Developmental coordination disorder,sex, and activity deficit over time: a longitudinal analysis of participation trajectories in children with and without coordination difficulties

Aim Children with developmental coordination disorder (DCD) are known to participate in active play less than typically developing children. However, it is not known whether the activity deficit between children with and without DCD widens or diminishes over time. Method Data were obtained from a large, prospective cohort study of children (baseline n=2278, total n=2470). Motor coordination was assessed for 2083 students using the short form of the Bruininks–Oseretsky Test of Motor Proficiency. Participation in organized and free‐play activities was assessed using a participation questionnaire on five occasions over 3 years. Mixed‐effects modelling was used to examine differences in participation over time between children with probable DCD (pDCD, n=111, 46 males, 65 females) and their typically developing peers (n=1972, 1016 males, 956 females). The mean age for the whole sample was 9 years 11 months (SD 5mo) at assessment 1, 10 years 5 months (SD 5mo) at assessment 2, 10 years 11 months (SD 5mo) at assessment 3, 11 years 4 months (SD 4mo) at assessment 4, and 11 years 11 months (SD 4mo) at assessment 5. Results Children with pDCD reported less participation in organized and free‐play activities than their typically developing peers, and these differences persisted over time. Among males, the gap in participation in free‐play activities between those with DCD and typically developing children diminished substantially over time; among females, it increased slightly. Interpretation DCD is associated with a persistent activity deficit in children. Its effect on participation appears to be particularly serious among females but may diminish with time among males.     

Motor proficiency of 6‐ to 9‐year‐old children with speech and language problems

Aim This study compared the gross motor skills of school‐age children (mean age 7y 8mo, range 6–9y) with developmental speech and language disorders (DSLDs; n=105; 76 males, 29 females) and typically developing children (n=105; 76 males, 29 females). The relationship between the performance parameters and the children’s age was investigated as well as the role of the type of DSLD. Method The children with DSLDs were classified by their schools’ speech and language therapists into three subgroups: children with speech disorders (n=16), those with language disorders (n=41), or those with both (n=48). They were tested with the Test of Gross Motor Development, 2nd edition. Results Compared with their typically developing peers, all three DSLD subgroups scored lower on the locomotor (all p values <0.001) and object control sub tests (all p values <0.001). Significant performance differences were found between the three types of DSLD (all p values <0.01) where the children with language disorders only performed better. Older children performed better than the younger ones (p_locomotor=0.029, p_{object control} <0.001), but the magnitude of differences between the children with DSLDs and their peers did not change with increasing age. Interpretation Children with DSLDs have poor gross motor skills. Although the performance of children with DSLDs improves with increasing age, it lags behind that of typically developing children. The present results emphasize the importance of early diagnosis and intervention for children with motor deficits.     

Mechanical properties of the plantarflexor musculotendinous unit during passive dorsiflexion in children with cerebral palsy compared with typically developing children

Aim To examine the passive length–tension relations in the myotendinous components of the plantarflexor muscles of children with and without cerebral palsy (CP) under conditions excluding reflex muscle contraction. Method A cross‐sectional, non‐interventional study was conducted in a hospital outpatient clinic. Passive torque–angle characteristics of the ankle were quantified from full plantarflexion to full available dorsiflexion in 26 independently ambulant children with CP (11 females, 15 males; mean age: 6y 11mo, range 4y 7mo–9y 7mo) and 26 age‐matched typically developing children (18 females, 8 males; mean age 7y 2mo, range 4y 1mo–10y 4mo). In the children with CP, the affected (hemiplegia; n=21) or more affected (diplegia; n=5) leg was tested; in typically developing children, the leg tested was randomly selected. Gross Motor Function Classification System levels were I (n=15) and II (n=11). Care was taken to eliminate active or reflex muscle contribution to the movement, confirmed by the absence of electromyographic activity. Results There were small but significant differences between the two groups for maximum ankle dorsiflexion (p=0.003), but large and significant differences in the torques required to produce the same displacement (p<0.001). Further, the hysteresis of the average loading cycle in the children with CP was over three times that of the typically developing children (p<0.001). Interpretation We believe that the plantarflexor muscles of children with CP are stiffer and intrinsically more resistant to stretch, even though they retain near normal excursion. This increased stiffness is a non‐neurally‐mediated feature demonstrated by these children. The extent to which it influences function and predisposes the children to development of soft tissue contracture is unknown.     

