Bilateral coordination, sometimes referred to as bilateral integration, is a critical developmental skill with which some kids struggle. It involves using both sides of the body together, and can impact both fine and gross motor skills Children who have difficulty with bilateral coordination may be diagnosed solely with developmental coordination disorder, but it’s also closely associated with other conditions such as autism spectrum disorder, Down syndrome, cerebral palsy and other developmental delays and disorders.
As Fort Myers pediatric occupational therapists, we recognize there’s been an increasing awareness about what bilateral coordination is as well as what deficits might look like. A reported uptick in bilateral coordination deficits could also be partially attributed to COVID closures, as lots of kids lacked regular exposure to certain activities (PE class, playground time, etc.) that can help build these skills.
How Do I Know If My Child Has Poor Bilateral Coordination?
Some indicators of poor bilateral coordination include:
- Trouble cutting with scissors.
- Struggles with handwriting.
- Difficulty tying shoes.
- Having a hard time dressing themselves (pulling on socks, pants, and shoes).
- Trouble with fasteners, like buttons, zips, or snaps.
- Clumsy movements.
- Trouble catching a ball.
- Awkward clapping.
- Troubling using a bicycle pedal.
Parents should note there are actually three different types of bilateral coordination: Symmetrical, reciprocal and leading/supporting.
All children develop at their own pace and in their own way, each displaying their own strengths. This is as true for speech and language development as it is for anything else. But while the traditional wisdom when it came to late talkers was to simply wait-and-see, medical professionals are increasingly urge parents to have their kids evaluated sooner than later. Our Fort Myers speech therapists encourage the same, knowing that while some kids really are late bloomers, a language problem becomes more difficult to correct the longer you wait.
Sometimes, this message can get a bit muddied when reports of some studies, such as one published by The American Academy of Pediatrics, are reported under headlines such as, “Late Talkers Do Fine as They Grow Up.” This ends up giving many parents a false sense of assurance. That study tended to show little to no lasting behavior or emotional problems associated with late-talking toddlers by age 5. However, it didn’t assess the language outcomes, so it’s a leap to say those kids went on to be “fine.”
Somewhere between 70 percent and 80 percent of toddlers who talk late will outgrow that language delay – but only if it is an expressive language delay (difficulties with verbal and written expression). Those with receptive language delays (understanding what is being said to them) may have a more difficult time. What our speech therapists want parents to bear in mind is that while many toddlers will outgrow a language delay, 20 percent to 30 percent will not – unless they have access to early intervention like speech therapy.
Early Intervention Speech, Occupational, ABA Therapy Preparing Wave of People With Autism for Workforce
As rates of autism diagnoses climb steadily, roughly 500,000 teens with autism are poised to enter the workforce over the next decade, according to advocates at Advancing Futures for Adults with Autism. Yet the majority of those people with autism struggle to land their first job, and 4 in 10 won’t work at all in their 20s. The spectrum is incredibly broad, so each comes to the table with their own strengths and challenges, but there is no question those who receive early intervention ABA therapy, speech and language therapy and occupational therapy fare much better long-term.
Last year, the U.S. Centers for Disease Control and Prevention updated autism prevalence rates by 15 percent to 1 in 59 children. That’s more than double what the rate was in 2000. Part of this has to do with improved awareness, earlier diagnoses and improved treatment models. Research published in the journal Frontiers in Public Health indicated early diagnosis (before 24 months, as early as 12 months) leads to earlier eligibility for intervention services (like ABA therapy), and other evidence-based research has indicated clear indication early intervention is causally related to better prognoses – including success in education and employment.
The AFFA reports that while most adults with autism want to work, fewer than 60 percent can land a job. The Americans With Disabilities Act prohibits employment discrimination on the basis of disability. Yet an adult deprived of early intervention therapies as a child has missed out on a critical development window to address significant challenges associated with everyday function and independence. This isn’t to say it’s ever entirely “too late” to initiate intervention strategies, but our ABA therapy team members know it’s most effective when it starts before age 5 (and the earlier the better).
Speech therapists at FOCUS Fort Myers study for years – first in the classroom and then for the rest of our careers in practice at our clinic – learning ways to help children master key communication skills, from appropriate conversation to phonological awareness to comprehension. We use all sorts of tools to make that happen – including puppets, games, puzzles, swings, crafts – even a ball pit! But the most effective tool? Parents!
Parental engagement in helping carry over these same strategies with their child undeniably results in better, faster progress. (And the earlier we/ you get started, the better!)
We can cite countless examples that have us convinced, but it’s backed up by peer-reviewed research too.
Parental Involvement Helps Children Make Faster Speech Therapy Progress
The American Journal of Speech-Language Pathology followed the effects of parental involvement in language intervention on children between 1.5-to-5-years-old with language impairments that were both primary (language only) and secondary (accompanied by cognitive impairment or disability). Researchers reviewed 18 previous studies examining how well children did when speech therapists offered parents specific strategies to work with their kids outside the clinic setting.
When it comes to speech therapy, there are two general schools of thought: Early Intervention and Watch and Wait. Increasingly, doctors, specialists and teachers are on board with what our FOCUS Fort Myers speech therapists have been saying for years: Early intervention is key!
You may be familiar with the legend of Albert Einstein’s childhood speech delay leading to his parents’ concern he might not be bright. This purported speech delay of an unequivocal genius lends inspiration to many who struggle with similar issues. Unfortunately, it’s also given families of “late talkers” validation for the “Watch and Wait Approach” – which is typically not what we advise.
Until fairly recently, most pediatricians were content to let parents wait before seeking assistance with their children’s speech concerns, often not pressing for speech therapy until the child was school-age. That is changing – much to our enthusiasm! Clinicians are increasingly aware that speech impairments in children can lead to a greater likelihood of social struggles and reading problems. The younger the child, the more malleable their brains, and the better outcomes we have.
A recent study published in the journal Pediatrics underscores the importance of early therapy intervention for children with autism spectrum disorder (ASD).
Ample previous research shows the sooner children with autism are able to receive services – including behavior therapy (applied behavioral analysis/ ABA), speech therapy and occupational therapy – the better their overall outcomes. The American Academy of Pediatrics recommends all 18-and-24-month children be screened for autism because intensive early intervention has been found to improve:
- Language Ability
- Social Interaction