Unlocking the secrets of paediatric exercise : Why it matters and the eye-opening stats

As health professionals and parents we have a responsibility to focus on children of all abilities as individuals. We have a responsibility to improve the life of our future generations and we can start  by simply providing them with more opportunities to play, move and consequently develop holistically. We know that no two children will develop at the same rate irrespective of their ‘typical’ development. We have an opportunity to provide holistic intervention and create meaningful participation in children. When we do this, we are in a position to promote intrinsic motivation which will improve a child’s scope and frequency of involvement in turn leading to improvement in overall health. 

Children develop at an individual pace and paediatric and neurological conditions impact both typical children and those with a disability. Therefore when we focus on the child individually and holistically and reframe focus on the condition, we  provide a more positive environment for the child to thrive.

In 2021 The Australian Early Development Census released data on children across Australia and how they are developing across  physical health and wellbeing, social competence, emotional maturity, language and cognitive skills ,communication skills and general knowledge. According to the AEDC 22% of children are developmentally vulnerable and 21.5% of children at risk or vulnerable in their physical development.  This represents a decline in percentage of children on track since 2009. While developmental difficulties can be seen from the age of two more often these conditions are intercepted at school age where issues become more transparent. However, providing various non-traditional ways to learn and opportunities to experience new things embraces a holistic approach to development. When incorporating exercise and movement into learning, children take on this mode of learning whilst reaping the benefits of exercise. 

Development aside general health, wellbeing, quality of life and life expectancy of our future generations is in jeopardy with inactivity one of the prime reasons. In Queensland 2 in 3 adults and 1 in 4 children live with overweight and obesity. Across Australia, children in lower socio-economic areas are facing rising obesity rates. Modelling shows that children born in 2023 could have shorter life expectancy than their parents, with a projected reduction of up to 5 years off their life expectancy due to the impact of overweight and obesity. 

In 2018, only two-thirds of children aged 0–14 participated in organised physical activities outside of school hours (3). According to self-reported data from the ABS, in 2011–12 less than one-quarter of children aged 5–14 undertook the recommended 60 minutes of physical activity every day (3). 

What are the recommendations for exercise for children?

For children aged 2–4 who are not in school, the guidelines recommend:

• at least 3 hours a day of physical activity, including energetic play
• no more than 60 minutes a day engaged in screen-based activity.

For children aged 5–12 and 13–17, the guidelines recommend:

• at least 60 minutes a day of moderate to vigorous intensity physical activity
• no more than 2 hours a day of screen-based activity for entertainment (for example, television, seated electronic games and computer use).
• ___________

Unfortunately, the stats look more unfavourable in the disability sector. The Australian Institute of Health and Welfare through the Ausplay survey has found that almost three-quarters of people aged 15 and over with disability do not do enough physical activity. AusPlay is a national survey conducted since 2015 with the aim to get a population level understanding of sport and physical recreation participation of people living in Australia to help guide policy and service development.

More than 1 in 5 adults with a disability participated in no sport, exercise or physical recreation over the past 12 months. Reasons why people with a disability are less physically active are diverse and barriers can include access, opportunity, knowledge and support.

In a 2010 report commissioned by the Australian Sports Commission 75% of 1050 people with a disability surveyed indicated they would like to participate in more sport and active recreation (2). 

The impact 

Child Development and inactivity 

Physical activity  bolsters social and emotional development by boosting self efficacy and confidence in a child. It provides opportunities for brain development and research demonstrates improved academic results. It allows children to fully engage with their senses and their body which lends a hand to managing stimulation and learning preparation. It provides opportunities for play, problem solving and trial and error. It gives them an opportunity to practise their receptive and expressive language all while  prevention of chronic disease is at play.   Prescribed and well thought out physical activity also promotes inclusivity and socialisation, particularly when we discard technique, capacity or levels of performance.  By providing inclusive programs for the greater community, we open up opportunities for everyone to be involved and reap the benefits of clinical intervention and prevention. 

 Gibson and her colleagues highlighted the importance in their study to encourage the development and practice of function without regard to how ‘nicely’ it is achieved.  They found that children are affected by normative ideas about movement  which can contribute to parental feelings of angst and doubt, and negative self-identities for children further identifying the importance to include children of all levels and abilities (2). They suggest that rehabilitation programmes need to consider how they may unintentionally reinforce potentially harmful beliefs (2). All which can contribute to participation and being physically active. 

It is also important to recognise  that children with disabilities can often be ‘deprived’ of experience. It can be extremely difficult for children and adults in the disability sector to participate in physical activity frequently.  Children with disabilities and their families can face a multitude of barriers to physical activity and sport including financial, psychosocial, emotional and logistical. Therapy and other prescribed interventions can also consume time and disallow opportunity for physical growth and development. By providing  opportunities for everyone to participate in holistically focused programs, ones which d shift the focus from condition or disability to health and enjoyment, we are bridging the gap on inclusivity. To maximise participation and reap the benefits for all, we must ensure everyone feels valued, seen and included. (1). 

Conditions impact children differently as will differing interventions, strategies and techniques. While most allied health professionals willingly work with children with NDIS funding, there are so many children in our early learning sector who remain undiagnosed. These children are the ones who struggle the most and would benefit  from exercise interventions and a fast tracked diagnosis. Once more, intervention can help massage their development holistically. Programs like Kids Heart Pilates present the opportunity to identify children who may not have otherwise been diagnosed. Mild symptoms identified through the program, can be resolved quickly through early intervention.

So what does a holistic program look like?

 Holistic programs provide both structure and flexibility promoting inclusivity through a paediatric clinical service that allows for greater reach and impact than otherwise offered. Currently there is huge support in the early childhood sector for this very reason. While it is generally assumed that kindergarten aged children are very active it has been reported that 3-5yr olds spend ~43 mins of any given hour in sedentary activity (6).

In respect to health outcomes alone, inactivity has been one of the leading causes of mortality rates across the world. ‘Estimates suggest that physical inactivity is the principal cause for approximately 21-25% of breast and colon cancer, 27% diabetes and 30% of ischemic heart disease worldwide’ (3).

And when we look at current statistics of these very diseases it is no wonder that the government is getting behind funding wellbeing programs. By not getting regular exercise and starting healthy habits from a young age you raise your risk of:

• Obesity.
• Heart diseases, including coronary artery disease and heart attack.
• High blood pressure.
• High cholesterol.
• Stroke.
• Metabolic syndrome.
• Type 2 diabetes.
• Certain cancers, including colon, breast, and uterine cancers.

The time to act is now, there is funding from the government and there are health professionals out there willing to help. We need to educate every person who has influence on children and we need to look at our own health as influencers and adults. We must start teaching children in a holistic way prioritising movement and exploration as an integral part of their learning. As of March 2023 Kids Heart Pilates runs 65 classes a week. We have 29 centres on the uplift grant program and are in discussions with a new chain with 23 centres. 

Currently we are directly influencing around 217 educators and 2000 kids per week directly through the Kids Pilates program. If every educator has access to 22 children we are indirectly impacting almost 5000 children across Queensland. Whether it be instilling healthy habits, picking up developmental delays or prescribing early interventions it is exciting to think that over 2000 children a week may not become a statistic..  Furthermore, upskilling educators  enables them to identify problem areas in children within their care and  adopt an early intervention approach. 

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