, call out a direction: “Left hand, yellow!” The student should put down their marker and touch the yellow dot on the right margin using their left hand.
  5. Turn on the music to draw again and repeat.

This activity is similar to the gross motor midline exercise because it requires the child to think on the spot. They have to listen to several instructions, but also process the motor skills and cross the midline automatically.

You can adjust this activity by numbering the dots, using less colors, or less dots, and reducing the amount of instructions. This activity can be used with any level by grading the activity.

Child bending to touch hand to opposite foot to cross the midline.

This post is part of the Gross Motor A-Z series hosted by Still Playing School. You can see all of the gross motor activities here.

Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to

Types of Scissors

Types of scissors

Did you know there are many different types of scissors to support development of scissor skills? It’s true! No matter the motor skill ability, there are different type of scissors that supports that ability or skill development. Cutting skills, like writing, are a foundational fine motor skill.  Just as you would spend time selecting the right pen/pencil, makeup, hair accessory, or pair of shoes, it is important to select the correct types of scissors.

Types of scissors and why each different type is used

Why do different types of scissors matter?  

What do you look for when selecting that perfect pair of shoes?

  • Fit
  • Size
  • Price
  • Durability
  • Reputation, reviews
  • Quality
  • Functionality 

Believe it or not, the same care can be placed in selecting the correct pair of scissors.  This is especially important if your learner has fine motor delays, hand weakness, difficulty with motor planning/coordination, small/large/irregular hands, or a diagnosis impacting their skills.

Here are a few real life examples:

  • Lula is 4 years old with dwarfism.  Her hands are tiny.  Her parents would be very unlikely to buy her shoes that fit a grown man.  At her school, Lula was provided with regular sized scissors, thus struggling to learn this important skill.
  • James is 7 and has Down Syndrome.  Not only are his hands weak, but they are small.  While care is taken to select the right shoes and clothes for him, selecting the right scissors is just as important.
  • Marcy is 5 year old and has cerebral palsy, limiting her hand and arm movements.  She too should have extra consideration in the type of scissors that she uses.
Different types of scissors

What are the options for types of scissors?

*Disclamer – Many of the following product recommendations are affiliate links from AmazonThis does not mean these are the best, just the easiest to find.  If you prefer another vendor, check out the examples below, then type them into your Google search bar.

1. Small Sized scissors

Beginner small-sized scissors- These scissors are all small in size.  They are not just for small hands.  These are great for learners with all types of fine motor issues, and hand weakness.

These beginner scissors are Amazon affiliate links.

  • I like these toddler sized scissors because they are very small.  They are great for tiny hands, or learners with fine motor weakness.
  • This learning pack of scissors contains toddler sized scissors, as well as training scissors.  See below for more information about training scissors.
  • Sewing scissors are great because they are tiny, however, they are SHARP!  If you are going to use these, either dull the edges with a file, or be extra careful with your learners.
  • These Benbow Scissors, made by Mary Benbow are the gold standard of training scissors.  

2. Training Scissors

Training scissors should be used as a stepping stone to graduating to a higher level type of scissors, once they are mastered.  If training scissors are not mastered, your learner can use these indefinitely.

The training scissors listed below are Amazon affiliate links.

  • Self-opening scissors: many learners are able to pinch their fingers together long before they can open them during cutting at will. The key to motivation is success.  While using these scissors, the hands get valuable feedback of this cutting motion. These self opening scissors fit the price and durability category, but they do not fit the functionality definition. These blunt scissors, while inherently safer than sharp scissors, do not cut well, and cause more frustration than progress.
  • Spring-assist scissors- This pair of self opening scissors or these soft-grip scissors fit the function, and durability categories. They are more expensive, but cut better than safety scissors.  They are larger than the toddler scissors, so be sure that size is not a concern first
  • Double loop scissors – While I do not like that these are labeled “mother and child scissors” (because this is not inclusive), they work well.  People learn by doing.  Kinesthetic awareness is learning by moving.  These double loop scissors give your learner the feedback needed to practice and learn the cutting motion
  • Trialing two kinds of scissors- This scissor pack has double loop scissors and self opening scissors to trial different kinds of scissors with your learners, or progress forward as they develop skills.

3. Scissors for Special Needs

There are times when traditional scissors do not work and a specific adaptive scissor type is required. If your learner has weakness, a hand injury, tremors, increased/decreased muscle tone, or another long term condition, various scissors for special need areas are a good option. 

Scissors in this category include loop scissors, block scissors, tabletop scissors, and electric scissors.

For learners with small hands, or who are developing hand strength, I would recommend self opening scissors first, or using these adaptive scissor types for a very short period of time.

These different types of scissors designed to meet specific needs are Amazon affiliate links.

Loop scissors – These are also described as self-opening scissors.  Some learners can not isolate their fingers enough to work traditional scissors, or have a sensory aversion to sticking their fingers into the little holes on the handles of the scissors. These spring open once depressed.  They do take a fair amount of strength to grip for a prolonged amount of time, so these may not be the best choice for your learners with low tone or decreased strength (unless of course you are looking for a tool to increase strength).  

  • While these mini loop scissors at 5.5 inches are smaller and take less grip strength, they also do not cut very fast, instead making small snips.
  • These larger loop scissors at 8 inches are a great choice for stronger hands.
  • These self opening loop type scissors are popular. They require less dexterity than traditional scissors, but they do not cut very well.  Because the mouth of the scissors does not open wide, they do not make large cuts.

Scissors for Limited mobility –  For learners missing digits, or with limited grasp, such as amputees or quadruplegic patients, use of just one upper extremity, visual challenges, or other mobility and coordination concerns, these tabletop scissors can be fastened to a table with a clamp or velcro to assist in opening containers.  They are not great for intricate cutting, as they are labor intensive and can be frustrating, but more usable for self help skills. 

