Why You Should be Crossing Midline in Speech

Wednesday, January 8, 2020
One of the things I love about our field, is the ability to work so closely with other professionals. Over the past 10 years I have worked very closely with occupational therapists and the children we share. I have learned SO much from them and love watching them work. It's always fun to me when I am co-treating with another OT, seeing one of the activities they do with a student and thinking AH HA! I will add that in with (insert speech activity here) next week! I feel like I am always learning and growing from our OT's!

One of the things I learned from occupational therapists (and those fabulous COTA's) is how important crossing midline is to development. If "midline" isn't a term that's familiar to you, it's basically an imaginary line from your head to your toes, right down the middle of your body. Kids who avoid crossing midline often have learning and motor difficulties because of the lack of integration between both sides of the brain. This is a really great blog post from the OT Butterfly about how midline develops, why it's important, and how to tell if your child isn't crossing midline.

Adding activities that allow kids to cross midline during speech therapy isn't hard. In fact, it gets them moving and adds a lot of fun to therapy sessions while encouraging integration of both sides of the brain. Here are a few ideas to add this skill to your bag of SLP ticks!


  • If you're using articulation cards in therapy, put them on the left side of the child but have them reach for each card using his or her right hand. The same concept can be used with blocks or toys. Purposeful placement of items that will get their trunk rotating is key.



  • Exercises! Incorporate exercises into your therapy sessions that cross midline (side bends, windmills, etc.) Do these as a fun warm up before each session or get creative and incorporate some speech activities with these exercises.



  • When I searched Pinterest for some inspiration for activities, many came up that incorporated a figure 8 shape. Whether it's tracing the shape or driving cars on a track that's shaped like an 8, it gives great opportunities to cross midline. Place some articulation cards, vocabulary words, or wh-questions on the track, and work on the goals as you add this important motor skill.



  • When doing cut and paste activities or sorting activities, put the items they need on both sides of their body. Encourage them to cross midline as they reach for the items they need to complete the activity.



  • If you're working in a group, put two students back to back and have them pass a ball (or any object) back and forth. You could easily incorporate speech and language skills into this activity. As the child passes the ball, have them describe the object being passed, name a synonym/antonym for a word given, name items in a category, practice articulation words... there are so many things you could do here!


One important tip I like to give to my interns and SLP's-to-be is to take advantage of the professionals you work with. There will never be a point in your career where you know everything. Stay humble. Learn something new everyday. Take advantage of asking good questions. Use  opportunities to observe. And take what you have learned and incorporate it into your sessions. I know I have said this before, but it takes a village to raise successful kids. Let's use that village to help them reach their goals!!



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