The Effects of Added Physical Activity on Performance during a Listening Comprehension Task for Students with and without Attention Problems

Kercood, Suneeta; Banda, Devender R.
April 2012
International Journal of Applied Educational Studies;Apr2012, Vol. 13 Issue 1, p19
Academic Journal
We conducted this study to investigate the effect of adding physical activities (sitting on therapy ball versus doodling) on listening comprehension of children with and without attention problems. We used an alternating treatment design to investigate the effects added motor activities, therapy balls versus doodling. Results show that all of the participants answered more comprehension questions compared to the baseline conditions. However, both the therapy ball condition and doodling conditions were equally effective with children. Implication for research and practice are discussed. Paying attention and listening during lectures or meetings or conversations can be challenging at times for all of us. When placed in such listening situations for extended time periods, most of us tend to keep ourselves occupied by doodling, moving around in our seats, tapping our finger/hands or legs, sometimes talk out of turn, making shopping or to-do lists in our note pads, or twirling strings in our clothing, etc. Listening can also be challenging for all children, who during school hours are required to listen to verbally presented educational materials such as lectures, or lesson and stories, and have to answer comprehension questions based on the content. This can be especially challenging for students who already have attention problems, and are expected to listen without moving or fidgeting. It is estimated that up to 1 in 20 children in the U.S. , and approximately 5.9% of school age children worldwide have a diagnosis of attention problems, making it one of the most commonly diagnosed disorders of childhood (Faraone, Sergeant, Gillberg, & Biederman, 2003; Polanczyk, De Lima, Horta, Biederman, & Rohde, L.A. 2007). These students have difficulty sustaining attention to their tasks and have been reported to display between three and eight times as many off-task behaviors as comparison students (Carroll et al., 2006). Research has suggested that instead of reprimanding students' movements and added activity, it might be beneficial to include physical activities before or during academic task. Studies have documented positive effects of physical activity for school aged children through school wide exercise programs (Hollar et al., 2010), incorporating physical activity across curriculum (Donnelly et al., 2009), reviewing school data on physical fitness tests and comparing them to academic test scores (Chomitz et al., 2009), including classroom wide exercise programs (Mahar et al., 2006), and integrating outside school activities (Coe, Pivarnik, Womack, Reeves, & Malina, 2006). In general, researchers in these studies demonstrated improvements in standardized test scores, on task behavior, and academic time on task in average functioning school age children. Physical activity has also been beneficial for school children who have problems in attention and learning, such as those with attention problems or diagnosed disorders. Adding physical activities to their routine academic tasks has been recommended by intervention studies that have been based on the Optimal Stimulation theory (see Kercood, Grskovic, Lee, & Emmert, 2007; Zentall, 2006 for reviews). The Optimal Stimulation Theory hypothesizes that that organisms will initiate stimulation- seeking activity to achieve a stimulatory state that might be described as homeostasis (Hebb, 1955), as in individuals with attention deficit hyperactivity disorders (ADHD) engage in excessive physical movement in an attempt to generate stimulation and reach homeostasis (Zentall, 2006; Zentall & Zentall, 1983). Therefore, by adding stimulating activities such as color, novelty or physical activities into routine tasks, one can provide the optimal level of stimulation that they require, which therefore, allows them to have improved task performance and reduced disruptive behaviors (see Zentall, 2006 for review). The use of physical activities with persons with and without ADHD have included yoga (Jensen & Kenny, 2004), physical activity as a reinforcer for calmness (Azrin, Ehle, & Beaumont, 2006; Azrin, Vinas, & Ehle, 2007), fine motor activities such as the use of flexible tangle toys (Kercood & Grskovic, 2010), and use of therapy balls (Schilling, Washington, Billingsley, & Deitz, 2003). Jensen and Kenny (2004) conducted a study with 20 children with ADHD who were stabilized on medication. The participants were randomly assignment to Yoga group (n=11) and a control group (n=8). Results indicated the participants in yoga performed better on several subscales of the Conners' Parental Rating Scale, Global Index Restless and Impulsive and ADHD Index. The authors concluded that Yoga may have some benefits for those students who are medically stabilized and suggested further replication of results. Azrin, Ehle, and Beaumont (2006) investigated whether scheduled physical activity could serve as a reinforcer for calmness with a four-year-old boy diagnosed with ADHD and autism. During the intervention condition, the student was provided 1-minute opportunity to play with typical gymnastic equipment. The investigators also used other conditions such as shaping, descriptive praise, and noncontingent reinforcement. Results indicated the engaging in physical activities along with descriptive praise improved the child's sitting behavior (attention and calmness). The investigators