Unpacking Theory of Mind in developmental coordination disorder: the role of manual dexterity and perspective-taking

Developmental Coordination Disorder (DCD) has often been associated with challenges in social functioning, but it remains unclear whether these reflect a generalized impairment in Theory of Mind (ToM) or selective vulnerabilities related to motor and cognitive constraints. This study examined multiple ToM components in 20 children with DCD aged 7, 11 years. Participants completed standardized measures of cognitive functioning (WISC-IV), motor coordination (MABC-2), and parent-reported social difficulties (SRS-2), along with a ToM battery assessing perspective-taking, second-order false belief, advanced ToM, and affective ToM. Partial correlations controlling for age, gender, and social symptom severity revealed distinct associations across ToM components. Perspective-taking was positively associated with manual dexterity, whereas affective ToM was related to verbal comprehension, and advanced ToM was associated with overall intellectual functioning, verbal comprehension, and working memory. Second-order false belief performance showed no significant associations. A multiple linear regression model indicated that manual dexterity was the only significant predictor of perspective-taking performance, even after controlling for demographic variables and social symptom severity. These findings suggest that ToM abilities in DCD are not globally impaired but differentially supported by motor and cognitive resources. Perspective-taking appears selectively associated with motor coordination, highlighting the importance of considering this relationship in rehabilitation of children with DCD.