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Review

The relationship between motor skills and cognitive skills in 4–16 year old typically developing children: A systematic review Irene M.J. van der Fels a , Sanne C.M. te Wierike a,∗ , Esther Hartman a , Marije T. Elferink-Gemser a,b , Joanne Smith a , Chris Visscher a a b

Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, The Netherlands Institute for Studies in Sports and Exercise, HAN University of Applied Sciences, The Netherlands

a r t i c l e

i n f o

Article history: Received 17 March 2014 Received in revised form 1 September 2014 Accepted 10 September 2014 Available online xxx Keywords: Motor performance Motor ability Cognition Intelligence Executive function Children

a b s t r a c t Objectives: This review aims to give an overview of studies providing evidence for a relationship between motor and cognitive skills in typically developing children. Design: A systematic review. Methods: PubMed, Web of Science, and PsychINFO were searched for relevant articles. A total of 21 articles were included in this study. Methodological quality was independently assessed by two reviewers. Motor and cognitive skills were divided into six categories. Results: There was either no correlation in the literature, or insufficient evidence for or against many correlations between motor skills and cognitive skills. However, weak-to-strong evidence was found for some correlations between underlying categories of motor and cognitive skills, including complex motor skills and higher order cognitive skills. Furthermore, a stronger relationship between underlying categories of motor and cognitive skills was found in pre-pubertal children compared to pubertal children (older than 13 years). Conclusions: Weak-to-strong relations were found between some motor and cognitive skills. The results suggest that complex motor intervention programs can be used to stimulate both motor and higher order cognitive skills in pre-pubertal children. © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

1. Introduction Historically, there have been different views about the relationship between motor skills and cognitive skills in children. On the one hand, motor and cognitive skills have been considered as entirely different processes, developing independently, and involving different brain regions.1 On the other hand, Piaget2 considered that motor and cognitive skills are closely related. Piaget’s theory was based on the idea that children learn from observable motor actions with objects. There are several explanations for a possible relationship between motor and cognitive skills in children. First, research has shown co-activations between the prefrontal cortex, the cerebellum, and the basal ganglia during several motor and cognitive tasks, especially when a task is difficult, a task is new, conditions of a task change, a quick response is required, and concentration is needed to perform a task.3,4 A second explanation for a relationship between motor and cognitive skills is that these

∗ Corresponding author. E-mail address: [email protected] (S.C.M. te Wierike).

skills might have a similar developmental timetable with an accelerated development between the ages of 5 and 10 years.5 Third, both motor and cognitive skills have several common underlying processes, such as sequencing, monitoring, and planning.6 These possible explanations highlight a need to explore how motor skills relate with cognitive skills and whether the link is specific to certain categories of skill. Motor and cognitive skills are broad concepts and have been defined in a number of different ways. In the current review, motor skills are defined as learned sequences of movements that are combined to produce a smooth, efficient action in order to master a particular task.7 Different categories of motor tasks are distinguished: (1) Gross motor skills, this includes skills like jumping, sprinting, and walking. Furthermore, all underlying physical abilities like strength, agility, flexibility, and balance, that are needed to perform a task are included in this category; (2) Fine motor skills which are tasks where fine motor precision and integration are needed;8 (3) Bilateral body coordination, this includes whole body coordination tasks and demands engagement of almost all body parts and bilateral motor coordination of lower and upper extremities;9 (4) Timed performance in movements, these are

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tasks (gross/fine motor skills or object control tasks) in which the time a child takes to perform a required number of movements is important and are often divided into repetitive movements and sequenced movements.10 Repetitive movements are simple movements that are repeated as quickly as possible.11 Sequenced movements include alternating patterns of more complex movements performed as quickly as possible;11 (5) In the category object control, skills are included in which an object has to be controlled, such as ball skills; Finally, (6) Total motor score, which is described as the sum score of a combination of motor skills out of the five other categories. It is worth to note that the categories are not exclusive and as such, motor skills from one category may contain elements of other categories. Cognitive skills are understood as the mental actions or processes of acquiring knowledge and understanding through thought, experience, and the senses.7 Different aspects of cognitive skills are included in this review, based on the skills used in literature. Executive functions are described as higher order cognitive skills that enable self-control and include the following metacognitive skills: response inhibition, which is described as the suppression of actions that are no longer required or that are inappropriate; planning, which is described as a plan that can be represented as a hierarchy of sub goals, each requiring actions to achieve the goal; attention, which is described as the ability to attend to some things while ignoring others; and working memory, which is described as the ability to store and manipulate information over a period of seconds to minutes.12 Visual processing is described as a path that information takes from visual sensors to cognitive processing.13 Short-term memory is described as the capacity to hold information in mind in the absence of external stimulation over a short period of time.14 Information retained for a significant time is referred to as long-term memory.12 Fluid intelligence is the ability to think logically and solve problems in novel situations; this is independent of acquired knowledge.15 Crystallized intelligence refers to the capacity to use skills, knowledge, and experience by accessing information from long-term memory.15 Intelligence quotient (IQ) is a measure to calculate a person’s intelligence. Academic skills are skills developed or measured in educational settings. Recent literature has reviewed relationships between motor and cognitive skills in children with DCD and children born preterm.16,17 Wilson et al.16 suggested a relationship between impaired motor skills like rhythmic coordination, gait and postural control, catching and interceptive action and impaired cognitive skills like internal (forward) modeling, executive function, and aspects of sensoriperceptual function in children with DCD. Jongbloed-Pereboom et al.17 found that information regarding the relationship between different components of motor learning and working memory in children born preterm was not available in literature. However, we are not aware of any reviews that focus on the relationship between motor skills and cognitive skills in typically developing children. Therefore, the present review aims to give an overview of studies providing evidence for a relationship between motor and cognitive skills in typically developing children. If there are indications for relationships between components of motor and cognitive skills, programs focusing on one domain could be designed to optimize performance of both motor and cognitive skills in typically developing children.

1. Motor skills (OR motor skill competency OR motor performance OR motor coordination OR motor function OR motor development OR motor abilities OR motor control OR motor examination OR motor milestones OR motor behavior OR fine motor skills OR gross motor skills OR postural control OR movement assessment battery OR fine and gross motor development) OR test of gross motor development. 2. Cognitive skills (OR cognitive performance OR cognitive function OR cognitive abilities OR cognitive behavior OR cognitive control OR cognitive processes OR cognition) OR intelligence (OR IQ) OR academic achievement (OR kindergarten achievement) OR language development OR executive functions (OR memory OR working memory OR attention). 3. Cognitive-motor structures (OR cognitive predictors of motor functions OR motor and cognitive dimensions OR executive function, motor performance and externalizing behavior). Inclusion criteria for this review were that the studies were: (1) Published between 2000 and 2013, (2) written in English, (3) focused on children aged 4–16 years old, (4) reporting a correlation, regression analysis, or factor structure between motor skills and cognitive skills, and (5) original articles. The age range was chosen, because motor functioning as well as executive functions show an accelerated development between 5 and 10 years with a continued development into adolescence.5 The limited range of literature between 2000 and 2013 was selected, because it gives an overview of the most recent literature on the relationship between motor and cognitive skills, without constraining the broad definitions of motor and cognitive skills. Exclusion criteria for this review were: (1) Studies with special populations (e.g. children with developmental disorders, brain injuries, adoptees, children born preterm, children with gifted performance), and (2) intervention studies.

