The review, led by Serena Cacciola of the University of Massachusetts Amherst together with colleagues at the University of South Carolina and the University of Minnesota, set out to map the existing research landscape rather than to pool results statistically. The team systematically searched nine databases for empirical studies published between 2004 and 2024, applying strict inclusion criteria: children had to be between 33 and 72 months old, the sample had to include children with developmental disabilities, and each study had to measure at least two of the three movement behaviors that together fill a child’s 24-hour day. Screening of titles, abstracts, and full texts was completed by two independent reviewers, a safeguard designed to reduce selection bias in which studies made it into the final synthesis.

Twenty articles, the vast majority of them cross-sectional snapshots rather than longitudinal studies, met the criteria. The studies spanned a wide range of developmental domains, including autism spectrum disorder, cerebral palsy, and developmental coordination disorder, among other delays, disorders, and disabilities. That breadth is itself informative, the authors note, because it reflects growing recognition that movement behaviors are not a one-size-fits-all phenomenon: a child with motor impairments from cerebral palsy faces very different barriers to active play than a child with autism who may experience sensory sensitivities or strong preferences for screen-based activities.

The central finding of the review is, in a word, inconsistency. Across the twenty studies, findings on sleep, sedentary behavior, and physical activity were mixed. Some investigations reported statistically significant differences between children with and without developmental disabilities, while others found no differences at all, or produced results that shifted depending on which behavior was measured, how it was quantified, and which diagnostic group was under study. Sleep emerged as one of the more commonly examined behaviors, with several studies suggesting that children with certain developmental conditions may experience more sleep problems or shorter sleep durations, but even here the evidence did not point uniformly in one direction.

This heterogeneity matters because the 24-hour movement behavior framework treats physical activity, sedentary time, and sleep as interconnected rather than independent. Time is a fixed resource: every additional hour of screen-based sedentary behavior is an hour not spent in active play or sleep, and the health effects of these behaviors are thought to interact. International guidelines for preschoolers typically recommend specific daily targets for each behavior, yet the review makes clear that researchers still lack a reliable picture of whether children with developmental disabilities are meeting, exceeding, or falling short of those targets, and whether the patterns seen in older children with disabilities are already visible before school entry.

The methodological details of the included studies help explain the muddled picture. Measurement approaches varied widely, from parent-report questionnaires to accelerometers and other wearable devices, and each approach carries distinct strengths and weaknesses. Parent reports of a child’s activity or sleep can be shaped by recall bias and by the practical realities of caring for a child with high support needs, while objective devices can struggle to capture the sometimes atypical movement patterns of children with motor disabilities. Few studies measured all three behaviors simultaneously, which limits the ability to characterize the full 24-hour cycle that the framework is designed to capture.

The review also highlights a deeper conceptual gap: developmental considerations have largely been absent from previous syntheses. Evidence from older children indicates that differences in movement behaviors between those with and without disabilities may begin to emerge in early childhood, but reviews to date have rarely focused specifically on the preschool window. The authors argue that this period, roughly ages three to five, is critical because habits formed in early childhood tend to track into later life, and because early intervention is generally more effective than remediation after problems become entrenched. Without preschool-specific evidence, clinicians and families are left extrapolating from research on older children that may not apply.

Another limitation the authors identify is the fragmentation of research across diagnostic categories. Studies of children with autism spectrum disorder rarely included children with cerebral palsy, and vice versa, making it difficult to determine whether observed differences in movement behaviors are driven by the specific domain of developmental difference or by broader factors such as family routines, access to inclusive recreational programs, or therapist recommendations. The review’s third research question, whether movement behaviors varied by developmental domain, could only be partially addressed because so few studies made direct comparisons across conditions.

What the review does offer is a roadmap. The authors call for more comprehensive and consistent measurement that considers all three 24-hour movement behaviors together, ideally using validated instruments and, where possible, objective monitoring. They also call for studies that follow children over time, so that researchers can distinguish transient early-childhood patterns from trajectories that persist into school age. Better evidence, they argue, is the prerequisite for designing targeted interventions, whether that means adapted physical activity programs for children with motor impairments, sleep hygiene support for families of children with autism, or strategies to reduce sedentary screen time in ways that accommodate sensory and communication needs.

For parents, educators, and therapists, the immediate takeaway is one of cautious awareness rather than alarm. The review does not establish that preschoolers with developmental disabilities are uniformly less active, more sedentary, or worse sleepers than their peers; rather, it shows that the evidence base is too thin and too variable to say with confidence. What is clear is that movement behaviors in early childhood are measurable, modifiable, and consequential, and that children with developmental disabilities deserve the same rigorous attention to their daily activity, sedentary time, and sleep that has increasingly been extended to typically developing children. Closing that research gap, the authors conclude, is an essential step toward ensuring that every child, regardless of developmental profile, gets the strongest possible start.

