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.

Department of Health Sciences Brunel University London London United Kingdom

Department of Movement and Sports Sciences Ghent University Ghent Belgium

Department of Natural Sciences in Kinanthropology Faculty of Physical Culture Palacký University Olomouc Olomouc Czechia

Department of Pedagogical and Educational Sciences Behavioural Science Institute Radboud University Nijmegen Netherlands

Department of Psychology Umeå University Umeå Sweden

Department of Rehabilitation School of Health and Welfare Jönköping University Jönköping Sweden

Division of Physiotherapy Department of Health and Rehabilitation Sciences Faculty of Health Sciences University of Cape Town Cape Town South Africa

Healthy Brain and Mind Research Centre School of Behavioural and Health Sciences Faculty of Health Sciences Australian Catholic University Melbourne VIC Australia

Heidelberg University Heidelberg Germany

Klinik für Kinderneurologie und Sozialpädiatrie Kinderzentrum Maulbronn gGmbH Maulbronn Germany

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Which outcomes are key to the pre-intervention assessment profile of a child with developmental coordination disorder? A systematic review and meta-analysis

Anticipatory postural adjustment deficits in children with developmental coordination disorder during a self-induced prehension task while standing on one leg

Awareness about developmental coordination disorder

Motor-cognitive coupling is impaired in children with mild or severe forms of developmental coordination disorder