Physical Activity, Fitness, School Readiness, and Cognition in Early Childhood: A Systematic Review

BACKGROUND

Early childhood is an important age for brain and cognitive development. Given the support of physical activity and fitness on cognition and academic performance in older children, more research has emerged recently focusing on younger children. In this systematic review, the authors review the relations between physical activity/fitness and academic-related (ie, school readiness and cognitive) outcomes in early childhood.

METHODS

A search was conducted from PubMed, PsycINFO, Web of Science, ERIC databases, and reference lists for articles that had participants aged less than 6 years were written in English, and were in peer-reviewed journals. Articles were excluded if the design was a case study or case series report. The Grading Recommendations Assessment, Development and Evaluation framework was followed to assess the quality of evidence by study design.

RESULTS

Sixty-eight articles reporting on 72 studies (29 observational and 43 experimental) were included. The majority of study effects were mixed, and the quality of evidence varied from very low to low.

CONCLUSIONS

A clear consensus about the role of physical activity and fitness on academic-related outcomes in early childhood is still lacking given the high heterogeneity in methodological approaches and overall effects. Additional high-quality studies are needed to determine what specific dosages of physical activity are impactful at this age.

Associations Between Household Socioeconomic Status, Car Ownership, Physical Activity, and Cardiorespiratory Fitness in South African Primary Schoolchildren Living in Marginalized Communities

BACKGROUND

Little is known whether physical activity (PA)-promoting environments are equally accessible to children with divergent socioeconomic status (SES) in low-/middle-income countries. The authors, therefore, examined whether South African children from poorer versus wealthier families living in marginalized communities differed in moderate to vigorous PA and cardiorespiratory fitness. We also tested associations between family car ownership and PA/cardiorespiratory fitness.

METHODS

Parents/guardians of 908 children (49% girls, mean age = 8.3 [1.4] y) completed a survey on household SES. PA was assessed via 7-day accelerometry, parental and child self-reports, and cardiorespiratory fitness with the 20-m shuttle run test.

RESULTS

Based on accelerometry, most children met current moderate to vigorous PA recommendations (≥60 min/d). About 73% of the children did not engage in structured physical education lessons. Whereas children of the lowest SES quintile accumulated higher levels of device-based moderate to vigorous PA, peers from the highest SES quintile engaged in more sedentary behaviors, but self-reported higher engagement in sports, dance, and moving games after school. Families' car ownership was associated with higher parent/self-reported leisure-time PA.

CONCLUSIONS

A deeper understanding is needed about why wealthier children are more sedentary, but simultaneously engage in more leisure-time PA. The fact that access to structural physical education is denied to most children is critical and needs to be addressed.

How are academic achievement and inhibitory control associated with physical fitness, soil-transmitted helminth infections, food insecurity and stunting among South African primary schoolchildren?

BACKGROUND

Cardiovascular fitness has been associated with both executive function and academic achievement in multiple cohort studies including children and adolescents. However, research is scarce among children from low- and middle-income countries. Hence, this paper focuses on South African primary schoolchildren living in marginalized areas and examines if academic achievement and inhibitory control can be explained by children's age, socioeconomic status, soil-transmitted helminth infections, food insecurity, stunting, grip strength, and cardiorespiratory fitness.

METHODS

The sample of this cross-sectional study consisted of 1277 children (48% girls, mean age: 8.3 years). Data were assessed via questionnaires, stool samples, anthropometric measurements, 20 m shuttle run test, grip strength test, Flanker task, and school grades. Data were analysed with mixed linear regression models with random intercepts for school classes, separately for boys and girls.

RESULTS

Higher socioeconomic status was most closely associated with academic achievement among boys (p < 0.05), whereas higher levels of cardiorespiratory fitness and not being stunted explained most variance in academic achievement in girls (p < 0.05). Higher age turned out to be associated with better performance in the Flanker task (p < 0.01). Additionally, in boys, higher grip strength was associated with better information processing and inhibitory control of attention (p < 0.01), whereas in girls, higher cardiorespiratory fitness levels were positively associated with these cognitive abilities (p < 0.05).

CONCLUSIONS

Academic performance has been shown to be compromised in schoolchildren living in marginalised areas, compared to schoolchildren in less disadvantaged parts of South Africa. The present study suggests that cardiorespiratory fitness and grip strength are two potentially modifiable factors that are associated with children's academic achievement and cognitive performance, and that should be targeted in future school-based interventions.

