Will Physically Active Lessons Improve Academic Achievement for All or Widen the Achievement Gap?

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(1)Will Physically Active Lessons Improve Academic Achievement for All or Widen the Achievement Gap? Sara E. Benjamin Neelon, PhD, MPH, RD,a,b Kathryn R. Hesketh, PhD,b,c Esther M. van Sluijs, PhDb. In this issue of Pediatrics, MullenderWijnsma et al1 report findings from an intervention to evaluate the effects of physically active lessons on enhancing children’s academic achievement. Conducted in primary schools in the Netherlands, results of the study are promising. After 2 years, intervention children showed greater gains in standardized mathematics and spelling test scores compared with control children. To what extent overall activity levels and health of the children have been affected is unknown, and we look forward to results from the children’s fitness tests, which are likely forthcoming. Globally, rates of physical activity in children are low,2,3 and schools are 1 potential setting for health promotion efforts. Indeed, physical activity interventions in primary schools have been implemented with some success.4 Although physically active lessons are 1 example of how children’s physical activity might be increased,5 it is imperative that these lessons do not detract from children’s learning and overall educational attainment. The article by Mullender-Wijnsma et al1 adds to a growing body of evidence showing that physically active lessons in schools may actually improve academic test scores.5 Previously, the large-scale US-based PAAC (Physical Activity Across the Curriculum) trial reported improvement in children’s academic achievement by using standardized tests after implementation of physically active lessons over multiple academic years.6. They also found positive effects on BMI. Thus, 2 large-scale trials have now shown positive effects on test scores for children participating in physically active lessons. Based on this evidence, wider scale implementation of physically active lessons in schools may warrant consideration. It is important, however, to consider the context of these studies and the children who participated. MullenderWijnsma et al1 do not report racial or sociodemographic information about the children in their study, but given the geographic location in the northern Netherlands, we may assume that the majority of children are white. Seventy-seven percent of the children in the PAAC study were white, and more than one-half were from middle to higher income families.6 Of the studies included in a recent systematic review on physically active lessons by Norris et al,5 most were also conducted in small samples of predominantly white children. Physically active lessons for children therefore appear to improve the academic outcomes of more advantaged white children, but are these effects similar across population subgroups, and what is the feasibility of implementing active lessons in schools serving disadvantaged children? The existence of socioeconomic,7–9 racial and ethnic,10,11 and gender12 inequalities in academic achievement has been well documented. Schoollevel factors7,8 and children’s health status13 also affect cognition and academic performance, potentially. aDepartment. of Health, Behavior and Society, Johns Hopkins University, Baltimore, Maryland; bCentre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom; and cInstitute of Child Health, University College London, London, United Kingdom. Opinions expressed in these commentaries are those of the author and not necessarily those of the American Academy of Pediatrics or its Committees. DOI: 10.1542/peds.2015-4137 Accepted for publication Dec 21, 2015 Address correspondence to Sara E. Benjamin Neelon, PhD, MPH, RD, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205. E-mail: [email protected] PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275). Copyright © 2016 by the American Academy of Pediatrics FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose. FUNDING: This research was undertaken by the Centre for Diet and Activity Research, a UK Clinical Research Collaboration Public Health Research Centre of Excellence. Funding from the British Heart Foundation, the Economic and Social Research Council, the Medical Research Council, the National Institute for Health Research, and the Wellcome Trust under the auspices of the UK Clinical Research Collaboration is gratefully acknowledged (RES-590-28-0002). In addition, this research was supported by the Medical Research Council (unit program number MC_UU_12015/7). Dr Hesketh was also supported by the Wellcome Trust (107337/Z/15/Z).. To cite: Benjamin Neelon SE, Hesketh KR, van Sluijs EM. Will Physically Active Lessons Improve Academic Achievement for All or Widen the Achievement Gap?. Pediatrics. 2016;137(3): e20154137. Downloaded from www.aappublications.org/news at Viet Nam:AAP Sponsored on August 29, 2020 PEDIATRICS Volume 137, number 3, March 2016:e20154137. COMMENTARY.

