Children and Youth Services Review 136 (2022) 106397

Contents lists available at ScienceDirect

Children and Youth Services Review

journal homepage: www.elsevier.com/locate/childyouth

Chinese preschool children’s physical fitness, motor competence, executive

functioning, and receptive language, math, and science performance
in Kindergarten
Yuju Chou a, Bi Ying Hu b, Adam Winsler c, Huiping Wu d, *, Jordan Greenburg c, Zhaowei Kong b
a
National Tsing Hua University, Taiwan
b
University of Macau, China
c
George Mason University, USA
d
Fujian Normal University, China

A B S T R A C T

This study aims to examine relations between Chinese preschoolers’ physical well-being (physical fitness and motor skills), executive functioning, and academic skills
(receptive language, math, and science skills) at the end of the Kindergarten year, the last year of preschool in the Chinese early childhood education system. A total
of 273 children (141 boys and 132 girls) from 30 preschools stratified by urbanicity were examined on physical fitness and motor skills at ages 4 to 5 years, and later
on receptive language, math, and science performance one year later before they exited the Kindergarten year. Findings first revealed a direct effect of physical fitness
on academic skills at the between-school level. Next the between-school indirect effect of physical fitness on academic skills and the within-school effect of motor
skills on academic skills, via executive functions, were found to be significant. Specifically, schools with better physical fitness had higher mean levels of executive
function which in turn related to higher mean levels of academic skills (the between variance reduction was 19.3%), and children with better motor skills had greater
executive functions and then gained more academic skills within a school (the within variance reduction was 4.1%). This study underscores the importance of
physical well-being on children’s outcomes at a critical transition point of schooling. Discussion on findings, the implications for practice and policy as well as the
limitations of this study were followed.

1. Introduction
Worldwide concern about physical health, physical activity levels,
and obesity in children is at an all-time high. The World Health Orga­
nization (WHO, 2017) reports that rates of obesity have tripled since
1975. In the U.S., one in three children are considered overweight
(Reinert et al., 2013), and one in five children are considered obese
(Pearce et al., 2018). The physical health and well-being of children in
rapidly developing nations such as China is also a serious concern (Liu,
2012). Relatedly, there are concerns regarding low levels of motor
competence among children, particularly those that have lower levels of
physical fitness (Hardy et al., 2013; Lopes et al., 2012; Luz et al., 2017).
As researchers explore the physical and mental health outcomes asso­
ciated with being overweight or obese in childhood, they have also
called for more studies to be conducted on links between physical and
motor fitness in early childhood and cognitive skills and academic per­
formance during the early school years (Biddle & Asare, 2011; Biddle
et al., 2019). In line with this call, the current study explores the rela­
tionship among preschool children’s physical well-being (including
physical fitness and motor competence), executive function skills, and
later academic achievement.
1.1. Motor competence and physical fitness as indicators of physical well-
being
Though distinct skill sets in childhood, both motor competence and
physical fitness may be important for children’s overall physical well-
being. For example, both physical fitness and motor competence have
been found to be associated with lower rates of obesity, cardiorespira­
tory fitness, and muscular strength (Lubans et al., 2010; Timmons et al.,
2012; Robinson et al., 2015). Previous research has found positive
correlations between motor competence and aspects of physical fitness
in children such as balance, coordination, speed, and agility (Haga,
2008; Luz et al., 2017). Such research suggests that both motor
competence and physical fitness can be considered indicators of chil­
dren’s physical well-being.

* Corresponding author at: College of Mathematics and Statistics, Fujian Normal University, University Town, Fuzhou, Fujian Province, People’s Republic of China.
E-mail address: hpwu168@163.com (H. Wu).

