Educational Research Paper proposal

Using

PHYSICAL

ACTIVITY MOTIONAL RECOVERY ^ After a Natural Disaster

ZACHARY WAHL-ALEXANDER OLEG A . SINELNIKOV

On April 27, 2011, a devastating seriesof tornadoes tore through southeastern UnitedStates, killing more than 300 people and causingover a billion dollars in damages (National Oceanic and Atmospheric Administration, 2012). Sixty-four

percent of the counties in the state of Alabama were directly af- fected by the severe weather. An EF4 tornado went through Tusca- loosa County causing over 50 dealths, 1,700 injuries, and in excess of 220 million dollars in damages in the city of Tuscaloosa alone (Katrandjian, 2011; Staff, 2012). Although the storm barely missed the heart of the University of Alabama campus, it did demolish more than 5,000 homes, nearly 13 percent of the city's total hous- ing inventory (Alabama Center for Real Estate, 2011). In addition, a number of local schools were partially or completely destroyed (Figure 1). For the new academic year starting in August of 2011, students from these schools were temporarily housed in other local schools that were spared by the tornado.

Common Emotional and Physical Responses to Natural Disasters After traumatic events, such as a natural disaster, children who are directly or indirectly affected by the event exhibit a number of in- tense emotional reactions. For example, shock and denial are typi- cal responses, especially shortly after an event (Myers, 1994). Most psychologists agree that both mechanisms (shock and denial) serve as normal protective reactions for individuals. However, after the initial shock wears off, a number of other responses typically occur: disbelief, fear, sadness, helplessness, and guilt (Myers).

The indications of traumatic stress are not just emotional; there are physical signs as well. It is imperative to understand these physical symptoms so they can be addressed. Physical responses to trauma and disaster can include trembling, shaking, heart pal- pitations, rapid breathing, stomach tightening or churning, feeling dizzy or faint, cold sweats, and racing thoughts (U.S. Department of Health and Human Services, n.d.). Even though these symptoms may seem unrelated, it is necessary to understand that they can be an individual response to traumatic events.

Physical activity has often been recommended as a strategy for reducing stress in children who are dealing with the aftermath of a traumatic event (Brown, 1991; Dunn, Trivedi, & O'Neal, 2001; McNamara, 2000). For example, Carson (2008) described a ser- vice-learning program that provided structured physical activity for 25 to 35 children after Hurricane Katrina in Louisiana. While

the stated goal of the program was to promote the importance of regular, lifelong physical activity among K-5 children, the program's anecdotal evidence of effectiveness included getting "the children moving, interacting, and, most important, smiling" (p. 22). This should not come as a surprise, since the well-known benefits of physical activity include increased self-confidence, which improves mood considerably (Barrios-Choplin, McCraty, & Cryer, 1997). In addition, exercise reduces children's heart rate and blood pressure reactivity to psychological stress (Roemmich, Lambiase, Salvy, & Horvath, 2009). Furthermore, a number of other somatic and psychological stress-relief strategies, which some physical edu- cators may not be aware of, can be integrated into a physical activity program.

The purpose of this article is to describe a physical activity pro- gram for elementary school students affected by a natural disaster. The goals of developing and implementing the curriculum for the program were to ( 1 ) reduce students' current stress and anxiety lev- els, (2) provide students with developmentally appropriate physical activity, (3) provide students with a platform for shared experiences, and (4) provide students with ways to cope with traumatic events.

Forty students (K-5) participated in the after-school program ad- ministered by the Department of Kinesiology at the University of Alabama. All participants were affected in some way by the April 27, 2011, tornadoes. Many students lost their homes, belongings, and toys, and some lost family and friends. The students attended an elementary school that was completely destroyed in the storm, and all classes had been moved to a neighboring school. The three- month curriculum conducted twice a week was carried out within the structure of an after-school program. A licensed psychologist who had an extensive background in responding to disastrous events provided initial training to all instructors.

The Road to Emotional Recovery The program included somatic stress reduction, psychological stress reduction, and art therapy techniques, as well as group-sharing ses- sions, all of which were integrated into developmentally appropri- ate physical activity. Somatic and physiological stress-reduction techniques were infused throughout each session, whereas the time

Zachary Wahl-Alexander ([email protected]) is a graduate student, and Oleg A. Sinelnikov ([email protected]) is an associate pro- fessor, in the Department of Kinesiology at the University of Alabama in Tuscaloosa, AL.

