Crossing the midline | Development

What is “crossing the midline” and why is it important? We show you how to help your child reach this developmental milestone. By Xanet van Vuuren

What is crossing the midline?

Have you ever watched your child play in the sand with his bucket and spade? Did you notice that often the bucket is on the left side of her body, for example, while she digs in the sand on her right side and then transfers the sand from the spade to the bucket on the opposite side of her body?
Instead of adjusting her body to her actual environment, she uses her limbs to cross into her opposite body space. In other words, she’s crossing her midline – the imaginary line down the centre of the body – and using her right hand in her left body space and vice versa.
This may seem like a simple task to accomplish, but there’s much more to this skill.
Midline crossing is what ultimately ensures the coherent communication between the left and right brain hemispheres so that we can coordinate and sequence our own body movements and organise the space surrounding us.

How will not reaching this milestone influence my child?

A child who struggles to cross her midline will make random movements, and it will take a lot more time to do things, and will become very frustrating for her to finish a simple task such as brushing her teeth or drying herself off.
Not being able to cross the midline can also have an impact on a child’s emotional development, as well as her reading, writing and spelling skills.

The importance of tummy time, rolling and crawling for midline crossing:
  • Placing your baby on her tummy during waking hours will help her to gain head control. Gaining head control is the first step in developing trunk muscle control (the main part of the body excluding head, arms, and legs), which is vital for her to be able to keep herself upright against gravity, and also to move and rotate her torso.
  • Rolling develops a baby’s awareness of the right and left sides of her body and this, in turn, helps the two sides of her body to work together.
  • Crawling plays a huge role in the development of a child’s posture and bilateral integration skills. It’s also very important for weight shifting. For example, when she’s on her hands and knees and reaches up to grasp an object, she has to weight-shift in order to do this.


Cause for concern

The following signs may indicate a problem with midline crossing. If you notice any of the following in your child, you may want to take her to an occupational therapist for an assessment:

  • If she hasn’t established a dominant hand by four years old
  • If she has poor hand dominance
  • If she’s only using her one hand to do everything, and neglecting the other one
  • If she uses her hands independently.

The importance of bilateral integration for midline crossing

“The importance of establishing bilateral integration is so that the child is able to establish dominance for her feet, arms, ears and eyes,” says occupational therapist Elsie Labuschagne. “First children learn to use two hands together for a symmetrical activity. Think of a toddler banging pot lids together. Then she learns to hold one hand still while the other works, and finally to use both hands simultaneously for different movements.”
This is what’s necessary to turn a paper with one hand while cutting out a circle with the other.

Activities to encourage midline crossing

Include these activities in your child’s everyday play. Remember that children develop at different rates and that the skill one child masters early may take another child a little longer to achieve.

You know your child best and will know when to introduce her to the below activities, as you’ll know what she’s capable of and what she’s not yet able to do.

  • Play Twister.
  • Let your child pretend to drive a car by using a ball as the steering wheel. Encourage her to cross her arms as she turns the “steering wheel”.
  • Play a marching game where she has to raise her right knee enough so her left elbow can touch it, and vice versa.
  • Draw your own hopscotch blocks outside or use a hopscotch mat for indoors – show her how to hop on one leg from block to block.
  • Let your child paint using big left and right movements while her feet are “glued” to a spot.
  • Let her play with sand, scooping it from one side of the body and putting it into a bucket on the opposite side with the same hand.
  • Give her a bucket of water and a sponge. Ask her to wash the windows for you in big swishing movements from left to right across the midline.
  • Let her smear shaving foam across a kiddies’ plastic table from left to right.
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