Brain activation associated with motor skill practice in children with developmental coordination disorder: an fMRI study

Children with developmental coordination disorder (DCD) have difficulty in learning new motor skills. At present, it is not known whether these children employ a different set of brain regions than typically developing (TD) children during skilled motor practice. Using functional magnetic resonance imaging, we mapped brain activity associated with skilled motor practice of a trail-tracing task in 7 children with DCD and 7 age-matched controls (aged 8-12 years). We indexed change in motor performance as a reduction in tracing error from early practice to retention. Children with DCD showed less blood-oxygen-level-dependent signal as compared to TD children in a network of brain regions associated with skilled motor practice: bilateral inferior parietal lobules (Brodmann Area (BA) 40), right lingual gyrus (BA 18), right middle frontal gyrus (BA 9), left fusiform gyrus (BA 37), right cerebellar crus I, left cerebellar lobule VI, and left cerebellar lobule IX. While no statistically significant differences were detected, effect size testing revealed that children with DCD demonstrated poorer tracing accuracy than TD children at retention (d = 0.48). Our results suggest that, compared to TD peers, children with DCD demonstrate under-activation in cerebellar-parietal and cerebellar-prefrontal networks and in brain regions associated with visual-spatial learning. These data suggest a neurobiological correlation with impaired learning of motor skills in children with DCD, which will need to be confirmed with a larger sample.     

Physical fitness in children with Developmental Coordination Disorder: Measurement matters

Children with Developmental Coordination Disorder (DCD) experience considerable difficulties coordinating and controlling their body movements during functional motor tasks. Thus, it is not surprising that children with DCD do not perform well on tests of physical fitness. The aim of this study was to determine whether deficits in motor coordination influence the ability of children with DCD to perform adequately on physical fitness tests. A case–control study design was used to compare the performance of children with DCD (n = 70, 36 boys, mean age = 8y 1mo) and Typically Developing (TD) children (n = 70, 35 boys, mean age = 7y 9mo) on measures of isometric strength (hand-held dynamometry), functional strength, i.e. explosive power and muscular endurance (Functional Strength Measurement), aerobic capacity (20 m Shuttle Run Test) and anaerobic muscle capacity, i.e. muscle power (Muscle Power Sprint Test). Results show that children with DCD were able to generate similar isometric forces compared to TD children in isometric break tests, but were significantly weaker in three-point grip strength. Performance on functional strength items requiring more isolated explosive movement of the upper extremities, showed no significant difference between groups while items requiring muscle endurance (repetitions in 30 s) and items requiring whole body explosive movement were all significantly different. Aerobic capacity was lower for children with DCD whereas anaerobic performance during the sprint test was not. Our findings suggest that poor physical fitness performance in children with DCD may be partly due to poor timing and coordination of repetitive movements.     

Toward a motor signature in autism: Studies from human-machine interaction

BackgroundAutism spectrum disorder (ASD) is a heterogeneous group of neurodevelopmental disorders which core symptoms are impairments in socio-communication and repetitive symptoms and stereotypies. Although not cardinal symptoms per se, motor impairments are fundamental aspects of ASD. These impairments are associated with postural and motor control disabilities that we investigated using computational modeling and developmental robotics through human-machine interaction paradigms.MethodFirst, in a set of studies involving a human–robot posture imitation, we explored the impact of 3 different groups of partners (including a group of children with ASD) on robot learning by imitation. Second, using an ecological task, i.e. a real-time motor imitation with a tightrope walker (TW) avatar, we investigated interpersonal synchronization, motor coordination and motor control during the task in children with ASD (n = 29), TD children (n = 39) and children with developmental coordination disorder (n = 17, DCD).ResultsFrom the human–robot experiments, we evidenced that motor signature at both groups’ and individuals’ levels had a key influence on imitation learning, posture recognition and identity recognition. From the more dynamic motor imitation paradigm with a TW avatar, we found that interpersonal synchronization, motor coordination and motor control were more impaired in children with ASD compared to both TD children and children with DCD. Taken together these results confirm the motor peculiarities of children with ASD despite imitation tasks were adequately performed.DiscussionStudies from human-machine interaction support the idea of a behavioral signature in children with ASD. However, several issues need to be addressed. Is this behavioral signature motoric in essence? Is it possible to ascertain that these peculiarities occur during all motor tasks (e.g. posture, voluntary movement)? Could this motor signature be considered as specific to autism, notably in comparison to DCD that also display poor motor coordination skills? We suggest that more work comparing the two conditions should be implemented, including analysis of kinematics and movement smoothness with sufficient measurement quality to allow spectral analysis.     

