Authors: Jörg Blech
The results: performance in the six-minute run did not actually correlate with results in the cognitive test. However, physical coordination was clearly linked to cleverness. The students with above-average motor activity were also superior in their ability to concentrate. Thus physical coordination and mental ability may reside in the same realm of the brain.
But how could that be? The researchers who carried out the study think it might be because the two skills are represented in overlapping brain areas. Thus activating certain parts of the brain by “motor activities ‘trains’ them possibly in such a way that they also function better in other situations, for example during work requiring mental concentration.”
3
Researchers from the International University in Bremen tested 85 boys and girls ages four to six and asked them to perform seven different tasks involving strength, physical flexibility, speed, and coordination. A further test measured their cognitive skills: the children had to spot certain differences in pictures, which measured their attention spans, memory, nonverbal intelligence, and other cognitive capabilities.
These results also show that cognitive and motor skills are connected. Well-coordinated children achieved above-average results in the picture test. These findings underline that the two kinds of development go hand in hand: The more time spent skipping rope, playing hopscotch, riding bicycles, climbing, walking to school, practicing gymnastics, and playing outdoors, the better. Claudia Voelcker-Rehage, lead author of the study, concludes that, especially among children aged four to five, development of coordination and cognition is linked, meaning that in preschools an “integrated stimulation for both cognition and motor activity is very important.”
4
Findings from brain scans analyzing the functional anatomy confirm that the two domains are indeed very closely connected. When the brain is working on a cognitive problem, areas of the prefrontal cortex are activated, and regions of the cerebellum
also
light up. A similar double pattern appears when the brain is trying to solve tasks related to language—for example, trying to say as many words as possible within one minute that start with the same letter. Conversely, as soon as the individual being tested has solved the problem and does not need to concentrate any longer, the activity patterns in both the prefrontal cortex and the cerebellum fade away.
People with damaged, malfunctioning cerebellums not only have impaired motor activities but often struggle when asked to solve cognitive tasks that involve planning, memorizing, and finding words. There are even speech disorders that are solely caused by pathologically low activity in the cerebellum.
5
The process of learning to speak and write is another example revealing that mental and motor activities are linked. Even when babies or small children are unable to speak, they can already grasp the words they hear. But only when children have the motor skills to write by hand can they internalize the concept of scripted language. The motor activities connected with handwriting cannot be replaced by hitting keys on a computer keyboard. Rather, experts recommend children and their parents train the motor skills with activities like drawing, crafts, and also ball games.
6
When such training does not occur, the motor skills may not fully develop, which in turn can result in cognitive impairments and disorders. Many children with dyslexia and related problems often also struggle to coordinate their movements. Adele Diamond, a neuroscientist at the University of British Columbia in Vancouver, states: “Children who are dyslexic, like children who are clumsy, have difficulties with continuous tapping tasks compared to same-aged peers.”
7
Among young people suffering from autism, impaired motor activities are also frequently seen. Interestingly, researchers believe autism is linked to a narrowed cerebellum as well as to a delayed maturation of the prefrontal cortex. The two areas seem to be so closely related that impairment in one area can cause a malfunctioning in the other.
GAMES, NOT PILLS, FOR ADHD
When they see restless and agitated children, many doctors are quick to diagnose a disease called attention deficit hyperactivity disorder (ADHD). Many claim that this disorder is genetically determined and should for this reason be treated with pharmacological substances like methylphenidate (Ritalin), which alter the metabolism of a child’s brain.
ADHD’s estimated worldwide prevalence in people under age 19 is about 5 percent, but there is enormous variability in estimates, and the United States has an especially high rate of ADHD, with 10 percent of males and 4 percent of females diagnosed with it. Thus, according to the statistics, in every classroom there are one or two fidgeting kids who need professional help. In recent years, many teachers and parents have arrived at the conclusion that ADHD is an innate disorder affecting the metabolism of the brain. But to this day there is no scientific method of telling the brain of a normal child from the brain of a child who is said to have ADHD.
Only with the aid of arbitrary criteria can a preschool child or young student be given the ADHD label. But the symptoms (“easily distracted,” “doesn’t sit still”) are so random that they can be seen in a variety of forms among most children. It appears impossible to draw an objective line between a healthy temperament and disturbed behavior.
Methylphenidate was first synthesized in 1944 by a chemist, Leandro Panizzon, with the company Ciba.
8
He swallowed the substance in an experiment on himself but did not experience much from it. His wife, Marguerite—known as Rita—tried it, too, and felt a quite inspiring effect. From this time on Rita would consume the substance occasionally when she was getting ready for a tennis match, and it was named after her: Ritalin.
At first, Ritalin was given to adults only to treat depression, mental fatigue, and disorientation among elderly people. The disease that would make Ritalin famous, and notorious, had not yet been invented. It was not until the 1960s that research became public showing that methylphenidate, and a similar substance called dexedrine, had a quieting effect on children with learning difficulties. By now, methylphenidate is marketed in specific doses, some lasting 8 to 12 hours. The children who are told to take this drug at breakfast spend the full day under medication.
