Clinical pathway
Bilateral coordination
The student struggles with two-handed tasks — cutting, stabilizing paper, managing a ruler, catching, or fasteners.
Step 1
Occupational performance problem
The student struggles with two-handed tasks — cutting, stabilizing paper, managing a ruler, catching, or fasteners.
Step 2
Clinical reasoning
- Check whether the non-dominant hand is available as a stabilizer at all.
- Watch for midline avoidance: does the student switch hands rather than cross?
Step 3
Likely limiting level
Level 4: Visual-Motor Integration
Vision must guide two hands with different jobs.
Level 5: Functional Integration
Coordination degrades as task duration rises.
Step 4
Intervention options
Nothing tagged for this step yet.
See all matching resourcesStep 5
Movement-based options
Nothing tagged for this step yet.
Step 6
Teacher strategies
- Tape or clip paper down while stabilizing is being built.
- Pre-cut or pre-fold to keep the student in the lesson rather than in the setup.
Step 7
Parent carryover
- Cooking, laundry folding, and ball games as natural bilateral practice.
Step 8
Progress monitoring
- Accuracy on a standard cutting or lacing probe.
- Spontaneous use of the helper hand without cueing.
Step 9
Reassessment
Re-screen the limiting level after 6–8 weeks of consistent intervention. If the occupational problem has not changed while the contributing level has, look upstream for a different limiting factor. If neither has changed, or symptoms are worsening, refer out rather than continuing to treat.