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.     

Perceived athletic competence and physical activity in children with developmental coordination disorder who are clinically referred,and control children

The relationship between perceived athletic competence (PAC) and physical activity (PA) in children with developmental coordination disorder (DCD) is still unclear. This study investigated differences in PAC and PA between, and within, a group of children with DCD that were clinically referred (n = 31) and a group of control children (n = 38), aged 7–12 years. All children were categorized in four groups: (1) children with DCD/low PAC, (2) children with DCD/normal to high PAC, (3) control children/low PAC, and (4) control children/normal to high PAC. PAC was assessed with the Self-Perception Profile for Children, and PA was assessed with the Modifiable Activity Questionnaire. Children with DCD participated less in unorganized PA, but not in organized PA, compared with control children. Normal to high PAC was found in more than half of the children (64.5%) with DCD. Children with DCD/low PAC and children with DCD/normal to high PAC participated significantly less in unorganized physical activity compared with control children/normal to high PAC, but not compared with control children/low PAC. The results indicate that there are large individual differences in PAC in children with DCD.     

High risk for obesity in children with a subtype of developmental coordination disorder

The purpose of this study was to compare the prevalence of overweight and obesity in typically developing (TD) children, children with developmental coordination disorder (DCD) and balance problems (DCD-BP), and children with DCD without balance problems (DCD-NBP). Two thousand and fifty-seven children (1095 boys, 962 girls) ages 9–12 years were recruited from 18 elementary schools in Taiwan. The Movement Assessment Battery for Children was used to assess motor coordination ability. International cut-off points for body mass index were used to classify participants into the following groups: normal-weight, overweight or obese. Compared with TD children, children in the DCD-BP group were more than twice as likely to be obese (OR = 2.28; 95% CI = 1.41–3.68). DCD-BP children were also more likely to be obese compared to DCD-NBP children (OR = 1.79; 95% CI = 1.02–3.16). Boys in the DCD-BP group were more likely to be obese when compared to DCD-BP girls (OR = 3.12; 95% CI = 1.28–7.57). Similarly, DCD-NBP boys were more likely to be obese when compared to DCD-NBP girls (OR = 2.67; 95% CI = 1.21–5.89). Children with both DCD and BP were significantly more likely to be obese when compared to TD and DCD-NBP children. From an intervention perspective, the inclusion of regular physical activity, including activities that encourage development of both balance and energy expenditure, may be required to prevent obesity in this population.     

Impact of tactile function on upper limb motor function in children with Developmental Coordination Disorder

This study investigated the presence of, and relationship between tactile dysfunction and upper limb motor function in children with Developmental Coordination Disorder (DCD) compared to typical developing (TD) children. Participants were 36 children aged 6–12 years. Presence of DCD (n = 20) or TD (n = 16) was confirmed using the Movement Assessment Battery for Children, second edition. All children participated in a comprehensive assessment of tactile registration (Semmes Weinstein Monofilaments); tactile spatial perception (Single Point Localisation (SPL) and two-point discrimination (2PD)); haptic perception (Stereognosis); speed of simple everyday manual tasks (Jebsen–Taylor Test of Hand Function (JTTHF)); and handwriting speed and accuracy (Evaluation Tool of Children's Handwriting (ETCH)). Compared to TD children, children with DCD demonstrated poorer localisation of touch in the non-dominant hand (p = 0.04), slower speed of alphabet writing (p < 0.05) and less legible handwriting (p < 0.01), but no difference in speed of simple everyday manual tasks (JTTHF: p > 0.05). Regression analysis showed that spatial tactile perception (SPL) predicted handwriting legibility (ETCH: r = 0.11) and speed of functional tasks (JTTHF: r = 0.33). These results suggest that tactile function, specifically single point localisation, should be a primary tactile assessment employed to determine reasons for upper limb motor difficulties experienced by children with DCD.     