2. Methods

The stages adopted in the systematic search resulted in 21 relevant articles being identified for further analysis (Fig. 1). The included articles were evaluated for methodological quality according to the guidelines of Law et al.18 This method evaluated each article using the following main categories: study purpose, literature background, study design, sample, outcomes, intervention, results, conclusions and clinical implications. The methodological quality was assessed using 14 questions (see footnote Table 1). These questions were scored as either 1 (met the criteria) or 0 (did not meet the criteria). The scores on the 14 questions were summed for each article. For question five, articles only met the criteria when the sample size was at least 100.19 For questions seven and eight, articles only met the criteria when all the assessment tools were reliable or valid. A total score below seven was considered as low methodological quality, a score between seven and ten points was considered as good methodological quality and 11 points or higher was considered as high methodological quality. Two reviewers independently assessed the methodological quality of the studies. Different scores were discussed and consensus was reached in all cases. Table 1 shows the methodological quality of the reviewed studies. To interpret levels of evidence, the following regulations were used20,21 :

The databases used for the literature search were PubMed, Web of Science, and PsycINFO; they were searched for records that contained one of the following combinations of terms ([1 AND 2] OR 3):

1. To state that there is strong evidence for or against a relationship between motor and cognitive skills, at least three high methodological quality studies with consistent results for this relationship were needed, or more than four studies of which

Please cite this article in press as: van der Fels IMJ, et al. The relationship between motor skills and cognitive skills in 4–16 year old typically developing children: A systematic review. J Sci Med Sport (2014), http://dx.doi.org/10.1016/j.jsams.2014.09.007

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Articles identified based on literature search based on inclusion criteria 1 and 2 Web of Sciencec PubMeda PsycINFOb

3

n = 774 n = 536 n = 229 n=9 Exclusion of duplicate studies (n = 24)

Analysis based on reading titles (n = 750) Exclusion after reading titles Based on exclusion criterion 1 Based on inclusion criterion 5 Based on inclusion criterion 3 Based on exclusion criterion 2 Based on inclusion criterion 4

n = 664 n = 364 n = 170 n = 96 n = 27 n=7

Analysis based on reading abstract (n = 86)

Exclusion after reading abstract Based on inclusion criterion 5 Based on inclusion criterion 3 Based on inclusion criterion 4 Based on exclusion criterion 1 Based on exclusion criterion 2

n = 62 n = 28 n = 13 n = 11 n=8 n=2

Exclusion after reading full text Based on inclusion criterion 3 Based on exclusion criterion 1

n=6 n=5 n=1

Analysis based on reading full text (n = 24)

Articles selected from electronic databases as described above (n = 18)

Articles suggested by principal investigators in the field d (n = 3)

Articles included in the review (n = 18 + 3 = 21) Fig. 1. Stages adopted in the systematic selection of articles. a Based on inclusion criteria 1, 2, and 3 (child: birth—18 years); b based on inclusion criteria 1, 2, and 3 (childhood, preschool age, school age, adolescence) and the search was based on title; c based on inclusion criteria 1, 2, and 5 and the search was based on title; d We asked several principal investigators in the field for suggestions to prevent missing key publications not included by searching electronic databases.

more than 66% found consistent results and no more than 25% find an opposite result. 2. To state there is weak evidence for or against a relationship between motor and cognitive skills, three studies of which two are in agreement and the third which is not in agreement, or at least three low or good quality studies with consistent positive results for or against the relationship were needed. 3. There was insufficient evidence for a correlation between motor and cognitive skills when there were low or moderate quality studies with inconsistent results or with fewer than three studies of whatever quality.

4. There was no evidence for a correlation between motor and cognitive skills when there was only one study available. Motor skills were divided into the following six categories: gross motor skills, fine motor skills, bilateral body coordination, timed performance in movements, object control, and total motor score. Motor skills from one category might contain elements of other categories, since the categories are not exclusive. When this was the case, these skills were classified in the category where they fitted the best according to the original article. Most of the studies reported correlations between motor skills and cognitive skills.

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Table 1 Methodological quality of the reviewed studies.a Question numberb

Roebers and Kauer6 Davis et al.7 Davis et al.8 Planinsec and Pisot9 Jenni et al.10 Martin et al.11 Cameron et al.24 Kovaˇc and Strel25 Rigoli et al.26 Livesey et al.27 Rigoli et al.28 Katic and Bala29 Planinsec30 Planinsec31 Morales et al.32 Pangelinan et al.33 Castelli et al.34 Decker et al.35 Nourbakhsh36 Smits-Engelsman and Hill37 Wassenberg et al.38

1

2

3

4

5

6

7

8

9

10

11

12

13

14

Total

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 1 1 1

1 1 1 1 1 1 1 1 0 0 0 1 1 1 1 1 0 1 1 1 1

1 1 1 1 1 1 0 1 1 1 1 0 0 0 1 0 0 0 0 1 0

0 1 1 1 0 1 1 1 1 1 1 0 1 1 1 1 0 1 1 1 1

0 1 1 1 0 1 1 1 1 0 1 0 1 1 1 1 0 1 1 1 1

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

1 1 1 0 0 0 0 1 0 0 1 0 0 0 0 0 0 1 1 1 0

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

1 1 1 0 0 1 1 0 1 0 1 0 0 0 1 1 0 1 1 1 0

1 1 1 0 1 1 1 0 1 0 1 0 0 0 1 1 0 0 0 1 0

12 14 14 11 10 13 12 11 12 9 13 8 10 10 13 12 6 11 12 14 10

a

1 = meet criteria; 0 = does not meet criteria. (1) Was the study purpose stated clearly? (2) Was relevant background literature reviewed? (3) Was the design appropriate for the research question? (4) Was the sample described in detail? (5) Was sample size justified? (6) Was informed consent obtained? (7) Were the outcome measures reliable? (8) Were the outcome measures valid? (9) Were results reported in terms of statistical significance? (10) Were the analysis methods appropriate? (11) Was clinical importance reported? (12) Were conclusions appropriate given the study methods? (13) Are there any implications for clinical practice given the results of the study? (14) Were limitations of the study acknowledged and described by the authors? b

