Active Smarter Kids (ASK): Rationale and design of a cluster-randomized controlled trial investigating the effects of daily physical activity on children's academic performance and risk factors for non-communicable diseases.
Evidence is emerging from school-based studies that physical activity might favorably affect children's academic performance. However, there is a need for high-quality studies to support this. Therefore, the main objective of the Active Smarter Kids (ASK) study is to investigate the effect of daily physical activity on children's academic performance. Because of the complexity of the relation between physical activity and academic performance it is important to identify mediating and moderating variables such as cognitive function, fitness, adiposity, motor skills and quality of life (QoL). Further, there are global concerns regarding the high prevalence of lifestyle-related non-communicable diseases (NCDs). The best means to address this challenge could be through primary prevention. Physical activity is known to play a key role in preventing a host of NCDs. Therefore, we investigated as a secondary objective the effect of the intervention on risk factors related to NCDs. The purpose of this paper is to describe the design of the ASK study, the ASK intervention as well as the scope and details of the methods we adopted to evaluate the effect of the ASK intervention on 5 (th) grade children.
The ASK study is a cluster randomized controlled trial that includes 1145 fifth graders (aged 10 years) from 57 schools (28 intervention schools; 29 control schools) in Sogn and Fjordane County, Norway. This represents 95.3 % of total possible recruitment. Children in all 57 participating schools took part in a curriculum-prescribed physical activity intervention (90 min/week of physical education (PE) and 45 min/week physical activity, in total; 135 min/week). In addition, children from intervention schools also participated in the ASK intervention model (165 min/week), i.e. a total of 300 min/week of physical activity/PE. The ASK study was implemented over 7 months, from November 2014 to June 2015. We assessed academic performance in reading, numeracy and English using Norwegian National tests delivered by The Norwegian Directorate for Education and Training. We assessed physical activity objectively at baseline, midpoint and at the end of the intervention. All other variables were measured at baseline and post-intervention. In addition, we used qualitative methodologies to obtain an in-depth understanding of children's embodied experiences and pedagogical processes taking place during the intervention.
If successful, ASK could provide strong evidence of a relation between physical activity and academic performance that could potentially inform the process of learning in elementary schools. Schools might also be identified as effective settings for large scale public health initiatives for the prevention of NCDs.
Clinicaltrials.gov ID nr: NCT02132494 . Date of registration, 6(th) of May, 2014.
In the first phase of this follow-up study we investigated how the use of more than one language affects mental wellbeing and school achievement among 320 school-aged Finnish-Swedish re-migrant children. Now, in the second phase, we screened the same series of children 6 years after migration for psychiatric and psychosomatic symptoms. Out of five groups distinguished in terms of patterns of language use, two had fared well and three showed evident vulnerability. Both successful groups were marked by consistent use of the two languages, Finnish and Swedish, whereas the risk groups were characterised by mixed use of languages before re-migration or substantial language shift after re-migration.
To investigate the effect of a seven-month, school-based cluster-randomized controlled trial on academic performance in 10-year-old children.
In total, 1129 fifth-grade children from 57 elementary schools in Sogn og Fjordane County, Norway, were cluster-randomized by school either to the intervention group or to the control group. The children in the 28 intervention schools participated in a physical activity intervention between November 2014 and June 2015 consisting of three components: 1) 90min/week of physically active educational lessons mainly carried out in the school playground; 2) 5min/day of physical activity breaks during classroom lessons; 3) 10min/day physical activity homework. Academic performance in numeracy, reading and English was measured using standardized Norwegian national tests. Physical activity was measured objectively by accelerometry.
We found no effect of the intervention on academic performance in primary analyses (standardized difference 0.01-0.06, p>0.358). Subgroup analyses, however, revealed a favorable intervention effect for those who performed the poorest at baseline (lowest tertile) for numeracy (p=0.005 for the subgroup*group interaction), compared to controls (standardized difference 0.62, 95% CI 0.19-1.07).
This large, rigorously conducted cluster RCT in 10-year-old children supports the notion that there is still inadequate evidence to conclude that increased physical activity in school enhances academic achievement in all children. Still, combining physical activity and learning seems a viable model to stimulate learning in those academically weakest schoolchildren.
We assessed the relationship between psychological deviance and performance level at school among 8-year-old children. The use of special education among children with psychiatric disorders was also studied. In Stage 1, 5813 children were studied using the Rutter Parent Questionnaire (RA2), the Rutter Teacher Questionnaire (RB2) and the Children's Depression Inventory (CDI). In Stage 2, a subsample (n = 424) of these children were interviewed, using the Isle of Wight Interview. In Stage 1, more children defined as low achievers (LAs) came from low SES families than did average (NAs) and high achievers (HAs). They also had more psychiatric symptoms, and they scored above the cutoff (13 points on the RA2, nine points on the RB2 and 17 points on the CDI) more commonly than other children. In Stage 2, two thirds of children who received special education had some psychiatric disorder. The probability of a child with psychiatric disorder obtaining some extra tutoring or special education was 3.1-fold when compared with children without psychiatric disorders. Depressive children and children with attention deficit disorders most commonly had extra tutoring (4.8-fold) when compared with children without psychiatric disorders. The probability of getting special education was highest for attention deficit disorders (6.2-fold), thereafter for anxiety (3.1-fold), and for oppositional/conduct disorders (2.8-fold).