The efficacy of two task-orientated interventions for children with Developmental Coordination Disorder: Neuromotor Task Training and Nintendo Wii Fit training

Neuromotor Task Training (NTT) and Nintendo Wii Fit Training (Wii training) are both task-based interventions used to improve performance in children with motor coordination problems. The aim of this study was to compare the efficacy of these two interventions on the motor performance, isometric strength and cardiorespiratory fitness (aerobic and anaerobic capacity) of children with Developmental Coordination Disorder (DCD) attending mainstream schools in a low-income setting. A pragmatic, quasi-experimental study design was utilized. Children between the ages of 6–10 years, who scored at or below the 16th percentile on the Movement Assessment Battery for Children-2 (MABC-2) and whose teacher reported a functional motor problem, were allocated to either NTT (n = 37) or Wii training (n = 19) groups depending on school of attendance. The MABC-2, a hand-held dynamometer, the Functional Strength Measure, the Muscle Power Sprint Test and the 20 m Shuttle Run Test were used to assess performance at baseline and after the intervention. The main findings show that the mean motor performance scores of both groups improved over the study period. However, significant differences in improvement were detected between groups, with the NTT group showing greater improvement in motor performance, functional strength and cardiorespiratory fitness. No improvements in isometric strength were seen in either group. The Wii training group showed significant improvement in anaerobic performance. This study provides evidence to support the use of both the Wii Training and NTT for children with DCD. However, in comparison to Wii training, the NTT approach yields superior results across measures of motor proficiency, cardiorespiratory fitness and functional strength. The decision to use either approach may be influenced by resources and time constraints.     

Anxiety profiles in children with and without developmental coordination disorder

Previous work has highlighted that children diagnosed with DCD may be at risk of greater problems related to emotional wellbeing. However, to date much work has relied on population based samples, and anxiety has not been examined within a group of children given a clinical diagnosis of DCD. Additionally, the profile of individual differences has generally not been considered within this group. Therefore, a group of parents (n = 27) completed the parent version of the Spence Children's Anxiety Scale (SCAS-P; Spence, 1998) in relation to their children with a diagnosis of DCD. Their responses on this measure were compared to those of parents with typically developing (TD) children (n = 35; both groups 6-15 years of age). Children diagnosed with DCD were reported to experience significantly greater levels of anxiety overall, as well as having significantly greater difficulty than the TD group in the domains of panic/agoraphobic anxiety, social phobia, and obsessive compulsive anxiety. In addition, the individual profiles of types of anxiety reportedly experienced varied widely across the DCD group. These findings suggest that anxiety is a major problem for a proportion of children diagnosed with DCD, and raises questions regarding intervention, long term outcomes, and the nature of the disorder itself.     

Psychological distress in children with developmental coordination disorder and attention-deficit hyperactivity disorder

This study explored whether or not a population-based sample of children with developmental coordination disorder (DCD), with and without comorbid attention deficit/hyperactivity disorder (ADHD), experienced higher levels of psychological distress than their peers. A two-stage procedure was used to identify 244 children: 68 with DCD only, 54 with ADHD only, 31 with comorbid DCD and ADHD, and 91 randomly selected typically developing (TD) children. Symptoms of depression and anxiety were measured by child and parent report. Child sex and caregiver ethnicity differed across groups, with a higher ratio of boys to girls in the ADHD only group and a slightly higher proportion of non-Caucasian caregivers in the TD group. After controlling for age, sex, and caregiver ethnicity, there was significant variation across groups in both anxiety (by parent report, F(3,235) = 8.9, p < 0.001; by child report, F(3,236) = 5.6, p = 0.001) and depression (parent report, F(3,236) = 23.7, p < 0.001; child report, F(3,238) = 9.9, p < 0.001). In general, children in all three disorder groups had significantly higher levels of symptoms than TD children, but most pairwise differences among those three groups were not significant. The one exception was the higher level of depressive symptoms noted by parent report in the ADHD/DCD group. In conclusion, children identified on the basis of motor coordination problems through a population-based screen showed significantly more symptoms of depression and anxiety than typically developing children. Children who have both DCD and ADHD are particularly at heightened risk of psychological distress.     