Stability of motor problems in young children with or at risk of autism spectrum disorders,ADHD, and or developmental coordination disorder

Aim The aim of this study was to investigate the stability of motor problems in a clinically referred sample of children with, or at risk of, autism spectrum disorders (ASDs), attention‐deficit–hyperactivity disorder (ADHD), and/or developmental coordination disorder (DCD). Method Participants were 49 children (39 males, 10 females; mean age 5y 6mo, SD 10mo) with various developmental problems, a Movement Assessment Battery for Children (M‐ABC) score on or below the 15th centile, and an IQ of 70 or more. Sixteen children were at risk of developing ADHD, 15 children had a diagnosis of, or were at risk of developing ASD, and 18 children had neither diagnosis. Children were reassessed 2 to 3 years later. Results At follow‐up (mean age 7y 11mo; SD 1y), the mean M‐ABC score was significantly increased, and in 22 children was no longer below the 15th centile. A general linear model to compare the difference in M‐ABC scores in the three groups of children demonstrated a significant difference between groups (p=0.013), with the age at the initial assessment as a significant covariate (p=0.052). The group of children with or at risk of ASD showed less improvement in motor performance. Interpretation Motor problems among preschool age children are not always stable, but appear to be so in most children with ASDs.     

Characterization of spasticity in cerebral palsy: dependence of catch angle on velocity

Aim To evaluate spasticity under controlled velocities and torques in children with cerebral palsy (CP) using a manual spasticity evaluator. Method The study involved 10 children with spastic CP (six males, four females; mean age 10y 1mo, SD 2y 9mo, range 7–16y; one with quadriplegia, six with right hemiplegia, three with left hemiplegia; Gross Motor Function Classification System levels I [n=2], II [n=3], III [n=2], IV [n=2], and V [n=1]; Manual Ability Classification System levels II [n=5], III [n=4], and V [n=1]) and 10 typically developing participants (four males, six females; mean age 10y 3mo, SD 2y 7mo, range 7–15y). Spasticity and catch angle were evaluated using joint position, resistance torque, and torque rate at velocities of 90°, 180°, and 270° per second, controlled using real‐time audio‐visual feedback. Biomechanically, elbow range of motion (ROM), stiffness, and energy loss were determined during slow movement (30°/s) and under controlled terminal torque. Results Compared with typically developing children, children with CP showed higher reflex‐mediated torque (p<0.001) and the torque increased more rapidly with increasing velocity (p<0.001). Catch angle was dependent on velocity and occurred later with increasing velocity (p=0.005). Children with CP showed smaller ROM (p<0.05), greater stiffness (p<0.001), and more energy loss (p=0.003). Interpretation Spasticity with velocity dependence may also be position‐dependent. The delayed catch angle at higher velocities indicates that the greater resistance felt by the examiner at higher velocities was also due to position change, because the joint was moved further to a stiffer position at higher velocities.     

The neurophysiological performance of visuospatial working memory in children with developmental coordination disorder

Aim The objective of this study was to investigate the mechanisms underlying the deficit in visuospatial working memory (VSWM) seen in children with developmental coordination disorder (DCD) and to compare brain activity while performing a VSWM task in children with DCD and typically developing children. Method Behavioural performance and event‐related potentials (ERPs) were recorded in 24 children (12 males, 12 females; mean age 139mo, SD 4mo) with DCD (as determined by a score <5th centile on the Movement Assessment Battery for Children – Second Edition) and in 30 age‐ and sex‐matched typically developing children (15 males; 15 females; mean age 140mo, SD 5mo) recruited from local schools, while performing one spatial non‐delay and two time‐delayed spatial memory tasks. Results Compared with typically developing children, children with DCD exhibited longer reaction times (p = 0.022; partial η²=0.10) and lower accuracy rates (p < 0.001; partial η² = 0.35) on the two spatial memory tasks. Electrophysiological indices also showed distinct modulatory effects, with children with DCD exhibiting smaller P3 (p < 0.001; partial η² = 0.26) and positive slow wave (pSW; p = 0.003; partial η² = 0.16) amplitude and a smaller area under the curve of P3 and pSW components (p = 0.002; partial η² = 0.17). Interpretation The combined analysis of behavioural performance and ERP data suggests that children with DCD have deficits of visuospatial working memory owing to fewer resources being allocated to comparison of spatial locations, less effort allotted to the response selection, and less neural processing employed during the retrieval process phase.     

