A publication of Appalachian Voices


A publication of Appalachian Voices


Prescription to Play

Getting Outside Truly is the Best Medicine

By Brian Sewell

A Prescription for Holistic Health: A child may not realize it at the time, but time spent playing and discovering the outdoors provides a framework for future health, psychological well-being and the social skills useful in everyday life. Photo by Jamie Goodman.

Once upon a time, on an ordinary fall afternoon after returning home from school, the kids from the neighborhood would get together. They might take to a nearby creek or hike to a secret fort deep in the woods. There, kingdoms were conjured, epic battles fought and the innocence of chilhood imagination reigned supreme.

Outside, children can inhabit two universes — in one, mythical monsters have invaded and jump from tree to tree; in the other, it’s time to retreat home for dinner.

Childhood is a time to imagine and create. It is also a time of physical and mental development, charting the course for an individual’s future health. In the midst of all those monsters, a child is unlikely to consider how much spending time outdoors will benefit them through childhood and into adolescence and adulthood.

Today, however, children are more likely to take to the couch and battle monsters on screens. Nearly every medical study into the matter concludes that, regardless of ethnicity, children in America are too plugged in, unhealthy and overmedicated. And in Appalachian and southeastern states, the challenges are even greater. The nature of childhood has changed, and growing up green seems more like a fairy tale than ever.

Remembering How to Play

The range of research into the factors affecting children’s development is staggering — from the influence of high-calorie sweets advertised on TV to the alarming number of prescriptions written as the prevalence of attention deficit-hyperactivity diagnoses grows. But in many cases the roots of the problem and the benefits of play are being ignored.

The most visible and immediate threat to children’s physical health is the obesity epidemic affecting nearly 20 percent of kids between the ages of six and 11. During the past decade, percentages of overweight and obese children in states such as West Virginia, Kentucky and Tennessee have crept into the upper 30s, according to data from the National Initiative for Children’s Healthcare Quality.

The increase in early-onset diabetes provides perspective into the future health of children with
poor diets and who grow up mostly indoors. Dr. David Ludwig, a pediatrician at Boston Children’s Hospital, recently described the severity of the problem on National Public Radio.

“It’s one thing for an overweight or obese 55-year-old gaining a few extra pounds a year to develop diabetes at age 65 and have a heart attack at age 70,” Ludwig said. “It’s a very different thing if the clock starts ticking at age 10.”

When it comes to physical health, parents and schools are beginning to think outside the box — namely the four walls with a TV in which too many children have settled.

Several states and major groups such as the Sierra Club and National Wildlife Federation have endorsed the No Child Left Inside movement, which focuses on environmental literacy through outdoor recreation and healthy living. The initiative is helping schools understand the importance of something as common as having recess, and reminding towns of the role parks and public spaces play in their communities.

For children, exercising outdoors, better known as “playing,” is simply one of the only opportunities to participate in an activity that promotes lifelong physical and, as families are beginning to learn, mental health.

The parents of today’s youth know something about growing up green, since many of them did. They remember fondly the family road trip to a national park, or perhaps closer to home, picnics at the neighborhood playground, where they would hang upside-down from the monkey bars and swing higher than once thought possible. For an appreciation for time spent outdoors to be passed down, parents need to remember their own childhood.

Thinking, Naturally

Developing a relationship with the outdoors at an early age provides children with more than a formula for lifelong physical health, it offers a framework for psychological well-being and the social skills useful in everyday life. As the library of research on middle childhood grows, a clearer understanding of how outdoor play contributes to the way a child learns and interacts with others is piling up. Less clear and more troubling, however, are the factors, including a child’s stress level, media consumption and diet, contributing to the rapid increase in diagnoses of attention deficit-hyperactivity disorder.

Researchers at the University of Illinois have explored treatment of attention deficit disorders through attention restoration theory — an idea developed in the 1980s asserting that adults can concentrate better after spending time in nature. They found that, similar to older subjects, children who are able to climb trees, dig in the dirt and play with bugs outside are better able to sit still and behave at home and in the classroom. On the other hand, the study also found that children who exhibit attention problems in the classroom are more likely to be kept from outdoor play during school because of poor grades or misbehavior.

Nearly 16 percent of children in North Carolina have been diagnosed with ADHD, the highest in the nation. Overall, according to the Center for Disease Control, more than four and a half million kids have been diagnosed with the learning disorder. And more than three million of those children are prescribed stimulants like Ritalin and Adderall to treat its symptoms. But as researchers such as University of Minnesota Institute of Child Development’s L. Alan Sroufe have noted, these pills do not constitute a cure, are unlikely to improve long-term social and academic outcomes, and can lead to dependency.

One study that has lasted for more than a decade found that after three years, positive behavioural modification effects from medication had faded, and by eight years there was no evidence that the drugs produced any academic or behavioral benefits.

“Clearly, these children need a broader base of support than was offered in this medication study, support that begins earlier and lasts longer,” Sroufe recently wrote in a New York Times op-ed titled “Ritalin Gone Wrong.”

Healthy children beget healthy adults, healthy families and a healthy society. And just as the threats to children’s overall health last into the future, so do the benefits of ample time for outdoor play. In fact, getting back to playing may be the key to holistic health for America’s children, getting them away from battling monsters on screens and back to battling monsters in trees.

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