Mild impairments of motor imagery skills in children with DCD.

Noten et al. (2014) asked 7- to young learners with and without DCD to rotate pictures of hands in their head. Kids decided if each photo showed a left or right hand. The photos flipped between back-view (easy) and palm-view (hard).

The team timed answers and counted errors. They wanted to see if children with DCD struggle with motor imagery only when the task gets tough.

Both groups scored the same on back-view hands. On palm-view hands, kids with DCD were slower and less accurate. The harder mental rotation exposed a subtle motor imagery gap.

This backs the idea that DCD includes an internal-model deficit, but the deficit hides until task demands rise.

Ben-Itzchak et al. (2020) also ran lab tests with DCD kids and found a different hidden gap: the children learned a new letter trace as fast as peers, but the skill did not transfer to writing without dots. Both studies show intact basic learning with fragile higher-level control.

Peng et al. (2026) meta-analysis of 24 exercise trials reports large motor-coordination gains after training. Malou’s palm-view test could serve as a sensitive yard-stick to catch these small therapy-driven changes that standard balance tests miss.

Wagner et al. (2012) link DCD to later behavior problems through peer rejection. Spotting imagery deficits early with a quick palm-view task may flag kids who need both motor help and social support before problems snowball.

You now have a 30-second paper-and-pencil probe that shows clear group differences. Slip five palm-view hand photos into your re-assessment packet. If the child slows or guesses, keep task demands low during teaching and add extra practice transferring skills to new views, just like Ben-Itzchak et al. (2020) recommend. Pair this with the evidence from Peng et al. (2026) and you can show parents that targeted exercise works—and you have a fine-grained way to prove it.