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Background. In everyday life, tasks are often performed simultaneously, which may be more difficult for children with developmental coordination disorder (DCD) than their peers. Aims. To examine (1) the effects of task complexity and type of concurrent task on dual-task performance in children with and without DCD; and (2) if the amount of effort that children put into the task performance differs between the groups. Methods. Participants were 64 children with and without DCD (aged 7–14 years). The dual-task paradigm consisted of a manual dexterity task of relatively low complexity (box and block test) or relatively high complexity (pegboard task), and a concurrent motor task (cycling task) or a concurrent cognitive task (word-listening task). To assess mental effort, children were asked how tired they felt before and after the experiment. Results. Dual-task interference was highest when the manual dexterity task of relatively high complexity was combined with the concurrent motor task. There were no group differences in dual-task interference, but children with DCD reported a larger increase in the level of tiredness after the experiment indicative of greater mental effort. Conclusions. Depending on task demands, children with DCD are able to perform dual-tasks at the same level as their peers, but performance may take children with DCD more mental effort.

This longitudinal study modeled children's complex executive function (EF) development using the Groton Maze Learning Task (GMLT). Using a cohort-sequential design, 147 children (61 males, 5.5–11 years) were recruited from six multicultural primary schools in Melbourne and Perth, Australia. Race/ethnicity data were not available. Children were assessed on the GMLT at 6-month intervals over 2-years between 2010 and 2012. Growth curve models describe age-related change from 5.5 to 12.5 years old. Results showed a quadratic growth trajectory on each measure of error—that is, those that reflect visuospatial memory, executive control (or the ability to apply rules for action), and complex EF. The ability to apply rules for action, while a rate-limiting factor in complex EF, develops rapidly over early-to-mid childhood.

Aim: The neurocognitive basis of Developmental Coordination Disorder (DCD; or motor clumsiness) remains an issue of continued debate. This combined systematic review and meta-analysis provides a synthesis of recent experimental studies on the motor control, cognitive, and neural underpinnings of DCD. Methods: The review included all published work conducted since September 2016 and up to April 2021. One-hundred papers with a DCD-Control comparison were included, with 1,374 effect sizes entered into a multi-level meta-analysis. Results: The most profound deficits were shown in: voluntary gaze control during movement; cognitive-motor integration; practice-/context-dependent motor learning; internal modeling; more variable movement kinematics/kinetics; larger safety margins when locomoting, and atypical neural structure and function across sensori-motor and prefrontal regions. Interpretation: Taken together, these results on DCD suggest fundamental deficits in visual-motor mapping and cognitive-motor integration, and abnormal maturation of motor networks, but also areas of pragmatic compensation for motor control deficits. Implications for current theory, future research, and evidence-based practice are discussed. Systematic Review Registration: PROSPERO, identifier: CRD42020185444.

Aim: The neurocognitive basis of Developmental Coordination Disorder (DCD; or motor clumsiness) remains an issue of continued debate. This combined systematic review and meta-analysis provides a synthesis of recent experimental studies on the motor control, cognitive, and neural underpinnings of DCD. Methods: The review included all published work conducted since September 2016 and up to April 2021. One-hundred papers with a DCD-Control comparison were included, with 1,374 effect sizes entered into a multi-level meta-analysis. Results: The most profound deficits were shown in: voluntary gaze control during movement; cognitive-motor integration; practice-/context-dependent motor learning; internal modeling; more variable movement kinematics/kinetics; larger safety margins when locomoting, and atypical neural structure and function across sensori-motor and prefrontal regions. Interpretation: Taken together, these results on DCD suggest fundamental deficits in visual-motor mapping and cognitive-motor integration, and abnormal maturation of motor networks, but also areas of pragmatic compensation for motor control deficits. Implications for current theory, future research, and evidence-based practice are discussed. Systematic Review Registration: PROSPERO, identifier: CRD42020185444.

