Assessment & Research

A systematic review of mirror neuron system function in developmental coordination disorder: Imitation, motor imagery, and neuroimaging evidence.

Reynolds et al. (2015) · Research in developmental disabilities 2015
★ The Verdict

Kids with DCD show weak mirror neuron signs, but plain motor and exercise programs already give large gains while brain-based therapies catch up.

✓ Read this if BCBAs working with school-age children who have coordination delays and want a brain-based reason for choosing interventions.
✗ Skip if Clinicians only running verbal or social-skills programs where motor deficits are not a target.

01Research in Context

01

What this study did

Austin et al. (2015) looked at 31 papers on mirror neuron system (MNS) problems in kids with developmental coordination disorder (DCD). They pulled studies that used imitation tasks, motor imagery tests, or brain scans. The goal was to see if weak MNS activity lines up with the clumsy, slow motor skills seen in DCD.

02

What they found

Across the studies, children with DCD were worse at copying others and at imagining moves. Brain scans also showed less MNS spark. The authors say the idea is exciting but still shaky because most studies were small or used different methods.

03

How this fits with other research

Smits-Engelsman et al. (2018) and Peng et al. (2026) add hope. Both groups ran big meta-analyses and found large gains after plain motor or exercise training. Their strong numbers seem to clash with E et al.'s call for more MNS work. The gap is simple: the 2015 review asked 'which brain circuit is off?' while the later reviews asked 'do active interventions help?' The answers fit together—MNS deficits may explain why kids struggle, but regular practice still works while we wait for brain-targeted games.

Schertz et al. (2016) closed the loop. One year after the MNS review they tested a short computerized motor-imagery program. Kids with DCD improved just as much as peers who got standard therapy, proving MNS-based drills can be useful, not just interesting.

04

Why it matters

You now have a two-step plan. First, screen with quick imitation or hand-rotation tasks to flag MNS trouble. Second, pick evidence-based motor or exercise programs today while fancier mirror-neuron games are still in the lab. Track progress the usual way—if the child moves better, the why can wait.

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→ Action — try this Monday

Add a one-minute hand-rotation or imitation warm-up to your motor session; note errors as a quick MNS probe, then run your normal exercise plan.

02At a glance

Intervention
not applicable
Design
systematic review
Population
developmental delay
Finding
not reported

03Original abstract

PURPOSE: The aim of this systematic review was to investigate the evidence of abnormal functioning of the mirror neuron system (MNS) in children and adults with developmental coordination disorder (DCD), through examination of imitation, motor imagery, and neuroimaging literature. METHODS: The following databases were comprehensively searched for relevant articles: CINAHL Plus, Embase, MEDLINE, PsycINFO, Pubmed, and Web of Science. Full-text articles of all potentially relevant citations were obtained and assessed for eligibility by two authors. Outcome measures of interest at a motor behaviour level were any measures of imitation or motor imagery proficiency and, at a neurological level, were any measures of neural activity in MNS brain regions. Due to differences in outcome measures between studies and the variables reported, a narrative review was undertaken to synthesise findings from the studies. RESULTS: Overall, 31 articles met the inclusion criteria. Children and adults with DCD display deficits imitating meaningful and novel gestures and demonstrate different response patterns to controls when undertaking complex motor imagery tasks. Children with DCD present reduced activation and connectivity of frontal, parietal, and temporal MNS regions. CONCLUSIONS: Preliminary evidence indicates some deficit in the functioning of the MNS at a motor behaviour and neurological level. As no published neuroimaging studies have been designed specifically to explore MNS function, these results must be interpreted with caution. Further research to explore the MNS hypothesis in greater detail, particularly from a neuroimaging perspective, has the potential to provide information on the underlying mechanisms of DCD, inform future research into the aetiology of this disorder, and inform intervention approaches.

Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2015.09.015