FirstCry Parenting

Adults are crossing the midline all the time. From flipping the pages across the centre of the book, bending over to tie their shoelaces or even reach across the other side to fasten our seat belt in the car. This biological phenomenon comes spontaneously to kids. Crossing the midline displays flexibility and the importance and activities for kids can really help them make their bodies more flexible.

Occupational therapists often look for this aspect in babies, toddlers and kids. Crossing the midline is one of the key sensory integration yardsticks that occupational therapists look for when working with children. It is a skill that is easy to miss. Extremely subtle, it can have a negative impact on your child’s ability to learn, play, develop their fine motor skills and even their vision if they are not crossing the midline. Basically, the midline is an imaginary line that goes vertically across the body and therapists look at how effectively kids or babies cross over to perform routine tasks.

Difficulties in crossing the midline specifically do not indicate a medical problem. But it is a sign of a neurodevelopmental issue and one among several abnormalities seen in children. It is important and without this ability, a child will not be able to get enough practice to use both hands and legs.

You child will establish their preference to use any one hand to perform tasks early on. But the ability to use the dominant hand will be affected if your child is not able to cross the midline. Without this, your child may experience delayed fine motor skills. A delay in the development of fine motor skills will manifest itself in poor handwriting, poor performance in sports and low self-esteem.

Crossing the midline means using both sides of the body which takes extra time to process. By engaging your child in activities to cross the midline you are not just helping them coordinate their bodies but also train their brain to work simultaneously.

Read on to find out more about what crossing the midline is and how it affects your child’s development. Learn more about therapeutic crossing midline activities that you can practice with your child at home and help them gain essential skills.

What Is ‘Crossing the Midline’?

Visualize a cut out of a paper doll. Fold that in half. Imagine the left half lying over the right half. Now open the cutout and the fold that goes down right through the center of the body is the midline. Crossing the midline is when your child moves their hand or foot across this line to work on the other side of their body.

Prior to using the midline, a child will use only one side of their body at a time. For eg: they may use their left arm to reach an object on their left. Once they cross the midline they could use the right arm to reach the object too.

A key building block to a child’s development of fine motor skills, crossing the midline is a milestone that many parents tend to miss. This is essentially because kids tend to find a way to do something they want. One needs to keenly note if a child is using both sides of their body and involving in bilateral coordination to reach out to objects and becoming independent.

When Do Babies Start Crossing the Midline?

When exactly do babies start to master this art of crossing the midline? Well, the answer is pretty soon. As soon as your baby starts to reach out to objects with two hands- when they are of 4–5 months of age, they have started their journey. But if your baby is not there yet, there is nothing to worry. This range could differ in babies.

Some infants reach this milestone at about 2 months while others may get there only when they are 6 months old. This is a continuously evolving process that develops until your child is 8-9 years old. By this age, they have the stability that is strong enough to use both sides of the body. By the time they are 8-10 years old, crossing the midline is a fully integrated skill.

How Do Babies Learn to Cross the Midline?

Most children cross the midline as they get to know more about their body through play and activities in daily life. As babies begin to reach their toys, feeding bottles and other objects with their hands they have begun to start crossing the midline. Even the skill of rolling over requires the ability to cross the midline to get the body to create the motion to rotate and roll.

Everyday routine tasks, like putting their clothes, shoes and cardigans requires them to cross the midline. Children need to develop bilateral integration skills that help them use both sides of the body in coordination to perform movements. This skill is called bilateral coordination. They need core stability to get their trunks to rotate, move the body from side to side and moving the limbs across the midline.

Most kids have the tendency to use the left hand for the left side of the body and the right for the right side, they develop bilateral coordination as they understand spatial perception. This helps to develop crossing the midline spontaneously.

How Important Is Crossing the Midline in Baby’s Development?

Why is crossing the midline important and why is crucial for a child to cross it successfully? It is key building block is developing pre-reading and pre-writing skills that form an important aspect to a child’s development. It helps a child to be more independent and interact with the environment. A child who is able to cross the midline will find it easier to dress themselves, pour themselves a drink, use cutlery and feed themselves.

During play children who cross the midline are able to reach across their body to grab objects or play with both hands. This expands their opportunities to play.

How to Know Your Child Has Trouble in Crossing the Midline?

It is not uncommon for children to have delays or impediments to cross the midline. Children often find a way to compensate for things that they cannot do. So if they do not happen to cross the midline, it could well be that you never get to notice it. Some signs you can look out for :

In Babies

• Some babies cannot put skills together to crawl. They find it difficult to coordinate their hands and leg movements and will, later on, have trouble with gross motor skills like jumping or skipping. Some babies may crawl late and not crawl at all. This does not necessarily indicate there is an issue.
• Babies who consistently reach out to things using only one side of the body.
• Babies who rotate their entire trunk to reach out to an object on the other side of their body.

In Big Kids

• Children who fail to perform self-care tasks like changing, brushing their hair. Most children who show lesser signs of independence to perform daily routine tasks.
• Children who lean over to one side when writing or drawing to avoid crossing the midline. Alternatively, they shift the task to the other side to reach easily.
• Children who constantly switch sides and hands to complete an activity.
• Children who kick a ball with their dominant foot have crossed the midline. Children who have not will switch between feet.

