The 6th Stage of Body Awareness - Midline Crossing

In our previous blog, we have discussed laterality and lateral preference and how it relates to body awareness. Before moving on to today's topic we need to recap what laterality and lateral preference are, as these concepts form important building blocks for the next phase of a child’s development, which is midline crossing.

As mentioned before, laterality is the internal awareness that there are two sides of the body and that these two sides feel different from one another. Once a child has developed laterality, lateral preference will occur spontaneously. If you can recall from our previous blog, lateral preference is where a child favors the use of one eye, ear, hand or foot over the other.

The book ‘Physical activities for improving children’s learning and behavior’, written by Cheatum and Hammond, explains that both laterality and lateral preference are an expected result of children progressing through a normal developmental sequence of body awareness. Crossing the midline comes next in this developmental sequence and will be the center of our discussion for this blog.

What is Midline Crossing?

A simple way to explain it is by drawing an imaginary line vertically down the center of the body, from the head to the feet. This imaginary line separates the left and the right sides of the body. We cross the midline every time we move a hand, foot, or eye across the line to do work and activities on the opposite side of the body.

Have you ever wondered how we would have lived if we were not able to cross our midline? All our movements would be like a robot - stiff and not very practical. Luckily, we were wonderfully made by our Creator to cross our midline.

As adults, we cross our midline without even thinking about it. Just stop and think about that for a second - we cross our midline every day when dressing, flipping through a book, fastening our seatbelts or preparing a meal.

Did you know that we can also cross the midline with our tongue? I am sure that while reading this you just moved your tongue around! Yes, we use our tongue to move food from one side of our mouth to the other. Wow, what masterpieces we are!

Why is midline crossing important in children?

Crossing the midline is vital to promote the coordination and communication of the left and right sides of the brain. As mentioned before, it also enables us to do daily self-care, practical and recreational tasks such as brushing our teeth, getting dressed, putting on shoes and socks, walking and climbing the stairs. Gross motor activities such as animal walks and ball skills further require a child to cross his midline.

Crossing the midline is also essential for scholastic skills such as reading and writing. When a child reads a book or follow the words on the blackboard in the classroom, his eyes continually cross the midline as they move across the page or board. Thus, midline crossing is essential for visual tracking.

During writing or colouring tasks, the arm, hand and eyes of the child also move from the left to the right side numerous times, crossing the midline. This enables the child to work efficiently, keep up with the pace and not fall behind with the workload.

According to Pederson and Young, the ability to cross the midline of the body is an integral part of many activities in both sport and everyday life. They are of opinion that we should incorporate midline crossing movements into sport and play as it may provide developing children with a larger repertoire of movement choices. This in turn will allow children to achieve greater success in physical activity and sports participation.

Building blocks of midline crossing

As mentioned above, laterality and lateral preference are important building blocks for midline crossing. There are also other important skills involved in crossing the midline:

• Body awareness: The information that muscles and joints send to our brain that tells us about our body position.

• Bilateral integration: Using both sides of the body at the same time.

• Core stability and trunk rotation: The muscles of the trunk help to stabilize the body, so that the arms and legs can move with control.

• Planning and sequencing: The ability to follow multi-step instructions to achieve a defined outcome or endpoint.

When does a child start to cross the midline?

As an adult, crossing our midline comes automatically. The question is: are we born like this? The answer is no. Luckily babies start to cross the midline early in life.

According to Cheatum and Hammond, in the early stages of development, the midline is like a wall that keeps a child from crossing one arm or leg across the center of his body into the other half. When a baby is a few months old, he will grasp a block in one hand, move it to the center of his body and then transfer it to the other hand.

Between 8 and 12 months, most children gain the ability to reach across the midline of their bodies to pick up a toy or snack. This ability may help a baby or toddler to interact more fully with the environment. Even if the hand on one side is occupied, the infant can cross over with the other hand to grasp a new object. Crossing the midline can help a toddler who needs to reach for an object while creeping/crawling as well as babies who are learning to feed themselves.

When pre-school children have developed lateral preference (dominancy), crossing the midline should happen automatically. Generally, by age 4, children cross the midline with ease. When a child reaches the age of five and cannot cross the midline, one should start to investigate the cause of it to prevent future developmental delays.

It is important to always remember that all children are different and not all developmental milestones are reached at the same time. In some cases, lateral preference (dominancy) is sometimes delayed until a child is about 7 years old.

According to some professionals, if a 7-year-old child still cannot cross his midline, he may be considered to have a midline problem. Other professionals feel that a child should have this skill in place before they enter a formal school setup.

Midline crossing difficulties

Are there signs that one can look out for if a child may have trouble crossing the midline? Yes, but children often find ways to compensate for what they cannot easily do. This makes it difficult to immediately notice when a child has trouble with this skill and can sometimes be overlooked.

There are two key facts to keep in mind when screening children for a possible midline problem. Firstly, if you ask a child to cross the midline, he may be able to do so even though he might have a midline problem. This may not be a natural skill or a comfortable movement for him and he really needs to concentrate to cross the midline. This indicates that the skill is not automatic yet.

The second key to remember is that children with a midline problem find crossing their feet or any part of the lower body much easier than crossing their arms. Therefore, one should not assume that a midline problem does not exist when a child can easily sit cross-legged or walk sideways, crossing his legs to do so.

Observations for midline crossing problems

According to a research article by Pedersen and Young, one way to benchmark the developmental progress of children is to assess their ability to achieve motor milestones. An example of a developmental motor milestone is the ability to efficiently perform midline crossing movements with the arms and legs during play.

