Health Psychology Research / HPR / Online First / DOI: 10.14440/hpr.0115
Submit to HPR
Cite this article
20
Download
89
Views
Journal Browser
Volume | Year
Issue
Search
Forthcoming Issue
Current Issue
View All
News and Announcements
View All
RESEARCH ARTICLE

Combined Effects of Perceptual–Motor Interventions and Transcranial Direct Current Stimulation on Motor Competence in Children with Developmental Coordination Disorder

Altay Ulusoy1* ,  Behzad Mohammadi Orangi2* ,  Aref Basereh3 ,  Sadettin Kirazci4
Show Less
1 Department of Exercise and Sport Sciences, School of Physical Education and Sports, Istanbul Nişantaşı University, Istanbul 34040, Turkey
2 Department of Sport Science, School of Humanities, Damghan University, Damghan, Semnan 36716-41167, Iran
3 Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Kharazmi University of Tehran, Tehran 15719-14911, Iran
4 Department of Physical Education and Sport, Faculty of Education, Middle East Technical University, Ankara 06800, Türkiye
HPR, e81240041 https://doi.org/10.14440/hpr.0115
Submitted: 30 April 2025 | Revised: 22 October 2025 | Accepted: 29 October 2025 | Published: 28 January 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Download PDF
Cite
XML
Abstract

Background

Developmental coordination disorder (DCD) is a common neurodevelopmental condition in children, characterized by deficits in both actual motor competence (AMC) and perceived motor competence (PMC).

Objective

This study aimed to investigate the effects of linear and non-linear perceptual–motor intervention, with or without transcranial direct current stimulation (tDCS), on AMC and PMC in children aged 7–9 years with DCD.

Methods

A quasi-experimental pre-test–post-test design with four groups was used: (i) Linear pedagogy (LP) perceptual–motor intervention, (ii) non-linear pedagogy (NLP) perceptual–motor intervention, (iii) tDCS combined with perceptual–motor intervention using the LP, and (iv) tDCS combined with perceptual–motor intervention using the NLP. A total of 40 children diagnosed with DCD based on the Movement Assessment Battery for Children-2 were randomly assigned to the groups. Perceptual–motor interventions were delivered over 10 sessions, and tDCS was applied to the right primary motor cortex for 20 min before each training session.

Results

Results showed that the group receiving NLP combined with tDCS exhibited the greatest improvements in both AMC and PMC compared to all other groups (p<0.001), whereas NLP alone also outperformed LP (p<0.001).

Conclusion

These findings suggest that combining brain stimulation with NLP can significantly enhance both AMC and PMC in children with DCD. Overall, the study highlights the importance of designing enriched, exploratory, and neuro-enhanced learning environments for the rehabilitation of children with motor coordination difficulties.

Keywords
Non-linear pedagogy
Linear pedagogy
Developmental coordination disorder
Perceptual–motor Interventions
Funding
None.
Conflict of interest
The authors declare they have no competing interests.
References
  1. Regier DA, Kuhl EA, Kupfer DJ. The DSM-5: Classification and criteria changes. World Psychiatry. 2013;12(2):92-98. doi: 10.1002/wps.20050

 

  1. Subara-Zukic E, Cole MH, McGuckian TB, et al. Behavioral and neuroimaging research on develop­mental coordination disorder (DCD): A combined systematic review and meta-analysis of recent find­ings. Front Psychol. 2022;13:809455. doi: 10.3389/ fpsyg.2022.809455

 

  1. Sánchez-Matas Y, Hernández-Martínez A, Gutiérrez D, Rudd YJ. Actual and perceived motor competence in children with motor coordina­tion difficulties: Effect of a movement-based intervention. Res Dev Disabil. 2024;151:104797. doi: 10.1016/j.ridd.2024.104797

 

  1. Gao J, Song W, Zhong Y, et al. Children with developmental coordination disorders: A review of approaches to assessment and intervention. Front Neurol. 2024;15:1359955. doi: 10.3389/ fneur.2024.1359955

 

  1. Stodden DF, Goodway JD, Langendorfer SJ, et al. A developmental perspective on the role of motor skill competence in physical activity: An emergent relationship. Quest. 2008;60(2):290-306. doi: 10.1080/00336297.2008.10483582

 

  1. Orangi BM, Shahbazi M, Ghanati HA. Real and perceived motor competence are further developed through the integration of modern teaching meth­ods with inclusive education. J Mot Control Learn. 2025;6(4):e156861. doi: 10.5812/jmcl-156861

 

  1. De Milander M. A Perceptual-Motor Intervention Programme for Grade 1-Learners with Developmental Coordination Disorder. South Africa: University of the Free State; 2015.