Subject of Research: 24-hour movement behaviors in preschool-aged children with developmental disabilities

Article Title: Exploring 24-h movement behaviors in preschool children with developmental disabilities: a scoping review

Article References: Cacciola, S., Burkart, S., Toole, E., Horger, M. N., Woodman, A. C., Kiely, K., Fisher, M., Johnson, E., Salvati, G., Rosas, L., Freedman, S., Fandy, M., & St. Laurent, C. W. (2026). Exploring 24-h movement behaviors in preschool children with developmental disabilities: a scoping review. Journal of Activity, Sedentary and Sleep Behaviors. https://doi.org/10.1186/s44167-026-00106-1

Image Credits: AI Generated

DOI: 10.1186/s44167-026-00106-1

Keywords: physical activity, sedentary behavior, sleep, developmental disabilities, preschool children, early childhood, autism spectrum disorder, cerebral palsy, developmental coordination disorder, scoping review, 24-hour movement behaviors, child health

Developmental coordination disorder, a neurodevelopmental condition characterized by substantial impairments in motor coordination, affects a notable percentage of the pediatric population worldwide. However, because its manifestations can be subtle and easily mistaken for clumsiness or normal developmental variations, many cases remain undiagnosed during the crucial early years. The study emphasizes that none of the parents whose children exhibited marked motor dysfunction were aware of these difficulties, underscoring a public health blind spot. This absence of parental recognition exacerbates delays in intervention, which are known to negatively impact academic achievement, social integration, and long-term motor skill development.

The researchers implemented an objective screening protocol suitable for widespread application in preschool environments. By utilizing standardized motor development assessments adapted for young children, the team was able to identify subtle yet clinically significant coordination deficits that often go unnoticed in routine pediatric evaluations. This methodology not only facilitates early detection but is also resource-efficient and designed for scalability in diverse educational and healthcare settings, ranging from urban centers to underserved rural areas.

Early identification is paramount because DCD is associated with secondary complications that extend beyond the neuromotor domain. Children with unaddressed motor coordination impairments frequently experience diminished self-esteem, increased risk of mental health disorders such as anxiety and depression, and challenges in engaging with physical activities and peer groups. Timely clinical referral prompted by structured screening can enable interventions, including occupational and physical therapy, which have been demonstrated to improve motor outcomes and enhance quality of life.

The absence of parental awareness revealed by the study highlights an urgent need for educational initiatives that inform families, educators, and primary care providers about the signs and implications of early motor development issues. This calls for integrated communication strategies encompassing media, healthcare frameworks, and preschool programming to ensure a collective response geared towards early support. The study’s implications extend to policy-making, advocating for the inclusion of routine motor screening in child health surveillance protocols globally.

Technically, the study leverages cross-sectional data collection methods combined with validated assessment tools tailored for developmental neuroscience. The stringent inclusion criteria ensured that children with coexisting neurological conditions or intellectual disabilities were excluded, thereby isolating motor coordination deficits as the primary variable. Statistical analyses confirmed significant correlations between standardized motor assessment scores and subsequent clinical evaluations, establishing the reliability and predictive validity of the screening approach.

Furthermore, the research challenges previous paradigms that delayed recognition of DCD until school age when functional limitations become more apparent. By interrogating the early preschool phase, this study opens avenues for neuroscientific exploration into the neuroplasticity potential during early childhood. The findings endorse early intervention models that harness critical periods of brain development, potentially altering the trajectory of motor and cognitive functions in affected individuals.

From a clinical perspective, the study serves as a call to action for pediatricians and allied health professionals to adopt objective motor screening as part of standard practice during well-child visits. It also suggests that health systems invest in training practitioners to interpret and act on motor assessment data effectively. Coupled with improved parental education, these measures could close the gap between symptom onset and formal diagnosis, reducing the long-term sequelae of undetected DCD.

This research adds to the growing body of evidence underscoring the vital intersection between developmental biology, early education, and clinical medicine. Its interdisciplinary approach aligns with contemporary trends in precision pediatrics, where individualized screening and timely, contextually tailored interventions are becoming the gold standard. The scalable nature of the screening tool ensures its suitability not only for high-resource settings but also for low- and middle-income countries striving to enhance childhood developmental health outcomes.

In summary, this pivotal study advances our understanding of developmental coordination disorder by highlighting the hidden prevalence of substantial motor difficulties in preschool-aged children and the critical importance of objective, structured screening strategies. It redefines early childhood motor assessment through rigorous methodology, bridging gaps in awareness and clinical referral processes. Ultimately, it offers hope for improved lifelong outcomes by advocating for the earliest possible recognition and support.

For researchers, clinicians, educators, and policymakers alike, these findings underscore the necessity of prioritizing early motor development monitoring as a public health imperative. The study’s innovative framework can serve as a prototype for integrating developmental neuroscience insights with pragmatic health system solutions. This convergence promises to transform how motor development challenges are identified and managed, ensuring children with DCD receive the timely care essential for thriving in both school and life.

The corresponding author, Barbara Scheiber, BSc, MSc, stands ready to engage with the scientific community to further discourse on implementation strategies for early DCD screening. Her team’s work represents a significant stride toward mitigating the pervasive but often invisible burden of motor coordination difficulties in early childhood.

Subject of Research: Developmental coordination disorder prevalence and early identification in preschool children through systematic motor screening.

Article Title: [Not provided]

News Publication Date: [Not provided]

Web References: DOI: 10.1001/jamanetworkopen.2025.36227

References: [Not provided]

Image Credits: [Not provided]

Keywords: Motor development, Children, Parenting, Preschool, Medical diagnosis