Motor imagery training enhances motor skill in children with DCD: A replication study.
Five weeks of computerized motor-imagery training lifted motor skills in kids with DCD as much as standard perceptual-motor therapy.
01Research in Context
What this study did
The team ran a five-week RCT with kids who have moderate-to-severe DCD. Half used a computer program that showed an action, asked the child to picture doing it, then let them try it for real. The other half got standard perceptual-motor therapy.
Both groups came in three times a week. The computer group never touched real balls or beams during the imagery drills; they only watched, imagined, then acted.
What they found
At the end, both groups gained the same amount on a motor-skill test. Imagery practice worked just as well as moving the whole time.
The kids who only imagined movements kept up with peers who had full gym sessions.
How this fits with other research
Smits-Engelsman et al. (2018) pooled 30 trials and found big gains for any motor-based DCD program. Their meta-analysis almost certainly includes this 2016 imagery study, so the large average effect they report already counts the computer-imagery approach.
Noten et al. (2014) looked like bad news: kids with DCD were slow on hand-rotation imagery tasks. That deficit, however, is exactly what the 2016 training fixed. The earlier paper showed the hole; the new one shows you can fill it.
Peng et al. (2026) confirm that exercise helps, but their 2026 meta adds nothing about imagery-only drills. Together the reviews say: move, or move in your head—both work.
Why it matters
You can add a cheap laptop or tablet to your clinic bag and run imagery loops while another child uses the balance beam. Five minutes of watch-imagine-do can equal five minutes of physical practice, so you double your therapy slots without doubling equipment or space. Try it next session: pick one target skill, show a short video, cue the child to picture the move, then let them perform it once. Track if the gains match your usual drill.
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02At a glance
03Original abstract
BACKGROUND: Children 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. AIMS: The study presented here was designed to replicate and extend this finding, targeting a select group of children with moderate-to-severe DCD. METHODS AND PROCEDURES: All 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. RESULTS: Results 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. CONCLUSIONS: Overall, 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.
Research in developmental disabilities, 2016 · doi:10.1016/j.ridd.2016.06.014