Why is crossing midline so important?

What is the midline? 

Our bodies have an imaginary line down the center that divides the body into left and right. 

What does it mean to cross midline? 

Crossing midline is the ability to reach across the middle of the body with our  arms and legs to perform a task. 

How soon does crossing midline develop?

Amazingly, babies as young as 3 months old, begin to cross midline with their eyes. They can visually track objects that are moved in front of them in an arc shape. Before crossing midline is fully established, children will typically do tasks on only one side of their body. For example, it a toy is on the left side of their body, they will use their left hand to grab it. At 6 months, babies begin reaching across their body with one hand. At 8 months, they cross the midline with both hands. This is seen when they  transfers objects from one hand to the other. By age 4, the children should be able to easily cross midline. This ability to cross midline is a critical part of child development. 

What is the effect of not crossing midline or having a dominant hand? 

When children are not able to easily cross midline, learning to write becomes a struggle. This happens because they now have two less skilled hands rather than one stronger, dominant hand. Difficulty crossing the midline can also impact reading, writing and language! When children have difficulty visually tracking moving objects from one side to the other it then delays their ability to read.  Being able to track left to right is a critical skill when reading. *Research has shown that children with ADHD are more likely to be cross or mixed dominant. This can cause problems with coordination, reading, math and attention.

What is the impact of mixed dominance?  

Kids  who are mixed dominant often do not have the coordination skills to cross midline smoothly. Reading, writing, completing worksheets and even navigating the playground for recess requires crossing the midline. 

Many children who have ADHD prefer sports like soccer, track and field and football.  The reason why; these sports do not require them to cross midline. Encouraging all kids to play a sport that crosses the midline is ideal! This additional midline crossing practice will benefit them on the field and in the classroom!

What are some activities that work on crossing midline? 

Acronyms Commonly Used In Our Profession

What do all these Acronyms mean?

SLPSpeech Language Pathologist
SLP-ASpeech Language Pathologist Assistant
ASHAAmerican Speech and Hearing Association
CCCCertificate of Clinical Competence
IEPIndividualized Education Plan
ESY Extended School Year
RTIResponse To Intervention
IDEAIndividuals with Disabilities Education Act 2004
IEEIndependent Educational Evaluation 
FAPEFree Appropriate Public Education
BIPBehavior Intervention Plan
EIEarly Intervention
IFSPIndividualized Family Service Plan
Dx Diagnosis

When should my child stop using phonological processes in his/her speech?

Phonological processes are speech sound errors that occur in patterns.  In younger children, these are sometimes developmentally appropriate.  However, some of them should disappear by age 3, and all of them should disappear by age 7.  Some common phonological processes include:

  • Reduplication: e.g. “baba” for bottle.  Should disappear by age 3.
  • Unstressed syllable deletion: e.g. “nana” for banana.  Should disappear by age 3.
  • Velar fronting:  The velar sounds /k/ and /g/ are replaced by /t/ and /d/, which are made closer to the front of the mouth.  For example, cookie becomes “tookie.” Should disappear by age 3.
  • Consonant cluster reduction:  A consonant in a cluster is omitted.  For example, “school” becomes “cool.”  Should disappear by age 7.
  • Gliding:  The sounds /r/ and /l/ are replaced by /w/.  For example, “run” becomes “wun.”  Should disappear by age 7.

If your child is still exhibiting phonological processes after turning 7, it is a good idea to consult with a speech-language pathologist.

What are Vocal Nodules?

Vocal nodules are non cancerous growths on the vocal folds. They affect the way a person’s voice sounds. The voice can sound hoarse, lower in pitch, or breathy. They form because of repeated stress on one area of the vocal folds. They often form in pairs.

Some causes for vocal nodules include talking loudly, allergies, smoke, singing, tense muscles, and drinking caffeine.

What are the stages of Early Language Development?

From birth to 3 months a child should began to recognize familiar voices and smile reflexively. A social smile should develop at around 3 months

From 4 to 6 months a child should begin to babble and use more consonant like sounds (p,b,m). They should move their eyes toward a source and begin to vocalize excitement and displeasure. 