 

  1. Hashemi A, Rostami R, Hadianfard H. The effec­tiveness of cognitive rehabilitation on Fundamental motor skills of children with developmental coor­dination disorder: A quasi-experimental study. J Sports Mot Dev Learn. 2022;13(4):391-405. doi: 10.22059/jmlm.2021.331598.1611

 

  1. Wilkerson GB, Nabhan DC, Crane RT. Upper-extremity perceptual-motor training improves whole-body reactive agility among elite ath­letes with history of sport-related concussion. J Sport Rehabil. 2021;30(6):844-849. doi: 10.1123/ jsr.2020-0337

 

  1. Buch ER, Santarnecchi E, Antal A, et al. Effects of tDCS on motor learning and memory forma­tion: A consensus and critical position paper. Clin Neurophysiol. 2017;128(4):589-603. doi: 10.1016/j. clinph.2017.01.004

 

  1. Guimarães AN, Porto AB, Marcori AJ, Lage GM, Altimari LR, Okazaki VHA. Motor learning and tDCS: A systematic review on the dependency of the stimulation effect on motor task char­acteristics or tDCS assembly specifications. Neuropsychologia. 2023;179:108463. doi: 10.1016/j. neuropsychologia.2022.108463

 

  1. Walters Y. The Effects of a Perceptual- Motor Development Program on Children with Developmental Coordination Disorder. Stellenbosch: University of Stellenbosch; 2005.

 

  1. Saha S, Sultana F, Ahmed M, Saha S. A systematic review on the effectiveness of perceptual motor training on improvement in motor performance in individuals with developmental coordination dis­order. Malays J Mov Health Exerc. 2016;5(2):51-64. doi: 10.15282/mohe.v5i2.104

 

  1. Tajari SN, Gholami S, Rostami R, Trabelsi K, Taheri M. The effect of perceptual-motor exercise on temporal dynamics of cognitive inhibition con­trol in children with developmental coordination disorder. Ment Health Phys Act. 2023;24:100495. doi: 10.1016/j.mhpa.2022.100495

 

  1. Grohs MN, Craig BT, Kirton A, Dewey D. Effects of transcranial direct current stimulation on motor function in children 8-12 years with developmen­tal coordination disorder: A randomized con­trolled trial. Front Hum Neurosci. 2020;14:608131. doi: 10.3389/fnhum.2020.608131

 

  1. Akremi H, Hamel R, Dumas A, Camden C, Corriveau H, Lepage JF. Cerebellar transcranial direct current stimulation in children with devel­opmental coordination disorder: A randomized, double-blind, sham-controlled pilot study. J Autism Dev Disord. 2022;52:3202-3213. doi: 10.1007/ s10803-021-05202-6

 

  1. Hashemi A, Rostami R, Hadianfard H. The effec­tiveness of cognitive rehabilitation and physical exercise on locomotor movement skill of children with developmental coordination disorder. Sport Sci Health Res. 2020;12(2):197-205. doi: 10.22059/ sshr.2020.86137

 

  1. Malboobi P, Khajavi D, Khanmohammadi R. The effects of transcranial direct current stimulation and badminton training on motor coordination in children with developmental coordination disor­der. Neurosci J Shefaye Khatam. 2024;13(1):27-39. doi: 10.61186/shefa.13.1.27

 

  1. Bahrami S, Mousavi Sadati SK, Daneshjoo A. Effect of transcranial direct current stimulation and selected exercises on balance in children with developmental coordination disorder. Sci J Rehabil Med. 2020;9(1):69-259.

