Deliberate Play and Preparation Jointly Benefit Motor and Cognitive Development: Mediated and Moderated Effects

Abstract

In light of the interrelation between motor and cognitive development and the predictive value of the former for the latter, the secular decline observed in motor coordination ability as early as preschool urges identification of interventions that may jointly impact motor and cognitive efficiency. The aim of this study was twofold. It (1) explored the outcomes of enriched physical education (PE), centered on deliberate play and cognitively challenging variability of practice, on motor coordination and cognitive processing; (2) examined whether motor coordination outcomes mediate intervention effects on children's cognition, while controlling for moderation by lifestyle factors as outdoor play habits and weight status. Four hundred and sixty children aged 5-10 years participated in a 6-month group randomized intervention in PE, with or without playful coordinative and cognitive enrichment. The weight status and spontaneous outdoor play habits of children (parental report of outdoor play) were evaluated at baseline. Before and after the intervention, motor developmental level (Movement Assessment Battery for Children) was evaluated in all children, who were then assessed either with a test of working memory (Random Number Generation task), or with a test of attention (from the Cognitive Assessment System). Children assigned to the 'enriched' intervention showed more pronounced improvements in all motor coordination assessments (manual dexterity, ball skills, static/dynamic balance). The beneficial effect on ball skills was amplified by the level of spontaneous outdoor play and weight status. Among indices of executive function and attention, only that of inhibition showed a differential effect of intervention type. Moderated mediation showed that the better outcome of the enriched PE on ball skills mediated the better inhibition outcome, but only when the enrichment intervention was paralleled by a medium-to-high level of outdoor play. Results suggest that specifically tailored physical activity (PA) games provide a unique form of enrichment that impacts children's cognitive development through motor coordination improvement, particularly object control skills, which are linked to children's PA habits later in life. Outdoor play appears to offer the natural ground for the stimulation by designed PA games to take root in children's mind.

Keywords: body weight; children; enrichment; executive function; physical activity; spontaneous play; variability.

FIGURE 1

Study flow diagram for the group-randomized trial.

FIGURE 2

Ball skills (impairment score – the lower, the better, ±SD) before and after traditional or enriched PE types as a function of children’s weight status. ^∗p < 0.008; n.s., non-significant.

FIGURE 3

Ball skills (impairment score – the lower, the better, ±SD) before and after traditional or enriched PE types as a function of children’s spontaneous outdoor play habits at weekend. ^∗p < 0.008; n.s., non-significant.

FIGURE 4

Multiple mediation model: effects of PE intervention type on post-intervention inhibitory efficiency mediated by post-intervention level of ball (aiming and catching) skills. a, b, c: regression coefficients with (SE), p and CI (95%) values. c: total effect; a₁^∗b₁, a₂^∗b₂, a₃^∗b₃: indirect effects; c1: direct effect after accounting for mediators. R² values with/without mediators (in parentheses) and bootstrap CI (95%) for indirect effects are also reported.

FIGURE 5

Statistical model of moderated mediation: effects of PE intervention type on post-intervention inhibitory efficiency mediated by post-intervention level of ball (aiming and catching) skills. a, b, c: regression coefficients with (SE), p and CI (95%) values. c: total effect; c₁: direct effect after accounting for the conditional indirect effect of ball skills moderated by outdoor play. R² values with/without mediators (in parentheses) and bootstrap CI (95%) for indirect effects at low vs. high levels of the moderator are also reported.