Extended Recess: A Cure for ADHD?

 At a social gathering not long ago, I found myself sitting next to the nine year-old son of my host. Seeking a constructive conversational topic, I asked Ariel some questions about school. The piece of information he was most eager to tell me was that having moved up a grade, he now stayed in his (all-boys, Haredi) school until 5PM. From the sparkle in his eyes, I gathered this was a source of pride to him, yet I couldn’t help but wonder how such a long day could be a good thing for a boy of nine years.

Going into detective mode, I began asking questions. “How many times a day do you have recess?” I asked him. “How long are your breaks?” I asked.

As it turns out, Ariel has 11 periods of free time during each school day. Sometimes a break is only 15-minutes long and at other points the boys get half an hour to run about and play. Since Ariel takes medication for Attention Deficit Hyperactivity Disorder (ADHD), he has no appetite for lunch and snack breaks, but instead uses the time to play. In good weather, that means soccer in the courtyard with his classmates.

Once I ascertained that he eats well in the morning at home before taking his medication, I felt much reassured. In fact, I was thinking: “What a fantastic school this boy attends! Here are educators who understand that boys need time to stretch and move. They’ve built it into the schedule.”

And this is why Ariel has such a long school day. He is getting around 2 hours of free time to move, exercise, play, compete, be free with his mind, and get some fresh air, every single school day. I thought of all this when I read this blog piece in the Washington Post about the high rate of new ADHD diagnoses these days, as reported by the Centers for Disease Control (CDC). Author Angela Hanscom, a pediatric occupational therapist, believes that at least some of these diagnoses are flat out wrong, and are derived from observing children squirming in their seats, unable to sit still during class time.

Hanscom describes a visit to 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!”

Ariel is a lucky boy. His teachers had this epiphany long ago. They know that boys need to move.

Hanscom goes on to detail the effects of a lack of movement on the brain, in particular on the vestibular system which regulates balance. The author makes it clear: children need to move in order to fully develop their sensory systems. Extending recess time is Hanscom’s recommended fix.

I’m in 100% agreement with Hanscom on everything she writes, and I don’t doubt that many of those children diagnosed with ADHD simply need more time to move during the school day. Some children, however, really do have ADHD, such as, for instance, Ariel.  In such a case, it’s important to recognize that there is a real problem and seek out ways to help the child learn to cope with his difficulty.

Note that I say: “help the child to learn to cope with his difficulty.” Ritalin and other medications commonly used to treat children with ADHD modify a child’s behavior. The best way to use the medication is to start it when the child is around 9 or 10 years old, and to discontinue the medication at around the age of 13.

By this time, the child will have hopefully learned the distinction between his behavior under the effects of the medication, and off the medication, such as at nighttime or during the long summer vacation, for instance. The child understands that his classroom behavior while on the medication is appropriate classroom behavior and in the best case scenario, learns to modify his behavior without the medication by the time he reaches high school. This is what I tell parents that tweet me questions about ADHD medication use in my capacity as a parenting education writer at Kars4Kids.

I hope that such will be the case with Ariel, and that he will learn how to model his behavior accordingly, with no further need for medication. But I am also really glad this child is getting lots of time to move and play during his school day. Otherwise, I can well imagine that Ariel’s need to move might interfere with his ability to modify his behavior, the prerequisite for weaning him from his medication in a timely manner.

The various medications for ADHD are no panacea. All medication has side effects. Almost all children on these medications cannot eat while under the influence of the medication. The meds interfere with appetite and cause stomach distress.

Which is awful: kids need calories to fuel their brains and bodies and they need it at regular intervals.

But children must also learn to cope with their symptoms of ADHD in order to achieve academic success, and at a later date, professional success as well. It can be a difficult choice: choosing nutrition or drugs that can make or break a child’s ability to learn. It’s a choice parents wish they didn’t have to make.

The CDC will continue to report the number of ADHD diagnoses per school year. That’s its job. But for us as parents, it may be smart for us to question the experts when a child is newly diagnosed with ADHD. Is it really ADHD or does the child just need to move more during the course of the day? Ask the teacher about breaks in your child’s school day. How often does your child have recess? How much time does he have to move about?

Who knows? Perhaps modifying and extending recess time may be the only thing your child needs to calm his fidgety body so he can drink in his teacher’s words and actually LEARN.

And wouldn’t that be a marvelous thing?