1. Why do we need a motor skills programme for younger children in schools?

Why is a motor skills programme even necessary for young children?

This blog entry describes the background to the development of The Alps motor skiills programme.

Background

The Born in Bradford research study is one of the largest cohort studies ever carried out to improve the health and well-being of the population, and is following over 13,000 children from prenatal care through to adulthood. A huge amount of data is being gathered on children's health, and their physical, educational and psychosocial development and progress. Data gathered from the oldest children, whose mothers were recruited in 2007, have already guided the development of promising research and interventions into improving children's health, education and dental health. 

Born in Bradford data has identified that a significant proportion of children have poor fundamental motor skills. Recognising that poor motor skills are damaging to children's life chances, teaching staff have asked Born in Bradford researchers "How we can help to improve these children's motor skills?" My research sets out to answer this question.

What is the impact of poor motor skills on children's life chances and health?

Poor motor skills have a devastating impact on children's development and life chances. Poor movement skills affect children's physical, emotional, social, psychological  and educational development. Improving children's motor skills could potentially make a significant impact on children's education and physical health, as well as prevent other psychosocial developmental issues. 

Most research into children affected by poor motor skills has been conducted on children with developmental coordination disorder. DCD affects up to three children in every classroom, and is a diagnosis usually given quite late: children's motor skills at the more difficult end of human motor activity, such as balancing on a narrow beam and other agility or gymnastic activities, are still developing aged six or seven years. One study found that a large number (80%) of seven year old children with DCD went on to experience drug and alcohol abuse, trouble with the police and mental health difficulties by the age of 22, compared to 11% of the children with typical movement skills. Further evidence also suggests that children’s motor skills have a positive association with physical fitness, body weight and physical activity. Because physical activity tracks across the lifespan, increasing physical activity in childhood can have huge benefits in population health (including mental health) and academic achievement.

Reducing physical inactivity could therefore reduce morbidity but it could also reduce premature deaths and save money. In 2006, research showed that physical inactivity caused 16.9% of premature deaths and costs £8.2 billion per year. However, only 22% of children meet Department of Health recommendations for physical activity, figures which are worsening over the years.  One in five children in Reception and one in three children in Year 6 are obese or overweight. In 2007 obesity cost the economy  £15.8 billion per year, including £4.2 billion in direct costs to the NHS.

What can be done to help children's motor skills? 

The evidence for activities designed to improve children's fundamental motor skills comes from research carried out with children who have DCD. To answer the question posed by teaching staff - how can teaching staff help to improve children's motor skills - we conducted a systematic review to search for and identify activities supported by good evidence for improving children's motor skills. A systematic review summarises the best of the available research evidence, and is held within medical circles to represent the highest level of evidence for or against treatments, interventions and policies.

Hierarchy of evidence

Our systematic review found nine studies which investigated a total of 16 interventions. Three well-conducted trials in particular found some physiotherapy activities that had produced large improvements in the children's movement skills. But these activities were delivered to children by trained, experienced health professionals, and in the UK, there is a long waiting list for children to get the help they need from these professionals. Before 2007, children with poor movement skills made up 60% of occupational therapy team's waiting lists, and some had to wait up to four years just for an assessment! My qualitative research at a PE teachers and head teachers conference, at meetings with head teachers and from piloting of the evidence-based activities in a school suggests that head teachers and school staff are keen and willing to deliver an appropriate motor skills programme. For this reason, I have developed these evidence-based activities into a physiotherapy programme designed to be delivered in schools by school staff, called The Alps (Towards Healthy Education: Accelerated Learning of Playground Skills).

The Alps manual, designed to enable teaching staff to deliver
evidence-based activities to children with poor motor skills

The long term aim is to evaluate, in a randomised controlled trial, whether there are similar benefits of The Alps on children's motor  skills, academic attainment, social and psychosocial development, and physical activity. Before we carry out the randomised controlled trial, we will pilot the manual in schools to iron out any misunderstandings or obstacles to effective delivery of the activities. But first, it is essential to ensure that teaching staff find The Alps manual easy to understand and that it gives them confidence to effectively deliver the activities. For this reason, teaching staff are helping to develop The Alps manual.