Once again, I am sharing an article by one of my favorite Wall Street Journal writers, Sumathi Reddy. CLICK HERE to read that piece in the Journal today. An article on the same study appeared a few days ago in the NY Times. CLICK HERE to read that piece at the Times website. Bottom line – if you have a child who has trouble paying attention in class, or who has been diagnosed with ADHD, find a way to build more exercise or “brain breaks” into his or her day!
Exercise Helps Children with ADHD in Study, by Sumathi Reddy
Researchers Hope Physical Activity Can Stem Growing Use of Medications; ‘Brain Breaks’ in the Classroom
Researchers seeking alternatives to the use of drugs to treat ADHD in children are taking a closer look at exercise as a prescription.
A recent study found regular, half-hour sessions of aerobic activity before school helped young children with symptoms of attention deficit hyperactivity disorder become more attentive and less moody. Other research found a single bout of exercise improved students’ attention and academic skills.
It isn’t clear whether physical exercise offers particular benefits to children with symptoms of ADHD, since students with typical development also showed improvements after the sessions. Children with the condition have greater-than-normal difficulty paying attention and may exhibit impulsive behavior, among other symptoms.
Some doctors who specialize in treating children diagnosed with ADHD say they often incorporate exercise in the therapy. And some teachers have begun getting students up from their desks for short bursts of physical activity, finding it helps them pay attention to their studies.
“It benefits all the kids, but I definitely see where it helps the kids with ADHD a lot,” said Jill Fritz, a fourth-grade teacher at Rutledge Pearson Elementary school in Jacksonville, Fla. “It really helps them get back on track and get focused.”
Growing numbers of children in the U.S. have been diagnosed with ADHD. The Centers for Disease Control and Prevention calculated 11% of children had an ADHD diagnosis in 2011, the latest data available. That was up from 7.8% in 2003. Among all children in the U.S., 6.1% in 2011 were taking an ADHD medication, such as Adderall and Ritalin, up from 4.8% in 2007.
In a study published online Tuesday in the Journal of Abnormal Child Psychology, students in kindergarten through second grade did 31 minutes of aerobic physical activity before the start of school for 12 weeks. Another group of students engaged in a sedentary, classroom-based activity. The study, conducted at schools in Vermont and Indiana, involved 202 students.
The participants included children with typical development and others who were classified as at-risk for developing ADHD because of elevated symptoms of the disorder based on parent and teacher assessments.
The study found children in the exercise groups showed greater improvements in areas such as attention and mood than did those in the sedentary groups. The benefits of the exercise applied similarly to typically developing children as well as children with ADHD symptoms.
“This is the first large-scale demonstration of improvements in ADHD symptoms from aerobic physical activity using a randomized controlled trial methodology,” said Betsy Hoza, lead author of the study and a professor of psychological science at the University of Vermont. “This shows promise as a new avenue of treatment for ADHD but more work needs to be done before we know for sure if it really is,” she said.
Dr. Hoza described the benefits as “moderate” but said the results were comparable with what would be expected from an ADHD behavioral intervention with a trained professional.
Many schools have cut back on the amount of time devoted to recess and physical education because of increasing curriculum demands. Instead, some schools have implemented programs to encourage exercise among students either before or after school, or in shorts periods of activity throughout the day.
Ms. Fritz, the fourth-grade teacher, uses an online program called GoNoodle that leads students in what it calls “brain breaks.” She said she puts it on three or four times a day between study periods. A two-minute program might lead the children in forming letters with their bodies, and a 10-minute session might run through a Zumba dance routine.
GoNoodle, a Nashville, Tenn., startup, launched the program last year. It says the product, offered in both free and premium versions, is currently being used by 130,000 elementary schoolteachers.
Another classroom program, ABC for Fitness, helps teachers use short bursts of activity of three to 10 minutes to accumulate 30 minutes a day. Activities include jumping in place and doing squats. The program was developed by David Katz, co-founder of the Yale University Prevention Research Center, and is offered free to school districts through Dr. Katz’s nonprofit, the Turn the Tide Foundation.
ABC for Fitness was evaluated in a 2010 report published in the journal Preventing Chronic Disease. The study, which took place in Missouri, compared three elementary schools using the program with two other schools not using it. Among the findings: Schools that adopted the exercise program for most of the academic year had a 33% decline in ADHD medications used by its students. That compared with a smaller, 7% decline in medication use in the schools not using the program.
