CRITICALLY APPRAISED TOPIC

TITLE

Recess Time and Academic Performance

AUTHOR

Prepared by Ashlyn Smith, OTS, Kim Rahimian, OTS, Dani Morio, OTS, Rachel

Artman, OTS, Rabia Mirza, OTS, Jessica Lee, OTS

Date 10/23/2018

Reviewed by Carole Ivey, PhD, OTR/L

CLINICAL SCENARIO

Schools across America are significantly reducing recess time in elementary schools in order to facilitate more time for structured, academic learning and standardized testing (Riser-Kositsky, 2018). Compounded with decreasing levels of physical activity and increased screen time on various technological gadgets, there are growing concerns for school-aged children’s overall health and well-being. Additionally, schools are employing disciplinary rules that take away recess altogether, further limiting students’ physical activity (Riser-Kositsky, 2018). The impact of decreasing recess warrants further research on all students in elementary schools.

Research shows that unstructured play provides children with the opportunities to develop social,

cognitive, and emotional skills in addition to being more attentive during class time (Ramstetter & Murray, 2017). Some studies indicate that participation in recess also increases academic performance, as demonstrated by improved scores in reading and math (Wendler, 2017). The American Academy of Pediatrics (2013) recommends including recess in schools as it “...is a necessary break in the day for optimizing a child’s social, emotional, physical, and cognitive development.” Even with much research supporting the positive impacts of recess on the development of children, more policies are being created by lawmakers to diminish the amount of time children spend in recess each week. While this may seem to be an acceptable way to emphasize

academics, the lack of opportunity to engage in occupations of play, social participation, and leisure likely has a negative impact on academic performance. Analyzing research regarding the effects of recess (or lack thereof) on academic performance could provide occupational therapists with better knowledge to advocate for the implementation of mandatory recess time.

FOCUSED CLINICAL QUESTION

In elementary school students, does recess time result in improved academic performance?

SUMMARY OF SEARCH

● ERIC, CINAHL, and Education Research Complete were used to find research that addressed the clinical question. Studies had to be published within the last 10 years, must have examined elementary school students, must have been published in scholarly journals, must have been peer reviewed, and must have used quantitative or quasi-experimental methodology to be included. Two quasi-experimental designs/two-

group comparisons (level II evidence), two pretest and posttest designs (level III evidence), five descriptive (level IV evidence), and three narrative literature reviews (level V evidence) were found. One pretest and posttest design and one two-group comparison design were selected for critical appraisal.

● The pretest and posttest design (level III) examined if on-task behaviors in the classroom increased or decreased after recess, if average time of on-task behavior is higher before or after recess, and if average time of off-task behavior is higher after recess. The study indicated that on-task frequency increased after

recess as compared to before recess and suggested that recess can improve academic achievement even

though it takes away from class instruction (Stapp & Karrb, 2018). ● The two-group comparison study (level II) compared the effects of cognitive-based movement breaks with

aerobic-only movement breaks in the context of classrooms. The study suggested that although movement breaks may take away a small amount of school instruction time, it is evident that taking physical activity breaks is helpful for student academic performance. Specifically, taking breaks that include only aerobic activity may slightly increase student academic achievement and physical activity more than breaks that

include academic material (Fedewa, Fettrow, Erwin, Ahn, & Farook, 2018).

CLINICAL BOTTOM LINE

Results from the studies indicated that incorporating physical activity into the school day was beneficial to students’ academic performance. Level II and III evidence gathered from the selected studies indicate sufficient

evidence, through strong study designs, to support the provision of physical activity in schools. A primary limitation of the pretest posttest design is the small sample size (n=12). Limitations of the two-group

comparison study include maturation bias, as results were taken over the course of an academic year, and multiple teachers providing interventions by choosing from a list of possible activities. The results from these studies may be generalizable to other elementary school students, as they utilized samples from general education classrooms. Findings provide significant insight into the behavioral and

academic advantages of keeping recess in elementary schools and can inform occupational therapy practice in school systems. Occupational therapists in schools can use information from these studies to advocate for additional break time and physical activity for students.

Important note on the limitation of this CAT

This critically appraised topic has been peer-reviewed by a course instructor as part of a university assignment.