Postural adaptations to a suprapostural memory task among children with and without developmental coordination disorder

Aim The present study investigated the effects of varying the cognitive demands of a memory task (a suprapostural task) while recording postural motion on two groups of children, one diagnosed with developmental coordination disorder (DCD) and an age‐matched group of typically developing children. Method Two groups, each comprising 38 child volunteers (21 males, 17 females) aged 9 to 10 years, participated in the study. Each child performed a digital memory task at two levels of difficulty, low and high. Positional variability (standard deviation of position) of the head and torso were recorded as the biomechanical responses to the variation in task difficulty. Results Both groups significantly reduced postural motion when engaged in the high‐difficulty condition (p<0.05) compared with the low‐difficulty condition. Children with DCD exhibited significantly higher levels of postural motion (p<0.05) than the typically developing children. The typically developing children significantly reduced their postural motion in the high‐difficulty condition (p<0.05) compared with the low‐difficulty condition, whereas children with DCD did not. Interpretation Our results suggest that the postural responses of children with DCD differ from those of typically developing children while engaging in a memory task with various levels of difficulty.     

Is lower IQ in children with epilepsy due to lower parental IQ? A controlled comparison study

Aim The aim of this study was to determine the relationship between parent and child Full‐scale IQ (FSIQ) in children with epilepsy and in typically developing comparison children and to examine parent–child IQ differences by epilepsy characteristics. Method The study participants were 97 children (50 males, 47 females; age range 8–18y; mean age 12y 3mo, SD 3y1mo) with recent‐onset epilepsy including idiopathic generalized (n=43) and idiopathic localization‐related epilepsies (n=54); 69 healthy comparison children (38 females, 31 males; age range 8–18y; mean age 12y 8mo, SD 3y 2mo), and one biological parent per child. All participants were administered the Wechsler Abbreviated Scale of Intelligence (WASI). FSIQ was compared in children with epilepsy and typically developing children; FSIQ was compared in the parents of typically developing children and the parents of participants with epilepsy; parent–child FSIQ differences were compared between the groups. Results FSIQ was lower in children with epilepsy than in comparison children (p<0.001). FSIQ of parents of children with epilepsy did not differ from the FSIQ of the parents of typically developing children. Children with epilepsy had significantly lower FSIQ than their parents (p<0.001), whereas comparison children did not. The parent–child IQ difference was significantly higher in the group with epilepsy than the comparison group (p=0.043). Epilepsy characteristics were not related to parent–child IQ difference. Interpretation Parent–child IQ difference appears to be a marker of epilepsy impact independent of familial IQ, epilepsy syndrome, and clinical seizure features. This marker is evident early in the course of idiopathic epilepsies and can be tracked over time.     

Head–torso–hand coordination in children with and without developmental coordination disorder

Aim This study investigated the nature of coordination and control problems in children with developmental coordination disorder (DCD). Method Seven adults (two males, five females, age range 20–28y; mean 23y, SD 2y 8mo) and eight children with DCD (six males, two females, age range 7–9y; mean 8y, SD 8mo), and 10 without DCD (seven males, three females, age range 7–9y; mean 8y, SD 7mo) sat in a swivel chair and looked at or pointed to targets. Optoelectronic apparatus recorded head, torso, and hand movements, and the spatial and temporal characteristics of the movements were computed. Results Head movement times were longer (p<0.05) in children with DCD than in the comparison group, even in the looking task, suggesting that these children experience problems at the lowest level of coordination (the coupling of synergistic muscle groups within a single degree of freedom). Increasing the task demands with the pointing condition affected the performance of children with DCD to a much greater extent than the other groups, most noticeably in key feedforward kinematic landmarks. Temporal coordination data indicated that all three groups attempted to produce similar movement patterns to each other, but that the children with DCD were much less successful than age‐matched children in the comparison group. Interpretation Children with DCD have difficulty coordinating and controlling single degree‐of‐freedom movements; this problem makes more complex tasks disproportionately difficult for them. Quantitative analysis of kinematics provides key insights into the nature of the problems faced by children with DCD.     

