Bilateral Integration: Stages of Bilateral Integration for Reading, Tracking, Writing and Crossing the Midline

This article provides helpful information for developing your child’s bilateral integration. Affiliate links are included for your convenience. Integrated Learning Strategies (ILS) is a learning and academic center. As a reminder, ILS is not a health care provider and none of our materials or services provide a diagnosis or treatment of a specific condition or learning challenge you may see in your child or student. If you seek a diagnosis or treatment for your child or student, please contact a trained professional who can provide an evaluation of the child.

As your child grows from a toddler to a small child, it’s fun to watch them reach developmental milestones that prepare them for learning. One of those developmental milestones your child begins to develop almost automatically is their dominance. Over time, your child will start showing signs of favoring one hand or foot over the other, which is preparatory for writing and for sports. This is what we call lateral dominance. Lateral dominance refers to your child’s preferred use, or inclination for favoring one hand, eye, or foot in skilled activities over the other side of the body.

As your child’s dominance begins to emerge, you will notice several other types of developmental stages that eventually prepare your child for writing, reading, problem solving, creativity, critical thinking and reasoning. Bilateral integration is one of these important developmental stages that goes along with establishing dominance. These stages are often referred to as bilateral milestones and each one aids in creating a stronger foundation for your child’s learning.

Why Lateralization is Important

We want children to establish laterality and dominance to prevent learning challenges as they grow older. Gaps in learning could stem from poor bilateral coordination and mixed dominance, which can prevent your child from tracking, reading, listening to the teacher, comprehension and expressive and receptive language. Here’s what to watch for in your child’s development.

Bilateral Integration

While laterality is the dominance of one side of the body, humans are bilateral animals because we have two sides of the body; therefore we need bilateral activities and movements for greater learning. Bilateral integration creates the opportunity for your child to use both sides of their body in a coordinated manner. This includes hands, eyes, arms, legs, feet and the brain. Your child must develop bilateral coordination in all parts of the body to perform fine motor skills, gross motor tasks, walking, logical thinking, studying, and the list goes on and on. This is why you see a two-year-old frequently eating with both hands, why they scribble with a crayon in either hand, why they push a wagon with both feet, and why they jump off the playground with both feet at the same time.

If your child has plenty of opportunity to experience sensory and motor experiences as a baby and toddler, the brain matures sequentially and their bilateral integration transitions smoothly. However, when it comes to certain functions and tasks, your child will establish dominance and the brain will start to specialize in one side of the brain.

Laterality

Laterality describes an important change in your child’s brain where it becomes aware of the two sides of the body and its differences and similarities. The brain starts to recognize that perhaps one hand or one foot is better at certain skills than the other. Eventually, you will want your child to choose a dominant foot, eye, ear and hand for learning, preferably on the same side of the body to prevent confusion in the brain.

If your child shows signs of mixed dominance, for some, it could create learning challenges as they grow older. Because the brain is divided into two hemispheres (right and the left), you may notice your child living more in the right side of the brain while they are younger (creative) and eventually work toward the left side of their brain as they grow older, which is used for more higher learning tasks (logical thinking, reading, writing).

Mixed Dominance

If your child displays signs of mixed dominance, they typically use alternating hands, feet, eyes and ears for different tasks or they switch back and forth between different hands, feet and eyes for different activities. For example, your child may have a dominant left eye, but a dominant right hand (opposite dominance).

Many children have mixed dominance and show no signs of learning challenges, but for some, this can create confusion in the brain when it comes to their learning ability. The reasoning behind this concept is because the left and right hemispheres of the brain store different information. For example, visual information comes in through the left eye and is stored in the right hemisphere, where all auditory information comes in through the right ear and is stored in the left hemisphere of the brain. What you have to ask yourself is how does your child receive and interpret different information? Are they a visual learner or an auditory learner? If possible, establishing same-side dominance will help them store and receive information better in the classroom.

In Reflexes, Learning and Behavior, Sally Goddard says, “The effect of mixed laterality can be failure to send information to the most efficient center in the brain for that skill; competition between two centers may occur which is rather like having two people in the front of a car, both wanting to drive and both trying to navigate.”

Cross Laterality

When your child is young and hand dominance is not yet set, you may notice they constantly cross over the midline to reach an object. They will use their right hand on the left side of the body and vice versa. This means they are exercising those neural pathways in the brain, setting up the body and brain for excelling in motor skills and higher learning. This is a great sign that they are developing their cross laterality milestones, which is also important for developing their bilateral coordination. It means the two sides of the brain are talking with each other, which is how your child will eventually learn their letters, recognize sounds, shapes, colors, numbers and follow instructions.

