A systematic review of high quality randomized controlled trials investigating motor skill programmes for children with developmental coordination disorder.

The review included only nine randomized trials with 311 children, and many conclusions rest on a single small single-site study. No large multisite randomized trial with blinded assessors was available for any motor skills intervention. In four trials the group assignment was not hidden, in two the method for choosing groups was not clear, and some studies used outcome assessors who knew the child's group. The review and an earlier review disagreed on which trials were high quality; five trials previously scored seven or higher on the PEDro scale were scored lower here. Some trials were too small to reliably detect an effect, and at least two had less than a 50% chance of detecting a true effect. Publication bias may have omitted negative high-quality studies, and developmental coordination disorder is heterogeneous, so trial results may not match an individual child's response.

The authors declared no conflicts of interest. Nick Preston, Elizabeth Andrews and Sara Ahern were funded by the National Institute for Health Research Collaboration for Leadership in Applied Health Research.

Do not read this as proof that any motor programme works for every child with developmental coordination disorder. The positive findings came from few small single-site trials, and Cognitive Orientation to Occupational Performance had no high-quality trial included here.