WHY CHILDREN FIDGET: And what we can do about it

A perfect stranger pours her heart out to me over the phone. She complains that her six-year-old son is unable to sit still in the classroom. The school wants to test him for ADHD (attention deficit and hyperactivity disorder). This sounds familiar, I think to myself. As a pediatric occupational therapist, I’ve noticed that this is a fairly common problem today.

The mother goes on to explain how her son comes home every day with a yellow smiley face. The rest of his class goes home with green smiley faces for good behavior. Every day this child is reminded that his behavior is unacceptable, simply because he can’t sit still for long periods of time.

The mother starts crying. “He is starting to say things like, ‘I hate myself’ and ‘I’m no good at anything.’” This young boy’s self-esteem is plummeting all because he needs to move more often.

Over the past decade, more and more children are being coded as having attention issues and possibly ADHD. A local elementary teacher tells me that at least eight of her twenty-two students have trouble paying attention on a good day. At the same time, children are expected to sit for longer periods of time. In fact, even kindergarteners are being asked to sit for thirty minutes during circle time at some schools.

The problem: children are constantly in an upright position these days. It is rare to find children rolling down hills, climbing trees, and spinning in circles just for fun. Merry-go-rounds and teeter-totters are a thing of the past. Recess times have shortened due to increasing educational demands, and children rarely play outdoors due to parental fears, liability issues, and the hectic schedules of modern-day society. Lets face it: Children are not nearly moving enough, and it is really starting to become a problem.

I recently observed a fifth grade classroom as a favor to a teacher. I quietly went in and took a seat towards the back of the classroom. The teacher was reading a book to the children and it was towards the end of the day. I’ve never seen anything like it. Kids were tilting back their chairs back at extreme angles, others were rocking their bodies back and forth, a few were chewing on the ends of their pencils, and one child was hitting a water bottle against her forehead in a rhythmic pattern.

This was not a special needs classroom, but a typical classroom at a popular art-integrated charter school. My first thought was that the children might have been fidgeting because it was the end of the day and they were simply tired. Even though this may have been part of the problem, there was certainly another underlying reason.

We quickly learned after further testing, that most of the children in the classroom had poor core strength and balance. In fact, we tested a few other classrooms and found that when compared to children from the early 1980s, only one out of twelve children had normal strength and balance. Only one! Oh my goodness, I thought to myself. These children need to move!

Ironically, many children are walking around with an underdeveloped vestibular (balance) system today--due to restricted movement. In order to develop a strong balance system, children need to move their body in all directions, for hours at a time. Just like with exercising, they need to do this more than just once-a-week in order to reap the benefits. Therefore, having soccer practice once or twice a week is likely not enough movement for the child to develop a strong sensory system.

Children are going to class with bodies that are less prepared to learn than ever before. With sensory systems not quite working right, they are asked to sit and pay attention. Children naturally start fidgeting in order to get the movement their body so desperately needs and is not getting enough of to “turn their brain on.” What happens when the children start fidgeting? We ask them to sit still and pay attention; therefore, their brain goes back to “sleep.”

Fidgeting is a real problem. It is a strong indicator that children are not getting enough movement throughout the day. We need to fix the underlying issue. Recess times need to be extended and kids should be playing outside as soon as they get home from school. Twenty minutes of movement a day is not enough! They need hours of play outdoors in order to establish a healthy sensory system and to support higher-level attention and learning in the classroom.

         In order for children to learn, they need to be able to pay attention. In order to pay attention, we need to let them move.

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09-Jun-2014 07:47 PM Kellie

So obviously we need to get them moving more, younger, but what do we do to help if they're older? How can we help the child that you spoke of at the beginning?

09-Jun-2014 07:57 PM Fiona

Fascinating findings with regard to balance and core strength. My daughter attends a Montessori school where she is free to move around the classroom however she pleases. She never has any trouble concentrating. She also spends at least 2 hours a day outside and has fantastic balance and strength. I just can't understand people who don't take their children outdoors.

09-Jun-2014 09:11 PM Karen

I wonder, is swimming an effective way to move the body in all directions and develop properly? I only ask because we live in Florida, the kids are in the pool from may until September or October for many hours a week, and I wonder if that's effective. It's pretty much the only activity other than gymnastics class and swings that my 5yo girl will do for extended periods.

