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Crossing midline … What it means, why it’s important and signs your child may need OT


Have you been told that your child is having difficulty crossing midline? Maybe they’re having difficulties getting dressed, reading left to right or even establishing a hand dominance? Catching a ball or riding a bike may also be difficult for them.

For most of us, crossing midline is something that just comes naturally; it’s not something you had to be taught. However, crossing midline can be difficult for some children and can contribute to delays in development.


Let’s start first with what crossing midline even means …

Did you know that you have an imaginary line that runs down the middle of your body? Well, it’s true! There are two sides of the body and in order for both sides to work together, they must cross this imaginary line. At the very basic level, crossing the midline is when we move our arm or leg across the middle of our body to perform a task. Before this skill is well established, children are usually observed to engage in tasks on only one side of their body, for example: reaching for an item placed on their left side with only their left hand.


Why it’s important

Developing this skill promotes the coordination and communication of the left and right sides of the brain. It also encourages bilateral coordination, the process of developing a dominant hand and development of fine-motor skills.

It may seem simple in theory but it requires the involvement of many skills including: body awareness, hand-eye coordination, muscular strength and most importantly brain communication. Developing this skill is the building block for the development of additional complex motor and cognitive skills such as reading, writing, self-care activities and physical activity.


When a child has trouble crossing midline, it can affect their ability to read. Their eyes may stop in the middle and frequently lose place. It can affect handwriting since a child must cross the midline in order to write from left to right; the child may need to stop in the middle of the page to switch hands.


Many self-care and daily living skills like putting on shoes/socks and brushing teeth require crossing the midline as well. Lastly, the inability to cross midline impacts eating. Children may have trouble properly moving food around in order to chew and swallow.


Signs your child may be struggling with this:

  • Not establishing hand dominance past the age of 5. Your child may appear “ambidextrous” using both of their hands to draw, eat and color.

  • Poor fine motor control including an immature pencil grip and trouble manipulating objects in their hands

  • Trouble catching a ball or using scissors which requires bilateral coordination.

  • Under developed upper/lower body coordination (jumping jacks, riding a bike), and poor right/left discrimination.

This list is not exhaustive but provides some examples that may help determine whether your child needs a little extra help developing these OH SO IMPORTANT skills.


If you are observing these things with your child, it may be a sign they need occupational therapy.

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