SEARCH STRATEGY

Terms used to guide the search strategy

● Patient/Client Group: elementary school students, students, children, kids, school-age children ● Intervention (or Assessment): recess, play, physical activity, break time ● Comparison: n/a

● Outcome(s): academic performance, school performance, academic achievement, academic success, grades

Databases and Sites Searched Search Terms Limits Used

ERIC database

CINAHL database

Education Research Complete

● Elementary school

students, primary school ● Recess breaks, break time ● Academic achievement,

educational attainment, student promotion

● Elementary school, primary School, grade school

● Academic performance, academic achievement, academic success

● Recess

● School children ● School recess breaks ● Academic achievement

● Peer-reviewed only

● Full-text available on ERIC ● Publication date: Since

2009 (last 10 years) ● Publication type: journal

articles ● Location: international

● Publication date: 2008-2018

● Language: English ● Peer-reviewed

● Publication type: Academic Journal

● Published: 09/2008-09/2018

● Language: English

● Scholarly (peer reviewed) journals

● Full text

INCLUSION and EXCLUSION CRITERIA

Inclusion Criteria

● Studies must have been published in the last 10 years or less ● Studies must examine elementary school students ● Studies must be published in scholarly journals ● Studies must be peer reviewed ● Studies must use quantitative or quasi-experimental methodology

Exclusion Criteria

● Studies published more than 10 years ago ● Studies published in a language other than English ● Studies used a strictly qualitative methodology

● Studies examined preschool, middle school, or high school students

RESULTS OF SEARCH

A total of 11 relevant studies were located and categorised as shown in Table 1 (based on Levels of Evidence, Centre for Evidence Based Medicine, 2011)

Table 1: Summary of Study Designs of Articles Retrieved

Study Design/Methodology of Articles Retrieved Level Number Located

Author (Year)

Quasi-experimental design & Two Group Comparison II 2 Tercedor, P., et. al. (2017)

Fedewa, A.L., Fettrow, E., Erwin, H., Ahn, S., & Minnah, F.

(2018)

Pre-test and Post-test design III 2 Brez, C., & Sheets,V. (2017)

Stapp, A. C., & Karrb, J., K. (2018)

Descriptive (Retrospective, Cross-sectional survey) IV 5 Dills, A., Morgan,H. N., &

Rotthoff, K. W. (2011)

Evenson, Ballard, Lee, & Ammerman (2009)

Kern, Graber, Shen, Hillman, & Mcloughlin (2017)

London, Westrich, Stokes-Guinan, & McLaughlin (2014)

Turner, Chriqui, Chaloupka (2013)

Narrative Literature Review V 3 Savina, E., Garrity, K., Kenny

P., Doerr, C. (2016)

Brusseau, T., Hannon, J.C.

Venable, S. (2017)

BEST EVIDENCE

The following studies were identified as the ‘best’ evidence and selected for critical appraisal.

Fedewa, A. L., Fettrow, E., Erwin, H., Ahn, S., & Farook, M. (2018). Academic-based and aerobic-only movement breaks: Are there differential effects on physical activity and achievement? Research

Quarterly For Exercise & Sport, 89(2), 153-163. doi:10.1080/02701367.2018.1431602

Stapp, A.C., & Karrb, J.K. (2018). Effect of recess on fifth grade students’ time on-task in an elementary classroom. International Electronic Journal of Elementary Education, 10(4), 449-456. doi:10.26822/iejee.2018438135lol

Reasons for selecting these studies were:

● The two-group comparison provides Level II research, the highest noted from the search strategy. ● The pretest and posttest study provided Level III evidence, but utilized a strong study design. ● Research objectives from both studies aligned with the topic and research question.

● These studies utilized samples from general education classrooms, indicating that results are likely generalizable to other general education students.

SUMMARY OF BEST EVIDENCE

Table 2a: Description and appraisal of two-group comparison by Fedewa, A.L., Fettrow, E., Erwin, H., Ahn, S.,

& Minnah, F. (2018)

Aim/Objective of the Study/Systematic Review:

This study aimed to determine if there was a difference between types of school physical activity break (aerobic-only or academic-based) in academic achievement and physical activity for elementary school

students.

