This article originally appeared on The Washington Post here, and was written by Valerie Strauss.
The Centers for Disease Control tells us that in recent years there has been a jump in the percentage of young people diagnosed with Attention Deficit and Hyperactivity Disorder, commonly known as ADHD: 7.8 percent in 2003 to 9.5 percent in 2007 and to 11 percent in 2011. The reasons for the rise are multiple, and include changes in diagnostic criteria, medication treatment and more awareness of the condition. In the following post, Angela Hanscom, a pediatric occupational therapist and the founder of TimberNook, a nature-based development program designed to foster creativity and independent play outdoors in New England, suggests yet another reason more children are being diagnosed with ADHD, whether or not they really have it: the amount of time kids are forced to sit while they are in school. This appeared on the TimberNook blog.
A perfect stranger pours her heart out to me over the phone. She complains that her 6-year-old son is unable to sit still in the classroom. The school wants to test him for ADHD (attention deficit and hyperactivity disorder). This sounds familiar, I think to myself. As a pediatric occupational therapist, I’ve noticed that this is a fairly common problem today.
The mother goes on to explain how her son comes home every day with a yellow smiley face. The rest of his class goes home with green smiley faces for good behavior. Every day this child is reminded that his behavior is unacceptable, simply because he can’t sit still for long periods of time.
The mother starts crying. “He is starting to say things like, ‘I hate myself’ and ‘I’m no good at anything.’” This young boy’s self-esteem is plummeting all because he needs to move more often.
Over the past decade, more and more children are being coded as having attention issues and possibly ADHD. A local elementary teacher tells me that at least eight of her twenty-two students have trouble paying attention on a good day. At the same time, children are expected to sit for longer periods of time. In fact, even kindergarteners are being asked to sit for thirty minutes during circle time at some schools.
The problem: children are constantly in an upright position these days. It is rare to find children rolling down hills, climbing trees, and spinning in circles just for fun. Merry-go-rounds and teeter-totters are a thing of the past. Recess times have shortened due to increasing educational demands, and children rarely play outdoors due to parental fears, liability issues, and the hectic schedules of modern-day society. Lets face it: Children are not nearly moving enough, and it is really starting to become a problem.
I recently observed a fifth grade classroom as a favor to a teacher. I quietly went in and took a seat towards the back of the classroom. The teacher was reading a book to the children and it was towards the end of the day. I’ve never seen anything like it. Kids were tilting back their chairs back at extreme angles, others were rocking their bodies back and forth, a few were chewing on the ends of their pencils, and one child was hitting a water bottle against her forehead in a rhythmic pattern.
This was not a special-needs classroom, but a typical classroom at a popular art-integrated charter school. My first thought was that the children might have been fidgeting because it was the end of the day and they were simply tired. Even though this may have been part of the problem, there was certainly another underlying reason.
We quickly learned after further testing, that most of the children in the classroom had poor core strength and balance. In fact, we tested a few other classrooms and found that when compared to children from the early 1980s, only one out of twelve children had normal strength and balance. Only one! Oh my goodness, I thought to myself. These children need to move!
Ironically, many children are walking around with an underdeveloped vestibular (balance) system today–due to restricted movement. In order to develop a strong balance system, children need to move their body in all directions, for hours at a time. Just like with exercising, they need to do this more than just once-a-week in order to reap the benefits. Therefore, having soccer practice once or twice a week is likely not enough movement for the child to develop a strong sensory system.
Children are going to class with bodies that are less prepared to learn than ever before. With sensory systems not quite working right, they are asked to sit and pay attention. Children naturally start fidgeting in order to get the movement their body so desperately needs and is not getting enough of to “turn their brain on.” What happens when the children start fidgeting? We ask them to sit still and pay attention; therefore, their brain goes back to “sleep.”
Fidgeting is a real problem. It is a strong indicator that children are not getting enough movement throughout the day. We need to fix the underlying issue. Recess times need to be extended and kids should be playing outside as soon as they get home from school. Twenty minutes of movement a day is not enough! They need hours of play outdoors in order to establish a healthy sensory system and to support higher-level attention and learning in the classroom.
In order for children to learn, they need to be able to pay attention. In order to pay attention, we need to let them move.
This article originally appeared on NPR.com here, and was written by Sam Sanders.
When Dr. Robert Zarr wanted a young patient to get more exercise, he gave her an unusual prescription: Get off the bus to school earlier.
“She has to take a bus to the train, then a train to another bus, then that bus to her school,” says Zarr, a pediatrician at Unity Health Care, a clinic that serves low-income and uninsured families in Washington, D.C. So the prescription read: “Walk the remaining four blocks on the second bus on your route to school from home, every day.”
Kelssi Aguilar, his 13-year-old patient, wasn’t exactly excited about the change at first. “He told me about the four blocks and I told him it was a 40-minute walk and I was too lazy,” she said. “I was thinking, am I really doing this? I’m going to be late for school.”
Kelssi was actually 10 minutes early the first day she tried the modified route. Kelssi has kept up the walking. And Zarr says she’s moved from obese to just overweight — which is very good.
About 40 percent of Zarr’s young patients are overweight or obese, which has led the doctor to come up with ways to give them very specific recommendations for physical activity. And that has meant mapping out all of the parks in the District of Columbia — 380 parks so far.
The parks, mapped and rated based on facilities and in a searchable database by zip code, can be linked to patients’ electronic medical records. Zarr did it with help from the National Park Service and volunteers from George Washington University’s School of Public Health, park rangers and other doctors. Zarr also received some funding for the project from the National Recreation and Park Association, the National Environmental Education Foundation, and the American Academy of Pediatrics.
Zarr writes park prescriptions on a special prescription pad, in English and Spanish, with the words “Rx for Outdoor Activity” on top, and a schedule slot that asks, “When and where will you play outside this week?”
But it’s not just about the parks. It’s about what the patients want, too.
“I like to listen and find out what it is my patients like to do,” Zarr says, “and then gauge the parks based on their interests, based on their schedules, based on the things they’re willing to do.”
There are other park prescriptions projects getting started across the country, but none have matched the level of detail in Zarr’s parks database.
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Many children aren’t used to going to parks, notes Dr. Steven Pont, medical director for the Texas Center for the Prevention and Treatment of Childhood Obesity in Austin.
“If you didn’t grow up in a family that went camping or experienced outdoors and if you’re more from an urban environment, then going out to a park and experiencing nature might seem a little daunting,” Pont says.
A program like Zarr’s can help reduce that discomfort, Pont says. “The park prescriptions really help kids and families engage and get to those parks and say, ‘Hey, I belong here too.’ ”
The CDC would be happy with these guys, who were playing in Birmingham, Ala., in July 2013. Teenage boys say basketball is their favorite activity.
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Of course, not every park is safe, especially in the District. The neighborhood next to one of the parks Zarr discussed with Kelssi, Kingman Island, had 30 incidents of violent crime over the past year.
“The more parks are used, the more people are there, the safer and the better they are,” Zarr says. “We want people first and foremost to be safe, and be active and be part of the solution to fixing parks that aren’t quite what they should be.”
Ultimately, Zarr says, he wants his parks database to exist in an app, on your smartphone, where doctors and patients alike can use it. And, one day he’d like to be able to track his patients’ activity in parks, to find out exactly how much good a little green space can do.