Motor ability and weight status are determinants of out-of-school activity participation for children with developmental coordination disorder

According to the International Classification of Functioning, Disability and Health model endorsed by the World Health Organization, participation in everyday activities is integral to normal child development. However, little is known about the influence of motor ability and weight status on physical activity participation in children with developmental coordination disorder (DCD). This study aimed to (1) compare motor performance, weight status and pattern of out-of-school activity participation between children with DCD and those without; and (2) identify whether motor ability and weight status were determinants of participation patterns among children with DCD. We enrolled 81 children with DCD (boys, n = 63; girls, n = 18; mean age, 8.07 ± 1.5 years) and 67 typically developing children (boys, n = 48; girls, n = 19; mean age, 8.25 ± 1.6 years). Participation patterns (diversity, intensity, companionship, location, and enjoyment) were evaluated with the Children Assessment of Participation and Enjoyment. Motor ability was evaluated with the Movement Assessment Battery for Children, second edition (MABC-2). Other factors that may influence participation such as age, gender, and body weight were also recorded. Analysis of variance was used to compare outcome variables of the two groups, and significant determinants of activity participation were identified by multiple regression analysis. Children with DCD participated in fewer activities (i.e., limited participation diversity) and participated less frequently (i.e., limited participation intensity) than their typically developing peers; however, companionship, location of participation, and enjoyment level did not differ between the two groups. Children in the DCD group demonstrated significantly worse motor ability as assessed by the MABC-2. Further, a greater proportion of children in the DCD group were in the overweight/obese category compared with their typically developing peers. After accounting for the effects of age and gender, motor ability and weight category explained 7.6% and 5.0% of the variance in participation diversity, respectively, for children with DCD. Children with DCD showed less diverse and less intense out-of-school activity participation than typically developing children. Motor impairment and weight status were independently associated with the lower participation diversity. Interventions aiming at improving participation for children with DCD should target weight control and training in motor proficiency. Further study is needed to identify other factors that may hinder participation in this group of children.     

Assessment of upper‐limb capacity,performance, and developmental disregard in children with cerebral palsy: validity and reliability of the revised Video‐Observation Aarts and Aarts module: Determine Developmental Disregard (VOAA‐DDD‐R)

Aim To investigate the validity and reliability of the revised Video‐Observation Aarts and Aarts module: Determine Developmental Disregard (VOAA‐DDD‐R). Method Upper‐limb capacity and performance were assessed in children with unilateral spastic cerebral palsy (CP) by measuring overall duration of affected upper‐limb use and the frequency of specific behaviours during a task in which bimanual activity was demanded (‘stringing beads’) and stimulated (‘decorating a muffin’). Developmental disregard was defined as the difference in duration of affected upper‐limb use between both tasks. Raters were two occupational and one physical therapist who received 3 hours of training. Construct validity was determined by comparing children with CP with typically developing children. Intrarater, interrater, and test–retest reliability were determined using the intraclass correlation coefficient. Standard errors of measurement and smallest detectable differences were also calculated. Results Twenty‐five children with CP (15 females, 10 males; mean age 4y 9mo [SD 1y 7mo], range 2y 9mo–8y; Manual Ability Classification System levels I–III) scored lower on capacity (p=0.052) and performance (p<0.001), and higher on developmental disregard (p<0.001) than 46 age‐ and sex‐matched typically developing children (23 males; mean age 5y 3mo [SD 1y 5mo], range 2y 6mo–8y). The intraclass correlation coefficients (0.79–1.00) indicated good reliability. Absolute agreement was high, standard errors of measurement ranged from 4.5 to 6.8%, and smallest detectable differences ranged from 12.5 to 19.0%. Interpretation The VOAA‐DDD‐R can be reliably and validly used by occupational and physical therapists to assess upper‐limb capacity, performance, and developmental disregard in children (2y 6mo–8y) with CP.     

Aggressive interactions during free-play at preschool of children with and without developmental coordination disorder

This aim of this study was to investigate an unexpected finding from a larger study examining the play of preschool children with and without developmental coordination disorder (DCD). We found that children with DCD were more frequently involved in aggressive incidents during free-play than their peers. Children with (n = 32) and without DCD (n = 31) were videotaped during free-play at preschool and their play was assessed using the Play Observation Scale. A post hoc analysis was conducted using a specifically developed rating instrument to examine the aggressive incidents captured on video. Videos from 18 children with DCD and 8 typically developing children without DCD were found to contain aggressive incidents. Children with DCD were significantly more often involved as both aggressor (p = .016) and victim (p = .008) than children without DCD (p = .031). This is the first study to identify victimization and aggression as being problematic for children with DCD as young as 4 years of age and needs replication. Given the negative consequences of involvement in aggression and victimization, play-based early intervention focusing on prevention needs to be developed and implemented.     