Power option – for learners with limited mobility or fine motor dexterity, electric scissors can be a motivating option for cutting.  They take some strength and coordination, but can be helpful for learners who can not use traditional scissors. These types of scissors take some practice to get used to them.

Left handed Scissors

Similar to questions on left-handed writing, teachers and parents are forever inquiring about left handed scissors and how to help with left handed cutting. 

What is the left handed scissors difference?

There is definitely a difference between left-handed scissors and right-handed scissors. Right-handed scissors have the right blade positioned on top, whereas left-handed scissors have the left blade positioned on top. This prevents unnecessary bending and tearing of the paper. This difference between left and right handed scissors also allows each user to maintain a clear visual view of the cutting line.

Scissor handles are often molded to accommodate either the left or right hand. When manufacturers claim they have created a pair of ambidextrous scissors, be aware that such a thing does not exist. They have simply created a “neutral” handle accessible for the both left and right hand. The blades are still right-hand oriented. Thus, left-handed users should not be given scissors marketed as being appropriate for both left-handers and right-handers.

True left handed scissors have the cutting blade positioned on the top. Neutral scissors or scissors that can fit both left and right hands may cause additional frustrations.

Read more on the term ambidextrous and what this means for functional tasks such as cutting with scissors.

There are several types of scissors for lefty’s available, but what are the best left handed scissors?

These basic lefty scissors (affiliate link) are ideal.  If it wasn’t such a right handed world, I would recommend these to all lefties. 

Being a lefty myself, I understand the benefit and fit of left handed scissors. The majority of scissors your learner will encounter will be right handed, so it is better to learn and adapt to traditional scissors. There are only a few left handed items that are necessary (can opener, ice cream scoop, binder, ladle, vegetable peeler.)

Tips for Left handed cutting:

  • Use sharp scissors – this way the blade has less chance of just bending the paper instead of neatly slicing through it
  • Don right handed scissors upside down – for some reason putting the thumb in the fingers hole changes the blade position, and makes cutting easier. 
  • Lefties cut CLOCKWISE.  Righties cut COUNTERCLOCKWISE.  This is important.  If your learner cuts in the wrong direction, this leaves them without the ability to hold onto and turn the piece of paper that is being cut.  Try it!

time to learn to cut

Now that you have selected the right fit, durability, functionality, and quality of scissors for your learner, it is time to learn to cut!  The OT Toolbox has multiple posts and products available for practicing scissor skills.  There is a comprehensive scissor skills guide available also.

The key to cutting skills

  • Thumb and middle finger in the scissor loops.  You can add ring finger into the loops if they are large.  Pointer finger stays out and points the way.  This adds to hand stability and opens the arches of the hand further.
  • Thumbs up!  The helper hand grips the object being cut, with their thumb facing up.  This gives the object being held greater stability, and ease of movement. All of the various types of scissors could have a sticker added as an additional adaptation to help with positioning.
  • How to hold scissors – check out this helpful post on the OT Toolbox
  • Steps of scissor skill development
  • Scissor Skills
  • Scissor Skills Crash Course

Guide to Types of Scissors

Want a printable guide to the various types of scissors? You are in luck. We have a one page printable guide that shows images of the different versions of scissors on the market. These are the different scissor types you might see in a therapists’ therapy bag!

Now you can quickly share information on why each type of scissor might be used and determine which type of scissor to use based on the individual needs of the learner.

To get your copy, just enter your email into the form below.

This handout set is also available in our OT Toolbox Member’s Club.

Current Membership Club members can log into your account and head to the dashboard toolbox labeled “Scissor Skills Downloads“. Print off the handouts without the need to enter an email address.

Want to add this resource to your therapy toolbox so you can help kids thrive? Enter your email into the form below to access this printable tool.

Want to add this resource to your therapy toolbox so you can help kids thrive? Enter your email into the form below to access this printable tool.

This resource is just one of the many tools available in The OT Toolbox Member’s Club. Each month, members get instant access to downloadable activities, handouts, worksheets, and printable tools to support development. Members can log into their dashboard and access all of our free downloads in one place. Plus, you’ll find exclusive materials and premium level materials.

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FREE Handout: Types of Scissors

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    a final note on selecting the correct types of scissors

    Pamper your learner with a great pair of scissors, just like you do when you purchase those amazing shoes.  Fit and function over price. Quality always wins.  Fiskars are the gold standard for traditional scissors, and the one type almost every therapy provider has in their OT bag of tricks.  They cut paper well and come in tons of sizes and designs. 

    So…what are the worst scissors?  Most therapists agree that those “safety scissors” that don’t cut anything except maybe playdough are absolutely the worst.  Save those for playdough, and upgrade when it comes to cutting anything else. 

    Victoria Wood, OTR/L is a contributor to The OT Toolbox and has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.

    *The term, “learner” is used throughout this post for readability, however this information is relevant for students, patients, clients, children of all ages and stages, or whomever could benefit from these resources. The term “they” is used instead of he/she to be inclusive.

    Looking for tips, strategies, and activities to support development of scissor skills? Grab a copy of The Scissor Skills Book!

    The Scissor Skills Book breaks the functional skill of cutting with scissors into several developmental areas including:

    • Developmental progression of scissor use
    • Fine motor skill involvement
    • Gross motor development
    • Sensory considerations and visual perceptual skills

    Each section includes strategies and tips to improve these underlying areas.

    • Help for kids who struggle with cutting accurately
    • Creative tips to keep things interesting for kids who lose interest easily
    • Quick, practical strategies that can be put into action today!
    • Ideas for kids who cut too fast or too slow
    • Support for kids who can’t grasp scissors efficiently
    • Strategies for right-handed and left-handed children

    Click here to get your copy today.