By Tiarne Kleyn

Tiarne Kleyn is a Secondary PDHPE Teacher at Australian Christian College and has a Bachelor of Human Movement and a Bachelor of Secondary Education (PDHPE) from the University of Technology Sydney. On the weekends, you will find her playing AFL (Australian Football League) for the Western Magic.

You no doubt realise that exercise is essential for kids physically, but a mounting body of evidence is confirming the benefits of physical activity for young peoples’ mental wellbeing. Given the alarming statistics regarding mental health in children and adolescents, teachers can play an important role by supporting them to adopt this simple but effective strategy.

The problem

Recent figures from the World Health Organisation (WHO) show that mental health conditions account for 16 percent of the global burden of disease and injury in people aged 10–19 years. While half of all mental health conditions start by age 14, most cases remain undetected and untreated (1).

Globally, depression is one of the leading causes of illness and disability among adolescents, while suicide is the third leading cause of death in 15-19-year-olds.

As WHO point out, “the consequences of not addressing adolescent mental health conditions extend to adulthood, impairing both physical and mental health and limiting opportunities to lead fulfilling lives as adults.”

Common mental health conditions young people experience include emotional and behavioural disorders,eating disorders, risk-taking behaviours, and even self-harm. 

In Australia where I work, suicide tragically remains the biggest killer of young people (2). One in seven young people aged 4 to 17 years old experience a mental health condition in any given year and one in ten people aged 12-17 will self-harm in one form or another (3).

While the statistics shared above tell a depressing tale, I list them in the hope of making a difference in the actions and attitudes of young people. WHO note that adolescence is a crucial time for developing and maintaining habits that support mental wellbeing, including healthy sleep patterns, learning to manage emotions, and participating in regular exercise.

As teachers, we may not be able to change our students’ home environments or family circumstances. However, encouraging them to develop healthy strategies and habits of behaviour can assist them to cope with the complex issues they face during their time as adolescents. Importantly, we’ll have helped them on the road to a healthier adulthood.

The activity connection

In the last decade, research on the link between exercise and mental health has increased significantly. A paper (4) reviewed the research since 2011 into the link between exercise and depression, self-esteem, anxiety and cognitive functioning and found that the strongest link was found between exercise and cognitive function. For depression, the intervention effects were classed as moderate, with the authors saying their findings constitute “partial evidence for a causal association” between increased physical activity and lower rates of depression in young people. Results for anxiety were less clear, due to a lack of studies in this area.

While there was no evidence for a causal association between physical activity and self-esteem in youth, the authors point out that this field is complex. 

How exercise can help

To understand these links further, it can be helpful to explore results from individual studies.

For example, a study in 2017 (5) assessed the association between moderate-to-vigorous physical activity (MVPA), sedentary behaviour and major depressive disorder in middle childhood. The researchers evaluated a community sample of 795 children living in Norway, who were enrolled at 6 years of age and followed up at ages 8 and 10.

The authors concluded that MVPA predicted fewer depressive symptoms in middle childhood, suggesting increased physical activity may be useful to prevent and treat childhood depression.

The study’s lead author Tonje Zahl, M.S.C., from the Norwegian University of Science and Technology, said in a statement: “Physical activity has a range of health benefits, and this study indicates that increasing children’s moderate and vigorous physical activity may prevent later depressive symptoms.

“Thus, increased physical activity may serve as an adjunct component to … pharmacological or psychological treatments. As regards prevention, because nearly all children can be targeted in efforts to increase MVPA, the gains at the population level might be substantial.”

Another study (6) examined an aerobic cybercycling intervention on behavioural self-regulation and classroom functioning in children with mental health disabilities attending a therapeutic day school.

Researchers randomly assigned 103 students to 7 weeks of aerobic cybercycling, in which they used the bikes twice per week during 30- to 40-minute physical education (PE) classes. In the control period, children participated in standard non-aerobic PE.

They found the children, who were aged 7 to 16, experienced 32 to 51 percent lower odds of poor self-regulation and learning-inhibiting disciplinary time out of class when participating in the intervention, which the authors note is both clinically and statistically significant.