As the consumption of methylphenidate has exploded in industrialized countries, teens and young adults in the United States take the drug for additional reasons: as an appetite suppressant or to stave off the urge to sleep. They crush the tablets and snort the powder to get high. Youngsters have little difficulty obtaining methylphenidate from classmates or friends with prescriptions. The U.S. Drug Enforcement Administration has posted a drastic warning: “Methylphenidate, a Schedule II substance, has a high potential for abuse and produces many of the same effects as cocaine or the amphetamines. The abuse of this substance has been documented among narcotic addicts who dissolve the tablets in water and inject the mixture. Complications arising from this practice are common due to the insoluble fillers used in the tablets. When injected, these materials block small blood vessels, causing serious damage to the lungs and retina of the eye. Binge use, psychotic episodes, cardiovascular complications, and severe psychological addiction have all been associated with methylphenidate abuse.”
9
To this day, it is not known what methylphenidate actually does in the still-developing brain of a preschool or kindergarten child. Nora Volkow, now director of the National Institute on Drug Abuse in Rockville, Maryland, found that the substance, by blocking certain transporting proteins, increases the level of the neurotransmitter dopamine in the synapses, thus acting much like cocaine.
10
However, methylphenidate does not appear to be as addictive, given that it is ingested in pill form. It takes hold much more slowly than cocaine and does not create such a high.
Even when properly prescribed by a doctor, the consumption of the drug comes with a whole range of side effects: agitation, fear, sleeping problems, and paranoia. If the drug is dropped after a long-term treatment, there may be withdrawal symptoms. The drug can spoil a child’s appetite.
Yet many parents are relieved when their child is diagnosed with ADHD because it unburdens them: If my child’s problems are caused by an innate defect of brain chemistry, the thinking goes, the way we are raising our children is not involved. The label ADHD, however, has serious repercussions for children, who learn to think: I can only be tolerated by my parents and teachers when I take my drugs.
“The medication with regulating substances might be advisable for correcting some deficits or for starting an integral therapy,” says Christina Hahn at the Institute of Sport and Sport Science of the University of Heidelberg, Germany. “As a child-oriented, long-ranging treatment, however, medication is by no means the only solution of the problem.”
11
Among children diagnosed with the syndrome, a familiar pattern appears. More than half of these children not only have problems concentrating but are conspicuously awkward; they are bad at balancing and have difficulties timing their movements. This could mean that exercises in improving coordination might be useful to improve concentration and attention.
Though problems with motor activity are not the main symptoms of ADHD, autism, and dyslexia, it is eye-catching that these problems appear so often along with impaired coordination. Adele Diamond concludes: “Motor development and cognitive development may be much more interrelated than has been previously appreciated. Indeed, they may be fundamentally intertwined.”
12
But physical training is nearly never prescribed; the rule instead is to give children medication. On any given day, hundreds of thousands of children are served tablets for breakfast to calm them down and make them attentive. In about 20 minutes the substance takes hold, and the children show a different behavior.
By contrast, prescribing sports programs for children with ADHD appears to be a much gentler and longer-lasting approach. Only a few researchers have developed specific exercise programs for inattentive children, and Gerd Hölter at the University of Dortmund, Germany, is one of them. In one trial, therapists, children, and their parents met once a week for three months in a swimming pool. While educators coached the parents, the children played in the water and tried things like diving for rings. After encouraging results, Hölter plans to expand his program by adding games in a gym. He says: “More exercise and behavioral therapy and less Ritalin—this is our concept.”
13
In the meantime, Hahn has already gathered scientific data documenting the beneficial influence of exercise on children diagnosed with ADHD. More than 90 children, mostly boys with an average age of eight and a half, participated in the study. At first, researchers tested motor skills and the ability to concentrate on problems. Some children were actually taking methylphenidate, and their parents were asked not to change the medication during the study so that the results would not be distorted.
The children were randomly assigned to three groups. Members of the first one played ball games most of the time, soccer and field hockey, learning techniques and tactics. That way, the researchers aimed to simulate how children played in the 1950s and 1960s when it was normal for them to spend summer days outside, playing in yards and fields. The participants of the second group rode mountain bikes, learned in-line skating, and took climbing lessons. Both sports programs lasted 90 minutes and took place twice a week. The third group was used as a control, with 37 ADHD-diagnosed children who did not play any sports at all.
Six months later, Hahn and her colleagues retested the motor skills and concentration abilities of the children. The sedentary children had largely the same results as at the beginning of the study, and there was even further deterioration to be seen, possibly an adverse effect of the methylphenidate some of the children continued to take. The drugs slow down the natural desire to move and thus impair the motor skills all the more.
By contrast, the children in both sports groups did much better. Although their motor skills were markedly subpar at the beginning of the study, they improved dramatically and even reached the lower range of what is considered normal. Their ability to concentrate also improved greatly. These budding athletes solved more cognitive problems than the controls in a given time.
14
These results confirm what the findings of the neuroscientists suggest: If we train our motor abilities by exercising, at the same time we strengthen regions of the brain that are important for paying attention and other cognitive capabilities. Playing sports makes us smarter, and all children can benefit from this effect—whether they are diagnosed with an attention disorder or not.
Lifting the Spirit
A
BLEAK MIND AND A LIFE FULL OF ACTIVITY? THESE TWO THINGS DO not seem to match. Sedentary people tend to have a heavy heart, and sad people are often physically inactive. The correlation is so stable and widespread that it has been demonstrated in many epidemiological trials. Study after study has shown that the more we utilize our muscles, the more positive feelings develop in our heads. This also applies to latecomers to exercise: if a person gets going in advanced age, the risk of developing depression drops to the low levels enjoyed by people who have been active from early on in life. The reverse strategy cannot be recommended. Formerly active people who refrain from using their muscles in middle age have a higher likelihood of developing psychiatric problems.