Movement difficulties in children with neurodevelopmental disorders: considering a transdiagnostic approach to classification

Disabil Rehabil. 2026 Apr;48(8):2345-2361. doi: 10.1080/09638288.2025.2548988. Epub 2025 Aug 23.

Abstract

Purpose: Children with neurodevelopmental disorders often experience difficulties in acquiring and executing movement skills. Although the motor profiles of neurodivergent children frequently overlap, rigid conceptual distinctions between diagnostic labels have been imposed by traditional categorical approaches to taxonomy. An alternative transdiagnostic approach is proposed to better represent the similarities between presentations.

Materials and methods: Movement Assessment Battery for Children (2nd Edition) data were available for children (4-15 years) diagnosed with autism (n = 59), developmental coordination disorder (n = 75), attention-deficit/hyperactivity disorder (n = 19), and intellectual disability (n = 22). Iterative agglomerative hierarchical and k-means clustering were performed alongside mean comparisons to contrast conceptually distinct neurodevelopmental disorders against data-driven arrangements of motor profiles.

Results: A four-cluster solution reflected children whose movement skills were (i) poor, (ii) adept relative to the total sample, (iii) adept only in aiming and catching, and (iv) borderline poor. The distribution of neurodevelopmental disorders was largely equal across clusters, with only intellectual disability occurring in the poor performing cluster at a rate above chance.

Conclusions: Clusters were driven by similarities in movement skill that were not aligned with diagnostic distinctions, supporting a transdiagnostic conceptualisation of movement difficulties. Implications are discussed with reference to opportunities for enhanced service models under a transdiagnostic approach.

Keywords: Neurodevelopmental disorders; attention-deficit/hyperactivity disorder; autism; developmental coordination disorder; intellectual disability; movement difficulties; transdiagnostic approach.

Plain language summary

Movement difficulties are highly prevalent across neurodevelopmental disorders such as autism, developmental coordination disorder, attention-deficit/hyperactivity disorder, and intellectual disability.The movement difficulties experienced by neurodivergent children are more similar than different and may be conceptualised most appropriately through a transdiagnostic lens.The early assessment of movement skills alongside other functional challenges is vital in affording parents the opportunity to seek support for their child’s motor development.By softening diagnostic distinctions, the conceptualisation of neurodiversity through a transdiagnostic lens will ensure more accessible support pathways.

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity* / diagnosis
  • Attention Deficit Disorder with Hyperactivity* / physiopathology
  • Autistic Disorder* / physiopathology
  • Child
  • Child, Preschool
  • Cluster Analysis
  • Female
  • Humans
  • Intellectual Disability* / diagnosis
  • Intellectual Disability* / physiopathology
  • Male
  • Motor Skills Disorders* / classification
  • Motor Skills Disorders* / diagnosis
  • Motor Skills Disorders* / physiopathology
  • Motor Skills* / physiology
  • Neurodevelopmental Disorders* / classification
  • Neurodevelopmental Disorders* / physiopathology