09-Jun-2014 09:23 PM Angela Hanscom

Karen, I think swimming is great if that works for your family.

09-Jun-2014 09:42 PM Jane

Interesting post!
I'm a high school teacher (and am certified in elem ed.), and I am a firm believer in the advantages of recess, movement, core strengthening, no/low processed diets, and kinesthetic learning in my lesson plans. A few years back I was a substitute for a fourth grade teacher. She had the exercise balls for seats for all but two of the students (who liked to stay quietly focused according to those students). Of all the substituting I had done, that day ranked as one of the worst. The students more than just "fidgeted;" I couldn't even concentrate. Additionally, within a few questions, I recognized that the balls were affecting everyone's concentration. Each were bouncing and different rates and in different directions. It was maddening; I had never had that much trouble engaging a class. Consequently, I would recommend any teachers to do their research before buying these balls for the entire class to use all day. I believe that the other options like movement breaks mentioned in these posts are more valuable.

09-Jun-2014 10:02 PM kim

i am 40 years old and i can't sit still for 8 hours. i have to get up from my desk every hour or so and move around. i also find that if i don't do some physical activity 3-4 times a week, i get very restless.

i can't imagine being a kid this day and age and not having recess. free, unstructured play is so important for development.

09-Jun-2014 10:11 PM KL

Makes absolute sense, so much so it becomes blinding obvious. Now if the schools could get on board, society dropped being so PC over what and how kids play and we as parents became more liberated about our kids liberating themselves then maybe, just maybe kids could be...just kids, fun free and loving living life.

09-Jun-2014 10:14 PM Ana Greenberg

Dr Montessori knew this 100 yrs ago... “Under the urge of nature and according to the laws of development, though not understood by the adult, the child is obliged to be serious about two fundamental things … the first is the love of activity… The second fundamental thing is independence.” -Maria Montessori, MD. "What You Should Know About Your Child" Chapter 3, p. 11.

09-Jun-2014 10:30 PM Anonymous

Seriously, did someone say to stay home with one's child to at least age four? What, go unemployed and on government assistance for that? No thank you. My girls had the best home daycare with lots of love, wholesome food, and plenty of play with exercise so I could be a teacher and have my students have fun singing, dancing, and playing classroom instruments. Homeschool? No way, my girls have a well balanced life learning alongside those with challenges and other thought processes. When the grow up and work in the 'real world' they will be able to tolerate all types of personalities because of their public schooling.

09-Jun-2014 10:50 PM Angela Hanscom

Some people are asking for a little more neuroscience and references. So if you like this sort of thing, read this:

The vestibular system has several functions. It is most known for its function of maintaining balance, but because of its neurological connections it plays important roles in posture, tone, coordination, vision, and arousal. Problems in the vestibular system can result in poor balance, clumsiness, blurred vision, vertigo (dizziness), and spatial difficulties.

The first sensory system to fully develop is the vestibular system at 5 months after conception. The primary structures of the vestibular system are located in the inner ear. There are three semicircular canals in each ear that are filled with fluid and hair cells. When the head moves the fluid moves, which stimulates the hair cells in the inner ear. This information is then sent to the eyes for adjustments so vision is not blurred. It is sent to the muscles for maintaining balance. It is also sent to the reticular activating system in the brain stem to increase alertness and attention.

These are just a few things the vestibular system does. Like I said before the brain is all interconnected. This comes from the following resources:

Laundy-Ekman, Laurie. (2002). Neuroscience: Fundamentals for Rehabilitation. New York: W.B. Saunders Company.

Physical Therapy Program for Vestibular Rehabilitation: by Smith-Wheelock, Shepard NT, Telian SA, American Journal of Otolaryngology

09-Jun-2014 10:53 PM Lyz

I want to share your article so badly- I wish that it also contained a recommendation for what kinds of movement and how much can really make a difference. (I know because my son is being treated for SPD) So many parents with young kids were raised in this "new academic climate." No recess, no outdoor time and no free play makes a horrible prison for children.

09-Jun-2014 10:54 PM Alicia

My son has the same problem he cannot sit still at school for long. His teacher this year has been great about letting him stand, kneel or sit in a rocking chair while he reads because he gets more done. When my children are home they are outside playing or they are jumping around inside. They rarely sit still because they love to be on the go having fun exploring and learning. I love the idea of the ball for them to sit on instead of the chairs. Great article and I enjoyed the read.