Activity participation intensity is associated with skeletal development in pre-pubertal children with developmental coordination disorder

PurposeThis study aimed (1) to compare the skeletal maturity and activity participation pattern between children with and without developmental coordination disorder (DCD); and (2) to determine whether activity participation pattern was associated with the skeletal development among children with DCD.Materials and methodsThirty-three children with DCD (mean age: 7.76 years) and 30 typically developing children (mean age: 7.60 years) were recruited. Skeletal maturity was assessed with the Sunlight BonAge system. Motor ability was evaluated by the Movement assessment battery for Children-2 (MABC-2). Participation patterns were evaluated using the Children Assessment of Participation and Enjoyment assessment. Analysis of variance was used to compare the outcome variables between the two groups. Multiple regression analysis was performed to examine the relationship between skeletal development, motor performance and activity participation intensity in children with DCD.ResultsThe DCD group had significantly delayed skeletal development, lower MABC-2 derived scores, and participated less intensely in various types of physical activities than their typically developing peers. After accounting for the effects of age and sex, activity participation intensity score remained significantly associated with delay in skeletal development, explaining 28.0% of the variance (F_{change1, 29} = 11.341, p = 0.002).ConclusionSkeletal development is delayed in pre-pubertal children with DCD. Limited activity participation intensity appears to be one of the contributing factors.     

The effect of early confirmation of hearing loss on the behaviour in middle childhood of children with bilateral hearing impairment

Aim To determine if the benefit of early confirmation of permanent childhood hearing impairment (PCHI) on children’s receptive language development is associated with fewer behavioural problems. Method Follow‐up of a total population cohort of 120 children with PCHI of moderate or greater severity (≥40 decibels relative to hearing threshold level) (67 males, 53 females; mean age 7y 11mo, range 5y 5mo–11y 8mo) and 63 hearing children (37 males, 26 females; mean age 8y 1mo, range 6y 4mo–9y 10mo). The main outcome measures were the Strengths and Difficulties Questionnaire (SDQ) completed by teachers and parents and the Vineland Adaptive Behaviour Scales (VABS) which are completed on the basis of a parental interview. Results Children with PCHI had lower standard scores than hearing children on the Daily Living Skills (p=0.001) and the Socialisation (p=0.001) scales of the VABS. They had significantly higher Total Behaviour Problem scores on the parent‐rated (p=0.002) and teacher‐rated SDQ (p=0.03). Children for whom PCHI was confirmed by 9 months did not have significantly fewer problems on the behavioural measures than those confirmed after that age (p=0.635 and p=0.196). Interpretation Early confirmation has a beneficial effect on receptive language development but no significant impact in reducing behavioural problems in children with PCHI.     

Sensory organization of balance control in children with developmental coordination disorder

This study aimed to (1) compare functional balance performance and sensory organization of postural control between children with and without developmental coordination disorder (DCD) and (2) determine the association between postural control and participation diversity among children with DCD. We recruited 81 children with DCD and 67 typically developing children. Balance was evaluated with the Sensory Organization Test (SOT) and the Movement Assessment Battery for Children-2 (Movement ABC-2). Participation patterns were evaluated using the Children Assessment of Participation and Enjoyment assessment. Analysis of variance was used to compare outcome variables between the two groups. A multiple regression analysis was performed to examine the relationship between participation diversity and balance performance in children with DCD. The DCD group had significantly lower Movement ABC-2 balance scores, SOT-derived equilibrium scores, and sensory ratios than the control group (p < 0.05). However, only the Movement ABC-2 balance score was significantly associated with participation diversity in children with DCD. After accounting for the effects of age and gender, Movement ABC-2 balance score remained significantly associated with participation diversity, explaining 10.9% of the variance (F_change1,77 = 9.494, p = 0.003). Children with DCD demonstrate deficits in sensory organization of balance control. This suboptimal balance ability contributes to limited participation in activities.     

Social information processing in children and adolescents with neurofibromatosis type 1

Aim To examine social information processing in children and adolescents with neurofibromatosis type 1 (NF1). Method Thirty‐two children with NF1 (12 males, 20 females; mean age 12y 4mo, SD 4y) and 32 comparison children (12 males, 20 females; mean age 13y 1mo, SD 3y 11mo) completed face recognition, identification of facial emotions (IFE), and matching facial emotions (MFE) tasks. A series of general linear model analyses of variance were used to compare performance between children with NF1 and comparison children. Results Children with NF1 performed less accurately than comparison children in the face recognition task when faces were presented ‘in profile’ (p=0.05), when fearful expressions had to be identified in IFE (p=0.017), and across conditions in MFE (p=0.009). When quality of cognitive control (i.e. mean standardized scores on tasks measuring working memory and inhibitory control) was introduced to the analyses, differences in face recognition were no longer significant and differences in MFE were largely reduced (p=0.048). Differences in IFE between the comparison group and children with NF1 remained largely intact (fear: p=0.047). Interpretation Children with NF1 have problems in social information processing, which, in part, appear to be caused by cognitive control deficits. Some of the deficits, however, appear to be caused by deficient bottom‐up processing of social signals (e.g. fear recognition).     