(2) acting as important mediators between socioeconomic status and educational attainment.8,14 Interventions that incorporate physical activity into the school day must therefore strive for effectiveness across all population subgroups and be mindful that they do not widen existing achievement gaps. Results from an earlier pilot study by MullenderWijnsma et al15suggested that the intervention positively affected time-on-task in both socially disadvantaged children and children without social disadvantage. Whether this observation holds for actual academic attainment in the larger trial published in this issue1 has yet to be investigated.. Interventions may need to be adapted or tailored to be suitable for wider implementation. It has been suggested that poverty influences brain development and is associated with lower neurocognitive functioning, negatively affecting children’s executive function, language ability, and recall.16–19 Poverty and social disadvantage can also create adverse home environments (eg, food insecurity, violence in the home), and children from lower income families have been shown to have more behavioral problems.20,21 These conditions may affect children’s ability to benefit from physically active lessons. Moreover, already-stretched teachers in disadvantaged schools may find it difficult to implement physically active lessons in their classrooms.. Despite these potential difficulties, however, such interventions may be of great benefit to young children from less advantaged backgrounds, improving not only their academic attainment and physical activity levels but also their overall health.22 The study by Mullender-Wijnsma et al1 adds to the increasing body of evidence supporting the potential of physically active lessons in schools. Although there may be cause for cautious optimism, further research is required to assess the potential of these lessons to reach large populations and positively affect inequalities in health and educational attainment. Until such evidence exists, it may be preliminary to advocate for wider implementation.. POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose. COMPANION PAPER: A companion to this article can be found online at www.pediatrics.org/cgi/doi/10.1542/peds.2015-2743.. REFERENCES 1. 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Physically active lessons as physical activity and educational interventions: a systematic review of methods and results. Prev Med. 2015;72:116–125 6. Donnelly JE, Lambourne K. Classroombased physical activity, cognition, and academic achievement. Prev Med. 2011;52(suppl 1):S36–S42 7. Sirin SR. Socioeconomic status and academic achievement: a meta-analytic review of research. Rev Educ Res. 2005;75(3):417–453 8. OECD. Equity and Quality in Education: Supporting Disadvantaged Students and Schools. Paris, France: OECD Publishing; 2012 9. Coe DP, Peterson T, Blair C, Schutten MC, Peddie H. Physical fitness, academic achievement, and socioeconomic status in school-aged youth. J Sch Health. 2013;83(7):500–507 10. Bhattacharyya G, Ison E, Blair M. Minority Ethnic Attainment and Participation in Education and Training: The Evidence. London, United. Kingdom: Department for Education and Skills; 2003 11. Aud S, Fox M, KewalRamani A. Status and Trends in the Education of Racial and Ethnic Groups. Washington, DC: National Center for Education Statistics, US Dept of Education; 2010. NCES 2010-015 12. Bécares L, Priest N. Understanding the influence of race/ethnicity, gender, and class on inequalities in academic and non-academic outcomes among eighth-grade students: findings from an intersectionality approach. PLoS One. 2015;10(10):e0141363 13. Hale DR, Bevilacqua L, Viner RM. Adolescent health and adult education and employment: a systematic review. Pediatrics. 2015;136(1):128–140 14. Barr AB. Family socioeconomic status, family health, and changes in students’ math achievement across high school: a mediational model. Soc Sci Med. 2015;140:27–34 15. Mullender-Wijnsma MJ, Hartman E, de Greeff JW, Bosker RJ, Doolaard S, Visscher C. Moderate-to-vigorous. Downloaded from www.aappublications.org/news at Viet Nam:AAP Sponsored on August 29, 2020 2. BENJAMIN NEELON et al.

(3) physically active academic lessons and academic engagement in children with and without a social disadvantage: a within subject experimental design. BMC Public Health. 2015;15:404 16. Farah MJ, Shera DM, Savage JH, et al. Childhood poverty: specific associations with neurocognitive development. Brain Res. 2006;1110(1):166–174 17. Noble KG, McCandliss BD, Farah MJ. Socioeconomic gradients. predict individual differences in neurocognitive abilities. Dev Sci. 2007;10(4):464–480 18. Noble KG, Houston SM, Kan E, Sowell ER. Neural correlates of socioeconomic status in the developing human brain. Dev Sci. 2012;15(4):516–527 19. Noble KG, Houston SM, Brito NH, et al. Family income, parental education and brain structure in children and adolescents. Nat Neurosci. 2015;18(5):773–778. 20. Dodge KA, Pettit GS, Bates JE. Socialization mediators of the relation between socioeconomic status and child conduct problems. Child Dev. 1994;65(spec no 2):649–665 21. Wilkinson R. Why is violence more common where inequality is greater? Ann N Y Acad Sci. 2004;1036:1–12 22. Erwin H. A quantitative review of physical activity, health, and learning outcomes associated with classroombased physical activity interventions. J Appl Sch Psychol. 2012;28(1):14–36. Downloaded from www.aappublications.org/news at Viet Nam:AAP Sponsored on August 29, 2020 PEDIATRICS Volume 137, number 3, March 2016. 3.

(4) Will Physically Active Lessons Improve Academic Achievement for All or Widen the Achievement Gap? Sara E. Benjamin Neelon, Kathryn R. Hesketh and Esther M. van Sluijs Pediatrics 2016;137; DOI: 10.1542/peds.2015-4137 originally published online February 24, 2016;. Updated Information & Services. including high resolution figures, can be found at: http://pediatrics.aappublications.org/content/137/3/e20154137. References. This article cites 15 articles, 2 of which you can access for free at: http://pediatrics.aappublications.org/content/137/3/e20154137#BIBL. Subspecialty Collections. This article, along with others on similar topics, appears in the following collection(s): Developmental/Behavioral Pediatrics http://www.aappublications.org/cgi/collection/development:behavior al_issues_sub Cognition/Language/Learning Disorders http://www.aappublications.org/cgi/collection/cognition:language:lea rning_disorders_sub. Permissions & Licensing. Information about reproducing this article in parts (figures, tables) or in its entirety can be found online at: http://www.aappublications.org/site/misc/Permissions.xhtml. Reprints. Information about ordering reprints can be found online: http://www.aappublications.org/site/misc/reprints.xhtml. Downloaded from www.aappublications.org/news at Viet Nam:AAP Sponsored on August 29, 2020.

(5) Will Physically Active Lessons Improve Academic Achievement for All or Widen the Achievement Gap? Sara E. Benjamin Neelon, Kathryn R. Hesketh and Esther M. van Sluijs Pediatrics 2016;137; DOI: 10.1542/peds.2015-4137 originally published online February 24, 2016;. The online version of this article, along with updated information and services, is located on the World Wide Web at: http://pediatrics.aappublications.org/content/137/3/e20154137. Pediatrics is the official journal of the American Academy of Pediatrics. A monthly publication, it has been published continuously since 1948. Pediatrics is owned, published, and trademarked by the American Academy of Pediatrics, 345 Park Avenue, Itasca, Illinois, 60143. Copyright © 2016 by the American Academy of Pediatrics. All rights reserved. Print ISSN: 1073-0397.. Downloaded from www.aappublications.org/news at Viet Nam:AAP Sponsored on August 29, 2020.

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