Such differences are now formalized in the DSM-5 as core diagnostic characteristics, and they carry real consequences: sensory overload and distress can drive avoidance, anxiety, and reduced participation in everyday activities, straining both learning and family life. Motor difficulties compound the picture, affecting roughly 50 to 85 percent of children with autism. Impairments span gross and fine motor skills, coordination, motor planning, postural control, and perceptual-motor integration, and both DSM-5 and ICD-11 acknowledge that many of these children also meet criteria for Developmental Coordination Disorder.

Over twelve consecutive weeks, each participating child attended two individual 60-minute sessions per week, totaling 24 sessions delivered by therapists trained in developmental and sensory-motor interventions. Every session followed the same six-phase architecture: a welcome and regulation period with breathing exercises and calming music, ten minutes of free sensory exploration, fifteen minutes of guided sensory-motor activities such as obstacle courses and balance exercises, fifteen minutes of immersion in a pre-heated, temperature-controlled sensory pool providing deep-pressure stimulation, a reorientation phase to return arousal to baseline, and structured therapist documentation. Although conceptually informed by Ayres Sensory Integration principles, the researchers are explicit that the program was not delivered under the standardized ASI Fidelity Measure and should be considered ASI-informed rather than a true ASI protocol.

The study enrolled 44 children in the intervention arm and compared them with a 10-child cohort receiving treatment as usual alone, all continuing their existing psychoeducational, behavioral, and speech therapy programs. The intervention group was clinically heterogeneous: mean age 6.59 years, 38 boys and 6 girls, with half classified at DSM-5 severity Level 3 and 43 percent nonverbal. Baseline adaptive difficulties were pronounced, with more than half of the sample not yet toilet trained and nearly 60 percent showing inadequate personal hygiene or food selectivity.

The team recoded ordinal behavioral items directionally into eight composites, feeding, sleep, coordination, play, personal autonomy, communication, social interaction, and behavioral regulation, and tested Time by Group interactions with Bonferroni correction applied separately across the behavioral and sensory families. Non-random allocation meant the interaction term could signal association but not causation, a limitation the authors state plainly rather than obscure. The headline result was the selectivity itself.

Mean autonomy scores in the MSR group nearly doubled from 0.44 to 0.86 on the study's ordinal scale, while the comparison group remained flat at 0.77. The between-group difference in change was 0.42 points with a 95 percent confidence interval of 0.22 to 0.63, and a nonparametric Mann-Whitney sensitivity analysis confirmed the finding. No other domain, including coordination, communication, feeding, sleep, play, social interaction, or behavioral regulation, survived correction.

Four tactile and thermal items, responses to rough, smooth, and soft surfaces and to warm sensations, showed statistically significant group-by-time interactions after correction, but the researchers argue these cannot be labeled clinical improvement. The raw ordinal scores quantified response intensity without classifying each child as hyperreactive or hyporeactive at baseline, meaning a decrease in score could be beneficial for one child and detrimental for another. Moreover, the interactions primarily reflected score reductions in the untreated comparison group and relative stability in the intervention group, patterns better described as divergent trajectories than as therapeutic gains.

No auditory, visual, gustatory, or olfactory item survived adjustment at all. The authors interpret the autonomy signal as compatible with a specific mechanism: a structured, repeatedly practiced therapeutic environment may first influence routine participation, initiation, and supported independence, capacities that transfer to daily self-care before broader behavioral or communicative change emerges. Personal autonomy is clinically meaningful because it concerns everyday routines and dependence on caregivers, and the size of the effect justifies focused replication using validated adaptive-behavior instruments capable of distinguishing dressing, washing, initiation, and need for adult prompting.

The team is equally clear about what the data do not show: a 12-week MSR program should not be expected to produce broad short-term gains in complex socio-communicative or regulatory domains, and descriptive within-group improvements in those areas must not be mistaken for intervention effects. Allocation was non-random, the comparison cohort comprised only 10 children, and baseline imbalances in autism severity, with standardized mean differences reaching 0.37, preclude any claim of equivalence. There was no a priori power calculation, the autonomy composite was study-specific rather than a validated standardized measure, observers reached consensus without archiving independent ratings, and the age range from just over two to nearly eleven years spans dramatic developmental change that the modest sample could not disentangle.

