Angela: Today we are going to be talking a lot about this issue of decreased play outdoors. I am going to actually start with giving you a little bit of my story and how this all came about. I think it really lays a nice foundation for the work that we are doing with TimberNook and also the message that really needs to get out there to the therapy world and parenting world. It is a hot topic right now and we are at the forefront of this movement.
This is my family in Figure 1.
Figure 1. Angela's family.
This is my husband Paul, my daughter Joelle, who is 12 years old, my daughter Charlotte who is nine, and then I have a two-year-old son Noah. I always start my presentation with my family because this journey for me really became very meaningful to me after I had children of my own. I am a pediatric occupational therapist and I had worked in about every setting except a nursing home. I started noticing some interesting sensory issues when I worked in an outpatient pediatric clinic. More and more kids were having issues with balance and an increase with clumsiness. A presenter from a past course I had taken said, "The number one thing that we need to treat these days is their vestibular system and their balance sense." Due to this, I really started paying attention to these things and made mental notes. I also had a child that came into the clinic that said, "I do not like wind in my face." I remember thinking, "How do I treat this inside a clinic setting? Do I get a fan?" I just remember being confused by these issues. Additionally, many kids did not like getting messy, did not want their hands dirty, and that sort of thing.
I ended up deciding to stay home with my two children when my second daughter was about nine months old. I wanted to enjoy the time I could with them when they were little. I started doing mom things, like play groups, and I joined a moms group. A couple friends started to ask me questions as they knew I was an OT. For instance, one person asked me, "Why does my child spin in circles all the time?" And then another mother asked me, "My child can't pay attention in preschool." All of these concerns were coming up, and so I remember one mom saying "you are an OT. You need to do something about this." As I was not working, again I made a mental note.
The other really interesting thing that was happening was we were living on about 12 acres of woods. There was also about 60 acres of conservation land surrounding us. I would often take a shortcut through the neighborhood to get to our house and would think, "Where are all the children?" It was very rare to see kids outside playing in the neighborhood. I grew up in Vermont and I remember playing until dusk. This was something that also resonated with me. Finally, I had a speech therapy friend and an educator say, "Let's form an enrichment program just for our own children and prepare them for kindergarten." They mentioned that their kids needed to practice sitting to prepare for kindergarten, and I remember thinking, "You can't teach attention. This is not even appropriate and what do you mean they are going to be sitting a lot in kindergarten?"
On the first day of kindergarten, the kindergarten teacher had us form a circle around her. She said, "This is not kindergarten like you remember when you were growing up." She said, "This is really like the new first grade. We are not going to have time to teach your children how to cut with scissors. I'm going to have my husband precut everything at nighttime. We will not be able to teach your children how to tie their shoes. If they cannot tie their shoes, please bring elastic laces or have them wear Velcro shoes." Then she said, "We will have a five-minute snack, and if that snack becomes a problem and gets in the way of curriculum, we are going to do a working snack. We are also going to have a 15-minute recess, and in the wintertime when it snows it will be indoors because we do not have time to change your children into their snow gear." I remember thinking, as an occupational therapist, that this was not developmentally appropriate. This went against everything that I was taught and felt passionate about. I left there very confused.
Finally, a couple months into the kindergarten program, my daughter started coming home saying, "I hate school." This broke my heart because I remember loving school growing up. I am still a nerd and I enjoy learning so much. To hear that your child does not want to learn or hates school is not good. I ended up pulling her out of kindergarten, which again was a big deal for me because I really loved school, and started to homeschool her. I met a lot of like-minded friends who were studying alternatives to education.
I learned about several programs: Reggio Emilia, which uses the environment as the third teacher; Montessori; Waldorf education; and especially about what they are doing in Finland, where the children use hands on learning like going into the river to learn about fish. These helped me to shape the program that we run now and learn how to step back. I remember wanting to schedule everything for my child and one of my mentors kept saying "She is playing. She is going to learn through play. You need to step back, Angie." This was a lesson for me. She also said, "Their ideas are going to be 10 times better than anything you could come up with no matter how creative you are."
I decided to start a nature program at the same time, because when I started looking at available programs (like Kindermusik and Gymboree), most of them were indoors. I wanted to do something to get kids outside in the form of nature classes. Then when I held a nature class, I had a parent come up to me with her son in tow and say "Can you tell my son why the leaves change color?" And I said "I think it has something to do with the pigment." However, I could not answer her and I felt embarrassed. I said, "I'll look it up for you." This helped me reflect on what my specialty was. Why was I running a nature program when I am an occupational therapist. What does this have to do with me? I started thinking about two things. One, OT is my specialty. We are trained to take any activity or experience and break it down into all its therapeutic components and look at the benefits of it from all different angles. Secondly, we are very concerned about play for children because that is the occupation of the child. However, we are really good at indoor play. We do a lot of board games, puzzles and that sort of thing, but we forget about the outdoor world. I kept thinking why are we not focusing more on inspiring them to be independent with outdoor play?