09-Jun-2014 11:18 PM Megan N

I agree with much of this but have a question. Where do kids with sensory issues fit? My daughter is a sensory seeker. She's outdoors a lot. She's attended a Waldorf school where she was outdoors daily, went on walks, climbed trees, used rocker boards and other methods of movement indoors. Now that she's homeschooled, she's outside daily, moving and playing and climbing and riding. We have rocker boards indoors and other methods of movement. She spins lots. But, she still has a hard time sitting still, still needs more sensory input. Her core strength is still underdeveloped. I agree wholeheartedly that kids need to move more and to be outside a lot (she would have an incredibly hard time sitting as much as is required in typical school), but it seems that at least some also need more than that. I'd love to hear your ideas on this.

09-Jun-2014 11:19 PM Angela Hanscom

More ideas?

I personally like to keep things simple. I tend not to be an activity and formal movement type person, so my ideas will be a little more general.

If you take a look at TimberNook - you will learn that I tend to promote and repeat the following things: unstructured play outdoors, open-ended & hands-on experiences in nature to inspire creativity, and plenty of time to move and play in nature.

Why outdoors? Because I feel the outdoors is the ultimate sensory experience - it engages all of the senses in the most natural of ways. To read more about this read my article with the Children & Nature Network: http://blog.childrenandnature.org/2014/05/12/nature-is-the-ultimate-sensory-experience-pediatric-occupational-therapist-makes-the-case-for-nature-therapy/

I really feel the answer (the ideas) that need to be carried through is education to the school and also to parents about the importance of movement and play outdoors on healthy child development. Once the education piece happens and adults can truly understand the neuroscience behind movement and how this affects normal development and learning - the school and parents can come up with their own plans on how to make this happen.

For some people that may look like extending recess times, building a school garden and/or outdoor classroom, less of a workload after school, keeping family life simple (less activities to take up the afternoons), and advocating for parents to let children play outdoors. This will vary depending on where you live, how open-minded the adults are, and what your goals are. For some people this may mean bringing TimberNook to your area - to inspire, educate, and help make the changes needed in the whole community.

09-Jun-2014 11:27 PM Miss H

I think this article is great! Unfortunately, as an educator, we are given a set recess time and don't have the opportunities we would like to get up and move more. I try to give my students stretching breaks and sometimes we do jumping jacks or walk around the room. It's so difficult when there is so much expected of us to teach and not enough time. We're also now being evaluated on a strict rubric so finding time for breaks from learning is even hader. I'm going to do my best to do more moving when we can. Thanks for this article.

09-Jun-2014 11:41 PM Apprentice Vinbeazel

COMO Se Dice/How Do You Say - Balanced and Barefoot - in Cherokee? or Spanish?? This needs to be translated into many languages!! Former ECE/ Child Development Center Worker at Edwards AFB...Edwards California.

09-Jun-2014 11:42 PM Angela Hanscom

Hi Megan! Great question. It sounds like she may need an experienced pediatric occupational therapist to evaluate her and possibly receive some treatment. Sometimes children need that extra therapy to get them where they should be. Not all sensory issues are environmental, some are genetic and some are biological according to a new study by http://www.ucsf.edu. However, through treatment children with sensory issues do get better. A lot of the activities we use for treatment are things children naturally experience when they play outdoors -- such as swinging, going upside down, climbing, pushing, pulling, and spinning. These all work on different things. The reason why I wrote this article is not because I feel play outdoors will solve ALL problems, because it won't. I wrote it because when we restrict children from moving for long periods of time, this can actually create problems in their inner ear -- which is their center for vestibular functioning. When this happens, we start to see problems with vision, attention, coordination, spatial awareness, and emotional regulation. It is important that we try to prevent some of these sensory issues from happening in the first place if we can - because there are not enough occupational therapists to treat every child. That being said, there are always going to be some children in which play outdoors is not enough and they need some therapy short-term to get them back on track. My only caution is to make sure (which it sounds like you are already providing) that once your child is done receiving occupational therapy that she goes back to playing hard and keeping that system activated to prevent relapse. Sometimes I treat a child and they are doing great and then go back to an environment of restricted movement throughout the day, and they start to have difficulties again. It is just like exercising - if you stop....you start to gain weight again. Not a perfect example, I know :) Hence the need for children to be allowed to move throughout the day.