Study Design

Level II: Two Group Comparison

Researchers were not blinded, as they knew which schools were assigned to each type of break and observed

teachers while they performed the activity breaks. Physical activity was measured using pedometers during the movement breaks. Academic achievement was measured during the fall and spring of the academic year (before and after the intervention took place).

Setting

This study took place in the classrooms of four urban Title 1 elementary schools in the Southeastern United States.

Participants

Participants were elementary students in Grades 3-5, were enrolled in an elementary school taking part in the study, and provided parental consent with verbal assent. The schools all qualified for Title 1 assistance, were located in Southeastern urban areas, were matched for demographic characteristics, and included students who

qualified for free and reduced lunch. Recruitment of schools and students was not explicitly stated. The schools were matched at baseline, with 51% male students and 49% female students. The mean demographic information was as follows: 59.5% White, 18.3% African American, 12.5% Hispanic, 4% Asian, and 5.7% Other. There was no dropout reported.

Intervention Investigated

Group 1: Aerobic-Only Movement Breaks

In this intervention group, classroom teachers provided aerobic-only movement breaks with no academic

content. There were 284 children from 2 of the elementary schools in the group. The movement breaks took place in the students’ classroom. Teachers delivered the intervention, but had been provided training and a list of movements by researchers at the beginning of the study. The students were given 2 breaks a day (one morning and one afternoon), 5 days a week, for 5 minutes per break (10 minutes a day). This intervention took

place over 9 months (the school year).

Group 2: Academic-Based Movement Breaks

In this intervention, teachers provided content-driven movement breaks using the GoNoodle platform (e.g., students dance and questions appear on screen to be answered). There were 176 children from 2 of the elementary schools in the group. The movement breaks took place in the students’ classroom. Teachers delivered the intervention, but had been provided training by researchers for using GoNoodle at the beginning of the study. The students were given 2 breaks a day (one morning and one afternoon), 5 days a week, for 5 minutes per break (10 minutes a day). This intervention took place over 9 months (the school year).

Outcome Measures (Primary and Secondary)

Measure 1: Physical Activity

Student physical activity was measured using Walk4Life LS 2500 pedometers. This measure was reported to be reliable and valid. The measure was used during activity breaks. Pedometers were passed out

immediately before each activity break and following the break the information was recorded by students.

Measure 2: Academic Achievement

Student math and literacy academic achievement was measured with FastBridge Learning math and reading standardized assessments using a Rasch Unit RIT Scale. This measure was reported to be reliable. The assessment was used in the fall and spring of the academic year as a preintervention and postintervention measure.

Main Findings

To determine the effect of the interventions on student achievement and physical activity, a mixed-effects (multilevel-growth) model was used by the study researchers represented in the tables below.

(Table 2 and Table 3 listed on page 159 of the study)

Original Authors’ Conclusions

This study concluded that aerobic-only movement breaks may have a greater effect than academic-based movement breaks on improving academic performance and improve the levels of physical activity in students. Additional research should be conducted to further examine the effects of different types of activity breaks. In

addition to addressing its objectives, this study also found that regardless of the treatment group (aerobic-only or academic-based break), students improved their academic performance; that is, students did not have any negative effects from the loss of instruction time for activity breaks.

Critical Appraisal

Validity

There were some potential intervention biases in this study that need to be addressed:

● Co-intervention: Students could have been participating in other forms of physical activity or academic support (tutoring) outside of the classroom which may have contributed to improved academic performance.

● Timing of intervention: The intervention occurred over the course of a school year, during which the

students naturally mature and improve their academic performance. ● Site of intervention: Each intervention took place at a different school which could influence the results

of the study. However, the type of site was the same for each intervention: in the students’ regular classroom.

● Use of different therapists to provide intervention: Interventions were provided by the individual teachers for each classroom. While all teachers were provided training by the researchers and the researchers visited the classrooms to ensure proper activity breaks were being performed, differing

personalities of the teachers or different types of selected breaks may have affected student outcomes. ● Baseline equality: Schools were matched for characteristics and then randomly assigned to the

intervention groups. In addition, descriptive statistics (two individual samples t-tests) revealed no statistically significant baseline difference between math and reading scores for the two groups.