Correlations lower than 0.3 were considered as weak, correlations between 0.3 and 0.5 were considered as moderate, and correlations above 0.5 were considered as strong.22,23 3. Results Table 2 shows the authors, number of participants, motor and cognitive skills, and the results of each of the 21 studies according to their category. All correlations (positive and negative) indicated that better performance in motor skills is related to better performance in cognitive skills. It is worth noting that sometimes lower scores in one test indicated better performance (the test had to be performed in less time) while in the other test, higher scores indicated better performance. The correlation between two tests can thus be negative, even though it indicates that better performance in one test is related to better performance in the other test. Some of the included articles studied different categories of motor skills, so they were included in more than one category. Table 3 provides a summary of the results section, including the relationships investigated and strength of evidence for or against relationships. Twelve articles were included in the category gross motor skills.6–8,10,24–31 Five articles had good methodological quality and seven articles had high methodological quality. Tables 2 and 3 show strong evidence for no correlation between gross motor skills and both executive functions and fluid intelligence.6–8,25–28,30,31 There was weak evidence for no correlation between gross motor skills and verbal comprehension.24,26,28 Weak evidence was found for a weak correlation between gross motor skills and crystallized intelligence.7,8,24 There was insufficient evidence for a correlation between gross motor skills and visual processing, short-term memory, long term memory, IQ, academic skills, and working memory.7,8,10,24,26,28 There was no evidence for a correlation between gross motor skills and general knowledge, visuospatial working memory, attention, and cognitive capacity to encode and analyze.24,26,28,29 Seven articles were included in the category fine motor skills.7,8,24,26–28,32 One article had good methodological quality and

six articles had high methodological quality. Tables 2 and 3 show strong evidence for a moderate-to-strong correlation between fine motor skills and visual processing.7,8 There was weak evidence for a weak-to-moderate correlation between fine motor skills and both short-term memory and fluid intelligence.7,8 There was insufficient evidence for a correlation between fine motor skills and executive functions, long-term memory, crystallized intelligence, academic skills, and verbal comprehension.7,8,24,26,27,32 No evidence was found for a correlation between fine motor skills and general knowledge, working memory, visuospatial working memory, and attention.6,24,26,28 Nine articles were included in the category bilateral body coordination.6–9,25,29–31,36 Three articles had good methodological quality and six articles had high methodological quality. Tables 2 and 3 show strong evidence for a weak-to-moderate correlation between bilateral body coordination and fluid intelligence.7–9,25,30,31 There was insufficient evidence for a correlation between bilateral body coordination and visual processing, short-term memory, long-term memory, and crystallized intelligence.7,8 There was no evidence for a relation between bilateral body coordination and executive functions, the cognitive capacity to encode and analyze information, and academic skills.6,29,36 Within the category bilateral body coordination, there was weak evidence that coordination of movement in rhythm showed the strongest correlations with cognitive skills.9,25,31 Eight articles were included in the category timed performance in movements.6,10,11,25,30,31,33,36 Three articles had good methodological quality and five articles had high methodological quality. Tables 2 and 3 show weak evidence for a weak-to-moderate correlation between timed performance in movements and both IQ and fluid intelligence.10,11,25,30,31,33 There was no evidence for a correlation between timed performance in movements and executive functions, spatial working memory, and academic skills.6,33,36 Within the category timed performance in movements, sequenced movements showed to be more strongly related to cognitive skills compared to repetitive movements.10,11

Please cite this article in press as: van der Fels IMJ, et al. The relationship between motor skills and cognitive skills in 4–16 year old typically developing children: A systematic review. J Sci Med Sport (2014), http://dx.doi.org/10.1016/j.jsams.2014.09.007

Measure(s) of motor skills

Assessment of motor skills

Measure(s) of cognitive skills

Assessment of cognitive skills

Resultsa

Gross motor skills Roebers and Kauer6

112, boys/girls

7

Jumping

Jumping

Executive functions

Jumping showed significant positive correlations, only with 2 out of the 4 executive functions tests (Flanker: r = −.26* ; cognitive flexibility: r = −.26* )

Davis et al.7 , b

248, boys/girls

4–11

Strength/agility

BOT-2

Visual processing, short-term memory, long-term memory, fluid intelligence, crystallized intelligence

The backwards colour recall task, the Flanker task, the Simon task, the cognitive flexibility task KABC-II

Davis et al.8 , b

242, boys/girls,

4–11

Strength/agility

BOT-2

Jenni et al.10

252, boys/girls

7–16

Static and dynamical Balance

ZNA

Visual processing, short-term memory, long-term memory, fluid intelligence, crystallized intelligence General IQ, verbal IQ, performance IQ, visuomotor IQ

Cameron et al.24

213, boys/girls

4

Gross motor skills

ESI-R

Reading, verbal comprehension, mathematics, general knowledge, crystallized intelligence

Kovaˇc and Strel25

1859, girls

10–16

Strength/agility, balance

ACDSi

Fluid intelligence

Rigoli et al.26 , c

93, boys/girls

12–16

Balance

MABC-2

Livesey et al.27

36, boys/girls

5–6

Balance

MABC

(Visuospatial) working memory, academic skills, verbal comprehension, executive functions Executive functions

Rigoli et al.28 , c

93, boys/girls

12–16

Balance

MABC-2

Katic & Bala29

162, girls

10–14

Agility, jumping, sprinting, strength

Board balance, seated straddle stretch, standing broad jump, 20-m dash, medicine ball throw from supine position, crossed-arm sit-ups bent-arm hang

Attention, executive functions, working memory, verbal comprehension Cognitive capacity to encode and analyze information

KABC-II

WPPSI, WISC-R, AID

WJ III, Word-reading, letter–word identification, reading comprehension, passage comprehension, TN-20

WIAT–II, WISC–IV, N-back task

Significant correlations were found between strength/agility and visual processing (r = .32** ), short-term memory (r = .27** ), long-term memory (r = .22** ), and crystallized intelligence (r = .24* ). The correlation between strength/agility and fluid intelligence was not significant. Significant correlations were found between strength/agility and visual processing (r = .32** ), short-term memory (r = .27** ), long-term memory (r = .23** ), fluid intelligence (r = .23** ), and crystallized intelligence (r = .24** ). Static balance was significantly related to general IQ (r = .20** ), verbal IQ (r = .16* ), performance IQ (r = .16* ), and visuomotor IQ (r = .15* ). The correlations between dynamical balance and all IQ score were not significant. There were significant correlations between gross motor skills and reading (r = .17* ), verbal comprehension (r = .16* ), and mathematics (r = .18* ). The correlations between gross motor skills and general knowledge and crystallized intelligence were not significant. The correlation between strength/agility and fluid intelligence in 10–16 year old girls was not significant, except for 12 year old girls (r = .26** ). The correlation between balance and fluid intelligence was not significant, except for 11 year old girls (r = .29** ) Balance only showed a significant correlation with executive functions (r = .26* ) and not with the other cognitive skills

Modified stop-signal task, modified day–night Stroop task WISC–IV, N-back task, NEPSY

Balance was not significantly related to executive functions

Raven’s SPM

In 10–12 year old children, cognitive functioning was implicated in their motor efficiency by agility. In 13–14 year old children, cognitive functioning was implicated in their motor efficiency by jumping, sprinting, agility, and trunk strength.