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.     

Deficits of visuospatial attention with reflexive orienting induced by eye-gazed cues in children with developmental coordination disorder in the lower extremities: An event-related potential study

The present study aims to investigate and compare the behavioral performance and event-related potentials (ERPs) measures in children with developmental coordination disorder (DCD) and typically developing (TD) children when performing the visuospatial attention task with reflexive orienting. Thirty children with DCD and 30 TD children were recruited and presented with central eye-gazed cues. The children needed to detect and respond to laterally presented reaction signals preceded by centrally presented non-predictive directional and non-directional eye-gazed cues, which directed them to attend covertly to the right or left field location, or straight ahead, via stepping on pedals with their bilateral lower limbs, while brain ERPs were concurrently recorded. The behavioral data showed that children with DCD responded slowly and exhibited a deficit in inhibitory control capacity as compared to TD children. In terms of electrophysiological characteristics, children with DCD showed distinct modulatory effects upon longer N2 and P3 latencies, smaller P3 amplitude, an elongated interval between N2 and the motor response (N2 latency-RT), and small areas on Contingent Negative Variation (CNV). The behavioral and ERP data suggest that children with DCD could have deficits in the ventral attention network and the mechanisms on the inhibitory control difficulty, when performing such a task, could be a slower response inhibitory process and stimulus classification speed, less ability in interhemispheric and cognitive-to-motor transfer speed, and less mature abilities with regard to anticipatorily executive and motor preparatory processes.     

Tool length influences reach distance estimation via motor imagery in children with developmental coordination disorder

Purpose: Children with developmental coordination disorder (DCD) often have difficulties with planning and generating a precise visuospatial representation of intended actions and using motor imagery to mentally represent motor behavior. Here, we aimed to extend the investigation of motor imagery in children with DCD by exploring its use with an estimation of reach paradigm that combines action representation and extension of space with tools. Method: Two groups of 18 children with DCD and typically developing (TD) matched controls were tested with an estimation of reach paradigm using a 20-cm (Experiment 1) and 40-cm (Experiment 2) tool. Conditions involved estimations via motor imagery with their arm, tool, and a switch-block (SB) involving an abrupt change of space with an “extension” from arm to tool and a “retraction” from tool to arm. Results: No significant group differences were found with the 20-cm tool; however, with the 40-cm implement, children with DCD were significantly less accurate than their TD counterparts. Conclusions: Compared to TD children, those with DCD have more difficulty estimating reach distances using the longer of two tool lengths: 40 cm compared to 20 cm. This finding may be related to differences in quality of motor imagery and in the ability to create an effective internal model for action in this context. Furthermore, our results suggest that tool length may present an additional action processing constraint on children with DCD. Additional studies are necessary to determine other constraints that children with DCD have when integrating tool use with spatial judgments for reach actions, as well as provide rehabilitation insights that involve motor imagery combined with tool use.     