The researchers put in effort to control for measurement biases. They did so by training both teachers and research assistants on proper pedometer placement and measurement of physical activity. However, some potential measurement biases still need to be addressed:

● Blind to treatment status: Researchers knew which schools were assigned to each type of break and observed teachers while they performed the physical activity breaks.

● Recall/memory bias: Researchers attempted to control for recall bias by having teachers record physical

activity breaks in a daily log, which was reported weekly. However, it is possible that teachers in the

aerobic-only group had recall bias when reporting since they were not following a specific activity platform.

This study did not identify a power analysis to determine if the number of participants was large enough to show a difference. The analysis methods reported in the study were appropriate for a two-group comparison. Descriptive statistics were appropriate in describing the mean scores pre- and post-intervention for both

groups. In addition, using two independent-samples t-tests to compare the mean baseline scores in order to determine that both groups started at the same math and reading level, and aerobic-only had significantly more physical activity at baseline, was appropriate. To determine the effect of the interventions on student achievement and physical activity, a mixed-effects (multilevel-growth) model was used. This was appropriate in comparing the outcomes between groups while being able to control for other variables.

Overall limitations of this study include:

● Use of different teachers when providing physical activity breaks could affect outcomes ● Differing levels of physical activity used during physical activity breaks ● Random assignment of schools (as opposed to classrooms) may have led to unexplained variation ● The effects of gender on outcomes is unclear

Interpretation of Results

● No statistical difference was found in math scores between aerobic-only breaks and academic-based breaks (p = 0.19).

● There was a statistically significant difference in reading scores between the two groups. Students in the aerobic-only group had significantly higher reading scores (p = 0.009) than those in the academic-based group.

● There was a statistically significant difference in the number of steps taken between the two groups.

Students in the aerobic-only group had significantly higher step improvement (p < 0.001) than those in the academic-based group.

● No statistical difference was found in the amount of physical activity hours between the two groups (p = 0.29).

Summary/Conclusion

This study emphasizes the importance of physical activity breaks throughout the school day for elementary school students. Specifically, taking breaks that include only aerobic activity may slightly increase student

academic achievement and physical activity more than breaks that include academic material. While taking cognitive breaks may be more beneficial to students, it is important to note that the study identified improved student academic performance for both types of break. This indicates that although a break may be taking away a small amount of school instruction time, it is evident that taking physical activity breaks is helpful for

student academic performance.

The results from this study of 460 students may be generalizable to other elementary school students. This can inform occupational therapy practice in school systems and provide evidence for increasing students’ break

times. Occupational therapists in schools can use this study to advocate for additional break time for students.

The implications of this study need to be understood relative to the strength of its’ evidence. This was a relatively strong study in terms of level of research. The researchers conducted a level II study using a comparison of two groups, an aerobic-only movement break group and an academic-based movement break group. There are a few limitations that should be considered. The interventions were conducted by individual classroom teachers, choosing from a list of possible break activities, which could impact the results of the

study. In addition, all four schools in the study were in urban Title 1 schools located in the Southeastern United States. While the information about physical activity breaks may be generalizable, it is unclear whether the

results can be generalized to all elementary schools in the United States or only those which match the demographics of the schools in the study.

Table 2b: Description and appraisal of correlational descriptive research by Stapp, A. C., & Karrb, J., K. (2018)

Aim/Objective of the Study/Systematic Review:

This study aimed to determine if on-task behaviors in the classroom increase or decrease after a 25-minute period of recess, if the average minutes of on-task behaviors is higher before or after recess, and if the average minutes of off-task behaviors higher before or after recess.

Study Design

Level III: One group, non-randomized, pre-post There was no blinding as there was no control group. Experimenters only made observations and did not

interact with study participants. Observations were made 30 minutes before recess and 30 minutes after recess.

Setting

The setting of the study was a fifth-grade general education classroom in Northwest Mississippi. The study did not identify how this specific school or classroom was chosen.