The authors frame their central result as hypothesis-generating: preliminary evidence of a selective, MSR-associated change in personal autonomy that now requires confirmation in randomized, adequately powered trials with prespecified autonomy endpoints, standardized intervention fidelity, and longitudinal follow-up to determine whether the gains endure and which clinical profiles benefit most.

Subject of Research: Effects of multisensory motor-sensory room training on behavioral and sensory functioning in children with autism spectrum disorder

Article Title: Selective change in personal autonomy associated with motor sensory room training in children with autism: an exploratory controlled pre-post study

Article References: Savarese, G., Carpinelli, L., Mandia, R., Diavoletto, A., Piscitelli, M., Impemba, F., Di Siervi, A., Vertullo, A., Bottiglieri, F., Sessa, M., & Corrivetti, G. (2026). Selective change in personal autonomy associated with motor sensory room training in children with autism: an exploratory controlled pre-post study. Frontiers in Psychology, 17, Article 1933418. https://doi.org/10.3389/fpsyg.2026.1933418

Image Credits: AI Generated

DOI: 10.3389/fpsyg.2026.1933418

Keywords: autism spectrum disorder, sensory integration, motor sensory room, personal autonomy, adaptive functioning, pediatric intervention, Bonferroni correction, quasi-experimental study, sensory processing, motor coordination, Frontiers in Psychology, child development

The trial, registered as NCT06797050 and led by researchers at IRCCS Fondazione Stella Maris in Pisa together with the University of Florence and two additional Italian research hospitals, will enroll 80 children randomly assigned to either a social robot training program or a control group continuing standard care. The design is a waitlist randomized controlled trial, meaning the control group receives the same training after a waiting period, an ethically motivated arrangement that ensures no child is denied access to the experimental intervention. Assessments occur at baseline, after the intervention or control period, and again three to four months later.

The scientific rationale rests on a well-documented clinical reality. Children with neuromotor disorders frequently show intertwined difficulties in both motor planning and cognitive planning. Motor planning encompasses the anticipation of goals, the selection and temporal organization of movement sequences, preparation for execution, and online monitoring of outcomes, including components such as anticipatory control, motor programming, and motor imagery. These deficits ripple outward, compromising executive functions like working memory, cognitive flexibility, and inhibitory control, which in turn undermine academic skills, particularly reading comprehension, a multidimensional ability that integrates decoding, inferential reasoning, attention, and metacognitive self-regulation.

The intervention itself is deceptively simple in appearance but carefully engineered underneath. Over 20 to 25 sessions delivered two to three times per week, each lasting roughly an hour, children teach the robot to reorder picture-based stories displayed on a tablet interface. Complexity escalates along three dimensions: the number of images grows from three to seven, the required reasoning deepens from temporal to causal and inferential logic, and the number of characters and locations multiplies. A custom algorithm adapts the sequence of trials to each child’s performance, providing facilitations when errors occur, a structure consistent with principles from gamified learning environments where adaptive progression helps sustain engagement.

The story materials were developed with deliberate inclusivity. The clinical team at Stella Maris created a narrative script featuring characters from diverse ethnic backgrounds and with different types of disabilities, focusing on everyday activities that require specific motor sequences. Professional designers produced the graphics under clinical supervision, and each picture comes with a verbal description the child can replay on demand. Once a story is reordered, the child can listen to the full sequence before confirming the selection, adding a layer of self-monitoring to the task.

Two humanoid platforms from SoftBank Robotics and United Robotics Group will share the workload. Pepper stands 120 centimeters tall with 20 motors and a chest-mounted touchscreen, while NAO measures 57.4 centimeters with 25 degrees of freedom and relies on an external tablet. Both are programmable through the manufacturer’s Choreographe software and Python, and the University of Florence has built custom user interfaces, one for the child on the robot’s tablet and one for the therapist on a computer. Although the two platforms differ, the intervention protocol, session structure, and therapist-mediated procedures are standardized across centers, with robot type treated as a potential covariate in the statistical analysis.