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Figure 1. Alberta Elementary School after the tornado

for group-sharing and art therapy sessions was specifically allocated between periods of physical activity. For example, a session that be- gan with deep-breathing exercises may have concluded with muscle relaxation and positive self-talk. The actual structure of each ses- sion consisted of the initial period of physical activity (20 min.), followed by a group-sharing or art therapy session (20 min.), and 20 more minutes of physical activity. Since this article focuses on the psychological and somatic techniques of reducing stress that some physical educators may not be familiar with, only a brief descrip- tion of the physical activity component of the program will be pre- sented. The developmentally appropriate physical-activity compo- nent followed NASPE (2004) guidelines, with most of the content dedicated to soccer-related activities. A comprehensive description of the psychological, somatic, and physiological techniques used during programming is also presented below.

Physical Activity. A developmentally appropriate soccer curricu- lum was created as the foundation for the physical activity aspect of the recovery program. Invasion games, like soccer, have been shown to promote high physical activity and motivation levels in children (Gao, Xiang, Lee, & Kosma, 2011). In this case, the choice of ac- tivity was based on student interest, availabihty of equipment and space, and the pedagogical content knowledge of the instructors. Previously, soccer has also been successfully used as a lifetime activ- ity for K-5 students after a natural disaster (Garson, 2008). While the focus of the physical activity portion of the program was on the basic skills and tactics of soccer, it also included rhythmic activities and cooperative games.

All sessions consisted of two separate periods of physical ac- tivity, each lasting 20 minutes. During the first period, students typically participated in an instant activity followed by a skill- acquisition or tactical segment, in which instructors focused on developing various techniques and solving tactical problems. Another 20-minute period of physical activity always followed the segment in which the children participated in one of the

two stress-reduction techniques that will be described in the next section.

Small-sided (3 vs. 3, or 2 vs. 2) modified games were generally played during the second physical-activity period of the day. Modi- fications included, but were not limited to, modifying the size of the field, the size of the goals, scoring criteria, and ball in-and-out of-play rules. For example, to encourage changing the direction of attack during one particular modified game, a team could choose to score into either of the two small goals positioned on the end line, close to sidelines, instead of one centrally located goal on the end hne. These games were modified to provide students with more op- portunities for success and appropriate difficulty levels.

During the initial games, instructors concentrated on explaining the basic rules during actual gameplay. As the program progressed, instructors focused more on assisting with tactics using indirect teaching styles while the children participated in the games.

In between the two physical-activity periods, students participated in stress-reduction and art therapy sessions. These sessions generally lasted about 20 to 25 minutes, though all activities focused more on accomplishing specific tasks rather than on adhering to time con- straints. These tasks included positive self-talk, deep breathing, mus- cle relaxation, art therapy, and group-sharing sessions.

Positive Self-Talk. Self-talk consists of statements said to oneself and not addressed to others (Hardy, 2006). These statements could be said out loud or mentally. While self-talk can be positive, nega- tive, or neutral, positive self-talk is the most beneficial. For example, positive self-talk is the most frequently reported cognitive coping strategy for children in stressful situations (Brown, O'Keeffe, Sand- ers, & Baker, 1986). Self-talk, as a basic psychological skill, is also frequently used in athletic contexts (Tod, Hardy, & Oliver, 2011).

When using self-talk in the program, at first the concept was explained and then a number of scripted positive self-talk exam- ples were provided. The complexity of the script depended on the children's cognitive and maturity levels. Initially, the instructors

24 VOLUME 84 NUMBER 4 APRIL 2 0 1 3

provided scripted self-talk statements and phrases that students re- peated in chorus. Later, students were encouraged to create their own statements in addition to those provided hy the instructors. Tahle 1 shows samples of scripted, positive self-talk statements and their purposes, in addition to some that were created hy individual students. Instructors purposefully created tasks that required stu- dents to use positive self-talk. For example, hefore a student could perform a complex or new technical skill (e.g., roll hack in soccer), he or she would use positive self-talk (e.g., "I can do this"). If stu- dents showed signs of frustration or stress during the lesson, they were also encouraged to use positive self-talk phrases. Tahle 2 pro- vides a sample instructional progression of how positive self-talk was incorporated into the lessons.

In addition to using positive self-talk aloud, students were prompted to use it mentally. Students were provided opportunities for mental or verhal self-talk at different times throughout the les- son. After initial explanations and training, most of these opportu- nities required only a few seconds and did not detract from the flow of the lesson. Students seemed to enjoy positive self-talk, and once they realized that it was a safe and acceptahle practice, they started to use it more frequently and without prompts.

Deep Breathing and Muscle Relaxation. These were chosen as the primary physiological stress-reducing techniques (Lehrer, Wool- folk, & Sime, 2007). Deep breathing and muscle relaxation are fairly simple to use and do not require much time to implement even though they provide noticeable benefits. At first, instructors allocated a specific time in a lesson during which deep hreathing and muscle relaxation were intentionally and specifically taught. It is best to use a script for deep-hreathing and muscle-relaxation ex- ercises. Instructors described and demonstrated deep hreathing and muscle relaxation and had students follow their lead.

