Crossing Midline

Occupational Therapy Department

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Crossing Midline (230kB pdf)

What is Crossing Midline?

Imagine a line drawn down from your child’s head to your feet which separates the right and left halves of the body. In order for a child to co-ordinate, they need to be able to cross this line. The brain is split in to two halves, the right side of the brain controls the left side of the body and the left side of the brain controls the right side of the body. To allow the child to use both sides of their body in a co-ordinated way, they need both sides of their brain and both sides of their body to work together. Being able to cross the midline is an important developmental skill.  It is needed for reading and writing, for dressing, for participating in many sports and many other day to day activities.

Why children may have some difficulties?

Children who have difficulty reaching across their middle may have to switch hands when doing an activity. Or they may compensate by turning their trunk to reach toward the opposite side. Poor midline crossing also makes it difficult to visually track a moving object from one side to the other, or to fully track from left to right when reading. If they avoid crossing midline it will interfere with their development of hand dominance, and make tasks that involve the use of two hands very difficult. These tasks may include:

• Tying shoelaces
• Coordinating a knife and fork
• Reading and writing
• Ball games
• Drawing and cutting skills

Strategies to help

• Position toys to the side, encourage them to use their opposite arm to reach across for toys. You can make this a game as they reach for items in your hand.

• Play sorting games: place objects to sort on the left side and containers to place them in on the right side; sort coins, cars or trucks, pompoms, marbles, etc.  

• Floor play: when playing on the floor, encourage your child to lean on one hand or elbow. Place the toys or games on the side being leaned on. This forces the child to cross the middle when playing.

• Throwing a beanbag with one hand to a container placed on the other side of the body.

• Draw large figure eights on paper, in sand, in the air with a finger, in shaving foam on a shower screen.

• While they are kneeling down, ask the child to draw a large rainbow on paper on the floor, ensuring the rainbow covers the whole page and the child uses the same hand. You could also do this using chalk outside.

• Let the child play with sand, scooping sand from one side of the body and putting it into a bucket on the opposite side of the body without switching hands.

• Create a figure 8 track for cars to drive around. Child should use one hand to get the car all the way around.

• Let your child help with washing the car and make sure their arms cross midline while scrubbing.

• The child can pretend to drive a car with a ball or plastic plate in both hands to use as a steering wheel, cross both arms while turning the “steering wheel”.

• Pop bubbles with only one hand (they will have to reach across their body to pop the bubbles floating on the opposite side).

• Play balloon tennis using one hand only and ensuring there are a lot of movements that encourage crossing the midline.

• Use a frisbee, throwing to the opposite side.

• Play flashlight tag. In a dimmed room, lie on your backs and have the child follow your flashlight beam projected on the wall with his own flashlight, shining it across the body.

• Cross one foot over the other while walking sideways.

• Knee Slap Walk- The child walks around raising each knee while touching/slapping it with the opposite hand (or elbow). Change it to a skip while touching the opposite knee as it comes up.

• Bend over at waist and tap right hand to left foot. Stand back up and then bend and tap left hand to right foot.

• Play body awareness games like the Hokey Kokey and Simon Says

Contact us

If you require any further information, please contact your occupational therapist.

This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.

This information can be made available in other languages and formats if requested.

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