The preschool age seems to be decisive for the development of motor skills and probably the most promising time-window in relation to improvement of motor skills. This trial investigates the effect of an intensive structured intervention to improve motor skills in 3 to 6-year-old preschool children. A total of 471 Danish preschool children participated in a cluster randomized controlled trial. The intervention was to enhance motor skills, including predefined minimum criteria. Motor skills were measured using the Motor Assessment Battery for Children-2 (MABC-2) (total and three domains) at baseline and 6-, 18-, and 30-months post-intervention. The effect was estimated by multilevel linear regression with preschool and child included as random effects and adjusted for baseline values. Effect estimates were mainly positive at 6 months, but negative at 30 months with very few statistically significant estimates. In preschools with baseline motor skills scores below average, there was a tendency towards a larger improvement in the intervention group. Future interventions and research should focus on clusters with poor motor skills, as there is larger room for improvement. It remains to be seen whether the intervention can influence general well-being, physical activity, and self-perceived competence, both short- and long-term.

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