Effects were more pronounced on days the children participated in the aerobic exercise, but carryover effects were also observed. The authors concluded that “aerobic cybercycling PE shows promise for improving self-regulation and classroom functioning among children with complex behavioural health disorders. This school-based exercise intervention may significantly improve child behavioral health without increasing parental burden or health care costs, or disrupting academic schedules.”

Lead author April Bowling, assistant professor at Merrimack College, explained to Healthline that cybercycling appealed to the children because they could successfully engage in it at their current ability level and found the video games and virtual reality courses entertaining.

Regarding how exercise influences mood and behaviour, Bowling explains: “First, it seems to change where the brain directs its resources, from areas of the brain that are involved in worrying, for example, and toward areas that are more involved in coordination and focus.

“Secondly, aerobic exercise can change brain chemistry, and specifically the levels of certain neurotransmitters that might help improve an individual’s self-regulation. When mood and self-regulation — the ability to control behavior — is improved, then children can function better in the classroom.”

She recommends schools “stop cutting out movement from the school day – taking time away from recess and physical education for more academic purposes – if we want our children to perform to their potential”.

What can teachers do?

There are numerous ways teachers can encourage students to be more physically active. Here’s a list of 11 ideas to get you started.

1. Know the ‘why’ – teach students about the benefits of being active for their physical and mental wellbeing and academic performance.

2. Help children find activities they enjoy. Many children with mental health conditions prefer non-competitive physical activities to competitive sports. 

3. Turn walking into a game. Children are recommended to walk an average of 12,000 steps each day. You could set walking goals for children, buy inexpensive pedometers (or have them track steps on their smartphone or watch) and give rewards for achieving walking goals.

4. Encourage children to use the playground facilities, equipment, walking paths etc that you have onsite.

5. Schedule physical activity into class times, by starting a lesson with some stretches or on-the-spot exercises, for example. 

6. Break up prolonged periods of sitting by delivering one standing lesson each day.

7. Assign ‘active homework’, such as taking a parent/carer for a walk or completing science tasks outside.

8. Include students in decisions about the type of physical activity they do, making them more committed to participation.

9. Even simple activities, such as blowing bubbles, teaches children deep breathing skills and gets them outside.

10. Be a role model – walk around during yard duty, join the activities during PE classes and breaks, cycle to school and talk to your students about your physical activity interests.

11. Encourages students to walk, ride, skate or scoot to and from school, get off the bus early and walk part way, or walk a few laps of the oval once they arrive.

Anything you can do to support your students to be physically active is a step toward a more positive future.

References:

(1) Kessler, R. C., Angermeyer, M., Anthony, J. C., De Graaf, R. O. N., Demyttenaere, K., Gasquet, I., ... & Kawakami, N. (2007). Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization's World Mental Health Survey Initiative. World psychiatry, 6(3), 168.

(2) Australian Bureau of Statistics. (2015). Causes of Death, Australia, 2014. Catalogue No. 3303.0. Canberra: ABS. Accessed 2 March 2015 from http://www.abs.gov.au/ausstats/abs@.nsf/mf/3303.0?OpenDocument

(3) Lawrence D., Johnson S., Hafekost J., Boterhoven De Haan K., Sawyer M., Ainley J., & Zubrick S. R. (2015). The Mental Health of Children and Adolescents. Report on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Canberra: Department of Health.

(4) Biddle, S. J., Ciaccioni, S., Thomas, G., & Vergeer, I. (2019). Physical activity and mental health in children and adolescents: An updated review of reviews and an analysis of causality. Psychology of Sport and Exercise, 42, 146-155.

(5) Zahl, T., Steinsbekk, S., & Wichstrøm, L. (2017). Physical activity, sedentary behavior, and symptoms of major depression in middle childhood. Pediatrics, 139, e20161711.

(6) Bowling, A., Slavet, J., Miller, D. P., Haneuse, S., Beardslee, W., & Davison, K. (2017). Cybercycling Effects on Classroom Behavior in Children With Behavioral Health Disorders: An RCT. Pediatrics, 139, e20161985.