Does attention‐deficit–hyperactivity disorder exacerbate executive dysfunction in children with neurofibromatosis type 1?

Aim Although approximately 40% of children with neurofibromatosis type 1 (NF1) meet diagnostic criteria for attention‐deficit–hyperactivity disorder (ADHD), the impact of ADHD on the executive functioning of children with NF1 is not understood. We investigated whether spatial working memory and response inhibition are impaired in children with NF1 without a diagnosis of ADHD and whether executive deficits are exacerbated in children with a comorbid diagnosis. Method Forty‐nine children aged 7 to 15 years with NF1 only (31 males, 18 females; mean age 11y, SD 2y 4mo) or 35 with NF1 and ADHD (18 males, 17 females; mean age 10y 8mo, SD 2y 4mo) and 30 typically developing comparison children (16 males, 14 females; mean age 10y, SD 2y 8mo) were compared on measures of spatial working memory and response inhibition. Group differences in IQ and visuospatial ability were controlled for as required. Results Compared with typically developing children, children with NF1 with or without comorbid ADHD demonstrated significant impairment of both spatial working memory (both p<0.004) and inhibitory control (both p<0.010). There were, however, no differences between the two NF1 groups in spatial working memory (p=0.91) or response inhibition (p=0.78). Interpretation Executive dysfunction occurs with the same severity in children with NF1, whether or not they have a comorbid diagnosis of ADHD, suggesting that executive impairments are not unique contributors to ADHD symptomatology in NF1. The findings are discussed within the context of recent evidence in Nf1 optic glioma (OPG) mice, in which a mechanistic connection between NF1 gene expression, executive system failure, and dopaminergic pathway integrity has been established.     

The effectiveness of exercise intervention on inhibitory control in children with developmental coordination disorder: Using a visuospatial attention paradigm as a model

Children with developmental coordination disorder (DCD) have been demonstrated to show a deficit of inhibitory control in volitional shifts of attention. The aim of this study was to use ecological intervention to investigate the efficacy of table-tennis training on treating both problems with attentional networks and motor disorder in children with DCD. Forty-three children aged 9–10 years old were screened using the Movement Assessment Battery for Children and divided into DCD (n = 27) and typically developing (TD, n = 16) groups. Children with DCD were then quasi-randomly assigned to either a DCD-training group who underwent a ten-week table-tennis training program with a frequency of 3 times a week or a DCD non-training group. Before and after training, the capacity of inhibitory control was examined with the endogenous Posner paradigm task for DCD and TD groups. Table-tennis training resulted in significant improvement of cognitive and motor functions for the children with DCD. The study demonstrated that exercise intervention employed within the school setting can benefit the inhibitory control and motor performance in children with DCD. However, future research efforts should continue to clarify whether the performance gains could be maintained over time.     

A comparison of the oxygen cost of locomotion in children with and without developmental coordination disorder

Aim The aim of this study was to compare the oxygen cost (V?o ₂) of walking and running, as well as aerobic fitness, in children with and without developmental coordination disorder (DCD). Method Thirty‐one males (17 with DCD and 14 in a comparison group; mean age 8y 7mo, SD 1y 3mo and 8y 5mo, SD 1y 2mo respectively) were tested on two separate occasions at least 1 week apart. On the first visit, motor proficiency was assessed by the McCarron Assessment of Neuromuscular Development instrument, which was followed by the determination of maximal aerobic capacity (V?o _2max). The second visit involved 4‐minute bouts of treadmill walking (at 4.3km/h and 5.8km/h) and running (at 7.8km/h and 8.4km/h). Oxygen consumption, heart rate, respiratory exchange ratio, rating of perceived exertion (RPE), step rate, and qualitative assessment of locomotion were obtained for each speed. Results Despite poorer locomotion proficiency, there was no significant difference in the oxygen cost of walking or running between males with and without DCD. However, the DCD group had significantly higher RPE while running at 7.8km/h (p=0.011) and had greater difficulty achieving V?o _2max, resulting in significantly lower scores for aerobic fitness. Interpretation The differences in locomotion proficiency between children with and without DCD are not large enough to affect the oxygen cost of locomotion. However, children with DCD are more likely to withdraw from exercising at higher intensities before achieving peak performance.