Participants

There were 12 participants in this study. There were an even number of male and female participants (6 male and 6 female). The participants did not have any specified disabilities or diseases, and of the participants

66.7% were Caucasian, 25% were African American, and 8.3% were biracial. The inclusion criteria were not explicitly stated. Students included in the study must have been in the fifth-grade class general education classroom in Northwest Mississippi that was chosen to be studied. Consent was obtained from the classroom teacher, librarian, and art teacher to conduct these observations, so all students in the class were included in the sample population. Parental consent and children’s assent were not required because there were no interactions between the children and the observers, so this would not exclude any students from being sampled. The children included were selected by non-probability purposive sampling. This type of sampling

does not allow for equal probability of a member in the population to be included in sample. This type of sampling could cause researchers to be biased in their selection of subjects for the study. However, for analysis, participants were compared to their own baseline. There were no reported participant dropouts.

Intervention Investigated

Group 1: 25-minute recess period

The intervention included a 25-minute recess session with the 12 participants. No guidelines were given for the type of play in which the children needed to engage, so it is likely that the recess involved free play. It was not explicitly stated where the intervention took place, but recess usually occurs outside. In the limitations section, the authors mention the effect of hot weather during the timeframe of the study, so this strengthens the idea

that the recess occurred outside. The intervention occurred for a six-week period from September 12, 2016 - October 19, 2016, and was delivered by the researchers/observers. Twelve 30-minute observations were completed on Monday and Wednesday mornings. Six observations took place in a singular fifth grade classroom prior to recess and the other six observations took place after recess with the same children, only in the school

library or with the art teacher in the regular academic classroom. This type of observation is a controlled structured observation.

Group 2: No control group

Outcome Measures (Primary and Secondary)

The first measure was on-task and off-task frequencies before recess. The second measure was on-task and off-task frequencies after recess. The Whole Interval Recording (WIR) was used for both measures in the study. The data collection method was discontinuous, meaning that it divided the observation into equal duration intervals and noted the occurrence and nonoccurrence of certain behaviors within a given interval. The study mentioned that the researchers selected the WIR after using a guide that was developed to help researchers

choose valid and reliable measurement systems based on the context of their study and the body of research. However, the validity and reliability of the WIR was not mentioned. The on-task and off-task frequency of the students (before and after recess) were measured and listed in a chart in Appendix A of the study (shown in Main Findings section). The authors included a list of behaviors they used when considering if the child’s behavior was on-task and off-task during the five-minute intervals. This list of behaviors was based on

research. For the first measure, the observations took place 30 minutes prior to recess in a fifth-grade classroom. Observations were divided into five-minute intervals wherein each interval, the behavior of the child

was labeled off-task or on-task based on the occurrence or non-occurrence of listed behaviors. For the second measure, the observations took place for 30 minutes after recess with the same fifth grade class, only in the school library or with the art teacher in the regular academic classroom. Observations were divided into five-minute intervals wherein each interval, the behavior of the child was labeled off-task or on-task based on the occurrence or non-occurrence of listed behaviors.

Main Findings

Observations, descriptions, and documentation were made on aspects of a natural occurring experience (time before and after recess). Frequencies of certain types of behavior were also measured. Statistics were clearly reported in charts and tables (seen below), and summarized in the study’s results section.

(Appendix A listed on page 456 of study, Table 1 listed on page 452 of study)

Original Authors’ Conclusions

The researchers noted significant (33.7%) increases in on-task behaviors after recess compared to before recess. One hundred percent of the students studied were more on task following recess. There is a significant positive association between allocating time for recess and on-task classroom behaviors. Additional research with a similar design, larger sample size, and higher level of evidence should be done to allow for causality to be drawn from the study. This research would be crucial for administrators, educators, OTs, and policymakers

that are advocating for policies that allow for more physical activity/recess in the school systems.

Critical Appraisal

Validity

There were some potential intervention biases that need to be addressed:

● Contamination: As there was no control group in this study, it impossible for there to be contamination. ● Co-intervention: Disability diagnoses was discussed in the exclusion or inclusion criteria, so there are no

known interventions or therapies being received by any of the children in the study. However, this does not rule out the idea that some of the children may be receiving therapies that could affect the results of the study.