This is how I started down this road. I also had a friend say "I think you'll find more parents interested if you actually run camps." I ran three weeks of summer camp my first year and I filled the camps. The word got out. After a few years, I would release the camp info. in February at 9:00 am, and by 9:02 am, I had waitlist for all four weeks. I had parents calling me crying and saying, "My kids got into your camp last year and did not get in this year. What are you going to do about that?" This is when I knew that I could not meet the demand of this program alone. I had an OT and a PT at the same time call and say, "What you are doing is so unique for our profession. Can we replicate what you've created?" Any time you create something unique, it is hard to let go. I had to realize that this was not about me and it has never been about me. This is something that needs to be shared and so that is when we decided to license the program and called it TimberNook. Originally, it was under Nature Stepping Stones as I was doing a private practice and doing this on the side. TimberNook started in 2013. In that first year, I wrote an article called, "Why Kids Fidget and What We Can Do About It." It was just something that really resonated with me as I was observing children in the classroom and comparing that to outdoor play. I put it on my blog and it went viral. It had over 1,000 comments on it. It just kept going and going, and got picked up by the Washington Post. It just recently went viral again and got picked up by the Jerusalem Post and the Times of India, and it was one of the most shared articles in 2014.
Then I started writing for the Washington Post about hot topics such as: how outdoor play is important for children, how recess needs to be longer, and how we need to keep the outdoor play in the preschool setting as well. Those were popular posts, and I got a book deal out of it. "Balanced and Barefoot" is now available and that is on Amazon and Barnes and Noble. There is a lot of great information in the advocating for outdoor play. This is also how I got a TED Talk for Johnson and Johnson. All of this was about this issue of restricted play and how children are simply not moving enough. We grew pretty quickly and went to New Zealand. We are now training people. There are also locations in Australia. Soon we will be in Canada and England. It is amazing to see the providers that come forward. Professionals, from psychologists to speech therapists, are all seeing it through a different lens and saying this is the best way for kids to heal. It all has been pretty amazing and quite the journey. We are going to be moving into schools this year too, which is really exciting, and affecting the educational culture a little bit.
Rise of Sensory and Motor Issues
After homeschooling for a couple years, my kids ended up going back to a private school. In 2012, one of the teachers asked me to help her because the kids could not sit still. I was picturing that kids would be tapping their pencil, tapping their foot, or having those sorts of issues, but nothing could have prepared me for what I was about to see. Instead, I saw that children were leaning back in their chairs at extreme angles so that there was only one point of contact left with the chair. One child was rocking in his chair back and forth, another child was hitting his head over and over with a bottle, and kids were finding excuses to get up and out of the chair to sharpen their pencil or to go to the bathroom. Almost all the kids in there were fidgeting in some way except for one little girl. I asked her after class what she did for fun and she said, "I do dance and gymnastics almost every day." This intrigued me and I thought clearly these children need to move more.
We did a pilot study implementing a therapeutic dance program. We got them moving in all different directions and working on their core to help with attention. We tested their core strength, so their stomach muscles and their back muscles, and then we had them spin in circles to the right and to the left 10 times each with eyes open and closed. We looked at nystagmus, or the eye response after. Were their eyes moving back and forth, which is normal after spinning? Was there excessive eye movement? Did it go longer than a minute? Was there no eye movement at all? What we found was interesting. When we had kids spin, some kids would have to alter their spinning so they would like almost shuffle around the circle slowly, some would lean their head onto their arm and follow their arm around, some kids were falling, other kids had really excessive eye movement, and some had no eye movement at all. When we tested their core strength, we used an OT assessment with standardized norms from 1984 (when I was a child) and compared that to the numbers we found. One out of every 12 children, when you combined the ability to have a normal balance response after spinning and their core strength, could meet both guidelines. It was not something we expected. They were not meeting the standards.
A few years ago at a conference, I remember one of the ladies came up to me and said "Do you know they are thinking of changing the standardized norms and what's normal for some of our standardized tests because a lot of these kids aren't able to meet the same strength requirements. We have an ethical dilemma. We are not sure if we should hold kids today to the same standards or if we should change them because most of the kids can't meet them." Kids are getting weaker too. This really intrigued me so we interviewed 10 teachers that had been around for at least 30 years. Were they seeing the same thing as occupational therapists were seeing? Were they seeing a rise of sensory and motor issues in the past 30 years? The teachers were from different states and did not know each other. The number one issue was decreased attention. One teacher indicated that in the early '80s she used to be able to teach the whole classroom with maybe only one or two kids having trouble paying attention. She said now, on a good day, at least eight out of her 26 kids have trouble paying attention and that she has actually had to change the way she teaches. She breaks them up into small groups and engages them into the task.
Some of the sensory and motor issues seen:
- Decreased attention
- Fidgeting
- Decreased strength
- Poor posture
- Decreased stamina
- Frail
- Falling
- Endless Colds
- Increased aggression
- Trouble reading
- Emotional
- Rise in anxiety
- Children not playing
Posture is another thing that has been coming up. Physical therapists are saying that they are seeing preadolescent posturing in an earlier age, a rounded curvature of the upper back. It makes sense to me because if their core is not quite where it should be and they are carrying around these heavy backpacks. We also have increased use of iPhones. This is bringing their head forward and adding to this type of posturing.
Teachers were also saying that kids were falling more in school than in years past. They were literally falling out of their seats and onto the ground. I did not believe it until I saw it myself when I was in a classroom observing. A kid fell out of his seat and the teacher said, "that is the third time today. Get back in your seat." Even a preschool teacher, who has been teaching for 40 years, said she cannot remember kids running into each other, the walls, or falling out of their seats in the past. Our local middle school actually put duct tape down the hallway at one point because the kids were running into each other. This is all very interesting and this will all make sense later when we talk about why this is happening.
