What’s the Big Deal with Midline?

Crossing the body midline is the ability to reach across the middle of the body with the arms and legs crossing over to the opposite side. Draw an imaginary line down the centre of the body and that is your midline. Crossing midline is an important developmental skill needed to be successful in learning and school. By the age of 3 or 4, a child should have mastered the bilateral skill.

Building blocks necessary to develop the ability to cross the body's midline include:

  • Bilateral integration skills (using both sides of the body at the same time).
  • Core stability and trunk rotation
  • Hand dominance
  • Planning and sequencing
  • Body awareness

You can tell there are problems with crossing the body's midline if the child:

  • Switches hands when writing, drawing, painting and colouring.
  • Uses left hand for activities on the left side of the body and right hand for activities on the right hand side.
  • Rotates their trunk to the opposite side when reaching across the body.
  • Has difficulty tracking an object from one side of the body to the other.
  • Has poor reading skills.
  • Has poor pencil skills.
  • Uses different feet to kick a ball.
  • Has difficulty coordinating gross motor patterns (e.g. crawling, skipping, star-jumps).

When you see difficulties with crossing the body's midline, you might also see difficulties with:

  • Pencil based activities – a child may avoid these activities.
  • Behaviour – a child may become angry or frustrated when engaging in fine motor activities due to less refined hand skills.
  • Performing self-care tasks independently (age influenced).
  • Coordinating both sides of the body.
  • Reading
  • Noticing all of the details on a page when copying drawings or writing.

What can be done to improve the ability to cross the body's midline?

  • Bilateral Integration Skills (using both sides of the body at the same time).
  • Daily Life Skills: Incorporate some midline crossing activities into your daily life.
  • Core Stability: Work on core stability and trunk rotation.

Activities that can help improve crossing the body's midline include:

  • Craft: Threading beads, cutting and pasting, folding paper.
  • Finger Puppets: Placing finger puppets on one hand and encouraging your child to remove the puppets with the opposite hand.
  • Blocks and Percussion: Getting your child tobang blocks or percussion instruments together in their midline.
  • Twister: Playing Twister
  • Simon Says: Playing Simon Says
  • Streamers: Getting your child to make streamer or ribbon circles and patterns in front of their midline (use two hands together or one in each hand).
  • Marching games using their arms and legs.
  • Stickers: Placing stickers on one arm and encouraging your child to remove them with the opposite hand.

Why should you seek therapy if you notice difficulties crossing the body's midline?

  • To help a child develop hand dominance.
  • To help prepare a child for the transition into the academic environment where many pencil skill and fine motor tasks are expected.
  • To help a child to complete many self-care tasks.
  • To help a child improve their gross motor skills such as kicking, hitting balls and running.
  • To help improve the ability to track effectively across a page so that reading is more fluent.

 If your child has difficulties crossing the body midline, it is recommended you consult an Occupational Therapist.

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Thank you for providing Tucson with a great resource for families looking for help for their children.
- KC-Oro Valley