Motor coordination and emotional–behavioural difficulties in children with congenital asymptomatic CMV infection at school age: Implications for DCD risk

Introduction Asymptomatic congenital CMV (acCMV) infection has been suggested as a potential condition associated with subtle neurodevelopmental differences. Although children with acCMV show no clinical signs at birth, mild motor coordination difficulties may emerge later in childhood. Developmental Coordination Disorder (DCD) has been proposed as a possible downstream expression of early CMV-related brain vulnerability. This study examined motor coordination, emotional– behavioural functioning, and their associations in school-age children with acCMV. Methods Parents of 51 children with acCMV (33 boys, 18 girls; age 5–13 years, M = 8.31, SD = 2.62) completed the Developmental Coordination Disorder Questionnaire (DCDQ-IT) and the Strengths and Difficulties Questionnaire (SDQ). Children were classified as “at risk” or “not at risk” for DCD based on Italian and Canadian cut-offs. Group differences in DCDQ and SDQ scores were examined using independent-samples t-tests and one-way ANOVAs. Pearson correlations assessed associations between motor coordination (DCDQ total and subscales) and emotional–behavioural dimensions (SDQ subscales). Results Across both cut-offs, 13.7% of children with acCMV were classified as “at risk” for DCD. This group showed significantly lower DCDQ scores (p < .001), with huge effect sizes (d = 4.12; d = 3.50). No gender differences emerged in DCDQ or SDQ scores (p > .17). Motor coordination was negatively associated with emotional symptoms (r = –.35), conduct problems (r = –.31), hyperactivity/inattention (r = –.50), and peer problems (r = –.42), and positively associated with prosocial behaviour (r = .43; all p < .05). Conclusion Children with acCMV may exhibit subtle yet meaningful motor coordination difficulties, along with challenges to emotional and social adjustment. Findings support the hypothesis of a neurodevelopmental continuum in which early acCMV-related vulnerability contributes to emerging DCD-like motor profiles and associated psychosocial difficulties. Early multidimensional screening may help identify children at risk and guide integrated motor–emotional interventions.