● Timing of intervention: As no intervention was implemented, timing was not an issue in this study. The natural tendency to be on-task or off-task was being measured, therefore the measurements being

taken over an extended period of time vs. a short period of time should not vary significantly. The authors mention hot weather, indicating that this took place in spring or summer. Results of this

intervention in the winter are not clear. ● Site of intervention: Observations prior to recess were in a fifth-grade classroom, but observations after

recess were in either the school library or with the art teacher in the regular academic classroom. The change in location or teacher (or both) after recess may sway the results toward or against the support

of recess. ● Use of different therapists to provide intervention: Recess was a naturally occurring intervention in the

students’ school day. Their teacher implemented recess as she would on any normal day. There was no discussion of what this recess entailed, suggesting that it was mainly free play for the students. The observations only took place before and after the intervention

● Baseline equality: The children were selected to be a part of the study through non-probability purposive sampling, meaning that the researchers selected the children based on availability and their

knowledge and judgement of the study/population, not through random sampling. This type of sampling does not allow for equal probability of a member in the population to be included in sample. This type of sampling could cause researchers to be biased in their selection of subjects for the study. However, for

analysis, participants were compared to their own baseline.

In terms of measurement bias, only observations were made and there was no control group. Thus, there was no need for the evaluators to be blind in this study. Additionally, the study did not require self-reports, surveys,

or any other measure that could promote recall or memory bias by participants. There were a few other areas where the researchers could have been biased in their measurements:

● The observers did not have contact or interaction with the 12 subjects, as the sole intent of the study was to observe behaviors in the most natural environment possible. Perhaps, when the observer coded the child as being off task (or on task for that matter), the child merely looked as if they were off task to the observer but were actually paying attention. The authors used a list of behaviors as ways to

decode if someone was off/on task, but these behaviors may not accurately describe the attention of all

of the children being studied. This list of off/on task behaviors was stated to have been “derived from literature” but this literature was not explained or described.

● Observers/researchers rated the children’s on-task and off-task frequency after recess. They obviously

would like for their research to support the idea that recess enhances on-task frequency and thus improving academic achievement. It is possible that the researchers rated the children as being more off-task before recess or more on-task after recess to support their bias of being pro-recess.

● While the observers used a given list of behaviors to code the children’s’ behaviors on task-or off-task,

it was still the responsibility of the observer to correctly note whether there were occurrences or non-occurrences of the behaviors. There were multiple observers, so there may have been differences in the accuracy of their observations.

This study was considered a one group, non-randomized, pre-post quantitative study. Observations, descriptions, and documentation were made on aspects of a natural occurring experience (time before and after recess). Frequencies of certain types of behavior were also measured. Both of these ideas are consistent with

this type of quantitative study. The relationship among the variables were then described as a strong positive correlation. A Shapiro-Wilk test was conducted to test for normality of the data, and a paired samples t-test was completed as well. As the researchers were looking to see increases in on-task behaviors in their sample

after an intervention (recess), it was appropriate to run a paired samples t-test to answer the objective questions.

Interpretation of Results

● Each of the 12 participants’ average time on-task increased from before recess to after recess. Overall increase for all participants in time on-task from before recess to after recess was 33.7%.

● During the 30-minute period following recess, 100% of the students spent more time on-task than off-task.

● During the 30 minutes prior to recess, 88.3% of the students observed in the fifth-grade classroom

spent more time off-task than on-task. ○ Two students were more on-task than off-task before recess as well (but they were even more

on-task after recess). ● A Shapiro-Wilk test was conducted to test for normality of the data, and a paired samples t-test was

completed as well. These tests indicated that the data was normal and that the mean time on-task

before recess (M= 36.59, SD= 13.70) varied from after recess (M= 70.27, SD= 9.61) at the .05 significance level.