 

  1. Mohammadi Orangi B, Yaali R, Ackah-Jnr FR, Bahram A, Ghadiri F. The effect of nonlinear and lin­ear methods and inclusive education on self-esteem and motor proficiency of ordinary and overac­tive children. J Rehabil Sci Res. 2021;8(2):69-78. doi: 10.30476/jrsr.2021.88992.1120

 

  1. Pugliese E, Forte P, D’Anna C. Cognitive vs eco­logical dynamic approach: A synthetical frame­work to guide effective educational choices. J Phys Educ Sport. 2023;23(9):2480-2485. doi: 10.7752/ jpes.2023.09285

 

  1. Coppola S, D’Anna C, Minghelli V, Vastola R. Ecological dynamics approach in physical edu­cation to promote cognitive skills development: A review. J Hum Sport Exerc. 2024;19(3):792-802. doi: 10.55860/k7ynwe36

 

  1. Chow JY, Komar J, Davids K, Tan CWK. Nonlinear pedagogy and its implications for practice in the Singapore PE context. Phys Educ Sport Pedagogy. 2021;26(3):230-241. doi: 10.1080/17408989.2021.1886270

 

  1. Orangi BM, Ghorbanzadeh B, Basereh A. A new idea in skill acquisition of children: Coordinating motor competence with motor learning strate­gies. BMC Pediatr. 2025;25(1):640. doi: 10.1186/ s12887-025-06019-3

 

  1. Crotti M, Rudd JR, Roberts S, et al. Effect of linear and nonlinear pedagogy physical education inter­ventions on children’s physical activity: A cluster randomized controlled trial (SAMPLE-PE). Children (Basel). 2021;8(1):49. doi: 10.3390/children8010049

 

  1. Bromilow L, Milne N, Woods CT, Dowsett CK, Keogh JW. The effectiveness of linear and non­linear pedagogical approaches in team-invasion ball sports: A systematic review. Sports Med Open. 2025;11(1):90. doi: 10.1186/s40798-025-00893-y

 

  1. Cooke DM, Harrison CB, Millar SK, Walters S. The impact of a nonlinear pedagogical approach to primary school physical education upon children’s movement skill competence. J Teach Phys Educ. 2022;42(2):323-330. doi: 10.1123/jtpe.2021-0221

 

  1. Mohammadi Orangi B, Shahbazi M, Bakhshinezhad B. Comparison of linear, nonlinear, differential, and TGFU methods on creativity and decision-making in futsal among ordinary, DCD, and ADHD children: A focus on inclusive educa­tion. J Sports Motor Dev Learn. 2025;17(4):1-22. doi: 10.22059/jsmdl.2025.383679.1801

 

  1. Chow JY. Nonlinear pedagogy: A new frame­work for designing learning environments for sport, physical education and recreational activities. In: Nonlinear Pedagogy and the Athletic Skills Model. United Kingdom: Routledge; 2021. p. 75-90.

 

  1. Edwards LC, Bryant AS, Keegan RJ, Morgan K, Jones AM. Definitions, foundations and associ­ations of physical literacy: A systematic review. Sports Med. 2017;47(1):113-126. doi: 10.1007/ s40279-016-0560-7

 

  1. Cairney J, Dudley D, Kwan M, Bulten R, Kriellaars D. Physical literacy, physical activity and health: Toward an evidence-informed con­ceptual model. Sports Med. 2019;49(3):371-383. doi: 10.1007/s40279-019-01063-3

 

  1. Segura-Berges M, Peñarrubia-Lozano C, Bustamante JC. Analysis of the predictive value of motor coordination, anxiety and self-esteem levels on self-perceived motor competence in pri­mary students. Psychol Sch. 2025;62:2620-2629. doi: 10.1002/pits.23489

 

  1. Nobre GC, Ramalho MHD, Ribas MS, Valentini NC. Motor, physical, and psychosocial parameters of children with and without develop­mental coordination disorder: A comparative and associative study. Int J Environ Res Public Health. 2023;20(4):2801. doi: 10.3390/ijerph20042801

 

  1. Purcell C, Schott N, Rapos V, Zwicker JG, Wilmut K. Understanding factors that influ­ence physical activity behavior in people with developmental coordination disorder (DCD): A mixed-methods convergent integrated system­atic review. Front Hum Neurosci. 2023;17:1274510. doi: 10.3389/fnhum.2023.1274510