Associations of physical activity and cognitive function with gross motor skills in preschoolers: Cross-sectional study

Gross motor development in the preschool phase depends on several factors that remain poorly understood. This study aimed to investigate whether level of habitual physical activity (HPA) and global cognitive function (CF) can be used as predictors of gross motor skills in Brazilian preschoolers and to verify their possible mediators. A cross-sectional study was conducted with 166 children, aged 3-5 years. Gross motor skills, HPA, CF and possible mediators (e.g., sex, prematurity) were evaluated. Preschoolers with little HPA, low CF, and girls were more likely to have gross motor performance below expected, but female gender did not mediate HPA or CF. Therefore, HPA and CF, in addition to females, may be independent predictors of delayed gross motor skills in Brazilian preschoolers.

A Follow-Up Study of Motor Skill Development and Its Determinants in Preschool Children from Middle-Income Family

We tracked the motor skill development of young children aged 3-6 years and investigated the influence of middle-income home environment on the development of motor skill. 268 children were selected from kindergartens in Beijing. The Test of Gross Motor Development (TGMD) tool was used to test the development of locomotor and object-control skills (LS and OS), and a survey of children's behaviour and home environment was conducted. During the follow-up, the LS and OS of children aged 3-6 years continued to grow, with an annual growth rate of 20% and 30%. Five LS indicators and two OS indicators were significantly higher in the 3-4-year group than in the 4-5 and 5-6-year groups (p < 0.01). The age-sex trend model showed that girls' locomotor skill developed at a significantly higher rate than that of boys (β = 6.3004 and 4.6782, p < 0.001). Three-year-old boys performed significantly better than girls on object-control motor skill (p < 0.05). Factors affecting the rate of children's motor skill development in middle-income families included the frequency of playing with friends (β = 0.133, p = 0.032) and the frequency of bicycling, skateboarding, dancing, running, and jumping (β = 0.041, p = 0.042). Family income, parents' education level, and family activity area did not significantly affect the growth rate of motor skills. For middle-income families, the improvement of material environment at home like more playing spaces and toys did not speed up the motor development, while more opportunities to play with friends and engage in a variety of sports activities could promote children's motor skill development.

Association between fundamental motor skills and physical activity in the early years: A systematic review and meta-analysis

BACKGROUND

Physical activity (PA) in the early years is associated with a range of positive health outcomes. Fundamental motor skill (FMS) competence is associated with PA and is theorized to be driven by PA in the early years and vice versa in mid to late childhood. However, to date, no studies have meta-analyzed the association between PA and FMS in the early years.

METHODS

Six electronic databases were searched for articles published up to April 2019. Cross-sectional and longitudinal studies were included if they targeted children (ages 3-6 year) as the population of the study and assessed the association between objectively measured PA and FMS. Total FMS, total physical activity (TPA), and moderate-to-vigorous physical activity (MVPA) data were meta-analyzed using a random effects model.

RESULTS

We identified 24,815 titles and abstracts. In total, 19 studies met the inclusion criteria, including 14 cross-sectional and 4 longitudinal studies, as well as 1 study with cross-sectional and longitudinal analysis. There was a significant but small positive association between FMS and MVPA (r = 0.20, 95% confidence interval (CI): 0.13-0.26) and TPA (r = 0.20, 95%CI: 0.12-0.28). Findings from longitudinal studies revealed that PA drives FMS in early childhood. Mediation was explored in 1 study, which found that perceived motor competence did not mediate the association between FMS and PA.

CONCLUSION

Using a meta-analysis, this study is the first to show a positive association between FMS, MVPA, and TPA in the early years of childhood, suggesting that the association begins at an early age. Limited evidence from longitudinal studies supports the theory that PA drives FMS in the early years of childhood. More evidence is needed from large studies to track PA and FMS until mid to late childhood and to explore the mediators of this association.

Task-Specific and Latent Relationships Between Motor Skills and Executive Functions in Preschool Children

There has been an increasing interest in the relationship between motor skills and executive functions (EFs) in young children over the years. However, no clear picture on the relationship between both domains has emerged from these studies. We have extended previous findings by conducting a comprehensive examination of task-specific and latent relationships between a range of motor skills and EFs in preschool children. The sample consisted of 198 3- to 5-year-old children (102 boys; 51.5%). Motor skills were assessed using the Movement Assessment Battery for Children Second Edition. EFs were assessed with the performance-based tasks ‘Day/Night,’ ‘Hand Tapping,’ ‘Forward Corsi Block,’ ‘Forward Digit Recall,’ and ‘Conflict Task,’ and a rating-based EF measure (i.e., the Behavior Rating Inventory of Executive Functioning - Preschool version). Task-specific relationships were examined using zero-order Pearson correlations. Latent factors of motor skills and EFs were examined using confirmatory factor analysis and exploratory structural equation modeling. Structural equation modeling (SEM) was used to examine latent relationships. The results of the Pearson correlation analyses showed statistically significant albeit weak correlations between specific motor and EF items (r = 0.15 to r = 0.23). SEM showed non-significant weak relationships between a general motor factor (as a unitary latent construct) on the one hand, and performance-based EFs and rating-based EFs (as latent EF components) on the other hand. In conclusion, this study suggested only weak relationships between motor skills and EFs in preschool children with no clear differences between their task-specific and latent relationships.