What distinguishes this protocol most sharply from prior work is its multimodal measurement of engagement, a construct the authors acknowledge remains complex and methodologically contested. Emotional engagement will be captured through heart rate recorded by a wrist-worn Fitbit, expressed as a ratio relative to a three-minute pre-interaction baseline, and through facial action units analyzed with the OpenFace toolkit. Cognitive engagement will be estimated from eye-gazing metrics extracted offline using tools such as DeepGaze or Gaze360, tracking the proportion of attention directed to task-relevant stimuli, alongside gaze entropy, blinking rate as an index of cognitive load, and eyebrow and head-pose dynamics. Behavioral engagement will be derived from game logs, including error counts, replay requests, and task durations, with audio analyzed through OpenSmile. Therapists will additionally complete observational checklists after each session.

The primary outcomes are planning abilities measured through the Picture Arrangement subtest of the WISC-III and an ad hoc motor planning test developed at Stella Maris, in which children imitate short sequences of goal-directed actions presented through different model modalities, scored for execution and sequential accuracy. Secondary outcomes span a broad cognitive territory: executive functions via the Tower of London and NEPSY-II inhibition and sorting subtests, visuo-spatial memory through the Corsi block-tapping task, sustained attention on the Leiter-3, narrative production in a freely invented story task coded for structural complexity and psychological lexicon, visual-perceptual skills on the TVPS-4, and reading comprehension with standardized Italian MT test batteries. Parent questionnaires including the BRIEF-2 and ABILHAND-Kids will capture everyday functioning.

The statistical plan is appropriately cautious for a novel intervention. The a priori sample size of 77, rounded to 80, was calculated from paired-samples assumptions, and the authors candidly note it does not formally power the primary between-group comparison. Effects will therefore be reported as estimates with 95 percent confidence intervals rather than as definitive confirmations. Analyses follow the intention-to-treat principle using linear mixed-effects models with group, time, and their interaction as fixed effects, supplemented by per-protocol sensitivity analyses. The Holm-Bonferroni procedure will control for multiple comparisons, and exploratory mediation analyses will test whether engagement predicts or mediates intervention gains, an explicitly underpowered but conceptually important question.

The authors are forthright about limitations: the structured clinical setting may not generalize to daily life, allocation will not be concealed, there is no active technology-matched control condition to isolate the robot’s social presence from the task itself, and the ad hoc motor planning measure has not yet established inter-rater reliability. Yet the trial’s longitudinal, multi-session structure addresses a genuine gap, since most prior robot studies relied on single sessions or small single-case reports. If the children who teach Pepper and NAO show durable gains in planning, executive function, and reading comprehension, the study could establish a template for personalized, engagement-informed rehabilitation, and its sensor-based engagement framework may prove as influential as the intervention itself.

Subject of Research: A randomized controlled trial of social robot-mediated Learning by Teaching intervention for cognitive and motor planning in children with neuromotor impairments

Article Title: A story for Pepper and Nao: applying the learning by teaching paradigm in children with patterns of neuromotor impairment

Article References: Del Lucchese, B., Di Lieto, M. C., Scrocco, A., Matteucci, E., Fiorini, L., Pescini, E., Beani, E., Cotardo, A., Vanni, E., Conti, E., Menici, V., Camuncoli, F., Mangani, G., Maselli, M. V., Adelucci, E., Pani, J., Cavallo, F., Pecini, C., Diella, E., … Sgandurra, G. (2026). A story for Pepper and Nao: applying the learning by teaching paradigm in children with patterns of neuromotor impairment. Frontiers in Digital Health, 8, Article 1929794. https://doi.org/10.3389/fdgth.2026.1929794

Image Credits: AI Generated

DOI: 10.3389/fdgth.2026.1929794

Keywords: social robots, learning by teaching, neuromotor impairment, cerebral palsy, developmental coordination disorder, motor planning, executive functions, engagement, rehabilitation, randomized controlled trial, Pepper robot, NAO robot

The study, led by Ji-Wei Chen and Guan-Li Ma, who contributed equally to the work, tested a school-based programme that combined fundamental movement skills training with a technique known as action observation and motor imagery, or AOMI. Twenty children with DCD were randomly assigned to one of two groups. The experimental group received movement skills training plus AOMI, while the active control group received the same movement training paired with video-based physical activity education. Both groups completed sessions three times per week for ten weeks, ensuring that any difference between the groups could be attributed to the added mental training rather than to extra attention or practice time.

