What is “Crossing Midline”?

Imagine a line dividing your body into right and left sides.
Crossing Midline includes any activity that requires one side to cross into the
other side. Imagine using both hands to put on your shoes and socks, brushing your
teeth, using your tongue to manipulate food from one side of your mouth to the
other, combing your hair, reading, writing, etc.

Why is this important for brain development?

Crossing midline all starts with crawling, which typically
develops around age 7-11 months. Crawling is a very important developmental
milestone.  For many children, especially
those with Autism, Dyspraxia (motor in-coordination), or Dyslexia, they may
have “skipped” the crawling stage all together. Crawling is important because
it works on upper and lower body dissociation, trunk/core rotation, weight
bearing/weight shifting, reciprocal movement patterns, and dynamic movement
transitions (ie.: quadruped to side sit, quadruped to ½ kneel, etc.). This is
also a precursor for crossing midline which is necessary for the brain to
communicate across the corpus collosum, the thick band of nerve fibers which
connects the two brain hemispheres. This is required for higher level skills
such as reading and writing. In fact, research has shown that children with
dyslexia have smaller, less developed, corpus collosums.


Children who do not cross midline often do not develop hand
dominance which should be determined by age 5. Children who do not cross
midline often show symptoms including:

poor fine motor control (immature pencil grasp, poor
manipulation skills)

poor bilateral coordination (catching a ball, cutting

poor upper/lower body coordination (jumping jacks, riding a

poor right/left discrimination

becoming “stuck” in mid-reach and having to switch hands


Activities for home:

*Tip: For young children you may need to use stickers to
match/touch (i.e.: red for right hand/left knee) or use a piece of tape to
divide the body in half

relay-style ball game for crossing the midline

Gross Motor:

Cross crawls (bring your opposite hand, or elbow, to your
opposite knee) x20-30

Behind-the-back cross crawls (touch your right hand to your
left food behind your back so the child uses body awareness instead of vision!)

Sit criss-cross and throw a ball to a target on the opposite
side of the body (look for core rotation). Gradually increase the angle of the

Sit back-to-back (or for a group sit in a circle) and use
trunk rotation to turn and pass an object (i.e.: ball). Remember to go 10-20x
both directions!

crossing the midline ball game
Simon Says or Hokey Pokey for right/left discrimination
i.e.: “Touch your left ear with your right hand”

Fine Motor:

Hand games (Patty-cake, etc.)

Bongo drums (may have to use stickers to match opposite hand
to opposite drum)

Restrict one hand, and use opposite hand to reach/grasp a
variety of items, remember to reverse so both preferred and non-preferred hands
are used. (i.e.: Memory game cards, puzzle pieces, anything!)

Place x10 pennies or playing cards as a semi-circle across
the table. Make sure child is exactly  in the middle of the table and does not lean
over to compensate. Use one hand to flip each item over than the opposite hand
to flip over again.
crossing the midline during a game

 “Infinity 8” – draw a
horizontal  8 on the table, or better yet
on a verticle surface such as a mirror or easel. Position the child exactly
in the middle then trace the 8 with both hands together, then right, then left.
Do 5-10 loops per hand. This can be especially fun with shaving cream and toy
cars to make a “racetrack” on your table or window J

Wand play: Make a “Racetrack” (figure 8), “Ferris Wheel”
circles (in front), and “Helicopter” blades (overhead) with bubble wands,
streamers, scarves, ribbons, etc.


Great pictures and additional activities:


Amanda Masters, MS, OTR/L
Clinic Occupational Therapist – TheerapyWorks