When children have trouble crossing the midline they may avoid using the pencil. One could also notice behavioural issues in children as they tend to become angry and frustrated when engaging in tasks that involve fine motor skills. Children tend to be less independent in performing self-care tasks and will have lesser coordination skill in comparison to their peers. Children who do not cross the midline may have difficulties reading and copying drawings or notes.

Age-wise Development of Crossing Midline – Signs to Watch Out For

As babies develop they cross the midline to perform various activities from rolling over, crawling, pushing, pulling etc. Unless you keep a close eye, you may miss that milestone. A few signs that will help you spot the milestone in your baby- age-wise are listed below:

At 4 Months

• Try holding their rattle or coloured toy slightly away from the centre. If they cross the midline to reach it then they are developing.
• Hold your hand high a little away from the centre and see if your child tries to grab your hand reaching over to the other side.

At 9 Months

• At this stage, infants are crawling, rolling, trying to stand up. Toys, clips, vegetable peels will never miss their sight. They will instantly try to cross the midline to reach out for these things.
• If you are playing with your child and holding toys, try to have toys in both your hands. If they have one in their hand, see if they try to cross the midline to reach for the other one in your hand.

At 10-12 Months

• By this age, children will start using their pincer grasp to eat finger food. If they have food in one hand, they will try to cross the midline to reach something with their other.

Crossing the Midline Activities for Children

Crossing the midline is something that happens naturally with kids. As they interact with the environment and are exposed to more things, they will start exploring the flexibility levels of their body and naturally build their skill. There are a few crossing midline exercises to encourage them to build their skills.

For Babies

Crossing the midline activities for infants could be very simple and it is best to set up activities that will create the right scenario. You could set the activities up without letting them know your real intention. Crossing the midline is a skill that develops by itself in children.

• Using a musical toy: Get your child to bang on a musical toy like a tambourine, rattle to reach across your midline.
• Tummy time: Make use of your babies tummy time. Scatter their toys, give them sensory objects spread across to reach out touch and feel. Scatter the toys across like an arc so that they can reach from all sides
• Reach the other side of the body: Get your baby to lie on their backs. Help them to use their hands to reach to the toe on their opposite foot. Keep trying it until they are able to do so.
• Peel off stickers: Put stickers on the back of your hand. Place your hand slightly off the center and get them to use their opposite sides to peel them or even touch them.
• Simple games: Play games like auctioning nursery rhymes. A few good ones are: Wheels on the Bus, Row Row Row Your Boat. Try playing Patty Cake to get them to use their hand alternatively on either side.
• Reach out to objects: Hold a large colourful ball a little off the centre. Encourage your child to use both hands to reach for the ball. It is clinically proven that getting a child to use both hands helps them to learn to cross the midline.

For Toddlers and Kids

Crossing midline activities for toddlers is like natural activity.  Babies tend to develop this skill when they roll over and start crawling. As they get exposed to the environment they tend to learn more and develop this skill. It increases their flexibility and also helps them become more independent and self-reliant.

• Simon Says: An excellent game to get them to not just follow instructions but also learn to cross the midline. Make sure you give instructions that will require them to reach out to the other side of the body.
• Figure 8: Draw a large figure of 8 across a horizontal paper. Get your toddler to run their fingers across the lines. Get them to run their cars across the lines. You can even do it at the beach by asking them to draw it in the sand. Occupational therapists find this activity to be very useful and encourage kids who have crossed the midline to follow it to increase their attention span.
• Aim for the target: Play bowling with miniature pins and a ball. Alternatively, you can draw circles on a large card paper, stick to a wall and then get your child to use small bean bags to aim at the circle.
• Football: Stand by the corner of a goal and get your child to use their opposite foot to hit a goal. This could also form the base for their soccer training.
• Finger puppets: Place finger puppets in fingers on one hand and get your child to remove them with the opposite hand.
• Craft activities: Threading beads, folding paper, cutting paper across lines are great activities to encourage crossing the midline.
• A game of Twister: Twister is a classic game that has probably been invented to cross the midline. Just get them to switch positions to reach the target.
• Marching games: Get kids to march with their legs and hands to a piece of music. It is a fantastic activity that involves a lot of concentration and coordination.

Apart from this, encourage your child to perform routine tasks like putting toothpaste on their brush, scrubbing parts of the body, putting their buttons on the shirt which will help them use their skill. Doing any of these activities on a regular basis will go a long way in developing core skills in a child. It will also have a positive impact on their reading and writing skills. These activities do not just help to cross the midline but also help to work both sides of the brain to become more skilful.

Crossing the midline is something that therapists believe happens as a natural process. What starts off at the age of months gets perfected by the age of, making children independent and self-reliant to perform their routine tasks. It is hard to gauge from the cherubic look on your child’s face that crossing the midline is such an important milestone. It definitely is an important milestone to reach, and if you believe that your child is lacking this skill then speak to your paediatrician. Occupational therapists could help you with activities that will train your child in this aspect.

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