https://doi.org/10.1016/j.childyouth.2022.106397
Received 8 January 2021; Received in revised form 1 January 2022; Accepted 30 January 2022
Available online 3 February 2022
0190-7409/© 2022 Elsevier Ltd. All rights reserved.
Y. Chou et al.
1.2. Physical well-being and academic outcomes
1.2.1. Physical fitness
The connection between one’s physical fitness (which can be defined
as including cardiorespiratory fitness, muscular strength, coordination,
and body composition) and academic achievement has been a recent
focus of research (Castro-Piñero et al., 2010; Chu et al., 2016; Haapala,
2013; van der Niet et al., 2014). While some studies suggest there is a
direct link between physical fitness and academic achievement, others
find no such links. For example, past studies suggest that higher levels of
physical fitness are related to better academic performance in children
and adolescents ranging from age 7 to 18 (Davis & Cooper, 2011; Dwyer
et al., 2001; Van Dusen et al., 2011; Welk et al., 2010; Wittberg et al.,
2010). However, other studies find that physical well-being is not
related to better cognitive outcomes (Etnier et al., 2006; Kramer &
Erickson, 2007; van der Fels et al., 2015).
In terms of research supporting the link between physical fitness and
achievement, studies find that aerobic fitness (cardiovascular fitness),
which refers to the capacity to carry out intensive physical activities
(Chu et al., 2016), shows a relatively strong positive association with
academic achievement in both school-aged children and adolescents
(Castelli et al., 2007; Haapala, 2013; Lambourne et al., 2013; Ortega
et al., 2008; van der Niet et al., 2014). In younger preschool samples,
subjectively measured physical activity (parent questionnaires) has been
found to be positively associated with vocabulary development (Carson
et al., 2017). Though most prior research has examined cardiovascular
fitness in relation to cognitive functioning, it may be important to
consider other areas of physical fitness, such as muscular strength, in
relation to cognitive outcomes (Tsai et al., 2020). For example, better
muscular fitness has been found to be associated with cognitive per­
formance in children and academic performance in children and ado­
lescents (Coe et al., 2013; Tsai et al., 2020). Such measures (e.g., tennis
ball throw), which measures body strength and power, are included in
the present study.
1.2.2. Motor competence
Motor competence is another important component of physical well-
being, in addition to physical fitness. Motor competence refers to the
ability to perform a wide variety of motor skills (both gross and fine)
(Haga, 2008; Luz et al., 2017). Motor skills refer to learned sequences of
movements that are combined to produce smooth, efficient actions to
master a particular task (van der Fels et al., 2015). Motor skills are often
divided into fine motor and gross motor skills. Fine motor skills refer to
the coordination of small muscle movements reflected in activities such
as writing, playing an instrument, and drawing, while gross motor skills
refer to moving large muscle groups, moving the entire body in coor­
dinated ways (e.g., walking, running, jumping, throwing), and pos­
sessing balance and orientation/coordination (Burton & Rodgerson,
2001).
Fine motor skills, in particular, are suggested to be a good predictor
of academic achievement (Haapala, 2013; Murrah, 2010). According to
Haapala (2013), for preschoolers, fine motor skills are a more accurate
predictor of reading achievement and mathematics achievement than
gross motor skills. Further, Leonard and Hill (2014) reported a signifi­
cant relation between motor skills and children’s development of social
cognition, language, and social interactions. Given these results, Leo­
nard and Hill (2014) advocated for motor interventions designed for
children at risk for motor, language, and social skill development.
Despite these studies, some evidence suggests that motor skills may
not be directly related to cognitive development. In a systematic review
of the motor and cognitive skills literature, van der Fels et al. (2015)
concluded that there is insufficient evidence to claim a clear, direct
relationship between motor and cognitive skills among children ages
4–16 years old. Although some correlations between motor and cogni­
tive skills did show weak-to-strong links (e.g., fine motor skills, body
coordination), the researchers pointed out that such links are likely due
2
Children and Youth Services Review 136 (2022) 106397
to the higher cognitive demand associated with these subsets of fine
motor skills. This suggests that while motor skills in general may not be
strongly associated with cognitive function, those that rely on higher-
order cognitive skills may be important.
In summary, previous research has focused on examining relations
between physical fitness and academic skills, as well as relations be­
tween motor competence and academic skills, separately. However,
even when some evidence supports positive correlations for these vari­
ables, there is a general lack of clarity on the underlying mechanism that
governs such associations. Executive function skills have been proposed
as a potential mediator because of their positive association with motor
skills, fitness, and academic performance. However, this rarely has been
tested (Schmidt et al., 2017). An aim of the current study is to test
whether executive functions (EFs) mediate the relationship between
components of physical well-being and academic skills.
1.3. Physical well-being and executive functions
1.3.1. Physical fitness
EFs are defined as a set of cognitive operations involving working
memory, inhibitory control (including selective attention and inhibition
of inappropriate or interfering responses), and mental flexibility (Dia­
mond, 2012). Past research often finds positive associations between
aerobic fitness and EFs (Castelli et al., 2007; Lambourne et al., 2013),
though this is not always the case (Diamond & Ling, 2016). Haapala’s
(2013) systematic review with children up to 13 years of age reveals that
higher cardiorespiratory fitness is associated with better inhibitory
control in tasks requiring rigorous attention allocation. Similarly,
Drollette and colleagues (2014) found a single, acute bout of moderate
aerobic exercise improved cognitive performance of preadolescent