Aim: The neurocognitive basis of Developmental Coordination Disorder (DCD; or motor clumsiness) remains an issue of continued debate. This combined systematic review and meta-analysis provides a synthesis of recent experimental studies on the motor control, cognitive, and neural underpinnings of DCD. Methods: The review included all published work conducted since September 2016 and up to April 2021. One-hundred papers with a DCD-Control comparison were included, with 1,374 effect sizes entered into a multi-level meta-analysis. Results: The most profound deficits were shown in: voluntary gaze control during movement; cognitive-motor integration; practice-/context-dependent motor learning; internal modeling; more variable movement kinematics/kinetics; larger safety margins when locomoting, and atypical neural structure and function across sensori-motor and prefrontal regions. Interpretation: Taken together, these results on DCD suggest fundamental deficits in visual-motor mapping and cognitive-motor integration, and abnormal maturation of motor networks, but also areas of pragmatic compensation for motor control deficits. Implications for current theory, future research, and evidence-based practice are discussed. Systematic Review Registration: PROSPERO, identifier: CRD42020185444.

Aim: The neurocognitive basis of Developmental Coordination Disorder (DCD; or motor clumsiness) remains an issue of continued debate. This combined systematic review and meta-analysis provides a synthesis of recent experimental studies on the motor control, cognitive, and neural underpinnings of DCD. Methods: The review included all published work conducted since September 2016 and up to April 2021. One-hundred papers with a DCD-Control comparison were included, with 1,374 effect sizes entered into a multi-level meta-analysis. Results: The most profound deficits were shown in: voluntary gaze control during movement; cognitive-motor integration; practice-/context-dependent motor learning; internal modeling; more variable movement kinematics/kinetics; larger safety margins when locomoting, and atypical neural structure and function across sensori-motor and prefrontal regions. Interpretation: Taken together, these results on DCD suggest fundamental deficits in visual-motor mapping and cognitive-motor integration, and abnormal maturation of motor networks, but also areas of pragmatic compensation for motor control deficits. Implications for current theory, future research, and evidence-based practice are discussed. Systematic Review Registration: PROSPERO, identifier: CRD42020185444.

Aim: The neurocognitive basis of Developmental Coordination Disorder (DCD; or motor clumsiness) remains an issue of continued debate. This combined systematic review and meta-analysis provides a synthesis of recent experimental studies on the motor control, cognitive, and neural underpinnings of DCD. Methods: The review included all published work conducted since September 2016 and up to April 2021. One-hundred papers with a DCD-Control comparison were included, with 1,374 effect sizes entered into a multi-level meta-analysis. Results: The most profound deficits were shown in: voluntary gaze control during movement; cognitive-motor integration; practice-/context-dependent motor learning; internal modeling; more variable movement kinematics/kinetics; larger safety margins when locomoting, and atypical neural structure and function across sensori-motor and prefrontal regions. Interpretation: Taken together, these results on DCD suggest fundamental deficits in visual-motor mapping and cognitive-motor integration, and abnormal maturation of motor networks, but also areas of pragmatic compensation for motor control deficits. Implications for current theory, future research, and evidence-based practice are discussed. Systematic Review Registration: PROSPERO, identifier: CRD42020185444.

This study investigated the role of working memory capacity on implicit and explicit motor sequence learning in young children. To this end, a task was utilized that required a gross motor response (flexing the elbow) and that could differentiate between movement speed (i.e., reaction time and movement time) and movement accuracy. Children aged 7–9 years practiced a serial reaction time task that involved the production of a fixed sequence of elbow flexions of prescribed magnitude across two consecutive days. Children in the explicit group were informed about the presence of the sequence and were shown this sequence, while children in the implicit group were not made aware of the sequence. Additionally, children's verbal and visuospatial working memory capacity was assessed. Results of day 1 regarding movement speed revealed no evidence of sequence learning for either group, but movement accuracy results suggested that sequence learning occurred for the implicit group. For both groups, only improvements in movement accuracy were consolidated on day 2, indicating both general and sequence specific learning. Working memory capacity did not correlate with learning in either of the groups. Children in the explicit group accumulated more sequence knowledge compared to children in the implicit group, but this knowledge did not translate to more or better sequence learning. The minimal differences found between the implicit and explicit condition and the absence of a role for working memory capacity add to the increasing evidence that the observed differences between implicit and explicit sequence learning in adults may be less distinct in children.