Balance did not show significant correlations with cognitive skills

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Table 2 Characteristics of the 21 articles reviewed.

5

Measure(s) of motor skills

Assessment of motor skills

Measure(s) of cognitive skills

Assessment of cognitive skills

Resultsa

Planinsec30

665, boys/girls

5–6

Strength and agility, balance

Fluid intelligence

The Test Razkol

Strength and agility and balance did not significantly contribute to fluid intelligence

Planinsec31

550, boys

10,12,14

Trunk flexibility/strength, shoulder flexibility, agility, balance

Stepping sideways, running with changing directions, running in a zigzag, standing long jump, standing triple jump, standing high jump, stepping on a bench, sideway jumps, sideway jumps with hand support, standing on a block, longitudinally standing on a block crosswise, standing on a vertical block Eurofit Test Battery

Fluid intelligence

TN-20

There were no significant relationships between the gross motor skills and fluid intelligence in 10 and 14 year old boys. In 12 year old boys, trunk flexibility and shoulder frame flexibility did significantly contribute to fluid intelligence (resp. ␤ = .18* and ␤ = .15* )

Fine motor skills Davis et al.7 , b

248, boys/girls

4–11

Fine manual control, manual dexterity

BOT-2

Visual processing, short-term memory, long-term memory, fluid intelligence, crystallized intelligence

KABC-II

Davis et al.8 , b

242, boys/girls

4–11

Fine manual control, manual dexterity

BOT-2

Visual processing, short-term memory, long-term memory, fluid intelligence, crystallized intelligence

KABC-II

Cameron et al.24

213, boys/girls

4

Fine motor skills

ESI-R

WJ III, Word-reading, reading comprehension, passage comprehension

Rigoli et al.26 , c

93, boys/girls

12–16

Manual coordination

MABC-2

Livesey et al.27

36, boys/girls

5–6

Fine manual control

MABC

General knowledge, reading, verbal comprehension, mathematics, crystallized intelligence (Visuospatial) working memory, verbal comprehension, academic skills Executive functions

Significant relations were found between fine manual control and visual processing (r = .54** ), short-term memory (r = .36** ), long-term memory (r = .27** ), fluid intelligence (r = .40** ) and crystallized intelligence (r = .40** ). There were also significant relations between manual dexterity and visual processing (r = .34** ) and short-term memory (r = .20** ), but not between manual dexterity and long-term memory and crystallized intelligence Significant correlations were found between fine manual control and visual processing (r = .54** ), short-term memory (r = .36** ), long-term memory (r = .27** ), fluid intelligence (r = .41** ), and crystallized intelligence (r = .40** ). There were also significant correlations between manual dexterity and visual processing (r = .34** ), short-term memory (r = .21** ), and fluid intelligence (r = .23** ). There were no significant correlations between manual dexterity and long-term memory and crystallized intelligence Fine motor skills showed significant correlations with general knowledge (r = .16** ), reading (r = .35** ), verbal comprehension (r = .25** ), mathematics (r = .17** ), and crystallized intelligence (r = .19** ).

WIAT–II, WISC–IV, N-back task

There were no significant correlations between manual coordination and the different cognitive skills.

Modified stop-signal task, modified day–night Stroop task

Fine manual control was significantly related to executive functions (r = −.36* ).

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Please cite this article in press as: van der Fels IMJ, et al. The relationship between motor skills and cognitive skills in 4–16 year old typically developing children: A systematic review. J Sci Med Sport (2014), http://dx.doi.org/10.1016/j.jsams.2014.09.007

Table 2 (Continued)

Age (years)

Measure(s) of motor skills

Assessment of motor skills

Measure(s) of cognitive skills

Assessment of cognitive skills

Resultsa

Rigoli et al.28 , c

93, boys/girls

12–16

Manual coordination

MABC-2

Attention, executive functions

WISC–IV, N-back task, NEPSY

Morales et al.32

487, boys/girls

9–16

Fine manual control

The Tower of Cubes test

Oral skills, mathematics

GABT, DAT

There was a significant correlation between manual coordination and attention (r = .52* ) and executive functions (r = .23* ) The correlations between fine motor skills and mathematics (r = −.73* ) and oral skills (r = −.72* ) were significant in 9–12 year old children. In the 13–16 age group, fine motor skills were also significantly correlated with mathematics (r = −.64* ) and oral skills (r = −.74* )

Bilateral body coordination 112, boys/girls Roebers and Kauer6

6–9

The Postural flexibility task

Executive functions

The Backwards Color Recall task, the Flanker task, the Simon task, the Cognitive Flexibility task

There were no significant correlations between body coordination tasks, postural flexibility, and moving sideways and executive functions

Davis et al.7 b

248, boys/girls

4–11

Body coordination, postural flexibility, moving sideways Body coordination

BOT-2

KABC-II

Significant correlations were found between body coordination and visual processing (r = .41** ), short-term memory (r = .23** ), long-term memory (r = .22** ), fluid intelligence (r = .39** ), and crystallized intelligence (r = .34** )

Davis et al.8 , b

242, boys/girls

4–11

Body coordination

BOT-2

KABC-II

There were significant correlations between body coordination and visual processing (r = .46** ), short-term memory (r = .22** ), long-term memory (r = .21** ), fluid intelligence (r = .37** ), and crystallized intelligence (r = .32** )

Planinsec and Pisot9

550, boys

13

ACDSi

TN-20

The above average intelligence group scored significantly better on whole body coordination, complex coordination movements, and coordination of movements in rhythm. There were no significant differences between above and below average intelligence groups in the motor coordination test climbing and descending

Kovaˇc and Strel25

1859, girls

10–16

Body coordination, complex coordination movements, coordination of movements in rhythm, climbing and descending Coordination of movements in rhythm

Visual processing, short-term memory, long-term memory, fluid intelligence, crystallized intelligence Visual processing, short-term memory, long-term memory, fluid intelligence, crystallized intelligence Fluid intelligence

ACDSi

Fluid intelligence

TN-20

Katic and Bala29

162, girls

10–14

Muscle tone regulation, coordination

Steps laterally, obstacle course backwards

Cognitive capacity to encode and analyze information

The Raven’s SPM

Planinsec30

665, boys/girls

5–6

Body coordination

Walking on rungs backwards, walking through hoops backwards, polygon backward, crawling under the bench, running after crawling