A similar study done with a larger sample size is currently under review, said Dr. Katz, who headed up the research teams on both studies.
Researchers at the University of Illinois at Urbana-Champaign examined the effects on attention and cognition from a single bout of activity. Forty children, age 8 to 10 years, spent 20 minutes either reading or exercising on a treadmill. After the tasks, the researchers measured the children’s attention and reading and math skills using computerized tests. They also measured electrical activity in the children’s brains.
After the tasks, test scores improved more for children who exercised than for those who were reading. Within the exercise group, children with ADHD symptoms scored better than the other children on one particular test that measured self-correction.
“Just 20 minutes of exercise of moderate intensity improved these core abilities to allocate attention and improved scholastic performance,” said Matthew Pontifex, lead author of the study and now an assistant professor of kinesiology at Michigan State University. The study was published in 2013 in the Journal of Pediatrics.
John Ratey, a clinical associate professor of psychiatry at Harvard Medical School and author of several books on ADHD, says he generally includes exercise in treatment plans. He recommends morning exercise for children, even something as little as running around or jumping rope. He said exercise can help reduce the medication dosage a patient is taking, or perhaps replace it altogether.
Dr. Ratey is a consultant to Reebok’s BOKS program, which leads 45-minute vigorous-exercise sessions three to five times a week at about 1,000 elementary schools across the country. “It’s for kids in general but it has a big effect for kids with ADHD,” he said.
When confronted with an overly active child, many exasperated teachers and parents respond the same way: “Sit still!” It might be more effective, though, to encourage the child to run. Recent research suggests that even small amounts of exercise enable children to improve their focus and academic performance.
By now it’s well known that diagnoses of attention deficit hyperactivity disorder are increasingly widespread among American children: The label has been applied to about 11 percent of those between the ages of 4 and 17, according to the latest federal statistics. Interestingly, past studies have shown a strong correlation between greater aerobic fitness and attentiveness. But these studies did not answer the question of which comes first, the fitness or the attentional control.
Addressing that mystery was a goal of a study published last year in The Journal of Pediatrics. Researchers at the University of Illinois at Urbana-Champaign recruited 40 8-to-10-year-old boys and girls, half of whom had A.D.H.D. They all took a series of computerized academic and attentional tests. Later, on one occasion they sat and read quietly for 20 minutes; on another, they walked briskly or jogged for 20 minutes on treadmills. After each task, the children wore caps containing electrodes that recorded electrical activity in the brain as they repeated the original tests.
The results should make administrators question the wisdom of cutting P.E. classes. While there were few measurable differences in any of the children’s scores after quiet reading, they all showed marked improvements in their math and reading comprehension scores after the exercise. More striking, the children with A.D.H.D. significantly increased their scores on a complicated test, one in which they had to focus on a single cartoon fish on-screen while other cartoon fish flashed on-screen to distract them. Brain-wave readings showed that after exercise, the children with A.D.H.D. were better able to regulate their behavior, which helped them pay attention. They responded more nimbly to mistakes like incorrect keystrokes. In short, the children with A.D.H.D. were better students academically after exercise. So were the students without A.D.H.D.
“In terms of a nonpharmacological means of dealing with attentional-control problems in children, exercise looks as if it could be quite beneficial,” says Charles Hillman, the professor of kinesiology at the University of Illinois who oversaw the study. “Especially since it seems to also improve the academic performance of children who don’t have attentional-control problems.”
What’s more, adds Matthew Pontifex, now an assistant professor at Michigan State University and the study’s lead author, “You don’t need treadmills.” Just get restless children to march or hop or in some fashion be physically active for a few minutes. Coax their peers to join in.
Of course, even as it reinforces the accumulating evidence that exercise is good for brains, this short-term study leaves many questions unanswered: How much and what kind of physical activity is optimal? Does it permanently lessen attentional problems? Does exercise directly affect attention at all? In their study, the researchers speculate that exercise might sharpen mental focus in part by increasing brain activity in the frontal lobe. But understanding its mechanisms may not be needed for teachers and parents to consider deploying movement to counter wandering attentions.