Motor imagery during action observation enhances automatic imitation in children with and without developmental coordination disorder.

Developmental coordination disorder (DCD) is a neurodevelopmental condition characterized by uncoordinated movement relative to age. While action observation (AO) and motor imagery (MI) can both independently enhance movement skills in children, we report the first study to assess the effects of combined action observation and motor imagery (AO + MI) on automatic imitation in children aged 7-12 years both with DCD (n = 12) and without DCD (n = 12). On each trial, participants planned to execute an instructed rhythmical action (face washing or paint brushing). Before responding, participants observed a rhythmical distractor showing the same or a different action with a subtle speed manipulation across trials (fast vs. slow). Automatic imitation was quantified as an imitation bias in subsequent response cycle times. Across blocks of trials, participants engaged in AO, MI, or combined AO + MI during the distractor phase or intentionally imitated the distractor speeds. Although there were no between groups differences, combined AO + MI instructions produced a significantly greater imitation bias (115%) than both AO (109%) and MI (109%), with intentional imitation yielding the strongest effects overall (128%). Within groups analyses revealed a significant bias for AO and MI in both groups. Combined AO + MI effects were significantly greater than AO in typically developing children and were greater than both AO and MI in children with DCD. These results demonstrate a clear capacity for different forms of motor simulation in children both with and without DCD. Moreover, combined AO + MI instructions represent an advantageous method for training movements in children with different motor abilities compared with separate AO and MI instructions.