Playing Outside Decreases ADHD Risk for Kids

Vision and playing outside

Children playing outside limits ADHD risk

Research has confirmed that playing outside is beneficial to the health of a child. In fact, studies have shown that playing outside reduces the risk of Attention deficit/hyperactivity disorder (ADHD). Playing outside also significantly improves childhood vision – especially in children who are hyperactive.

ADHD and outside play

A study from the University of South Carolina found that hyperactive children played more than lower-active children outside, for example.

And a more recent study of 45,897 kids in the U.S. between 10 and 17 years old found that less sedentary activity and not only increases obesity, but also significantly increases the risk of attention deficit disorders among kids.

Do children play enough? Observational studies have shown that kids play far less than they used to. This is partly due to the plethora of online games and other gadgets. Funny how ADHD in kids has skyrocketed just as playing has plummeted.

Play reduces ADHD

A study from the University of Sydney has found that ADHD children significantly benefit from playing. The study found that social play and feedback training increased social skills of children diagnosed with attention-deficit hyperactivity disorder.

The study included 14 ADHD children who were between five years old and eleven years old, and 14 non-ADHD children. The study consisted of seven weekly play sessions. These involved the parents, the kids and their peers, and therapists. The free-play sessions were recorded by video tape, and played back with discussions afterword. Then peer-modeling was used.

The results were measured by gauging the social interactions between the children, and the closeness to normal social play. These tests were given before and after the video playback and modeling sessions. They found that social play among both the attention-deficit hyperactivity disorder kids and the non-ADHD kids significantly improved.

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The researchers concluded:

“Results support the use of play, video feed-forward/feedback techniques, therapist- and peer-modelling and parent involvement as an effective means to develop the social play skills of children with ADHD.”

In a 2011 study, attention-deficit hyperactivity disorder children had to each invite a non-ADHD child to participate in play-based activity. Dr. Reinie Cordier, one of the researchers in the study, commented about the ability of play-based intervention to help heal social problems:

“This is important because having a childhood friend is crucial to preventing the development of serious relationship issues, or even anti-social behaviour, in adulthood.”

The study was led by Professor Dr. Anita Bundy, and published in the Australian Occupational Therapy Journal. Dr. Bundy has led a number of studies that have illustrated the health and psychological benefits of play.

Dr. Bundy discussed some of the previous research on ADHD kids and play.

“In a previous study involving 350 children, we discovered that the play of children with ADHD differed from that of their peers.”

“Their study found children with ADHD had difficulty identifying the emotional states of their playmates and taking on their perspectives. Perhaps the biggest problem for children with ADHD is failing to respond to the cues their playmates are giving and to recognize when they may have gone too far. Thus play becomes disrupted,” she added.

About 8% of all U.S. children between four and 17 have now been diagnosed with ADHD. We reported recent studies showing that ADHD is associated with the western diet.

Playing outside helps vision

A review of eight studies has also found that children who play outside more have better vision. The review, presented by ophthalmologist Anthony Khawaja, MBBS at the 2011 annual meeting of the American Academy of Ophthalmology, included more than 10,000 kids. It showed that nearsightedness incidence was reduced by more outside playing.

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Those children who spent more time outside playing had an average of 13% less chance of developing nearsighted vision for every hour spent outside doing physical activity.

Nearsightedness, or myopia, is symptomized by far away objects becoming blurry and unfocused. A common sign is that a child will complain that the chalkboard at school, a movie screen or something else in the distance appears blurry. An abnormal cornea shape lies at the root of the issue, preventing the ability to focus well.

The review also revealed that nearsighted children were indoors an average of four hours more per week than their peers.

“Increasing children’s outdoor time could be a simple and cost-effective measure with important benefits for their vision and general health,” commented Khawaja.

Nearsightedness has been increasing over the last four decades, especially among wealthier countries, whose kids tend to that spend more time indoors and in front of computers. About 30% of U.S. children are nearsighted, and some Asian countries have myopia rates as high as 80%.

In a recent study not included in Khawaja’s review, half of 80 nearsighted children between seven and eleven years old changed their activity schedule for two years. They spent at least 14 hours a week outside playing and no more than 30 hours a week reading, watching television or being on the computer. After the two years, those kids who spent more time outdoors more had significantly less incidence of nearsightedness.

Playing outside is critical for health

Whatever the reason, playing outside has been a historical staple for children around the world. Decreased outdoor activity for children may impact more than just vision. Other research has found that playing outside increases immunity. Increased exposure to soil organisms and other microorganisms lowers the risk of infection.

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Researchers differ in their theories for the mechanisms involved with regard to ADHD and vision. Some believe that more time indoors means more television and computer games and less social interaction. Many also believe that outside play not only exercises the eyes, but increases healthy interactions with other kids.

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Another factor is that increased exposure to the sun’s radiation can increase vision health and exert a calming effect at the same time. This is due to the fact that the eyes are allowed to see a full spectrum of color around them when outside. Colors such as green and blue have been shown to have a calming effect, and can increase cognition.

We have also discussed how social play helps kids diagnosed with ADHD and how hatha yoga helps autism in kids.


Howie EK, Brown WH, Dowda M, McIver KL, Pate RR. Physical activity behaviours of highly active preschoolers. Pediatr Obes. 2013 Apr;8(2):142-9. doi: 10.1111/j.2047-6310.2012.00099.x.

Cook BG, Li D, Heinrich KM. Obesity, Physical Activity, and Sedentary Behavior of Youth With Learning Disabilities and ADHD. J Learn Disabil. 2014 Jan 21.

Jacobs KW, Suess JF. Effects of four psychological primary colors on anxiety state. Percept Mot Skills. 1975 Aug;41(1):207-10.

Wilkes S, Cordier R, Bundy A, Docking K, Munro N. A play-based intervention for children with ADHD: a pilot study. Aust Occup Ther J. 2011 Aug;58(4):231-40.

University of Sydney News. Managing ADHD Through Play


Case Adams, PhD

Case Adams has a Ph.D. in Natural Health Sciences, is a California Naturopath and is Board Certified as an Alternative Medicine Practitioner, with clinical experience and diplomas in Aromatherapy, Bach Flower Remedies, Blood Chemistry, Clinical Nutritional Counseling, Homeopathy and Colon Hydrotherapy. He has authored 27 books and numerous articles on print and online magazines. Contact: [email protected]

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