For deep breathing, the students lay or sat down in a comfort- able position, putting one hand over their stomach and one hand on their chest. This particular hand placement helped younger students focus on and hetter control their hreathing patterns. An appropri- ate breathing sequence was encouraged (e.g., hreathe in through the nose, out through the mouth; breathe deep, expand chest). A sample instructional sequence for incorporating deep breathing appears in Table 3. As the sessions progressed, students were able to perform each technique hy themselves and with little assistance from the instructors.

Art Therapy and Group-Sharing Sessions. Through drawing and painting, art therapy has been shown to diminish trauma symp- toms and anxiety in children and adults (Cohen, Barnes, & Rankin, 1995). Often, verbally discussing a traumatic event can be difficult for a child. Consequently, approaches that do not focus on verhal recollection of traumatic memories, like art therapy, can be impor- tant in the recovery process. In the program, students were given the opportunity to express their feehngs, emotions, and fears during art therapy sessions, which were held every other lesson.

Students were given a drawing pad, a choice of drawing media (different colored crayons, markers, and pencils), and ample time to complete each drawing. Different prompts and instructions were used for each session. The key element of instruction was to create a safe environment in which all students felt comfortahle to draw, share their drawings with the group if they chose to, and develop healthy ways to tolerate stress through creativity. A sample student drawing expressing emotions appears in Figure 2. In the program, instructors initiated each art therapy session with an intended out- come designed to focus student creativity. The intended outcomes for drawings were based on Cohen and colleagues' (1995) recom- mendations for developing hasic tools for managing distress. These

outcomes, prompts, and instructions included establishing a safe place, creating a protective environment, providing sensory relief, and creating a support net. Each session was intended to allow stu- dents to express artistically their feelings and emotions with regard to the traumatic events and to create psychological mechanisms for managing stress. An example of a student's depiction of establishing a safe place appears in Figure 3.

Program Effectiveness Although a formal evaluation of the program has yet to be com- pleted, it has undoubtedly been successful in providing students with developmentally appropriate soccer instruction and stress-re- duction techniques. Through ohservations of not only the practice sessions, hut of the gameplay, it was evident that students' skill lev- els improved. Students were also seen making better tactical choices during gameplay. While learning was important, the most satisfying moments of the program were those in which students could be seen enjoying themselves during the sessions. The joy of movement, the joy of learning, and the joy of success were evident on students' faces throughout the program.

Furthermore, during group-sharing sessions at the conclusion of the program, children spoke about their positive experiences us- ing the stress-reduction techniques. In addition, on multiple occa- sions and without being prompted, children descrihed using deep breathing and positive self-talk at home and in school. One child expressed, "I like to use the positive self-talk right hefore my math tests. It helps calm me down and makes me feel more confident."

Additionally, some students shared stories about teaching friends and family members to use positive self-talk and deep breathing. While the evidence of program effectiveness is suhjective thus far.

Table 1 . Sample Positive Self-Talk Statements

Purpose Scripted Examples

Student-Created Examples

Self-confidence ' I know with time and effort I can accomplish anything.

' 1 can accomplish any task set out before me.

I am skilled in soccer.

Overcoming fear/doubt

Everything will be okay.

' I am smart, confident, and capable.

It's okay— just be positive.

Stress free • Everything will work out.

• 1 am always cool, calm, and understanding.

Everyone has a bad time, but this isn't my time.

Motivational I can do this. I am doing great.

Just smile.

Performance ' I can accomplish this task.

I can do the roll back—put my foot on top and roll the ball back.

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General Tasks

Table 2. Sample Instructional Sequence for Incorporating Positive Self-Talk

Verbal Teacher Script

Introduce and explain positive self-talk, and draw distinctions between mental or verbal self-talk.

"Positive self-talk is communication with yourself in a way that helps you get through tough times." "These are sayings that you can either say aloud or say in your head."

Explain the importance of positive self-talk.

"It may help you feel better and more relaxed, do certain things better, and give you more confidence.' "The more you do self-talk the better you may feel."

Provide examples of when to use positive self-falk.

"Positive self-talk can be used many times throughout the day. It can be used right when you wake up, and even while you brush your teeth or eat breakfast. You can use it if you are at school, with friends, or right before you go to sleep at night."

Give students examples. "For example, you can say 'Everything is going to work out' or 'I can do this!'"

Practice verbal self-talk: Choose a statement and have the group say it back chorally and by themselves.

"Now, repeat after me: 'Everything is going to work out.' 'I can do this.'" "Let's try it again, 'Everything is going to work out.' 'I can do this.'"

Change your voice, accentuate different words, and make it fun.

"Everything is going to work out." "I can do this." "Everything is going to work out." "I can do this."

Practice mental self-talk.

Have students create their own self-talk.