This study investigated the role of working memory capacity on implicit and explicit motor sequence learning in young children. To this end, a task was utilized that required a gross motor response (flexing the elbow) and that could differentiate between movement speed (i.e., reaction time and movement time) and movement accuracy. Children aged 7–9 years practiced a serial reaction time task that involved the production of a fixed sequence of elbow flexions of prescribed magnitude across two consecutive days. Children in the explicit group were informed about the presence of the sequence and were shown this sequence, while children in the implicit group were not made aware of the sequence. Additionally, children's verbal and visuospatial working memory capacity was assessed. Results of day 1 regarding movement speed revealed no evidence of sequence learning for either group, but movement accuracy results suggested that sequence learning occurred for the implicit group. For both groups, only improvements in movement accuracy were consolidated on day 2, indicating both general and sequence specific learning. Working memory capacity did not correlate with learning in either of the groups. Children in the explicit group accumulated more sequence knowledge compared to children in the implicit group, but this knowledge did not translate to more or better sequence learning. The minimal differences found between the implicit and explicit condition and the absence of a role for working memory capacity add to the increasing evidence that the observed differences between implicit and explicit sequence learning in adults may be less distinct in children.

Aim: To analyse the development of motor skill and executive function in school-aged children with and without developmental coordination disorder (DCD). Method: Using a longitudinal design, 186 children (86 males, 100 females) aged 6 to 11 years at Time 1 were tested over a 2-year period, 52 of whom were diagnosed with DCD at Time 1 (27 males, 25 females; mean age 8y 5mo, SD 1y 6mo) using DSM-5 criteria. The McCarron Assessment of Neuromuscular Development assessed motor status at Time 1 and at 2-year follow-up (Time 2). Executive function was assessed using a well-validated measure, the Groton Maze Learning Test. Results: The DCD cohort at Time 1 had moderate incidence of executive function deficit (41%). Most importantly, at a group level, children with persisting DCD (across Times 1 and 2) also showed significantly lower levels of executive function than children with typical motor development at both time points. At an individual level, around 26% of children in this group had persisting executive function deficits relative to normal ranges of performance. Interpretation: Children with persisting DCD are at significant risk of executive function issues. The combination of motor and cognitive issues as a potential risk factor in the longer-term development of children is discussed. What this paper adds: Around half of children initially diagnosed with developmental coordination disorder (DCD) had the same diagnosis at 2-year follow-up. 41% of children with DCD have impaired executive function. Children with persisting DCD show poorer executive function than those with typical motor development or remitting DCD.

Effective learning methods are essential for motor skill development and participation in children with low motor abilities. Current learning methods predominantly aim to increase declarative knowledge through explicit instructions that necessitate sufficient working memory capacity. This study investigated the roles of declarative knowledge and working memory capacity in explicit motor learning of children with low motor abilities. We studied both acquisition performance (i.e., performance during practice) and learning (i.e., the improvement in performance from pretest to posttest). After practice with explicit instructions, children with low motor abilities showed significant learning, albeit that improvement was relatively small. However, working memory capacity and declarative knowledge did not predict learning. By contrast, working memory capacity and declarative knowledge did predict performance during practice. These findings suggest that explicit instructions enhance motor performance during practice, but that motor learning per se is largely implicit in children with low motor abilities.

Effective learning methods are essential for motor skill development and participation in children with low motor abilities. Current learning methods predominantly aim to increase declarative knowledge through explicit instructions that necessitate sufficient working memory capacity. This study investigated the roles of declarative knowledge and working memory capacity in explicit motor learning of children with low motor abilities. We studied both acquisition performance (i.e., performance during practice) and learning (i.e., the improvement in performance from pretest to posttest). After practice with explicit instructions, children with low motor abilities showed significant learning, albeit that improvement was relatively small. However, working memory capacity and declarative knowledge did not predict learning. By contrast, working memory capacity and declarative knowledge did predict performance during practice. These findings suggest that explicit instructions enhance motor performance during practice, but that motor learning per se is largely implicit in children with low motor abilities.