Comparison of sleep problems in children with anxiety and attention deficit/hyperactivity disorders

This cross-sectional case–control study compared sleep problems in consecutively referred children aged 7–13 years meeting DSM-IV criteria for anxiety disorder, attention deficit/hyperactivity disorder (ADHD), comorbid anxiety disorder and ADHD, and a group of control children of similar age and gender. Diagnoses were assessed with the Kiddie-SADS PL interview, parent form, and the sleep problems with a standardized sleep questionnaire, the Children’s Sleep Habits Questionnaire (CSHQ), as reported by the mother. A total of 141 children were included (anxiety disorder (n = 41), ADHD (n = 39), comorbid condition (n = 25), controls (n = 36)). Children in the clinical groups had more sleep problems than controls. Children with anxiety disorders and children with comorbid condition were reported to have more sleep problems than children with ADHD alone. Night waking was associated with comorbid anxiety disorder and ADHD. Bedtime resistance was associated with anxiety disorder, while daytime sleepiness affected all clinical groups. Clinical management of children with ADHD and anxiety disorders needs to include assessment of sleep problems.     

Identification of emotional and behavioral problems by teachers in children with developmental coordination disorder in the school community

Current evidence on the co-occurrence of Developmental Coordination Disorder (DCD) and psychosocial problems mainly concerns parent-reported information, but rarely includes teacher information. The aim of this study was (1) to investigate the teachers’ identification of emotional and behavioral problems in children with DCD and (2) to examine the performance of the teacher version of the Strengths and Difficulties Questionnaire (SDQ-T) compared with the Teacher Report Form (TRF) in children with DCD. We assessed primary school children (202 boys, 200 girls, range 4–10.8 years, mean age 7.2 years) for DCD following the DSM IV-TR criteria. Emotional and behavioral problems were measured with the TRF (n = 327) and the SDQ-T (n = 361). DCD was established in 23 (5.7%) children, 16 boys and 7 girls (mean age 7.0 years). Children with DCD had a higher proportion of clinical scores on both the TRF Total Problem Scale (TRF TPS) and SDQ-T Total Difficulties Score (SDQ-T TDS). Children with DCD had increased odds on the TRF domains Thought (odds ratio, OR: 5.39), Externalizing (OR: 4.12) and Internalizing (OR: 4.42) problems, and on all SDQ-T-domains and Total Difficulties score (OR: 7.30). In the DCD group the SDQ-T TDS correlated strongly (Spearman's rho 0.80) with the TRF TPS and demonstrated a moderate agreement (Cohen's Kappa 0.53). In conclusion, teachers identified significantly more emotional and behavioral problems in children with DCD compared with their peers. The SDQ-T showed moderate agreement with the TRF in identifying emotional and behavioral problems in children with DCD.     

Psychometric properties of the DCD-Q-07 in children ages to 4–6

It is important to identify Developmental Coordination Disorder (DCD) early in a child's life to allow for proper and timely intervention and support, and to reduce the negative secondary consequences associated with this condition. In this study we assessed the psychometric properties (construct validity, concurrent validity, reliability and test accuracy) of the Developmental Coordination Disorder Questionnaire (DCD-Q-07) in preschool children. A community-based sample of children ages 4–6 (n = 181) were screened for motor difficulties using the Movement Assessment Battery for Children (M-ABC-2). Use of the M-ABC-2 resulted in the identification of 29 children below the 15th percentile, which we classified as probable DCD. Parents of these children concurrently completed the DCD-Q-07 to report their child's motor performance. The DCD-Q-07 demonstrated high internal consistency for both the full scale (alpha = 0.881) and each subscale: control during movement (alpha = 0.813), fine motor and handwriting (alpha = 0.869) and general coordination (alpha = 0.728). Moderate correlations (r = 0.47–0.63) were also seen between the subscales on the DCD-Q-07, the strongest correlation being between control during movement and general coordination (r = 0.63). Based on published age and sex cut points, the DCD-Q-07 showed poor sensitivity (20.7%) but high specificity (92.1%) against the M-ABC-2. Overall agreement with the M-ABC-2 was low using ROC analysis (area under the curve = 0.654). Although it is important to screen for DCD in young children, the DCD-Q-07 may not be the best choice as a screening tool for DCD in preschool children ages 4–6 due to its low test accuracy.     