10-Jun-2014 12:04 AM Lisa

My son NEVER stops moving unless he's sleeping ~ kicking a footy, bouncing a basketball, running, jumping (trampoline) surfing, swimming and STILL fidgets, cracks his knuckles, etc. It's exhausting!

10-Jun-2014 12:51 AM Anonymous

As person who is actually Diagnosed ADHD (mild/moderate) I completely agree. Even if a couple of the kids actually do turn out to really have ADHD movement greatly helps improve focus in these people too. So this is win all around. Me and my fellow ADHD class mate were always fidgeting though we had other signs of ADHD (most people do not know the extensive list of signs that must be ticked off on a regular basis and that is the majority of the list has to be ticked off because most people do not properly understand anything abotu the condition at all). My mum always always always made sure we had outdoor run around time after school before homework. We did homework in 20-30 min sections then had run around breaks. It really helped. I still always feel better going for a bike ride or a run. My son is only 18 months but I am planning on putting him in our local environmental school (which is a special project in our district) that is the school is completely run outdoors in parks in all weather (they have tents or park shelters for rainy or snowy days). All subjects are integrated into learning outdoors. This will mean lots of movement. Schools are definitely going backwards these days. Also yoga helps a ton. I get really upset at people who freak out about yoga for some poorly understood thought that it is some kinda religion when it is really just a way to stretch and use the body and seriously improves focus and relaxation that is good for the body and brain as well. I am happy to see some schools are starting to include this in their schedules.

10-Jun-2014 01:09 AM Anonymous

Montessori. The children are independently learning all over the room. The can sit at tables, lie or sit on the floor, or stand. They have to move around to get the materials they need and turn in their work. Our class has mini p.e. almost every morning to get out some of the squirrel and "wake" up their brains. It has been really effective and the children feel more productive and successful.

10-Jun-2014 01:11 AM Carrie

Great post! As a teacher, I absolutely agree that students spend too much time sitting and I think you'd be hard-pressed to find a teacher in this country who disagrees. Make your feelings known to your legislators! It is great to raise awareness through social media, however, as long as lawmakers continue to micromanage educators and punish schools if their tests scores are unacceptable, these types of issues will continue and increase. Tell your legislators how you want your children to be educated! Excuse your child from the "mandatory" state testing. Parents have more power than they realize - imagine the message it would send if every child in your state was exempted from testing. Just some food for thought.

10-Jun-2014 01:16 AM Monica

I agree about the dyes in the food that our children are eating and I also know that all the immunizations that a tiny baby receives before the age of 2 and then again before entering kindergarten have a huge impact on their attention and other areas of the brain and body. Many would deny this, but why are there so many children on ADD/ADHD medications and also, they're kids and need to play.

10-Jun-2014 01:51 AM Anonymous

If anyone ever went to James Bay Elementary School Victoria BC Canada in the 70's you'll remember a wonderful grade 6 teacher Mr Clayton, his philosophy was that he didn't believe all learning could be taught in the classroom so we spend our mornings doing academic work and then our afternoons outside at the Breakwater exploring the beach and learning about sea life and the animals at Beacon Hill Park....I wish we had a system that allowed children to learn both inside and outside the classroom providing many happy memories to our children as well as fresh air, excerize and a greater appreciation for the world they live in and not just field trips

10-Jun-2014 01:59 AM owdwife

What an excellent article! When I was teaching Primary school children (not so long ago) I used to send the whole class outside or into the assembly hall to run and play for 5 minutes when they started to get restless. it always worked and they came back ready to work again. now I know why!

10-Jun-2014 02:25 AM Anonymous

wow !!! This posting was very interesting for me to read . It somewhat hits home tying in with my 8 y.o. Grandson . Basically since kindergarten he has had many times of behavior problems , also times of " fidgeting " / moving in class , etc. This past school year he had an incident that brought about more serious thinking as to why he is the way he is , etc. My overall opinion is that he is " bored " . Testing wound up being done with him to determine if he has " ADHD " , the tests seem to indicate that he does , but I don't 100 % agree with this at all . In reading this article on " fidgeting " , to me it helps to put the life of this grandson of mine into what I can say a clearer perspective of how life , especially at school could perhaps be better for him w/out it being thought by anyone at all that his behavior / fidgeting is all tied into " ADHD "


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