Fluid intelligence

The Test Razkol

The correlation between coordination of movement in rhythm and fluid intelligence was significant in 10, 11 and 14 year old children (resp. r = .20** , r = .27** and r = .26** ) In 10–12 year old children, cognitive functioning was implicated in their motor efficiency by muscle tone regulation and coordination. In 13–14 year old children, cognitive functioning was not implicated in their motor efficiency Body coordination significantly contributed to fluid intelligence (boys: ␤ = .41* ; girls: ␤ = .24* )

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Table 2 (Continued)

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Measure(s) of motor skills

Assessment of motor skills

Measure(s) of cognitive skills

Assessment of cognitive skills

Resultsa

Planinsec31

550, boys

10,12,14

Coordination of movements in rhythm, body coordination, complex coordination movements

Eurofit Test Battery

Fluid intelligence

TN-20

Nourbakhsh36

400, boys/girls

10–11

General static coordination, general dynamic coordination

The Oseretsky scale

Academic skills

A grade-point average of the final exams

Coordination of movement in rhythm significantly contributed to fluid intelligence (10 years: ␤ = .20* , 12 years: ␤ = .22* , 14 years: ␤ = .19* ). Body coordination and complex coordination movements did not significantly contribute to fluid intelligence There was a significant correlation between general static coordination and academic skills (0.22* ) and between general dynamic coordination and academic skills (0.20** )

Timed performance in movements 112, boys/girls Roebers and Kauer6

6–9

Speed of movement

The Pegboard task

Executive functions

Jenni et al.10

252, boys/girls

7–16

Repetitive/sequenced movements, hand-foot motor tasks, Speed of movement

ZNA

General IQ, verbal IQ, performance IQ, visuomotor IQ

The Backwards Color Recall task, the Flanker task, the Simon task, the Cognitive Flexibility task WPPSI, WISC-R, AID

Martin et al.11

136, boys/girls

6–16

Repetitive/sequenced movements

PANESS

General IQ, verbal IQ

WISC-III, WISC-IV

Kovaˇc & Strel25

1859, girls

10–16

Speed of simple movements

ACDSi

Fluid intelligence

TN-20

There was no significant correlation between the pegboard task and executive functions

Correlations between sequenced finger movements and general IQ (r = .23** ), verbal IQ (r = .20** ), performance IQ (r = .16* ), and visuomotor IQ (r = .22** ) were systematically higher than those between repetitive finger movements and general IQ (r = .16* ), verbal IQ (r = .13* ), performance IQ (r = .11* ), and visuomotor IQ (r = .15* ). There were also significant correlations between hand-foot motor tasks and general IQ (r = .25** ), verbal IQ (r = .21** ), performance IQ (r = .16* ), and visuomotor IQ (r = .22** ). Correlations were found between the pegboard task and performance IQ (r = .31** ), visuomotor IQ (r = .35** ), and general IQ (r = .18* ). There was no correlation between the pegboard task and verbal IQ Verbal IQ added a significant proportion of unique variance to the prediction of the sequenced motor speed factor (R2 = .02* ). For the repetitive factor, verbal IQ was not a significant predictor of motor speed, after controlling for age and sex. The same was found for general IQ and repetitive/sequenced movements There was a significant relation between speed of simple movements and fluid intelligence in 11 year old girls (r = .27** ) and in 12 year old girls (r = .26* ). There were no significant relationships between speed of simple movements and fluid intelligence in 10 and 13–16 year old girls

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Table 2 (Continued)

Age (years)

Measure(s) of motor skills

Assessment of motor skills

Measure(s) of cognitive skills

Assessment of cognitive skills

Resultsa

Planinsec30

665, boys/girls

5–6

Speed of simple/complex movements

Hand tapping in two fields, foot tapping, hand tapping in four fields

Fluid intelligence

The Test Razkol

Planinsec31

550, boys

10,12,14

Eurofit Test Battery

Fluid intelligence

TN-20

Pangelinan et al.33

315, boys/girls

6–13

Speed of movement Speed of movement

The Purdue Pegboard bimanual task

IQ, spatial working memory

WASI, CANTAB

Nourbakhsh36

400, boys/girls

10–11

Movement speed

The Oseretsky scale

Academic skills

A grade-point average of the final exams

Speed of simple and complex movements significantly contributed to fluid intelligence (resp. boys: ␤ = .32* ; girls: ␤ = .28* and boys: ␤ = .17* ; girls: ␤ = .25* ) Speed of movement did not significantly contribute to fluid intelligence There was a significant correlation between the pegboard task and IQ (r = .27** ), but not between the pegboard task and spatial working memory There was no significant correlation between movement speed and academic skills

Object control Planinsec & Pisot9

550, boys

13

Object control

ACDSi

Fluid intelligence

The Pogaˇcnik Test of Series

Rigoli et al.26c

93, boys/girls

12–16

Ball skills

MABC-2

(Visuospatial) working memory, reading, verbal comprehension, spelling, mathematics

WIAT–II, WISC–IV, N-back task

Livesey et al.27

36, boys/girls

5–6

Ball skills

MABC

Executive functions

Rigoli et al.28c

93, boys/girls

12–16

Ball skills

MABC-2

Planinsec30

665, boys, girls

5–6

Object control

Morales et al.32

487, boys/girls

9–16

Ball skills

Rolling the ball around the hoop, crawling with a ball, circling the ball around the body, rolling the ball around the feet, leading the ball with two hands in a standing position, building a tower from big foam rubber cubes, insertion into hollow cubes, building a tower from small wooden cubes The Target-Throwing test

Attention, executive functions, (visuospatial) working memory, verbal comprehension Fluid intelligence

Modified stop-signal task, modified day–night Stroop task WISC–IV, N-back task, NEPSY

Castelli et al.34

37, boys

7–12

Ball skills

Basketball, bowling

The above average intelligence group scored significantly better on object control skills (p < 0.05) There were significant correlations between ball skills and working memory (r = .25* ), visuospatial working memory (r = .28** ), reading (r = .28** ), and mathematics (.23* ). Balls skills were not related to verbal comprehension and spelling Ball skills were not significantly related to executive functions Ball skills were significantly related to working memory (r = .25** ) and visuospatial working memory (r = .28** ), but not to executive functions, attention, and verbal comprehension

The Test Razkol

Object control skills did significantly contribute to fluid intelligence (␤ = .17* )

Oral skills, mathematics

GABT, DAT

Executive functions

The Stroop Color-Word Task

There were significant correlations between ball skills test and mathematics (r = −.44* ) and oral skills (r = −.34* ) in 9–12 years old children. In the 13–16 age group, ball skills demonstrated much lower correlations with mathematics (r = −.16* ) and oral skills (r = −17* ) There was a significant relationship between balls skills and executive functions (r = .40** )

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Table 2 (Continued)