Motor imagery training enhances motor skill in children with DCD: A replication study

BackgroundChildren with impaired motor coordination (or DCD) have difficulty using motor imagery. We have suggested that this difficulty is explained by the internal modeling deficit (IMD) hypothesis of DCD. Our previous training study lent support for this hypothesis by showing that a computerized imagery training protocol (involving action observation, and mental- and overt-rehearsal) was equally effective to perceptual-motor therapy (PMT) in promoting motor skill acquisition.AimsThe study presented here was designed to replicate and extend this finding, targeting a select group of children with moderate-to-severe DCD.Methods and ProceduresAll 36 children with DCD who participated were referred to the study and scored below the 10th percentile for their age on the Movement Assessment Battery for Children (MABC). Using a randomized control trial, the referred children were assigned randomly to one of three groups using a blocked procedure: imagery training, perceptual-motor training (PMT), and wait-list control. Motor proficiency was measured using the MABC, pre and post-training. Individual training consisted of 60-min sessions, conducted once a week for 5 weeks.ResultsResults showed that the imagery protocol was equally effective as PMT in promoting motor skill acquisition, with moderate-to-large effect sizes. Individual differences showed that the majority of children in the two intervention groups improved their motor performance significantly.ConclusionsOverall, these results further support the use of motor imagery protocols in the treatment of DCD, and tentative support for the IMD hypothesis. Developmental and dose issues in the implementation of imagery-based intervention are discussed.     

Neural underpinnings of impaired predictive motor timing in children with Developmental Coordination Disorder

A dysfunction in predictive motor timing is put forward to underlie DCD-related motor problems. Predictive timing allows for the pre-selection of motor programmes (except ‘program’ in computers) in order to decrease processing load and facilitate reactions. Using functional magnetic resonance imaging (fMRI), this study investigated the neural correlates of motor timing in DCD (n = 17) and typically developing children (n = 17). The task involved motor responses to sequences of visual stimuli with predictive or unpredictive interstimulus intervals (ISIs). DCD children responded with a smaller reaction time (RT) advantage to predictive ISIs compared to typically developing children. Typically developing children exhibited higher activation in the right dorsolateral prefrontal cortex (DLPFC) and right inferior frontal gyrus (IFG) for responses at unpredictive as opposed to predictive ISIs, whereas activations in DCD children were non-differentiable. Moreover, DCD children showed less activation than typically developing children in the right DLPFC, the left posterior cerebellum (crus I) and the right temporo-parietal junction (TPJ) for this contrast. Notably, activation in the right temporo-parietal junction (TPJ) positively correlated with RT as an indicator of processing load in both groups. These data indicate that motor performance in DCD children requires extra processing demands due to impaired predictive encoding.     

A prospective cohort study comparing workload in children with and without developmental coordination disorder

The purpose of this prospective cohort study was to assess how cardiorespiratory fitness (CRF) of children with probable developmental coordination disorder (DCD) changes over a period of 4.7 years relative to a group of typically developing controls. A school-based sample of children in a large region of Ontario, Canada with 75 out of a possible 92 schools consented to participate. Children enrolled in Grade 4 (mean = 9.9 years, SD = 0.35) at baseline (n = 2278) were followed over the course of 56 months. A total of eight waves of data collection were carried out throughout the study period. The short form of the Bruininks-Oseretsky test of motor proficiency was used to identify children with probable DCD and the maximal speed attained on the Léger 20-m shuttle run to measure CRF. Mixed-effects modeling was used to estimate the change over time in maximal Leger run speed for both groups adjusting for relevant covariates (e.g., gender, BMI, school, activity level, predilection for activity). Children with pDCD had consistently lower maximal run speed relative to controls. The trajectories of run speed in children with probable DCD and those without the disorder differed by gender with pDCD females demonstrating the lowest scores over time. Both genders with probable DCD showed a greater rate of decline in CRF over time relative to the controls. In conclusion, the difference in CRF between children with and without probable DCD is substantial, and it tends to increase over time. This adds to the argument suggesting that interventions intended to improve CRF may be appropriate and necessary for children with motor difficulties.