The logic behind AOMI rests on one of neuroscience’s most celebrated discoveries: the brain’s motor system does not merely execute movements, it also rehearses them. Watching someone perform an action activates many of the same neural circuits that fire when we perform it ourselves, and vividly imagining a movement engages overlapping machinery, including the primary motor cortex and the corticospinal pathways that carry commands to the muscles. Previous meta-analyses have shown that combining action observation with motor imagery can heighten corticospinal excitability and improve movement outcomes in healthy adults. What remained untested was whether this approach, layered onto conventional movement training, could help children whose motor systems develop atypically.

To measure progress, the researchers used the Test of Gross Motor Development, third edition, a widely validated instrument that scores children on locomotor skills such as running and hopping and on ball skills such as catching and throwing. Executive function was probed with three computerized tasks: the More-Odd Shifting task, which taps cognitive flexibility; the Stroop task, a classic test of inhibitory control in which children must suppress the urge to read a word and instead name its ink colour; and a Spatial Working Memory task. The team also computed inverse efficiency scores, which combine reaction time and accuracy into a single measure, a technique designed to guard against the well-known speed-accuracy trade-off that can make raw reaction times misleading.

The results were encouraging, though the authors are careful to frame them as preliminary. Both groups improved their gross motor skills over the ten weeks, which is itself reassuring, since it suggests that structured movement training benefits children with DCD regardless of the cognitive component. But the gains were larger in the experimental group, the children who had watched and mentally rehearsed movements in addition to practising them physically. In other words, the mental layer appeared to amplify the physical one.

The executive function findings followed a similar but more nuanced pattern. The experimental group showed greater improvements mainly in reaction time and inverse efficiency scores, meaning that after training, these children responded faster on cognitive tasks and performed better once speed and accuracy were considered together. Accuracy improvements, by contrast, were limited and reached statistical significance only in selected task conditions. This dissociation is scientifically interesting. It suggests that the intervention may have sharpened the efficiency of cognitive processing rather than fundamentally changing how often children got answers right, a pattern consistent with faster and more automatic recruitment of attentional and inhibitory resources.

Why might watching and imagining movements improve executive function at all? One possibility lies in the deep entanglement of motor and cognitive development. Learning a new movement requires holding instructions in mind, monitoring errors, inhibiting habitual but incorrect responses, and adapting plans on the fly, all of which are executive processes. Neuroimaging work has shown that cognitive control influences motor learning through local variations in inhibitory signalling within the primary motor cortex, and that skilled motor performance engages prediction-error mechanisms shared with cognitive learning systems. By repeatedly asking children to observe, imagine, and then execute movements, the training may have exercised these shared circuits from multiple angles simultaneously, strengthening a network that supports both domains.

The school-based setting is another important feature of the trial. Most existing interventions for DCD focus narrowly on motor skills and are delivered in clinics, which limits their reach. International clinical practice recommendations have emphasized the need for accessible, evidence-based services for these children, and recent systematic reviews of motor-based interventions have called for better-designed randomized trials. A programme that can run in a school gymnasium, three times a week, with no equipment beyond videos and standard sports gear, could be scaled far more easily than specialist therapy. The active control design, in which comparison children received an equally plausible educational video programme, strengthens the case that the AOMI component itself drove the additional benefit.