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Measure(s) of motor skills

Assessment of motor skills

Measure(s) of cognitive skills

Assessment of cognitive skills

Resultsa

Decker et al.35

846, boys/girls

4–7

Copy, recall

SB5

Fluid intelligence, knowledge, quantitative reasoning, (visuospatial) working memory

Bender-Gestalt II

Cognitive skills were tested verbally and non-verbally. There were significant (nonverbal/verbal) correlations between copy and fluid intelligence (r = .19** /r = .20** ), knowledge (r = .20** /r = .18** ), quantitative reasoning (r = .25** /r = .30** ), visuospatial working memory (r = .23** /r = .24** ), and working memory (r = .21** /r = .21** ). There were also significant correlations (nonverbal/verbal) between the recall test and fluid intelligence (r = .25** /r = .24** ), knowledge (r = .25** /r = .26** ), quantitative reasoning (r = .29** /r = .34** ), visuospatial working memory (r = .31** /r = .30** ), and working memory (r = .28** /r = .28** )

Total motor score Davis et al.7 b

248, boys/girls

4–11

Total motor score

BOT-2

Total cognitive score

KABC-II

Livesey et al.27

36, boys/girls

5–6

Total motor score

MABC

Executive functions

Rigoli, et al.28c

93, boys/girls

12–16

Total motor score

MABC-2

Attention, executive functions, working memory, verbal comprehension

Modified stop-signal task, modified day–night Stroop task WISC–IV, N-back task, NEPSY

There was a significant positive correlation between the total motor score and the total cognitive score (r = .52** ) There was no significant correlation between total motor score and executive functions

Smits-Engelsman and Hill37

460, boys/girls

4–13

Total motor score

MABC

IQ

Wassenberg et al.38

378, boys/girls

5–6

Total motor score

MMT

Visual motor integration, executive functions, visual processing, working memory

WISC-III, WISC-IV, WPPSI, KABC, SON-test the Raven’s SPM, RAKIT The Beery VMI, The Picture Vocabulary test, RAKIT, KABC, ANT

The total motor score accounted for a significant proportion of the variance in executive functions (r = .28** ) but not for attention, working memory, and verbal comprehension The correlation between total motor score and general IQ was significant (r = .44** ) Visual motor integration significantly contributed to total motor score (␤ = .05*** ). Total motor score was not significantly related to the cognitive tasks, except for the working memory task word order (␤ = .04* ). The executive functions task verbal fluency was only related to a quantity motor score (␤ = .16* )

Abbreviations: ACDSi, The Analysis of Children’s Development in Slovenia 2013; AID, Adaptives Intelligenz Diagnostikum; ANT, Amsterdam Neuropsychological Tasks; Beery VMI, The Beery Developmental Test of Visual Motor Integration; Bender–Gestalt II, Bender Visual–Motor Gestalt Test—2nd edition; BOT-2, Bruininks–Oseretsky Test of Motor Proficiency—2nd edition; CANTAB, The Cambridge Neuropsychological Test Automated Battery; DAT, the Differential Aptitude Test; ESI-R, the Early Screening Inventory—Revised; GABT, The General Aptitude Test Battery; KABC-II, Kaufman Assessment Battery for Children—2nd edition; MABC, Movement Assessment Battery for Children; MABC-2, Movement Assessment Battery for Children—2nd edition; MMT, the Maastricht Motor Test; NEPSY, A Developmental Neuropsychological Assessment; ns, not significant; PANESS, Physical and Neurological Examination for Soft Signs; RAKIT, Revisie Amsterdamse Kinder Intelligentie Test; Raven’s SPM, Raven’s Standard Progressive Matrices; R2 , explained variance; SB5, Stanford–Binet Intelligence Scale—5th edition; SON-test, the Snijders–Oomen Non Verbal Intelligence Test–Revision; TN-20, The Pogaˇcnik Test of Series; WASI, Wechsler Abbreviated Scales of Intelligence; WIAT-II; Wechsler Individual Achievement Test—2nd edition; WISC-R, Wechsler Intelligence Scale for Children—Revised version; WISC-III, Wechsler Intelligence Scale for Children—3rd edition, WISC-IV, Wechsler Intelligence Scale for Children—4th edition; WPPSI, Wechsler Preschool and Primary Scale of Intelligence; WJ II, The Woodcock–Johnson III test; ZNA, Te Zurich Neuromotor Assessment; ␤, regression coefficient. a r < 0.3, weak correlation; r between 0.3 and 0.5, moderate correlation; and r > 0.5, strong correlation.22 b Studies of Davis et al.7 , 8 reporting on the same sample size. c Studies of Rigoli et al.26 , 28 reporting on the same sample size. * p < 0.05. ** p < 0.01. *** p < 0.00.

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Table 3 Summary of systematic review on relationships between motor and cognitive skills. Motor skill

Cognitive skill

No correlation

Weak correlation

Gross motor skills

Executive functions Visual processing Short-term memory Long-term memory Fluid intelligence Crystallized intelligence IQ Academic skills General knowledge Visuospatial working memory Working memory Verbal comprehension Attention Cognitive capacity to encode and analyze information Short-term memory Long-term memory Fluid intelligence Crystallized intelligence Visual processing General knowledge Academic skills Verbal comprehension Working memory Visuospatial working memory Executive functions Attention Executive functions Visual processing Short-term memory Long-term memory Fluid intelligence

6, 27, 28c

6, 26c

Fine motor skills

Bilateral body coordination

Timed performance in movements

Object control

Total motor score

a b c f m pp p

Academic skills Cognitive capacity to encode and analyze information Crystallized intelligence Executive functions IQ Fluid intelligence Academic skills Spatial working memory Executive functions Fluid intelligence Working memory Visuospatial working memory Verbal comprehension Academic skills Attention Knowledge Quantitative reasoning Total cognitive score Executive functions Attention Working memory Verbal comprehension IQ Visual motor integration Visual processing

Moderate correlation

Strong correlation

Strong (no correlation) Insufficient Insufficient Insufficient Strong (no correlation) Weak (weak) Insufficient Insufficient No No

7a , 8a

7a , 25, 30, 31 24 10 26b 24 26b 26b , 28b 26b , 28b 28b

7a ,8a 7a ,8a 8a 7a ,8a 10 24

Insufficient Weak (no correlation) No No

24 29

7a , c ,8a,c 7a , c ,8a , c

26b 26b 26b 26b

7a , c 7a , c ,8a , c 8a , c 24

7a , c ,8a 7a ,8a , c 7a , c ,8a , c 7a , c ,8a , c

7a , c ,8a , c

24 24c 24

24c

32

28b

27 28b

6 7a ,8a

9c ,31c

7a ,8a 7a ,8a 9c ,25,30g , 31c

29p

36 29pp

7a ,8a ,30b

7a ,8a 6 10c 25p ,31 36 33 27, 28b

c

10 ,11, 33 25pp , 30f , 30m , c

10 30m , c

34

26b

32pp

35 35 7a 27,38 28b 28b 28b

28b 38 37 38

38

Weak (weak-moderate) Insufficient Weak (weak-moderate) Insufficient Strong (moderate-strong) No Insufficient Insufficient No No Insufficient No No Insufficient Insufficient Insufficient Strong (weak-moderate correlation) No No

Insufficient No Weak (weak-moderate) Weak (weak-moderate) No No Insufficient Weak (weak) Weak (weak) Strong (weak)

c

9,30,35 26b ,28b ,35 26b ,28b ,35 26b ,28b 32p 28b

Evidence

Insufficient Weak (weak-moderate) No No No No Weak (no correlation) No Insufficient No No No No

Studies of Davis et al.7,8 reporting on the same sample size. Studies of Rigoli et al.26,28 reporting on the same sample size. Studies used different underlying aspects of motor skills and found different results. Female participants. Male participants. Pre-pubertal children (13 years).

