Assessment and Exercise Interventions in Early and Middle Childhood Development

Original Editor - Jess Bell based on the course by Tracy Prowse
Top Contributors - Jess Bell, Wanda van Niekerk, Tarina van der Stockt, Kim Jackson, Aminat Abolade, Cindy John-Chu and Olajumoke Ogunleye
This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! (4/08/2021)

Introduction[edit | edit source]

There are a range of assessment tools to both quickly screen and assess children in more detail. These assessments will highlight if a child has a specific developmental difficulty that may affect their school and sports readiness.

PhysiFun Checklist[edit | edit source]

The PhysiFun checklist has been developed to highlight to the teacher / therapist if a particular student needs help with any activity. It is also a useful feedback tool for parents:[1]

  • Class list check
    • Completed by the teacher and takes approximately 10 minutes
  • Grade 0 - 1 check
    • Completed by either the parent or the teacher and takes approximately 5 minutes
  • Quick tests
    • Checked each term (see Table 1)
  • Specific assessments for a delayed child
    • Always refer for one one one physiotherapy if a child is severely delayed
Table 1. Quick Tests
Skill 4 years 5 years 6 years
Stand on 1 leg (seconds) 7 10 15
Walk heel to toe on a line (steps) 4 5 6
Knee push up in 30 secs (repetitions) 3 to 5 6 to 10 11 to 15

Specific Tests[edit | edit source]

The following balance, strength and activity tests can be used to quickly identify any deficit a child might have:

Standing on one leg:[1]

  • Children aged 4 years tend to be able to hold this position for 7 seconds
  • Children aged 5 years, 10 seconds
  • Children aged 6 years, 15 seconds

Walking heel to toe on a line:[1]

  • Children aged 4 years tend to be able to take 4 steps
  • Children aged 5 years, 5 steps
  • Children aged 6 years, 6 steps

Number of knee push ups in 30 seconds:[1]

  • Children aged 4 years, tend to be able to do 3 to 5 repetitions
  • Children aged 5 years, 6 to 10 repetitions
  • Children aged 6 years, 11 to 15 repetitions

The plank test can also be used to assess torso strength in children aged 8 to 12 years:[2]

  • Children aged 8 to 10 years can typically hold this position for 69 to 108 seconds
  • Children aged 11 to 12 years can typically hold this position for 86 to 127 seconds

Taking a daily step count using a pedometer can also be used as a measure of physical activity:[1]

  • Children aged 6 to 19 years take an average of around 12,000 steps per day[3]
  • There are, however, gender differences:[3]
    • Girls average 11,000 to 12,000 steps
    • Boys average 13,000 to 15,000 steps

Supine flexion (i.e. lie on back and bring knees to chest and lift head up):[4]

  • Children aged 3 should be able to hold this position for around 15 seconds
  • Children aged 4 hold for around 17 seconds
  • Children aged 5 hold for around 27 seconds
  • Children aged 6 hold for around 53 seconds

Prone extension test (i.e. lifting arms, head and legs off floor):[4][5]

  • Children aged 4 years should be able to hold this for around 18 seconds
  • Children aged 6 should be able to hold this position for around 29 seconds
  • Children aged over 8 should be able to hold this position for over 30 seconds

Push ups:[4]

  • Children aged 5 and 6 should be able to complete 3 repetitions
  • Children aged 7 should be able to complete 4 repetitions
  • Children aged 8 should be able to complete 5 repetitions

Curl up (i.e. a sit up with legs straight):[4]

  • Children aged 5 and 6 should be able to do 2 repetitions
  • Children aged 7 should do 4 repetitions
  • Children aged 8 should do 6 repetitions

Monitoring Effectiveness[edit | edit source]

It is important to consider your aims when monitoring the effectiveness of an intervention. The above tests can be repeated every few months in order to measure changes following an intervention. There are also a range of outcome measures that can assess specific areas.[1]

For increasing physical activity, literacy and fitness, the following tools can be used as both assessment and outcome measures:

  • Canadian Assessment of Physical Literacy[6]
  • Progressive Aerobic Cardiovascular Endurance (PACER) Run (similar to a beep test)
  • PANIC Physical Activity Questionnaire[7]

For assessing motor coordination skills (i.e for Developmental Coordination Disorder), the following can be used as both assessment and outcome measures:

  • Movement ABC and Movement ABC Checklist[8]
  • Bruininks Oseretsky Test (BOT) and BOT2[9]
[10]
[11]

For improving concentration, self regulation, social participation:

  • The Strength and Difficulties Questionnaire is a freely available self-report assessment tool[12][13]

For improving the experience of the child in all aspects of life (i.e. an ecological intervention), it is important to use intervention outcomes (that look at the environment, task and child). Examples include:

  • School Function Assessment[14]
  • Goal Attainment Scaling (GAS)[15]

Key Benefits of Classroom Integration[edit | edit source]

There is a need for interventions that are:[1]

  • Cost effective
  • Easy to implement during school hours
  • Address gross motor difficulties, postural problems, poor physical activity participation levels and concentration difficulties during school hours.
  • “Little and often”

Physical Activity Guidelines[edit | edit source]