 

  1. Asadi A, Daneshfar A, Maleki B, Aiken CA. Effects of attentional focus and gaze instruction during observational learning of a basketball free-throw. Hum Mov Sci. 2023;87:103038. doi: 10.1016/j. humov.2022.103038

 

  1. Ghanati HA, Letafatkar A, Almonroeder TG, Rabiei P. Examining the influence of atten­tional focus on the effects of a neuromuscu­lar training program in male athletes. J Strength Cond Res. 2022;36(6):1568-1575. doi: 10.1519/ jsc.0000000000003681

 

  1. Ghorbanzadeh B, Kirazci S, Badicu G. Comparison of the effect of teaching games for understanding, sport education, combined and lin­ear pedagogy on motor proficiency of children with developmental coordination disorder. Front Psychol. 2024;15:1385289. doi: 10.3389/fpsyg.2024.1385289

 

  1. Brown T. Movement assessment battery for children: (MABC-2). In: Encyclopedia of Autism Spectrum Disorders. Berlin: Springer; 2021. p. 3000- 3018. doi: 10.1007/978-3-319-91280-6_1922

 

  1. Kerkez, F. (2013). An overview of TGMD-2 practices in the evaluation of motor development among children in Turkey. Hacettepe J Sport Sci. 2013;24:245-256.

 

  1. Bruininks RH, Bruininks BD. Bruininks- Oseretsky Test of Motor Proficiency. United Kingdom: Pearson Publishing; 1978.

 

  1. Deitz JC, Kartin D, Kopp K. Review of the Bruininks-Oseretsky test of motor proficiency, second edition (BOT-2). Phys Occup Ther Pediatr. 2007;27(4):87-102. doi: 10.1080/J006v27n04_06

 

  1. Mohammadi Orangi B, Lenoir M, Yaali R, et al. Emotional intelligence and motor com­petence in children, adolescents, and young adults. Eur J Dev Psychol. 2023;20(1):66-85. doi: 10.1080/17405629.2022.2034614

 

  1. Ghorbanzadeh B, Orangi BM, Sahin T. The relationship between motor competence and executive function as influenced by age, sex, and family socio-economic status. Front Psychol. 2025;16:1544168. doi: 10.3389/fpsyg.2025.1544168

 

  1. Ghorbanzadeh B, Mohammadi Orangi B, Sahin T, Tunçkol M, Badicu G. Pilot study investigating the relationship between motor skill, intelligence and perceptual reasoning and early academic achieve­ment in children. Alex J Med. 2025;61(1):1-7. doi: 10.1080/20905068.2025.2463140

 

  1. Barnett LM, Ridgers ND, Zask A, Salmon J. Face validity and reliability of a pictorial instru­ment for assessing fundamental movement skill perceived competence in young children. J Sci Med Sport. 2015;18(1):98-102. doi: 10.1016/j. jsams.2013.12.004

 

  1. Orangi BM, Yaali R, Bahram A, Van Der Kamp J, Aghdasi MT. The effects of linear, nonlinear, and differential motor learning methods on the emer­gence of creative action in individual soccer players. Psychol Sport Exerc. 2021;56:102009. doi: 10.1016/j. psychsport.2021.102009

 

  1. Mohammadi Orangi B, Yaali R, Ghorbanzadeh B, Loprinzi P, Abdalifar A. The effect of aerobic exer­cise with nonlinear pedagogy on anxiety, depres­sion, motor proficiency and cognitive ability of boys with attention deficit hyperactivity disorder. J Rehabil Sci Res. 2021;8(3):144-150. doi: 10.30476/ jrsr.2021.91068.1163

 

  1. Palm U, Segmiller FM, Epple AN, et al. Transcranial direct current stimulation in chil­dren and adolescents: A comprehensive review. J Neural Transm (Vienna). 2016;123(10):1219-1234. doi: 10.1007/s00702-016-1572-z
Share
Back to top
Health Psychology Research, Electronic ISSN: 2420-8124 Published by Health Psychology Research
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here
Accept