24-hour movement behaviour and executive function in preschoolers: A compositional and isotemporal reallocation analysis

Adherence to healthy behaviours promotes several health benefits in preschool children, including executive function (EF). Recently, the predictive power of the 24-hour movement behaviour (24 h MB) composition on health outcomes has been evidenced; however, its relationship with EF in preschoolers is unknown. Thus, the present study had two objectives: (1) to analyse the associations between the 24 h MB composition and EF of preschoolers; and (2) to investigate the theoretical changes in EF when time in different movement behaviours is reallocated. This cross-sectional study was carried out with 123 preschoolers (3-5 years old) of low socioeconomic status. Physical activity (PA) and sedentary behaviour were assessed using an accelerometer for 7 days, sleep time was obtained through interviews with parents, and EF was measured using the Early Tool Box battery. To verify the association between 24 h MB and EF, compositional data analysis was used, and for time reallocation, compositional isotemporal substitution analysis was utilized. It was observed that the 24 h MB composition was positively associated with EF (p < .0001; R² = 0.34), and that reallocating 5, 10, 15 or 20 min of the time spent on sleep and light PA to moderate-to-vigorous PA, respectively, was associated with significant improvements in EF (p < .05). These findings provide hitherto unseen insight into the relationship between 24 h MB and EF in preschool children, and warrants consideration for researchers and practitioners seeking to improve EF and PA in preschool children.

Relationship between Fundamental Movement Skills and Physical Activity in Preschool-Aged Children: A Systematic Review

Preschool-aged children are in a critical period of developing fundamental movement skills (FMS). FMS have a close link with physical activity (PA). This study aimed to systematically review the associations between FMS and PA in preschool-aged children. Searching Cochrane Library, Web of Science, PubMed, ScienceDirect, and EBSCO (including SPORTDiscus, ERIC, and Academic Search Premier) was utilized to conduct a systematic review of the available literature. Studies were included if they examined associations between FMS and PA among typically developing children aged 3-6 years, published between January 2000 and April 2020. A total of 26 studies met the inclusion criteria, including 24 cross-sectional studies and two cohort studies. There was a strong level of evidence to support low to moderate associations between moderate to vigorous physical activity and components of FMS, specifically, the total FMS (r = 0.11-0.48, R2 = 16%-19%) and object control skill (r = 0.16-0.46, β = 0.28-0.49, R2 = 10.4%-16.9%). Similar associations were also found between the total physical activity and components of FMS, specifically, the total FMS (r = 0.10-0.45, R2 = 16%), locomotor skills (r = 0.14-0.46, R2 = 21.3%), and objective control skills (r = 0.16-0.44, β = 0.47, R2 = 19.2%). There was strong evidence that there is no significant association between light physical activity and FMS, specifically, total FMS and locomotor skills. The associations, including "stability skills-PA" and "locomotor skills-moderate to vigorous PA", were uncertain due to insufficient evidence. Our findings provide strong evidence of associations between specific FMS components and a specific PA intensity. Future studies should consider using a longitudinal study design in order to explore the causal relationship between specific-intensity PA and the FMS subdomain.

Proximal and distal predictors of self-regulatory change in children aged 4 to 7 years

Background

Growth in early self-regulation skills has been linked to positive health, wellbeing, and achievement trajectories across the lifespan. While individual studies have documented specific influences on self-regulation competencies in early childhood, few have modelled a comprehensive range of predictors of self-regulation change across health, development, and environment simultaneously. This study aimed to examine the concurrent associations among a range of proximal and distal influences on change in children’s self-regulation skills over 2 years from age 4–5 years.

Methods

Data from the Longitudinal Study of Australian Children (N = 4983) were used in a structural equation model, predicting a multi-source composite measure of self-regulation at each of 4–5 years and 6–7 years. By controlling for earlier self-regulation and covariates, the model examined the relative contributions of a comprehensive range of variables to self-regulation change including health, development, educational, home environment, time-use, and neighbourhood characteristics.

Results

The significant predictors of children’s self-regulation growth across 4 to 7 years were fewer behavioural sleep problems, higher gross motor and pre-academic skills, lower levels of maternal and paternal angry parenting, and lower levels of financial hardship. There were also marginal effects for high-quality home learning environments and child-educator relationships.

Conclusion

Findings suggest that if we are to successfully foster children’s self-regulation skills, interventionists would do well to operate not only on children’s current capacities but also key aspects of their surrounding context.