The following guidelines are based on recommendations by the World Health Organisation: [16][17]

  • Children aged 5 to 18 years should engage in:
    • Moderate (5-6/10) to vigorous activity (8/10) for 60 minutes per day
    • Screen time should be less than 2 hours
  • Children aged 3 to 5 years old should aim for:
    • 3 hours of exercise per day
    • Screen time should be less than 1 hour
  • Children’s physical activity should include a variety of aerobic activities, including some vigorous activity
  • On at least 3 days per week, children should engage in activities that strengthen muscle and bone
  • To achieve additional health benefits, children should engage in more activity – up to several hours per day
[18]

The programme should address all the key areas of a child's development and exercises should include a variety of skills.[1]

Intervention[edit | edit source]

The following factors should be considered when designing an intervention:

  • Warm-up activities based on:[1]
    • Injury prevention strategies[19][20]
    • Targeting health benefits[21]
    • Targeting the cognitive benefits of short bursts of vigorous activity[22][23]  
  • General core and body strengthening exercises to:[1]
    • Prevent injury[24][25]
    • Prevent pain associated with hypermobility / ligament laxity
    • Prevent fidgeting and improve postural control for learning
    • Increase upper body strength to help with handwriting
    • Increase lower body strength for playground and sport activities
  • Fundamental movement skills to help achieve:
  • Self regulation and executive attention skills through:
    • Mindfulness training during yoga and mobility movements and postures[28][29][30]
  • Inclusion of all children regardless of physical capability, through:
    • Understanding of the difficulties faced by some children through the education and empowerment of teachers and coaches[31] - coaches and teachers should be taught to choose appropriate activities that are tailored to a child’s specific ability and needs
  • Children should be encouraged to have self efficacy and self esteem about their physical capabilities - coaches should also be taught methods to develop these skills[1]

Warm-Up[edit | edit source]

A warm-up should include:[1]

  • Half or three-quarters speed jogging and backwards jogging
  • Mild jog with high knees, skipping, butt kicks and toe reaching
  • Crawling calf stretch
  • Lunges with twist
  • Walking quadriceps stretch

Active, dynamic mobility exercises[32] are essential in a warm-up. Children should be encouraged to move through the range of motion required for a specific sport. If a child does not have the range of motion / flexibility required for a sport, they should be encouraged to stretch during the cool-down or at home.[1]

A warm-up should also include three-quarter speed sport-specific coordination training (i.e. anything that challenges balance / stability and agility such as bounding, hopping and diagonal cutting).[1]

Some strengthening exercises should be included - specifically for muscles that tend to become strained in the child's preferred / regular sport (such as the hamstrings or groin muscles).[1]

Cool-Down[edit | edit source]

The cool-down should include static stretches and children should be allowed time to drink fluid.

NB: Dynamic stretches facilitate movements similar to those during play. They raise muscle tissue temperature in the body, increase blood flow and activate the nervous system, thus preparing the body for movements during play.[1]

Strength Training[edit | edit source]

  • Children should engage in strength training – this should include both general strength training and core strengthening (basic strength training will also train the core)
  • Basic running around or chasing activities encourage endurance adaptations in the core (and other systems)
  • Three bouts of high intensity activity (one minute long) should be included in a programme (60-95% maximum effort) in order to achieve the potential cognitive and metabolic benefits of exercise[1]
    • High intensity exercise has been found to benefit inhibition and working memory in children[33]

References[edit | edit source]