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Eight articles were included in the category object control.9,26–28,30,32,34,35 One article had low methodological quality, two articles had good methodological quality and five articles had high methodological quality. Tables 2 and 3 show strong evidence for a weak correlation between object control and visuospatial working memory.26,28,35 There was weak evidence for a weak correlation between object control and both fluid intelligence and working memory.9,26,28,30,35 Insufficient evidence was found for a correlation between object control and executive functions, verbal comprehension, and academic skills.26–28,32,34 There was no evidence for a correlation between object control and attention, knowledge, and quantitative reasoning.28,35 Five articles were included in the category total motor score.7,27,28,37,38 Two articles had good methodological quality and three articles had high methodological quality. Tables 2 and 3 show weak evidence for no correlation between total motor score and executive functions.27,28,38 There was insufficient evidence for a correlation between total motor score and working memory.28,38 No evidence was found for a correlation between object control and total cognitive score, attention, verbal comprehension, IQ, visual motor integration, and visual processing.7,28,37,38

4. Discussion The aim of the present review was to give an overview of studies providing evidence for a relationship between motor and cognitive skills in 4–16 year old typically developing children. Following the results, there is either no correlation in the literature, or insufficient evidence for or against many correlations between motor skills and cognitive skills. However, weak-to-strong evidence is found for some correlations between underlying categories of motor and cognitive skills, resulting in some interesting findings: fine motor skills, bilateral body coordination, and timed performance in movements show the strongest relations with cognitive skills. However, balance and strength/agility were less related to cognitive skills. These findings might be explained by the fact that the first group of motor skills (fine motor skills, bilateral body coordination, and timed performance in movements) have a higher cognitive demand. The motor skills that show stronger relations to cognitive skills can be interpreted as complex motor skills and require higher order cognitive skills.39 The motor tasks that show lower relations to cognitive skills require less cognitive engagement in the tasks.39 This is supported by a neuropsychological view; the relation between motor and cognitive skills is mediated by the co-activation of the cerebellum (important for complex and coordinated movements) and the prefrontal cortex (important for higher-order cognitive skills).4 Furthermore, there was weak evidence for a weak-to-moderate correlation between different motor skills and fluid intelligence and visual processing. Fluid intelligence is a higher-order complex cognitive skill and is important for performing complex motor movements.39 Visual processing may be an important cognitive skill for performing motor tasks, as Koziol and Lutz40 argued that a child’s knowledge of motor skills is initially grounded in the process of sensorimotor anticipations and this represents the forerunner of the thinking that is required for executive functions. Their study demonstrates important relationships between movement, action control, and thinking. Lastly, weak evidence was found for a stronger relationship between underlying categories of motor and cognitive skills (e.g. bilateral body coordination with fluid intelligence, timed performance in movements with fluid intelligence, and fine motor skills with academic skills) in pre-pubertal children compared to pubertal children (older than 13 years).24,28,31 This finding supports the statement of Anderson et al.5 that motor skills and cognitive skills develop in equal stages in young children, with an accelerated

development between 5 and 10 years old. However, when children get older, the motor skills and cognitive skills might begin to develop more separately. A limitation of this review is that motor skills are classified according to the articles that have been reviewed and are based on the most essential aspects. However, the distribution of the categories is still a point of discussion, since almost all motor skills contain elements of other categories and are not mutually exclusive. A strength of this review is that wide concepts of motor skills and cognitive skills were used which resulted in a detailed overview of the relationship between motor and cognitive skills. Furthermore, this review included mostly good or high methodological quality studies. Therefore, some weak-to-strong evidence for or against relationships between underlying categories of motor and cognitive skills were found. However, there is either no correlation in the literature, or insufficient evidence for or against many correlations between motor skills and cognitive skills. There were some indications for correlations between different categories of motor and cognitive skills; however, there were insufficient articles to provide evidence. Future studies should investigate these correlations between motor and cognitive skills to get evidence for these relationships. Furthermore, in future studies it would be interesting to compare the level of evidence as well as the strength of relationships between typically developing children and special populations (e.g. children scoring higher/lower on motor and/or cognitive skills) and between different age categories.

5. Conclusions The aim of the present review was to give an overview of studies providing evidence for a relationship between motor and cognitive skills in 4–16 year old typically developing children. There is either no correlation in the literature, or insufficient evidence for or against many correlations between motor skills and cognitive skills. However, weak-to-strong evidence was found for some correlations between underlying categories of motor and cognitive skills. The only correlations that were found suggest the importance of complex motor skills and higher order cognitive skills to explain correlations between motor and cognitive skills. Furthermore, this review shows stronger relationship between underlying categories of motor and cognitive skills in pre-pubertal children compared to pubertal children (older than 13 years). The results of this review are interesting in the context of training programs focusing on optimizing motor and/or cognitive skills in children, as it would support the concept that interventions in one domain (motor or cognitive skills) may support development of both motor and cognitive skills, especially in pre-pubertal children. This is supported by a recent study by Westendorp et al.41 Following the results in this review, complex motor skills such as fine motor skills, coordination of movement in rhythm, and sequenced movements should be included in motor intervention programs to improve higher order cognitive skills or vice versa.

Practical implications • The relationships between categories of motor and cognitive skills in typically developing children vary from weak-to-strong. • The strongest relationships have been found between complex motor skills and higher order cognitive skills. • The strength of the relationships between motor and cognitive skills seems to decrease in pubertal children (>13 years). • Complex motor intervention programs could be developed in order to stimulate both motor and higher order cognitive skills in children.

