PLAY AND EXECUTIVE FUNCTION IN PRESCHOOL-AGED CHILDREN

M. Ramprasad^1,2, N. Srinivasan³, R. Rajesh⁴, J. Dimple⁴, S. Sruthi⁴

¹Gulf Medical University, Department of Physiotherapy, Ajman, United Arab Emirates, ²Ramakrishna Mission Vivekananda University, Faculty of Disability Management and Special Education, Coimbatore, India, ³Ramakrishna Mission Vivekananda University, Faculty of Disability Management and Special Education. Ramakrishna Mission Vidyalaya, Coimbatore, India, ⁴Srinivas University, Physiotherapy, Mangalore, India

Background: Play is the work of children, and underutilized area in developmental action-neuroscience. Executive Function (EF) is a collection of higher order mental functions - supervise and regulate cognition and behavior of the organism and governed by prefrontal or frontal cortices. Currently available executive function testing in preschoolers were table or static approaches similar to adults and the focus of this study was to examine physical activity or play based tasks to test EF in preschool children.

Purpose: 1. Develop and validate set of tasks or games mediated by play to assess executive function in pre-school children
2. Examine the relationship between executive function on play activity status of pre-school children.

Methods: Study design: Development and Validation of play tasks associated with executive function and factor analysis study. Focus group discussion and consensus were drawn by panel of experts, i.e, Psychologist, Sport physiotherapist, Physical educator, Kinder-garden teacher, Parent and Pediatric-physician and content validated 72 physical activity or play based tasks targeted to the components of EF, i.e., inhibition, mental flexibility and metacognition. PAQ-preschool version questionnaire scores was obtained after validation from 139 preschoolers. Inclusion criteria: Typically developing Indian children 4-6 yrs in preschools. Exclusion Criteria: Known ADHD,AUTISM, Any other known psychiatric disease and non-cooperation.

Results: Rotated factor matrix analysis, varimax with Kaiser normalization revealed 8 dimensions out of 42 level progressively difficult mental flexibility tasks, 5 for inhibition, 3 for meta cognitive play tasks out of 15 and 15 level tasks respectively with above 1 eigen values. Excellent internal consistency was found in the EF domains, with a Cronbach's alpha above 0.84. Correlational analysis found total PAQ scores was significantly positively correlated with GDPL (scores of goal directed persistence) of mental flexibility component of 4-5 years preschoolers (r = 0.375, p < 0.020). TPL (Time prioritization), MFL (mental flexibility tasks) and TML (Time management) have no correlation with PAQ scores. Play tasks for inhibition and meta cognition with PAQs scores were associated form low to moderate levels.

Conclusions: This is the first study attempted to establish and provided avenues to use play based physical activity to quantify executive functions in preschool children.

Implications: The set of valid, reliable play based activities used in this study, serve as a new pilot battery, i.e.,Executive function assessment – play mediated version battery and preliminary normative data trajectories for EF components were established. This novel play methods for testing EF may serve better compared to computer based stroop tests which are monotonous and stationary with the absence of 'potential interest in play' for preschoolers. This study expanded more avenues for physiotherapists in the area of pediatric mental health and physical activity.

Funding acknowledgements: Department of Science and Technology-Cognitive Science Initiative. Government of India

Keywords:
Executive function
Play
Pre-school children

Topics:
Paediatrics
Health promotion & wellbeing/healthy ageing/physical activity
Mental health

Did this work require ethics approval? Yes

Institution: Ramakrishna Mission Vivekananda University SRKV Post, Coimbatore, Tamil Nadu India

Committee: IRB

Ethics number: 2014/77/DSTCSI-RMVU