If your child struggles to cross the midline and does not develop their cross laterality milestones, you may notice a breakdown in their auditory and visual learning abilities in the classroom. For instance, they may struggle with simple tasks that require bi-lateralization, like holding their paper with their left hand while they write across the page with their right hand. Your child could also show signs of a retained Asymmetrical Tonic Neck Reflex (ATNR), which stems from birth and prevents your child from crossing the midline.

Bilateral Integration Stages

What is amazing about bilateral integration and lateral dominance is the two go hand-in-hand. As your child grows, their bilateral integration eventually transitions into lateral dominance. For instance, in the example above, your toddler may begin coloring with both hands, but they will eventually select a preferred right or left hand to color, draw and write with as they get older.

According to Carol Kranowitz in The Out-Of-Sync Child Has Fun, bilateral integration develops as babies grow and learn to move their limbs and torsos. As they develop, sometimes the movements are symmetrical, sometimes they occur in opposite directions, and other times they coordinate movements between limbs. Bilateral integration happens in stages. When your child is developing, you may notice they will go through each bilateral integration stage in a sequential order. Research shows, as your child ages and develops, different bilateral skills and exercises increase with efficiency.

The five stages of bilateral integration are: Symmetrical Bilateral Integration, Reciprocal Bilateral Integration, Asymmetrical Bilateral Integration, Crossing the Midline, and Bilateral Development for Academic Skills.

Symmetrical Bilateral Integration

When your child is in the process of developing their symmetrical bilateral integration, both sides of the body mirror each other. As you observe your child, you will notice each side of their body is mirroring the exact movement or action at the same time. For example, your child may bring their hands to their face at the same time, clap their hands together, and swing their legs at the same time. As they get older and become more active, you will see them use their symmetrical bilateral skills as they jump rope, use a rolling pin, do the bunny hop, pop bubbles with both hands, and use certain musical instruments like symbols and drums with both hands at the same time.

Reciprocal Bilateral Integration

In this stage of bilateral integration, one side of the body does the exact opposite movement or action of the other side of the body. Crawling or creeping are prime examples of this phase. Swinging one arm forwards while the other swings back is also another illustration. Other activities that incorporate reciprocal bi-lateralization in your child can include walking, climbing stairs, riding a bicycle, skipping, hopscotch, and swimming. These are all rhythmic activities that follow the reciprocal movement patterns.

Asymmetrical Bilateral Integration

This is a very important and critical phase of bilateral integration for your child. It’s where each side of the body learns to perform a different and separate task, but both sides cooperate on the same activity. In this stage, the brain must coordinate two streams of skilled thinking. As your child develops their asymmetrical bilateral integration, they will start using their skills for coloring on paper while other hand holds paper, they will use scissors to cut a piece of paper, spread peanut butter on bread, stir food in a bowl, trace around stencils and string beads through thread. The dominant hand does the main task, while the non-dominant hand stabilizes the action.

Crossing the Midline

In the previous stage the brain has accomplished the goal of coordinating both sides. In this phase, crossing the midline equates to the extremities or senses by crossing an imaginary line down the body, dividing it right from left. This is where your child may start dribbling a soccer ball, kicking with the dominant foot in a cross pass, picking up a pencil by crossing over their shoulder, hitting a ball with a bat, and touching their toes with the opposite hands.

Bilateral Development for Academic Skills

This stage accumulates all prior movements and achievements from prior phases and puts them to work. Academic skills rely on good bilateral integration and solid midline crossing development. Without the ability to cross the midline smoothly, a student will struggle with reading and writing. For example, when a child is reading, the eyes must follow the entire line before moving to the next line of text. Without well-developed bilateral integration skills, your child’s eyes will follow the first few words and then pause and continue to finish the rest of the words on that line. This pause means your child cannot instinctively cross the midline with their eyes.

Any type of coloring, writing or drawing will be affected as well if bilateral integration is poorly developed. If the hand is not naturally able to cross the midline easily then the brain pauses to think out the movement instead of it being instinctual. Asymmetrical bilateral skills are also essential for writing as the non-dominant hand is expected to hold the paper as the dominant hand is forming letters and writing words.

As we start to understand the stages a child goes through to master complete bilateral integration, we can check their skills to determine how they are progressing. Children are expected to begin preschool with certain bilateral skills such as: control of large movements of their extremities, walking up stairs, holding a crayon, walking, and carrying a small bin of toys. The finer movements of these activities will come later. As the child moves into kindergarten and older grades, teachers expect that a child has increased control of all muscle movements and can exercise precision in fine motor skills.

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