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Acknowledgement There has been no financial assistance with this review article. References 1. Hertzberg OE. The relationship of motor ability to the intelligence of kindergarten children. J Educ Psychol 1929; 20(7):507–519. 2. Piaget J. The origins of intelligence in children, New York, NY, Norton & Company, 1952. 3. Desmond JE, Gabrieli JDE, Wagner AD et al. Lobular patterns of cerebellar activation in verbal working memory and finger tapping tasks as revealed by functional MRI. J Neurosci 1997; 17:9675–9685. 4. Diamond A. Close interrelation of motor development and cognitive development and of the cerebellum and prefrontal cortex. Child Dev 2000; 71(1):44–56. 5. Anderson V, Anderson P, Northam E et al. Development of executive functions through late childhood and adolescence: an Australian sample. Dev Neuropsychol 2001; 20:385–406. 6. Roebers CM, Kauer M. Motor and cognitive control in a normative sample of 7-year-olds. Dev Sci 2009; 12(1):175–181. 7. Davis EE, Pitchford NJ, Limback E. The interrelation between cognitive and motor development in typically developing children aged 4–11 years is underpinned by visual processing and fine manual control. Brit J Psychol 2011; 102(3):569–584. 8. Davis EE, Pitchford NJ, Jaspan T et al. Development of cognitive and motor function following cerebellar tumour injury sustained in early childhood. Cortex 2010; 46(7):919–932. 9. Planinsec J, Pisot R. Motor coordination and intelligence level in adolescents. Adolescence 2006; 41(164):667–676. 10. Jenni OG, Chaouch A, Caflisch J et al. Correlations between motor and intellectual functions in normally developing children between 7 and 18 years. Dev Neuropsychol 2013; 38(2):98–113. 11. Martin R, Tigera C, Denckla MB et al. Factor structure of paediatric timed motor examination and its relationship with IQ. Dev Med Child Neurol 2010; 52(8):e188–e194. 12. Gazzaniga MS, Ivry RB, Mangun GR. Learning and memory, In: Cognitive neuroscience: the biology of the mind. 3rd ed. New York, NY, W.W. Norton & Company, 2009. Chapter 8. 13. Boden C, Giaschi D. M-stream deficits and reading-related visual processes in developmental dyslexia. Psychol Bull 2007; 133(2):346–366. 14. Nee DE, Jonides J. Trisecting representational states in STM. Front Hum Neurosci 2013; 26(7):796. 15. Catell RB. The discovery of fluid and crystallized general intelligence, In: Abilities: their structure, growth, and action. New York, NY, Houghton Mifflin, 1971. Chapter 5. 16. Wilson PH, Ruddock S, Smits-Engelsman B et al. Understanding performance deficits in developmental coordination disorder: a meta-analysis of recent research. Dev Med Child Neurol 2013; 55(3):217–228. 17. Jongbloed-Pereboom M, Janssen AJ, Steenbergen B et al. Motor learning and working memory in children born preterm: a systematic review. Neurosci Biobehav Rev 2012; 36(4):1314–1330. 18. Law M, Stewart D, Letts L et al. Guidelines for critical review of qualitative studies—based on guidelines for critical review form-qualitative studies, Hamilton, McMaster University, 1998. 19. Hair TF, Black WC, Babin BJ et al. Multivariate data analysis, 6th ed. New Jersey, Pearson Prentice Hall, 2006.

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20. Berghmans LC, Hendriks HJ, De Bie RA et al. Conservative treatment of urge urinary incontinence in women: a systematic review of randomized clinical trials. BJU Int 2000; 85:245–263. 21. De Croon EM, Sluiter JK, Nijssen TE et al. Predictive factors of work disability in rheumatoid arthritis: a systematic literature review. Ann Rheum Dis 2004; 63:1362–1367. 22. Field A. Everything you ever wanted to know about statistics (well, sort of), In: Discovering statistics using SPSS. 3rd ed. London, Sage, 2009. Chapter 2. 23. Cohen J. The analysis of variance, In: Statistical power analysis for the behavioral science. 2nd ed. New Jersey, Lawrence Erlbaum Associates, 1988. Chapter 8. 24. Cameron CE, Brock LL, Murrah WM et al. Fine motor skills and executive function both contribute to kindergarten achievement. Child Dev 2012; 83(4):1229–1244. 25. Kovaˇc M, Strel J. The relations between indicators of intelligence and motor abilities. Kinesiology 2000; 32(1):15–25. 26. Rigoli D, Piek JP, Kane R et al. Motor coordination, working memory, and academic achievement in a normative adolescent sample: Testing a mediation model. Arch Clin Neuropsychol 2012; 27(7):766–780. 27. Livesey D, Keen J, Rouse J et al. The relationship between measures of executive function, motor performance and externalising behaviour in 5- and 6-year-old children. Hum Mov Sci 2006; 25(1):50–64. 28. Rigoli D, Piek JP, Kane et al. An examination of the relationship between motor coordination and executive functions in adolescents. Dev Med Child Neurol 2012; 54(11):1025–1031. 29. Katic R, Bala G. Relationships between cognitive and motor abilities in female children aged 10–14 years. Collegium Antropol 2012; 36(1):69–77. 30. Planinsec J. Relations between the motor and cognitive dimensions of preschool girls and boys. Percept Motor Skill 2002; 94(2):415–423. 31. Planinsec J. Developmental changes of relations between motor performance and FI. Studia Psychologica 2002; 44(2):85–94. 32. Morales J, González L, Guerra M et al. Physical activity, perceptual-motor performance, and academic learning in 9-to-16-years-old school children. Int J Sport Psychol 2011; 42(4):401–415. 33. Pangelinan MM, Zhang G, Van Meter JW et al. Beyond age and gender: relationships between cortical and subcortical brain volume and cognitive-motor abilities in school-age children. Neuroimage 2001; 54(4):3093–3100. 34. Castelli D, Erwin H, Buck S et al. Relationship between motor skill competency and cognitive processes in children. Res Q Exercise Sport 2006; 77(1):A51–A52. 35. Decker SL, Englund JA, Carboni JA et al. Cognitive and developmental influences in visual-motor integration skills in young children. Psychol Assessment 2011; 23(4):1010–1016. 36. Nourbakhsh P. Perceptual-motor abilities and their relationships with academic performance of fifth grade pupils in comparison with Oseretsky scale. Kinesiology 2006; 38(1):40–48. 37. Smits-Engelsman B, Hill EL. The relationship between motor coordination an intelligence across the IQ range. Pediatrics 2012; 130(4):e950–e956. 38. Wassenberg R, Feron FJM, Kessels AGH et al. Relation between cognitive and motor performance in 5- to 6-year old children: results from a large-scale crosssectional study. Child Dev 2005; 76(5):1092–1103. 39. Best JR. Effects of physical activity on children’s executive function: contributions of experimental research on aerobic exercise. Dev Rev 2010; 30:331–351. 40. Koziol LF, Lutz JT. From movement to thought: the development of executive function. Appl Neuropsychol Child 2013; 2(2):104–115. 41. Westendorp M, Houwen S, Hartman E et al. Effect of a ball skill intervention on children’s ball skills and cognitive functions. Med Sci Sports Exerc 2014; 46(2):414–422.

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