The basal ganglia and certain regions of the cerebellum are reasonably mature at birth [236]. All infant, toddler, or childhood movement is purposive [237]. It represents goal-directed action that foresees or predicts events in the child’s world. This viewpoint emphasizes anticipation and action control, which is at the base of executive functioning. Early motor development predicts later development and performance on complex cognitive tasks of working memory and related functions [238].

Despite the fact that activity is so central to child development, the cerebellum, which has traditionally been considered as a processor of movement, has rarely been considered as an essential or primary driver of motor and cognitive development. The vestibulocerebellum is believed to be mature at the time of full-term birth, and investigations of newborn babies and typically developing infants reveal that reciprocal cerebellar-vestibular interconnections are fully myelinated at a very early age [239, 240]. By the age of four years, stains of ponto-cerebellar tracts resemble those of adults [241]. In addition, at full-term birth, the cerebellar cortex already exhibits its well-established architecture: all the Purkinje cells are believed to be present and the climbing fibers that synapse with the Purkinje cell bodies are also in place [242]. Cerebellar adult volume can be achieved between the ages of 7–11 years; peak size is typically reached at the age of a little over 15 years in males and at approximately 11 years in females [243, 244]. The expected level of motor development in typically developing right-handed children is dependent upon the establishment of neocortical left-hemisphere dominance. This includes an intrinsic motor network connectivity profile that consists of frontal motor cortices, basal ganglia, and thalamic connections. Supplementary motor-anterior cerebellar connectivity, presumably one of the anatomic underpinnings of automatic motor behavior, is included in this circuitry profile [245]. This circuitry primarily involves the dorsal stream.

It is known that infant latching-on and sucking abilities predict neurodevelopmental outcomes; babies who exhibit poor suck coordination/sucking cycles are likely to experience motor and complex cognitive delays later [246]. Sucking, feeding, and the subsequent production of speech and language are encoded and modified by overlapping neural networks of brainstem, subcortical, and cortical regions. Piek and colleagues [155, 238] have demonstrated a strong relationship between early gross motor problems and later executive function deficits in school-aged children, manifest in limited WISC-IV processing speed and working memory. Westendorp et al. compared locomotor skills, object-control skills, and levels of performance on reading and mathematics tasks in 7–12-year-old children with learning disabilities versus those of age-matched normal controls [247]. They found children with learning disabilities performed worse on all motor tasks, and they observed relationships between reading and locomotor skills, and between mathematics and object-control skills, such as grasping. The poorer the learning skills, the lower the specific motor skill scores. Why does motor development predict the development of executive cognitive ability and academic skills? Because we were not born to think [248]. Birth necessitates movement. We were born to move.

The functional architecture of the brain evolved to meet the needs of interactive behavior and fundamentally, to control action [117]. Attempting to understand executive function from a purely cortico-centric or cognitive point of view is doomed to fail because the underlying, traditional assumption that cognitive functioning is separate from motor functioning is misleading. Executive functions are those that an organism employs to act independently in its own best interest as a whole, at any point in time, as first proposed by Miller [160]. Cognition developed to control the motor system, the motor system allows cognition to unfold and to develop control over interactive behavior. Deficits in early motor skills development predict problems in executive functioning because early motor problems represent failures in action control. These can be construed as forms of executive function that do not rely upon conscious cognitive awareness. Effective executive functioning cannot develop from a fundamentally disrupted motor platform. It requires the bottom-up support of the motor system; executive control is not simply a top-down control function. In the developing child, observing and inferring why movements are made, how movements are planned, and how movements anticipate or predict what is going to happen next provides a window into executive function, if only on a rudimentary level.