From 7-9 months a child should begin to play vocally, shout for attention, and begin using jargon (pre-linguistic vocalizations in which infants use adult like stress and intonation). 

From 10-12 months the child should recognize their own name, use one or more words, and follow simple commands.

How do I know if my child has Dyslexia?

Dyslexia looks different at different ages. The only way you will know for sure is by having your child tested.  Here are some red flags from preschool to early elementary age.


  • Delayed speech
  • Mixing up sounds in multisyllabic words
  • Early stuttering
  • Ear infections
  • Difficulty rhyming.


  • Struggles to read familiar words
  • Doesn’t know how to decode unfamiliar words
  • Often substitutes words when reading aloud
  • Often skips over or confuses small words

Early Elementary

  • Immature speech
  • Doesn’t consistently recognize words
  • Inaccurate reading of single words in isolation
  • Reading is slow and choppy.

https://www.understood.org: https://www.readingrockets.org/article/common-signs-dyslexia-0 

When are letter reversals in writing no longer appropriate?

Letter reversals, when children write letters backwards or upside down, can be common up until the age of 7 years. It is often called mirror writing. This is due to poor working memory as well as weaknesses in visual processing skills. Children typically reverse the letters b, d, q, p and the numbers 9,5 and 7. People often think this is a sign of dyslexia however dyslexia is more complex than that.


What can I do to help my child with letter reversals?

Have your child say the sound as they are writing the letter to develop muscle memory. 

Work on one letter or number at a time.

Use textured writing (sandpaper, salt tray, gel mats)

What can I do at home to help my child improve his working memory?

There are several ways you can help improve your child’s working memory at home. 

Practice visualization. Encourage your child to create an image in their mind or draw a picture of what they have just read. 

Let them teach you. Ask your child to teach you what they have recently learned, whether it be something they learned at school or in soccer practice. 

Play memory games or cards. Games such as concentration, UNO, or Go Fish are fun games to help build your child’s working memory.

What are sight words?

Sight words are written words that can not be decoded (sounded out) and must be memorized. Examples of these words are “the”, “and”, “you”, “said”, and “two”. To help your child memorize sight words, put magnets of the sight words on the refrigerator, have your child practice them with chalk on the driveway or sidewalk, and practicing reading with them often.

Here is a list of sight words categorized into grade level – https://sightwords.com/sight-words/dolch/#lists

What is the difference between an articulation disorder and a phonological disorder?

Articulation refers to the movement of speech mechanisms such as the tongue, lips, larynx, teeth, hard palate, nose, etc., These mechanisms may not work properly due to being weak, damaged, or malformed, which causes a speech sound disorder. 

On the other hand, phonological disorders focus on the predictable rule-based errors in speech. An example of a phonological disorder is the repeated “fronting” of our velar sounds /k/ and /g/ and are replaced with the sounds /t/ or /d/. 

Refer to the Little Bee Speech for a full list of phonological disorders and an approximate age these errors are eliminated.

Is Phonemic Awareness the Same as Phonics?

Phonemic Awareness is often confused with Phonics. They are not the same. Phonemic Awareness involves oral activities while Phonics involves both print and sound activities. 

Phonemic Awareness is considered a meta-cognitive skills. Once the concept is learned, it can be generalized to other words. In English, Phonics requires the memorization of 26 letters and approximately 98 letter sound combinations. This takes memorizing and practicing until all combinations are quick and automatic.

Why is Phonemic Awareness so Important? 

Phonemic Awareness is a foundational skill that is critical for learning to read. In English (phonemes, which are tiny speech sounds) are mapped onto letters that we use for reading and spelling. 

Reading involves mapping a spatial sequence of letters, from left to right, onto a temporal sequence of phonemes, organized from first to last. 

Spelling involves a similar process but in the other direction. In order to spell, the child must be able to go from sound to print. 

The above mentioned reasons are what makes Phonemic Awareness so important.

We often get new clients that have been receiving tutoring but are not making progress. Once we complete testing we often find that they are lacking the crucial skills for reading and spelling. These skills include, rhyming, isolating sounds, blending, segmenting and manipulating sounds.