The Mirror Neuron System in Typically and Atypically Developing Children: Evolution, Dysfunction and Rehabilitative Purpose. A Systematic Review.

Abstract

Studies on the Mirror Neuron System (MNS), a network activated during both action execution and observation, suggest a key role in several functions. Although present from early postnatal life, its maturation across developmental stages remains unclear, as does its vulnerability to adverse conditions such as early brain injury or Neurodevelopmental Disorders affecting action planning, execution, and imitation. To better understand MNS development along the continuum from typical to atypical trajectories, a systematic review was conducted. The work, carried out in January 2026 across multiple databases, identified three main findings. First, the MNS is active in early infancy but becomes increasingly specialised and lateralised with development, influenced by goal-directed actions, social context, and motor experience. Second, the network appears to be susceptible to atypical neurodevelopmental processes, as evidenced by different activations in specific Neurodevelopmental Disorders, such as Developmental Coordination Disorder and Autism Spectrum Disorder, although findings are conflicting, or as shown by studies in children with Cerebral Palsy, in whom different activations are generally observed. Third, preliminary evidence suggests a link between rehabilitation outcomes and MNS-related neuroplasticity, particularly in Action Observation Treatment for children with Cerebral Palsy. The present systematic review serves as a first step in enhancing the importance of furthering knowledge of the evolution and peculiarities of MNS in children. Understanding how this system develops, adapts and changes in response to experience can have fundamental implications for clinical and rehabilitation purposes.