Summary/Conclusion

This study indicates that the on-task frequency of children increases after recess in comparison to the on-task frequency before recess. As being on-task aids learning, this suggests that recess can improve academic achievement even though it takes time away from class instruction. While much research in addition to this study supports these claims, many policies across the country are diminishing recess to increase instruction time during class. Occupational therapists understand the importance of balancing play, education, and other occupations, but policy makers may not. It is important for OTs to use research like this to advocate for more

recess in the school systems to improve the education and play of students. The study’s findings only apply to general education classes at this time. However, a study like this could be done with students with disabilities (like ADHD) to support inferences that this idea could apply to special education classes as well. This study provides a small yet significant insight into the behavioral and academic

advantages of keeping recess in elementary schools. The researchers suggest completing further research, using bigger sample sizes, more diverse schools, etc., to increase the level of evidence. This would further

validate this study’s findings, and potentially play a large role in increasing recess in the school systems.

Table [3]: Characteristics of included studies

Study 1

[Fedewa, Fettrow, Erwin, Ahn, & Farook, 2018]

Study 2

[Stapp & Karrb, 2018]

Intervention

investigated

Level II: Two Group Comparison Level III: One group, Non-randomized,

Pre/Post Test

Comparison intervention Aerobic-Only versus Academic-Based

movement breaks

Recess

Outcomes used Physical Activity and Academic Achievement

Frequency and time of on-task and off-task behaviors

Findings Aerobic-only movement breaks

increased academic achievement slightly more than academic-based

There was a significant increase with

on-task behaviors after recess as

movement breaks; both provided beneficial physical activity in the classroom.

compared to behaviors observed before recess.

IMPLICATIONS FOR PRACTICE, EDUCATION and FUTURE RESEARCH

The two-group comparison (level II) investigated the importance of physical activity breaks throughout the day for elementary school students, and how purely aerobic activity can impact student academic achievement as compared to academic-based movement breaks. The study found that student’s academic achievement improved with both types of break, with slightly more improvement noted with aerobic-only breaks. The pretest-posttest (level III) study investigated the on-task frequency of elementary school students before and after 25 minutes of recess. It was found that there was a significant increase (33.7%) in on-task behavior and that there was a positive association between allocating for recess and on-task classroom behaviors.

Results from the studies indicated that incorporating physical activity into the school day is beneficial to students’ academic performance. Level II and III evidence gathered from the selected studies indicate sufficient evidence, through strong study designs, to support the provision of physical activity in schools. Results from these studies may be generalizable to other elementary school students, as they utilized samples from general education classrooms. Findings provide significant insight into the behavioral and academic advantages of

keeping recess in elementary schools and can inform occupational therapy practice in school systems.

Areas for future research include:

● Research on individual student performance related to physical activity rather than solely group data on the subject

● Research on the effects of recess/physical activity in special education classrooms

Implications for practice:

● Physical activity can improve on-task behaviors and academic achievement in the classroom. ● Both studies were completed in American school systems, suggesting that incorporation of physical

activity may be possible at a national level. ● Occupational therapists in schools can use information from these studies to advocate for additional

break time and physical activity for students. ● School-based practitioners are adequately equipped to educate school administration personnel and

teachers on the importance of play and physical activity in children’s development and academic performance.

● Occupational therapists may collaborate with other school staff to incorporate physical activity in standard curriculum.

REFERENCES

American Academy of Pediatrics (2013). The crucial rise of recess in school. Pediatrics, 131(1). doi:10.1542 /peds.2012-2993 Brusseau, T. A., & Hannon, J. C. (2015). Impacting children's health and academic performance through comprehensive school physical activity programming. International Electronic Journal Of Elementary Education,

7(3), 441-450. Brez, C., & Sheets,V. (2017). Classroom benefits of recess. Learning Environments Research, 20(3), 433-445. doi:10.1007/s10984-017-9237-x Dills, A., Morgan,H. N., & Rotthoff, K. W. (2011). Recess, physical education, and elementary school student

outcomes. Economics of Education Review, 30(5), 889-900. doi:10.1016/j.econedurev.2011.04.011

Evenson, K. R., Ballard, K., Lee, G., & Ammerman, A. (2009). Implementation of school-based state policy to increase physical activity. Journal of School Health,79(5), 231-238. http://dx.doi.org/10.1111/j.1746 -1561.2009.00403.x Fedewa, A. L., Fettrow, E., Erwin, H., Ahn, S., & Farook, M. (2018). Academic-based and aerobic-only

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