What Motor Skills Do Children Perceive as Important? A Child-Centred Exploration Using the Motor Coordination Questionnaire

Background: Understanding children's perceptions of motor skill importance is essential for designing motivating and participatory interventions. However, little is known about which motor activities children with and without motor coordination difficulties value, particularly in culturally diverse, low-resource settings. This study explored how children perceive the importance of motor activities and how these views are shaped by cultural context, sex and motor skill level. Methods: A culturally adapted version of the motor coordination questionnaire (MoCQ) was administered to 1438 children aged 6–13 years in South Africa and Ghana. The MoCQ includes sections on perceived competence (MoCQ-C) and perceived importance (MoCQ-I). Motor skill level was assessed using the Movement Assessment Battery for Children, Second Edition in South Africa and the Developmental Coordination Disorder Questionnaire in Ghana. Children were classified into two motor coordination groups: as typically developing (TD) or having probable developmental coordination disorder (pDCD). Importance ratings from the MoCQ-I were compared across countries, sex and motor coordination groups. Results: Total MoCQ-I scores differed significantly between countries (p < 0.001, d = 0.235), sex (p = 0.031, d = 0.134) and motor coordination groups (p < 0.001, d = 0.335). Children in both countries rated self-care, handwriting and household chores as highly important. Ghanaian children rated kicking, throwing, running, hopping and indigenous games more often as important. South African children gave a higher importance rating to handwriting. Males rated kicking, team sports and biking as more important, whereas females rated dancing higher. Differences between TD and pDCD groups at the item level were more pronounced in Ghana compared to South Africa. Conclusion: Children's perceptions of motor activity importance are shaped by cultural context, sex and motor proficiency. These findings highlight the need for culturally responsive, child-centred interventions. While the MoCQ-I effectively captures key activities, further expansion is recommended to enhance cultural inclusivity and relevance.