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 Prowse T. The Social, Cognitive and Emotional Development of Children - Assessment and Treatment Course. Physioplus, 2021.
  2. ↑ Boyer C, Tremblay M, Saunders TJ, McFarlane A, Borghese M, Lloyd M et al. Feasibility, validity and reliability of the plank isometric hold as a field-based assessment of torso muscular endurance for children 8-12 years of age. Pediatr Exerc Sci. 2013;25(3):407-22.
  3. ↑ 3.0 3.1 Colley RC, Janssen I, Tremblay MS. Daily step target to measure adherence to physical activity guidelines in children. Med Sci Sports Exerc. 2012;44(5):977-82.
  4. ↑ 4.0 4.1 4.2 4.3 Your Therapy Source. Norms for core strength in children. Available from: https://www.yourtherapysource.com/blog1/2015/10/01/norms-for-core-strength-in-children (accessed 2 August 2021).
  5. ↑ Harris NP. Duration and quality of the prone extension position in four-, six-, and eight-year-old normal children. Am J Occup Ther. 1981;35(1):26-30.
  6. ↑ Longmuir PE, Boyer C, Lloyd M, Yang Y, Boiarskaia E, Zhu W et al. The Canadian Assessment of Physical Literacy: methods for children in grades 4 to 6 (8 to 12 years). BMC Public Health. 2015;15:767.
  7. ↑ Väistö J, Eloranta AM, Viitasalo A, Tompuri T, Lintu N, Karjalainen P et al. Physical activity and sedentary behaviour in relation to cardiometabolic risk in children: cross-sectional findings from the Physical Activity and Nutrition in Children (PANIC) Study. Int J Behav Nutr Phys Act. 2014;11:55.
  8. ↑ Schulz J, Henderson SE, Sugden DA, Barnett AL. Structural validity of the Movement ABC-2 test: factor structure comparisons across three age groups. Res Dev Disabil. 2011;32(4):1361-9.
  9. ↑ Jírovec J, Musálek M, Mess F. Test of motor proficiency second edition (BOT-2): Compatibility of the complete and short form and its usefulness for middle-age school children. Front Pediatr. 2019;7:153.
  10. ↑ jorich dalistan. Bruininks-Oseretsky Test of Motor Proficiency Second Edition (BOT2). Available from: https://www.youtube.com/watch?v=4RaQ3lb1lPc [last accessed 4/8/2021]
  11. ↑ Pearson Clinical Assessment. The Movement ABC-2. Available from: https://www.youtube.com/watch?v=CJsOoqy5OH8 [last accessed 4/8/2021]
  12. ↑ Goodman R. The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden. J Child Psychol Psychiatry. 1999;40(5):791-9.
  13. ↑ Santiago R, Henrique P, Manzini D, Haag D, Roberts R, Smithers LG et al. Exploratory graph analysis of the Strengths and Difficulties Questionnaire in the Longitudinal Study of Australian Children. Assessment. 2021.
  14. ↑ Coster WJ, Deeney TA, Haltiwanger JT, Haley SM. School function assessment. San Antonio, TX: Psychological Corporation/Therapy Skill Builders, 1998.
  15. ↑ King G, McDougall J, Palisano R, Gritzan J, Tucker M. Goal attainment scaling. Physical & Occupational Therapy In Pediatrics. 2000;19:31-52.
  16. ↑ World Health Organsation. Physical activity. Available from: https://www.who.int/news-room/fact-sheets/detail/physical-activity (accessed 2 August 2021).
  17. ↑ Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine 2020;54:1451-62.
  18. ↑ Middle Childhood Matters Coalition Toronto. Physical Activity for Children Ages 6-12. Available from: https://www.youtube.com/watch?v=R0-PBXXljXM [last accessed 4/8/2021]
  19. ↑ Lauersen JB, Bertelsen DM, Andersen LB. The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med. 2014;48(11):871-7.
  20. ↑ Herman K, Barton C, Malliaras P, Morrissey D. The effectiveness of neuromuscular warm-up strategies, that require no additional equipment, for preventing lower limb injuries during sports participation: a systematic review. BMC Med. 2012;10:75.
  21. ↑ Gibala MJ, Little JP, Macdonald MJ, Hawley JA. Physiological adaptations to low-volume, high-intensity interval training in health and disease. J Physiol. 2012;590:1077-84.
  22. ↑ Themanson JR, Pontifex MB, Hillman CH. Fitness and action monitoring: evidence for improved cognitive flexibility in young adults. Neuroscience. 2008;157(2):319-28.
  23. ↑ Westfall DR, Gejl AK, Tarp J, Wedderkopp N, Kramer AF, Hillman CH et al. Associations between aerobic fitness and cognitive control in adolescents. Front Psychol. 2018;9:1298.
  24. ↑ Faigenbaum AD, Myer GD. Resistance training among young athletes: safety, efficacy and injury prevention effects. Br J Sports Med. 2010;44(1):56-63.
  25. ↑ Faigenbaum AD, Bush JA, McLoone RP, Kreckel MC, Farrell A, Ratamess NA et al. Benefits of strength and skill-based training during primary school physical education. J Strength Cond Res. 2015;29(5):1255-62.
  26. ↑ Balyi I, Way R, Higgs C. Long-term athlete development. Sheridan Books, 2013.
  27. ↑ Barnett L, Stodden D, Cohen K, Smith J, Lubans D, Lenoir M et al. Fundamental movement skills: an important focus. Journal of Teaching Physical Education. 2016;35(3):219-25.
  28. ↑ Posner MI, Rothbart MK, Tang YY. Enhancing attention through training. Current Opinion in Behavioral Sciences. 2015;4:1-5.
  29. ↑ Rueda MR, Posner MI, Rothbart MK. The development of executive attention: contributions to the emergence of self-regulation. Dev Neuropsychol. 2005;28(2):573-94.
  30. ↑ Tang YY, Posner MI. Attention training and attention state training. Trends Cogn Sci. 2009;13(5):222-7.
  31. ↑ Tsai EH, Fung L. Parents experiences and decisions on inclusive sport participation of their children with intellectual disabilities. Adapt Phys Activ Q. 2009;26(2):151-71.
  32. ↑ Faigenbaum A, McFarland JE Jr. Guidelines for implementing a dynamic warm-up for physical education. Journal of Physical Education, Recreation & Dance. 2007;78(3):25-8.
  33. ↑ Hsieh SS, Chueh TY, Huang CJ, Kao SC, Hillman CH, Chang YK et al. Systematic review of the acute and chronic effects of high-intensity interval training on executive function across the lifespan. J Sports Sci. 2021;39(1):10-22.
Retrieved from "https://www.physio-pedia.com/index.php?title=Assessment_and_Exercise_Interventions_in_Early_and_Middle_Childhood_Development&oldid=279947"