Still, the caveats deserve emphasis, and the authors state them plainly. Twenty children is a small sample, and pilot trials are designed to test feasibility and generate hypotheses, not to establish definitive efficacy. The registered trial, listed on ClinicalTrials.gov under identifier NCT07486856, will need larger and more diverse cohorts to confirm whether the observed advantages hold up, whether they persist after training ends, and whether they transfer to real-world activities such as classroom participation and playground play. The study was funded by the National Social Science Fund of China, and the authors declare no competing interests, with ethical approval from Shanghai University of Sport and written informed consent from all participants’ guardians.

Even as a pilot, the trial points toward a genuinely integrated future for paediatric rehabilitation. If mentally rehearsing movement can amplify the benefits of physical practice while also nudging executive function in the right direction, then the artificial boundary between motor therapy and cognitive training begins to look like an artefact of history rather than a feature of the brain. For the millions of children who dread the ball games and handwriting drills that classmates find effortless, a ten-week programme of watching, imagining, and moving may offer something more valuable than better test scores: a faster, more confident pathway into the physical world of childhood.

Subject of Research: Motor-cognitive integrated training for executive function and gross motor skills in children with developmental coordination disorder

Article Title: Motor-cognitive integrated training improves executive function and gross motor skills in children with developmental coordination disorder: a pilot RCT

Article References: Chen, J.-W., Ma, G.-L., Du, W.-Q., Zhang, X., Sun, B., Zhang, B., & Zhu, K. (2026). Motor-cognitive integrated training improves executive function and gross motor skills in children with developmental coordination disorder: a pilot RCT. Pediatric Research. https://doi.org/10.1038/s41390-026-05549-5

Image Credits: AI Generated

DOI: 10.1038/s41390-026-05549-5

Keywords: developmental coordination disorder, executive function, gross motor skills, motor imagery, action observation, fundamental movement skills, randomized controlled trial, pediatric research, school-based intervention, cognitive training, motor learning, child development

The research, conducted by Anika Stoffel, Johanna Linimayr, and Christina Schulze of the Zurich University of Applied Sciences, surveyed 35 parents of children aged 4 to 7 with a confirmed diagnosis of developmental coordination disorder, commonly abbreviated as DCD. Families lived across eight regions of German-speaking Switzerland and Liechtenstein, and each parent evaluated the playground their child used most frequently. The children, whose average age was 6.0 years, were predominantly boys, and more than half showed impairments in gross motor function. Eight parents reported common comorbidities, including attention deficit hyperactivity disorder, learning disability, Tourette syndrome, and vestibular disorder, reflecting the broader clinical reality that DCD rarely appears in isolation.

The study’s conceptual backbone is a framework of occupational wellbeing developed by Saraswati and colleagues, which breaks a child’s experience of meaningful activity into five domains: competence, autonomy, contentment and pleasure, identity, and belonging. In playground terms, competence means mastering the climb up a lookout tower or balancing across a beam; autonomy means freely choosing what and with whom to play; contentment describes the deep immersion of uninterrupted play; identity reflects a child’s sense of self built on strengths and interests; and belonging captures the experience of connecting with peers. The researchers paired this wellbeing framework with the concept of usability, defined as the ability to navigate and interact with an environment on comparable terms with others, always from the user’s own perspective rather than against official design standards.

Because no existing German-language instrument could capture both constructs, the team built a custom questionnaire, refining it through panels of researchers, occupational therapists, and mothers of young children. Parents rated statements on five-point Likert scales covering everything from sensory stimulation to equipment accessibility, and they added open-ended comments at the end. The data were analyzed descriptively using SPSS, an approach the authors acknowledge was appropriate given the small, exploratory sample. Recruitment ran through 120 pediatric occupational therapy practices, of which 23 agreed to distribute survey materials, with an extension through a Swiss parent counseling organization’s social media channels after the initial four-week window produced too few responses.

The headline finding is unambiguous: parents overwhelmingly value playgrounds. Ninety-four percent agreed or strongly agreed that the playground is an important and valuable play area for their child, and 88 percent endorsed the idea that playgrounds should stimulate multiple senses. Eighty-three percent agreed that diverse children can play according to their own abilities, and 80 percent said versatile equipment that can be used in many ways helps their child. Most families lived within a kilometer of their favorite playground, children spent an average of 72 minutes per visit, and 77 percent of the playgrounds were rated attractive or very attractive. On the surface, the person-environment fit appears remarkably good.

