by Danielle Carter, MS OTR/L


 zac baseball

What is crossing the midline? 

Pretend there is an imaginary line that divides the left and right side of the body from top (head) to bottom (feet).  Crossing the midline is when we reach across this imaginary line, with arms and legs crossing over to the other side.  This should happen spontaneously in daily activities but some children need to be encouraged to develop this skill. 


Why is this important? 

Crossing the midline is an important developmental step that is often stressed by Occupational Therapists.  When a child is not able to cross the midline, it means that the two sides of a child’s brain are not communicating with each other.  Since the left and right sides of the brain each have different functions, their communication is crucial for physical, emotional, and cognitive success and future learning and quality driven movement. A child who is unable to cross the midline physically or visually is unlikely to meet developmental milestones on time and the quality of his/her motor movements and learning are affected. Difficulty crossing the midline affects visual tracking leading to difficulty with learning such as reading and writing, independence self-care tasks such as putting on shoes and socks, and difficulty with sports and motor coordination. 


Signs that a child is not crossing the midline: 

  • Delayed crawling or skipping the crawling stage entirely 
  • Switches objects between hands to use their left hand for things on the left side of their body and right hand for things on the right 
  • Moves his/her body to face an abject versus using trunk rotation and moving their hand across their body 
  • Difficulty making a horizontal line across a piece of paper (may stop in the middle and switch hands, or pause visually) 
  • Difficulty using two hands in play 
  • Poor handwriting/coloring skills
  • Skips words when reading
  • Difficulty with jumping jacks, skipping, etc. 


Activities that encourage crossing the midline: 

  • Put stickers on a child’s left hand, arm, and leg and have her remove it with her right hand.  Then switch to the right side of the body using the left hand.   
  • Have your child draw (or trace) figure 8’s on a piece of paper or in sand, with shaving cream, or other fun textures. 
  • Engage your child in activities of daily living such as placing her clothes to the opposite side and having him/her reach to get them. 
  • Place toys to the side and hold down the hand on the same side so he/she needs to use the opposite hand to get the toy. 
  • Work on core strength and stability so trunk weakness is not limiting crossing the midline.  Help your child break the W-sitting habit!
  • Pop bubbles with only one hand.  Reach across to pop. 
  • Play Simon says: Right hand on left shoulder, right hand on left knee, cross one foot over the other foot, close your eyes and tap a fingertip to your nose etc. 
  • Sit back to back and pass a ball to each other sideways 
  • Bean bag games:  Set a container on the left and have the child use his/her right hand to fill the container.  Then switch.  You can also do this game in standing and balance your bean bags on your foot.  Make sure there is midline crossing! 
  • Crawl through tunnels to encourage reciprocal motion
  • Play the hokey pokey
  • Play Twister 


Crossing the midline is a very important building block for many other developmental skills.  If you or your Occupational Therapist have concerns about your child crossing the midline, it is important to follow through with recommendations and your home program to help prevent delays now and in the future.