Crossing the Midline: What It Means and 20 Activities

By Laura Lurns · Reviewed by Philip Weaver · Last reviewed 2026-10-08

What crossing the midline means

A leaflet from Alder Hey, an NHS children's hospital, explains the idea. It asks you to imagine a line from your child's head to their feet. The line splits the body into left and right halves. The leaflet's review date, May 2025, has passed.

To one study team, crossing is a hand or foot moving over by itself (Jacobs and colleagues, 2021). We could read only its summary.

One study of babies held one arm still (Provine and Westerman, 1979). Older babies in the study were more likely to reach across with the free arm. That shows a baby can cross. It does not show that a child chooses to. We could read only its summary.

A gradual change, not a set age

Two older studies watched children reach across the body (Cermak and colleagues, 1980; Stilwell, 1987). In both, crossing without being asked became more common as children grew. In the 1987 study, the task set-up mattered. It changed how often children crossed. For both, we could read only the summary.

A larger study watched 432 children reach for cards (Carlier and colleagues, 2006). Older children crossed more often than younger ones. But age explained less than 5 percent of the differences between children. Children of the same age varied a lot. We could read only its summary.

One study followed 20 babies (van Hof and colleagues, 2002). Whether they crossed depended partly on the task. The size of the object was one thing that mattered. We could read only its summary.

These findings are about groups of children, not a test for one child.

We found no study that tests midline crossing as a milestone.

What studies found about hands, coordination and learning

Researchers use reaching across the body to measure hand preference (Hill and Khanem, 2009). That shows how preference is measured. It does not show that crossing causes a preferred hand. Younger children, as a group, preferred one hand less strongly than older children. The task also changed which hand they used. Another study found a reaching test did not point to any one condition (Hill and Bishop, 1998). For both, we could read only the summary.

One older study compared 179 children with learning disabilities and 120 without (Cermak and Ayres, 1984). As a group, the children with learning disabilities scored lower on one midline test. The difference was clear in some comparisons and less clear in others. The authors said to use the test with other observations. A group difference cannot show a cause, or pick out one child. We could read only its summary.

One study compared 48 children with coordination trouble and 48 without (Smits-Engelsman and colleagues, 2006). The children made small pen movements on a tablet. Crossing the midline did not affect the children with coordination trouble more than the others. The movements were tiny, not handwriting. We could read only its summary.

Two studies looked at pen and peg tasks (Smits-Engelsman and colleagues, 2004; Bradshaw and colleagues, 1988). In the 2004 study, children were less accurate on the far side of the body. That was true even when the hand did not cross the midline. In the 1988 study, children did not slow down when crossing. These were not handwriting tasks. For both, we could read only the summary.

Handwriting improves most consistently with handwriting practice; motor work alone has not been shown to improve it.

The one trial of midline activities we found

One small trial looked at 22 children with signs of coordination trouble (Bagrowski and colleagues, 2026). All of them did the same movement program. One group also did midline exercises. Both groups got better on the coordination tasks tested. The midline group's gains showed up earlier. But at each check, the two groups did not differ. The trial was reported twice. We could read only the two summaries. The summaries report no reading, writing or school result.

Handwriting improves most consistently with handwriting practice; motor work alone has not been shown to improve it.

What we found no study of

We found no study linking midline crossing to reading. Some NHS leaflets say crossing the midline is needed for reading and writing. The leaflets we read cite no study for this. Keep midline play alongside reading instruction, not in place of it. Reading improves with reading instruction.

We found no study that tests midline crossing as a screening check. We found no review that pulls together the midline studies. We found no definition from a national therapy body.

We found no evidence that midline activities improve reading, writing or attention. Handwriting improves most consistently with handwriting practice; motor work alone has not been shown to improve it.

20 activities to try as play

The activities on this page are ours, not a program from a study. We offer them as play, for fun and for moving. Keep any movement work alongside handwriting practice, not in place of it. Handwriting improves most consistently with handwriting practice; motor work alone has not been shown to improve it.

At the table

1. Sticker move. Put stickers on the left. Your child moves each one to the right, using the right hand.
2. Bowl to bowl. Set a bowl on each side. Use one hand to move soft toys from one bowl to the other.
3. Side-to-side sort. Put big blocks on one side. Using one hand, sort them by color into cups on the other side.
4. Puzzle reach. Put big puzzle pieces on one side. Build the puzzle on the other, using one hand.
5. Card deal. Deal cards to everyone at the table with one hand.

On the floor

6. Twist and pass. Sit back to back. Pass a ball around, twisting to one side, then the other.
7. Toy pickup. Scatter toys on one side. Your child kneels in the middle. Using one hand, they drop the toys in a box on the other side.
8. Bean bag toss. Set a basket on the side away from the throwing hand. Toss bean bags in.
9. Car road. Lay a tape road from side to side in front of your child. Sitting still, drive a toy car along it with one hand.
10. Sock match. Pile socks on one side. Using one hand, lay each pair on the other side.

Standing and moving

11. Simon says, crossed. Play Simon says with moves like "right hand on left knee."
12. Toe touch. Stand with feet apart. Touch each foot with the opposite hand.
13. Scarf wave. Wave a scarf in big sweeps across the body.
14. Beach ball tap. Keep a beach ball in the air, tapping it across the body.
15. Mirror moves. Face each other. Your child copies your moves that reach across the body.

Art and around the house

16. Rainbow arcs. Tape big paper to a wall. Paint rainbows from edge to edge, feet still.
17. Window wipe. Wipe a window or whiteboard with big side-to-side sweeps, using one hand.
18. Pot drums. Set pots on both sides. Drum on them with crossed arms.
19. Clapping games. Play clapping rhymes where hands cross over, like patty-cake.
20. Sweep up. Sweep with a small broom, side to side across the body.

How to use them

In our view, keep each activity to a few minutes. Pick the ones your child enjoys. To us, enjoyment keeps a child coming back.

We make no promise that these activities change reading, writing, focus or coordination. Keep any movement work alongside handwriting practice, not in place of it. Handwriting improves most consistently with handwriting practice; motor work alone has not been shown to improve it.

In our view, clear some space for moving games, and stay close. In our view, stop any activity that hurts.

When movement worries you

If movement or coordination worries you, talk to your child's doctor or the school. A therapist, such as an occupational therapist, can assess movement. A doctor rules out other causes. An international guideline on coordination trouble describes both routes (Blank and colleagues, 2019).

If only the writing worries you, start with the teacher. Handwriting improves most consistently with handwriting practice; motor work alone has not been shown to improve it.

When to ask for help

Each of these is a reason to ask for help on its own.

• Little change, even with steady practice and good teaching.
• Writing well below your child's other schoolwork.
• A teacher who raises a concern about writing.
• Extreme upset about writing.
• Complete avoidance of writing.
• Hopelessness about learning.
• Sadness or worry that lasts.
• Significant delays in speech, language or motor development.
• A skill that was there and has gone. Our position is that a lost skill goes to a doctor first, not a tutor.

If no skill has gone, start with the teacher. Say what you are seeing at home, and what you have tried. Beyond the teacher, the right person depends on what it turns out to be about. If the work is too hard, someone who works on that school skill. If worry or mood is the thing, someone who works with children's mental health. In our view, delays in speech, language or movement are worth raising with your child's doctor. In our view, if you are worried enough to ask, a professional evaluation is worth asking about.

Any talk of hurting themselves is a same-day call to your doctor or a crisis line.