Beneath that positive surface, however, the wellbeing data tell a more complicated story. While autonomy scored high, with a median of 4.5, and contentment and pleasure reached a median of 4, with 89 percent of parents reporting their child has fun almost always or often, the domain of competence exposed the sharpest limitations. Only 34 percent of parents said their child frequently seeks out motor challenges, and exactly half reported that their child could not consistently master playground risks without help. The activities children most wanted to do, climbing (66 percent) and swinging (54 percent), were precisely the activities most often restricted: 54 percent of parents said balancing was difficult, 42 percent flagged climbing, 38 percent monkey bars, and 32 percent swinging. In other words, the very equipment that draws children to playgrounds is where children with DCD hit a wall.

This contradiction between desire and capability carries real clinical weight. Children with DCD are already at elevated risk of anxiety, depression, low self-efficacy, and poor quality of life, and repeated experiences of failure in a public, peer-visible setting can reinforce motor anxiety and learned helplessness. At the same time, risky play is a documented motivator for physical activity and health. The authors argue that playgrounds must therefore strike a delicate balance: offering graduated challenges that invite children to take the next step in mastering motor skills at different levels, without excluding those who are not yet ready. Equipment with multiple difficulty levels, generous handrails, wide platforms, and surfaces that remain safe in all weather emerged from parents’ comments as concrete design priorities.

The domain of belonging showed similarly mixed results. Seventy-one percent of parents said their child could play easily with other children, and the overall belonging score reached a median of 4. Yet responses about positive affirmation from peers spanned the full range from 1 to 5, and among the five children who faced social difficulties, outright social isolation was reported in two cases. Qualitative comments emphasized that keeping up with peers was the key to inclusion in parents’ eyes. The authors note this is more optimistic than earlier studies describing solitary play tendencies in DCD, but they caution that subtle peer dynamics may still reinforce isolation in children already vulnerable to negative self-appraisal. They also raise an intriguing possibility: children may be quietly adapting their own play styles and creating their own places on the playground in ways parents cannot observe, meaning some of the apparent fit may reflect children’s hidden agency rather than genuinely inclusive design.

The study has clear limitations. The self-developed questionnaire was not statistically validated, the sample of 35 is small and purposively recruited, potentially overrepresenting highly engaged parents, and there was no comparison group of typically developing children. Crucially, the children’s own voices are absent; parents served as proxy informants, and prior research suggests adult perceptions of children’s play choices may diverge from children’s lived experiences. The authors call for future work incorporating direct child reports, observational data, and universal design principles to build playgrounds that work for all children from the outset.

Even so, the implications are immediate. For occupational therapists, parents are valuable informants when evaluating a child’s competence and wellbeing in natural settings, and the five-domain framework offers a structured lens for tailoring interventions to playground participation. For planners and communities, the message is that accessibility is not just about ramps for wheelchairs; it is about whether a child with coordination difficulties can climb, swing, and balance alongside friends without help. Playgrounds, the study concludes, are genuinely important places where children with DCD experience autonomy, joy, and connection, but realizing their full inclusive potential will require design that treats the full spectrum of motor ability as a core requirement rather than an afterthought.

Subject of Research: Playground usability and occupational wellbeing in children with developmental coordination disorder

Article Title: Occupational wellbeing on playgrounds: Parents’ views on children with coordination disorder

Article References: Stoffel, A., Linimayr, J., & Schulze, C. (2025). Occupational wellbeing on playgrounds: Parents’ views on children with coordination disorder. Scandinavian Journal of Occupational Therapy, 32(1), Article 2526417. https://doi.org/10.1080/11038128.2025.2526417

Image Credits: AI Generated

DOI: 10.1080/11038128.2025.2526417

Keywords: developmental coordination disorder, playgrounds, occupational wellbeing, inclusive design, parent perspectives, child development, motor skills, occupational therapy, usability, social participation, Switzerland, pediatric health

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