MONDAY, Jan. 26 (HealthDay News) -- As a pediatric resident in a hospital in Brooklyn, N.Y., Dr. Romina M. Barros sat in on a regular first-grade class at a local elementary school. Classes started at 8:30 in the morning, lasting till noon, with one 10-minute break during which children were not allowed to talk or move from their chairs.
"It was winter, and I thought maybe they didn't go outside because of the weather," said Barros, now an assistant professor of pediatrics at Albert Einstein College of Medicine and Montefiore Children's Hospital in New York City. "I had a headache."
In fact, the children always had one 10-minute break but were not allowed to talk and had to stay in their chairs. There was nowhere for the kids to go outside and play, the teacher explained.
Barros has now published a study in the February issue of Pediatrics documenting the value of recess: Children who have it during the day behave better in class.
"When we restructure our education system, we have to think that recess should be part of the education system, and if we have to get more help, we'll have to get more help," Barros said. "Even if we don't have space, if they could have 15 minutes indoors. Unstructured time, that's all that they need."
Children learn as much on breaks as they do in the traditional classroom, experimenting with creativity and imagination and learning how to interact socially.
"Conflict resolution is solved on the playground, not in the classroom," said Dr. Jane Ripperger-Suhler, an assistant professor of psychiatry and behavioral science and pediatrics at Texas A&M Health Science Center College of Medicine and a psychiatrist with Scott & White Mental Health Center, in Temple.
Recess is recommended at least once a day, for 20 or more minutes. Physical activity should also be part of this time. Most Asian elementary schools allow children a 10-minute break after every 40 minutes to 50 minutes of instruction, the authors stated.
Although it's unclear how much recess children in the United States are getting, some studies have documented a dramatic decrease, and this study reported that the No Child Left Behind Act of 2001 has resulted in less recess for many children.
"They started to find out that kids in the U.S. were not doing well compared to other countries and started penalizing schools when kids weren't passing the state test," Barros explained. "That's when schools [started to cut recess] not only because of space, but also because they wanted to put more in academics."
Barros and her colleagues looked at a national database of about 11,000 8- and 9-year-olds. Children had one of two levels of recess: none/minimal (1 to 15 minutes/day) or "some recess." The population was divided equally between boys and girls.
Kids with more recess behaved better in school, according to a teacher rating system.
The 30 percent of children who had no or only minimal breaks were more likely to be black, from households with lower incomes and lower education levels, to be living in the Northeast or South, and to be attending urban public school.
"The kids who are already disadvantaged in a number of different ways are getting further disadvantaged," said Ripperger-Suhler.
Almost two-thirds of this disadvantaged group had physical activity only twice a week or less, putting them at greater risk of becoming obese.
"Children are receiving less than the recommended time or opportunity to engage in physical activity each day and this is especially true for lower income, ethnic minorities," said Josh Langberg, an assistant professor of pediatrics for the Center for ADHD at Cincinnati Children's Hospital Medical Center. "There are some significant limitations of this study that make conclusions about the relationship about kids getting recess on their behavior difficult to make . . . this highlights the importance of further research evaluating does this indeed impact child behavior or does it impact learning."
Visit the International Play Association for more on recess for children and related issues.
SOURCES: Romina M. Barros, M.D., assistant professor, pediatrics, Albert Einstein College of Medicine and Montefiore Children's Hospital, New York City; Jane Ripperger-Suhler, M.D., assistant professor, psychiatry, behavioral science and pediatrics, Texas A&M Health Science Center College of Medicine, and psychiatrist, Scott & White Mental Health Center, Temple, Texas; Josh Langberg, Ph.D., assistant professor, pediatrics, University of Cincinnati College of Medicine, Center for ADHD, Cincinnati Children's Hospital Medical Center; February 2009, Pediatrics