Atypical brain development and early brain injury have profound and long lasting impact on the development, skill acquisition, and subsequent independence of a child. Heterogeneity is present at the brain level and at the motor level; particularly with respect to phenomena of bilateral activation and mirrored movements (MMs). In this multiple case study we consider the feasibility of using several modalities to explore the relationship between brain structure and/or activity and hand function: Electroencephalography (EEG), both structural and functional Magnetic Resonance Imaging (sMRI, fMRI), diffusion tensor imaging (DTI), transcranial magnetic stimulation (TMS), Electromyography (EMG) and hand function assessments. Methods: 15 children with unilateral CP (ages: 9.4 ± 2.5 years) undertook hand function assessments and at least two additional neuroimaging and/or neurophysiological procedures: MRI/DTI/fMRI (n = 13), TMS (n = 11), and/or EEG/EMG (n = 8). During the fMRI scans and EEG measurements, a motor task was performed to study cortical motor control activity during simple hand movements. DTI tractography analysis was used to study the corpus-callosum (CC) and cortico-spinal tracts (CST). TMS was used to study cortico-spinal connectivity pattern. Results: Type and range of severity of brain injury was evident across all levels of manual ability with the highest radiological scores corresponded to children poorer manual ability. Evidence of MMs was found in 7 children, mostly detected when moving the affected hand, and not necessarily corresponding to bilateral brain activation. When moving the affected hand, bilateral brain activation was seen in 6/11 children while 3/11 demonstrated unilateral activation in the contralateral hemisphere, and one child demonstrated motor activation predominantly in the supplementary motor area (SMA). TMS revealed three types of connectivity patterns from the cortex to the affected hand: a contralateral (n = 3), an ipsilateral (n

Atypical brain development and early brain injury have profound and long lasting impact on the development, skill acquisition, and subsequent independence of a child. Heterogeneity is present at the brain level and at the motor level; particularly with respect to phenomena of bilateral activation and mirrored movements (MMs). In this multiple case study we consider the feasibility of using several modalities to explore the relationship between brain structure and/or activity and hand function: Electroencephalography (EEG), both structural and functional Magnetic Resonance Imaging (sMRI, fMRI), diffusion tensor imaging (DTI), transcranial magnetic stimulation (TMS), Electromyography (EMG) and hand function assessments. Methods. 15 children with unilateral CP (ages: 9.4 ± 2.5 years) undertook hand function assessments and at least two additional neuroimaging and/or neurophysiological procedures: MRI/DTI/fMRI (n = 13), TMS (n = 11), and/or EEG/EMG (n = 8). During the fMRI scans and EEG measurements, a motor task was performed to study cortical motor control activity during simple hand movements. DTI tractography analysis was used to study the corpus-callosum (CC) and cortico-spinal tracts (CST). TMS was used to study cortico-spinal connectivity pattern. Results. Type and range of severity of brain injury was evident across all levels of manual ability with the highest radiological scores corresponded to children poorer manual ability. Evidence of MMs was found in 7 children, mostly detected when moving the affected hand, and not necessarily corresponding to bilateral brain activation. When moving the affected hand, bilateral brain activation was seen in 6/11 children while 3/11 demonstrated unilateral activation in the contralateral hemisphere, and one child demonstrated motor activation predominantly in the supplementary motor area (SMA). TMS revealed three types of connectivity patterns from the cortex to the affected hand: a contralateral (n = 3), an ipsilateral (n

This review outlines a conceptual approach to inform research and practice aimed at supporting children whose lives are complicated by impairment and/or chronic medical conditions, and their families. ‘Participation’ in meaningful life activities should be an essential intervention goal, to meet the challenges of healthy growth and development, and to provide opportunities to help ensure that young people with impairments reach their full potential across their lifespan. Intervention activities and research can focus on participation as either an independent or dependent variable. The proposed framework and associated hypotheses are applicable to children and young people with a wide variety of conditions, and to their families. In taking a fresh ‘non-categorical’ perspective to health for children and young people, asking new questions, and exploring issues in innovative ways, we expect to learn lessons and to develop creative solutions that will ultimately benefit children with a wide variety of impairments and challenges, and their families, everywhere.

This paper examines how current understandings of childhood participation and motor development provide opportunities for using new technologies (such as virtual reality—VR) for children with neurodevelopmental disorders. Specifically, the International Classification of Functioning, Disability and Health is used to conceptualize the role of technology in treatment across body structures and body function, activity performance, and participation (WHO 2007, 2012). First, we review the particular motor control and learning mechanisms that have been implicated in children with atypical motor development, like DCD. This section will highlight avenues for targeted remediation. Next, VR-based rehabilitation systems are reviewed in relation to neurodevelopmental disorders, focusing first on CP and second on more recent applications for children with DCD. We describe the evolution of particular design innovations in virtual rehabilitation including recent advances using tangible interfaces, as well as other methods targeting cognitive function more specifically. Benefits of these various treatments will be viewed through the lens of current theory and evaluated at the level of child and family outcomes. Finally, we consider the broader aspects of the potential for technological innovation in rehabilitation and its impact on brain function, activity competence, and longer-term participation.