So, what are things that can indicate a delay in younger and older children when it comes to crossing their midline? Casually observing children on the playground or in the classroom is one of the best ways to see if a midline problem exists.

According to SRI International, there will likely be more opportunities to observe a child's ability to cross the midline during fine motor activities versus gross motor activities. However, any setting where children are interacting with materials and/or objects that are on either side of their midline is appropriate. If the skill does not naturally occur doing everyday activities, then one should suspect a midline problem.

More signs that a child has trouble crossing the midline, are explained by Healthline.

• Younger children consistently use their right hand to reach for things on their right side and their left hand to reach for things on their left side.

• Some children avoid crossing the midline to reach for objects on the opposite side of their bodies. Instead, they rotate their entire trunk to reach the objects without crossing the midline.

• Age-appropriate self-care tasks in older children can become tricky when they cannot cross the midline. Children who cannot cross the midline may show reduced independence when they need to do tasks like brushing their hair.

• Some children will lean way over to one side when drawing or writing to avoid crossing over the midline. Alternatively, they may shift their paper over to the side to reach it more easily. Also, children who consistently switch hands during an activity like cutting, have found a way to avoid crossing the midline.

• Most children will discover that they prefer kicking a ball with their dominant foot, but children who cannot cross the midline may switch feet easily.

Another sign to look out for is children who can perform activities and writing tasks with both hands equally well. This is also called ambidexterity. They seem to be stuck at the midline level. The building block of laterality and lateral preference (dominancy) is usually delayed, and the two sides of their bodies have no relationship to one another.

Informal assessment for crossing the midline

What can you do if you notice some of the above-mentioned signs that indicate possible midline crossing problems in children? An informal fun activity using stickers is a great way to informally assess midline crossing. (Please take note that this is by no means a replacement for a formal assessment done by a professional).

Let the child sit at appropriately sized tables or work areas (to maximize opportunities to observe crossing the midline). Give the child a large piece of paper with one shape on the left side of the page and a different shape on the right side of the page. Tell him that he will be putting stickers in the corners of each shape and remind him to sit facing the paper with both feet on the floor.

Now place stickers on the child’s left fingers (one sticker for each corner of the shape) so that the child is more likely to use his right hand to place stickers on the left side of the page. By placing stickers on one hand, the child will be encouraged to use his other hand to cross the midline. Give the child a chance to use each hand (both his dominant and non-dominant hand) in this activity. This activity will allow you to observe if the child is crossing the midline or not.

The above informal assessment was developed by SRI International. Click on the link to download the full PDF assessment sheet for midline crossing.

How to improve a child’s midline crossing?

While you are reading this blog, you may suddenly realize that your own child or a few children in your class, are struggling with one of the above items mentioned and may possibly have a delay in crossing their midline. What now? What can you do to encourage the development of this skill?

Firstly, do not panic! Remember that gross motor and sensory development as well as moving and exploring from a young age is directly linked to midline crossing. Creating an environment for movement and freedom will help to lay a solid foundation. There are also many fun activities that you can do to encourage younger and older children to cross their midline. Below are a few practical and easy ideas for the young and old:

Activities for younger children:

• Babies should be given plenty of tummy time and freedom to move around and play. Place toys in front of the baby and encourage him to reach for the toy.

• When the baby starts to crawl, encourage the baby to crawl for as long as possible. Crawling is very important for effective midline crossing and the longer the baby practices this skill, the better.

• Using stickers is a simple way to enhance midline crossing. Place stickers on one arm and encourage the baby (12 months and older) to remove them with the opposite hand. You can also place the stickers on the baby’s feet.

• Place a ball on a string and hang it in front of the child. Move it from one side of the midline over to the other side and encourage the child to reach for it with both hands. Remember to practice this skill on both the left and right sides of the baby.

• Let the baby sit facing you. First, roll a ball straight to the baby. Let him cradle the ball with both hands. Then roll the ball a tiny bit to the left side of the baby. He will reach over to the side to cradle the ball with both hands, thus crossing the midline with one of his arms. Practice this to the right side as well.

Activities for older children:

• Motivate a child to do age-appropriate self-care tasks on their own. This will also help the child to develop independence. Brushing teeth, washing in the bath and picking up a bag, then putting it on your back are all tasks that require one to cross the midline.

• Gross motor activities such as throwing, kicking and animal walks should be done on a regular basis. This is such a fun and playful way to develop midline crossing.

• Drawing a large figure 8 in the sandpit, on paper, in the air or on the blackboard is a great way to cross the midline. Why not also do the activity with your foot. I am sure there will be many laughs!

• Everyone knows the game Twister. By placing your hand or feet on the correct color, you need to cross the midline. This game is full of fun and the children do not even realize that they are practicing the skill.

In the book, ‘Perceptual-Motor Activities For Children’ you will find more creative ways to enhance midline crossing.

By creating the perfect environment for moving, learning and exploring, most children will cross their midline normally as part of their development. For some children, it might not come so easily and they may need to do a few extra activities. However, after a time, the skill of crossing the midline should start to appear.

In a few cases, some children may need a bit more help developing the skill. A consultation with a Kinderkineticist or Occupational Therapist can determine what the underlying cause may be and put a plan of action in place to enhance the skill and resolve the midline problem.

Summary

We have come to the end of our discussion about midline crossing. I am sure that after reading all the information about crossing the midline, you can agree that we are wonderfully made by our Creator. Every small detail in a child’s development is planned to perfection. I just stand in AWE!

In our next blog, we are going to look at directionality and directional discrimination. These are the skills that we ultimately need to learn how to read and write. Until next time, happy moving moments from all of us at Kwanda Kinetics!

https://www.youtube.com/watch?v=lIfRWWTboUA