"Remember I told you before that you can repeat these sfafements mentally in addition to saying them aloud? Let's fry that now. You can choose any of the positive self-talk statements that you like, and repeat them in your head.

"You can also come up with your own sayings that you feel may help you. Choose one or two statements that you want to focus on. Remennber to be positive. Use it constantly, even in the worst situations. Add to them over time."

Closure "Anytime you get scared, worried, nervous, or stressed, you can use any of the positive statements. You can say fhem aloud or in your head. It is also okay to share your positive self-talk with friends and family, and explain fhat it makes you feel better."

General Tasks

Table 3. Sample Instructional Sequence for Incorporating Deep Breathing

Verbal Teacher Script

"Breathing and controlling your breathing can help calm you down when you are upset, stressed, scared, or angry. This is something you can control. You can breathe deeply almost anywhere and anytime you want."

"Everyone, gather around. Let's find an area in your own personal space where you can be comfortable. You can sit or lie down."

"Close your eyes. Relax. Begin to slow down your breathing. Make sure your eyes are comfortably closed. Breathe deeply. Listen to your breath."

Introduction

Find a comfortable position

Close eyes, slow breathing

Hand placement "Now, put one hand on your stomach and one on your chest and try taking slower, deep breaths. Can you feel yourself breathing? Feel your chest and stomach rise and fall."

Chest movement "Relax. Try to have your chest rise and fall with every breath. Then try the same with your stomach."

Deep breathing "Let's try to use both, chest and stomach. Have them rise and fall. Continue to breathe deeply for the next 30 seconds."

Closure "Let's breathe normally. Open your eyes. Anytime you get scared, worried, nervous, or stressed, you can use this breathing exercise. You can also share it with your friends and family."

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Figure 2. Student's drawing expressing emotions

(Note: Krispy Cream [sic] and Hobby Lobby are businesses that were

completely destroyed.)

Figure 3. Student's drawing depicting the home

as a safe place

JOPERD 27

the instructors believe the program's psychological benefits to stu- dents were even more important than the skill benefits from provid- ing quahty physical-activity instruction.

Conclusion The purpose of this article was to describe an after-school program that provided students with developmentally appropriate physical activity that was specifically designed to reduce their stress and anxi- ety levels and help them cope with traumatic experiences. It is impor- tant for all educators to understand children's common emotional and psychological responses to disastrous events.

While this program was conducted during after-school hours, any of its programmatic elements can be implemented in a regular physi- cal education class. It was administered by the University of Alabama graduate students and professors, but a physical educator could use a similar approach for teaching his or her physical education classes, specifically after traumatic events in the community. Additionally, teachers or parents could use the scripts in Tables 1,2, and 3 to incor- porate the deep-breathing and positive self-talk techniques into any class or after-school activity. However, before initiating a similar pro- gram, it is recommended that instructors receive appropriate training from a licensed psychologist who has a background in responding to disastrous events. It is also a good idea to discuss the programmatic elements and specific techniques with a school psychologist or social worker who might be available to provide additional support.

This article offers a variety of tools for teachers and parents to help the students' recovery process. These skills and tools are vital because, according to Centre for Research on the Epidemiology of Disasters (2012), over 20 million people in the United States have been affected by natural disasters from 2003 to 2012. The stress- reducing and coping techniques described here can be used after any stressful event in students' lives (e.g., parent divorce, family and/or friend illness or death). Common routines, such as going to school, doing homework, and completing academic tasks, can also provide a sense of normalcy for students. While some of the described techniques are easy to teach and do not require a large time commitment, it is important to allot sufficient time for their implementation. Teachers must create a nonthreatening and safe environment for students in order for these techniques to be benefi- cial. It is important to be supportive, allow students to talk freely, and encourage sharing.

A combination of somatic, physiological, and art therapy tech- niques in the program created a unique environment for students who were previously unseen in the physical activity settings. Al- though physical activity programs have been used successfully to. provide safe physical activity for children who were in need of regular exercise after a natural disaster (Carson, 2008), this program focused on improving students' well-being following a traumatic event by integrating stress-reducing techniques with physical activity.

While this article has not focused on the service-learning or physi- cal activity components, the importance of these aspects should not be underestimated. By providing elements that target basic psycho- logical and somatic coping skills in addition to developmentally ap- propriate physical activity, the overall effect of the physical education or after-school program can be increased.

Acknowledgment We would like to express our gratitude to all participants in the pro- gram, in particular to the graduate students from the Department

of Kinesiology at the University of Alabama who taught the pro- gram and to the children who participated in it. In addition, we would like to acknowledge Dr. Matthew Curtner-Smith for his help in starting the program as well as Dr. Mary Elizabeth Curtner-Smith for providing a traumatic recovery workshop to instructors.

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