concluded that physical activities could be used as reinforcers to improve attention in children with ADHD. Azrin, Vinas, and Ehle (2007) extended the previous study results to two older children with ADHD in a special education classroom. The authors found similar results as in the previous study and concluded that exercises could be used as behavioral contingency programs to increase attention in children with ADHD. Recently, Kercood and Grskovic (2010) conducted two studies using fine motor activity such as tactile manipulation of a flexible tangle toy during math problem solving tasks, with school age children with attention problems. In the first study, the students were asked to listen to the math problem presented auditorily (via a taped recording) and give a verbal answer. Participants were presented with the math problems in two counterbalanced conditions, with and without the fine motor activity. Results indicated that fine motor activity was associated with more problems correct during math tasks. In the second study, the authors presented the math problems visually (on a computer screen), with and without auditory distraction. Students were required to read the math problems and verbally provide the solution. Results showed that auditory distraction impeded the performance in the participants, but adding the fine motor activity lessened the effects of the distraction and improved the performance two of the three students. In reviewing the results of both the studies, the authors commented on the effectiveness of the fine motor activity on the listening versus the reading requirements of the experimental tasks, and suggested that adding a fine motor activity may be more beneficial for tasks that require listening but are less useful for tasks that require reading, because reading may provide adequate stimulation for some students with attention problems. In this present study we proposed to expand on prior research and evaluate the effects of adding physical activity during a listening comprehension classroom activity. Listening comprehension is a frequently occurring classroom activity that involves attention to the auditory stimulus, ignoring distracting activities, waiting through a delayed time period, and answering questions either verbally or in writing. In a study conducted by Shroyer and Zentall (1986), it was demonstrated that students with ADHD have challenges with listening comprehension, and performed better in listening comprehension activities that were stimulating and less repetitive. Waiting through a delayed time period, a skill required for listening comprehension, is also difficult for individuals with ADHD. Antrop, Buysse, Roeyers, and Van Oost (2005) examined the activity level of 14 children with ADHD and 14 control children between the ages of 6 and 11 years. The students were observed during two non-waiting class situations (i.e., waiting while a story read by the experimenter and waiting with clock and metronome) and three waiting situations without any stimulation. Results indicated that during the waiting condition, all participants in both groups were restless, noisier, interactive, and sought higher levels of stimulation, and were more disruptive. Therefore, we proposed that, adding physical activities during a listening comprehension task would likely increase the task performance allowing the students to be actively attending to the task and reducing the distracting effects of delayed and waiting time. To create interventions for children with ADHD that could be applied in an inclusive classroom, we propose to compare a large motor activity such sitting on exercise balls versus a fine motor activity such as actively doodling during the listening task. Both these physical activities have been previously used to demonstrate improved academic performance. For example, Schilling, Washington, Billingsley, and Deitz (2003) conducted a study with children with ADHD in 4th grade language arts class, comparing therapy balls as seating versus chairs, on in-seat behavior and legible word productivity. Sitting on therapy balls resulted in students' increase in in-seat behavior and legible word productivity, and both the teachers and students preferred therapy balls to chairs. Similarly, doodling was investigated by Andrade (2010) who conducted a study by investigating the effects of doodling with adults between 18-55 years. Forty participants were divided into two groups: doodling (n = 20) and non-doodling condition (n = 20). Participants in the doodling group shaded printed shapes while listening to a telephone call while the control group listened to phone call and wrote the target information on a lined piece of paper. All of the participants were asked to recall the information. Participants in the doodling group recalled more on the memory test compared to the control group participants. The author concluded that doodling may aid concentration. However, this study was conducted with adults without disabilities. In general, children in classrooms, especially those with attention problems, doodle anyway, move around on their seats, stay off task, and have poorer performance. We decided to evaluate the effect doodling versus sitting on exercise balls (which naturally allows for gross motor movement), by adding it to their routine academic task. We believe that adding minor physical activities within a classroom setting and within regular curricular activities is likely to generalize in inclusive settings, and can be beneficial for all children with and without attention problems.



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