children, and that the effect was greater for those with lower inhibitory
control ability. In other words, children with the lowest impulse control
benefit the most from acute physical exercise. Though most research on
physical fitness and EFs examine cardiorespiratory fitness specifically,
some research suggests that muscular fitness (measured by crunch curl-
ups, standing long jump, standing on one leg with eyes closed, sit-and-
reach, and BMI) were associated with children’s cognitive processing
(Tsai et al., 2020). This suggests that research should consider additional
measures of physical fitness as they relate to such abilities. These types
of physical fitness indicators are included in the present study.
Additional recent work has also examined the link between physical
activity and EFs in specifically early childhood. The results from these
studies have been mixed. McNeill et al. (2018, 2020) found that objec­
tively measured vigorous physical activity (measured using accel­
erometry) was associated with working memory and set shifting
performance in preschool. However, another study using accelerometry
with preschool children found no associations between physical activity
and working memory or response inhibition (Carson et al., 2017).
The correlation between physical fitness and EF is often attributed to
the enhanced and more rigorous physical activities present for those
who are fit (Best, 2010; Diamond, 2012). That is, doing exercise in­
creases cerebral blood flow among some brain regions (both short- and
long-term) which are important to functions such as attention, memory,
and learning (Best et al., 2009; Etnier et al., 1997). Several studies have
supported this hypothesis —researchers find that physical activities
enhance children’s attentional process (Spitzer & Hollmann, 2013;
Syväoja et al., 2014), planning (van der Niet et al., 2014) and inhibitory
control (Castelli et al., 2007; Chaddock-Heyman et al., 2013; Syväoja
et al., 2014).
It is important to note that some researchers find that not all types of
physical activities are linked to EF. Diamond and Ling (2016) conducted
a comprehensive review of interventions, programs, and approaches for
improving EFs, and identified 18 studies that examined acute effects of
physical activity programs on EFs. They concluded that “mindless”
physical activities like simple aerobic exercise that just increases heart
rate and blood flow (although still beneficial for cardiovascular health)
Y. Chou et al.
often show no effect on increasing EFs in individuals of various ages
(Angevaren et al., 2008; Fabre et al., 2002; Smiley-Oyen et al., 2008).
Instead, it is only physical activity that also involves a cognitive
component or mindfulness that is more robustly linked to improved EFs
(Best, 2010; Diamond & Ling, 2016; Moreau & Conway, 2013; Tom­
porowski et al., 2015). That is, in order to gain EF benefits, aerobic
exercise or physical activity may need to be cognitively challenging,
involve some reflection and/or focus on the body during the motor ac­
tivity, and be something of interest and enjoyment to the participant.
1.3.2. Motor competence
Links between motor competence and EF also have been found for
children ages 5 to 10 years, mainly due to the shared underlying
mechanisms of planning, sequencing, and monitoring that are linked to
the growth of the cerebellum (Diamond, 2000). Research on children
ages 6 to 15 years shows that both fine and gross motor skills are
significantly positively correlated with attention, working memory, and
cognitive control (Piek et al., 2004). Moreover, research with both
typically and atypically developing children has found correlations be­
tween motor skills and EFs (Ziereis & Jansen, 2015).
1.4. Executive functions and academic outcomes
It is widely believed that enhancements in EF promote student aca­
demic achievement (Best et al., 2009; Blair & Razza, 2007, Bull et al.,
2008; Etnier & Chang, 2009; van der Sluis et al., 2007). Response
planning and cognitive flexibility are two foundational components of
EF that underpin relations between EF and academic outcomes and
adaptive behavior (Carson et al., 2016). Response planning refers to
many cognitive components, such as working memory and response
inhibition (van der Niet et al., 2014). These skills are critical to goal-
oriented behavior that enable children to revise and evaluate their
behavior in different environments (Best et al., 2009). Tests that mea­
sure response planning often ask children to plan multiple processes in
advance and evaluate their plans while performing actions (Best et al.,
2009). Therefore, response planning ability is likely to be a foundation
for mathematics which largely involves multiple-step problem solving
(Sikora et al., 2002).
Likewise, cognitive flexibility, which is crucial for switching among
tasks, has been shown to influence reading (Van der Sluis et al., 2007)
and math (Bull et al., 2008). According to Arbuthnott and Frank (2000),
inhibitory control is required for successful task shifting, and is impor­
tant in environments where the target of attention changes. Both
response planning and cognitive flexibility are associated with chil­
dren’s academic achievement, especially mathematics and reading (Best
et al, 2011; van der Niet et al., 2014).
1.5. The path from physical well-being to academic outcomes via
executive functioning
While significant associations have been shown between children’s
physical well-being and academic outcomes, the underlying mechanism
through which improvements in physical fitness and motor skill are
related to social and cognitive outcomes remains unclear (Van der Niet
et al., 2015). The pathway from physical fitness and motor competence
to cognitive outcomes seems to be complex and most likely influenced
by mediators (Howie & Pate, 2012). Several models have been proposed
to explore the path between the two components. Howie and Pate
(2012) hypothesized a model to illustrate how physical activity affects
academic achievement through cognition. This model suggests that
physical activity would affect children’s cognition, which includes
components such as EF and attention. Though Howie and Pate (2012)
note that no definitive mechanisms for this relationship have been
identified, they hypothesize that physical activity may affect processes
such as hippocampal neurogenesis which improves brain function.
Progress in cognition could improve academic achievement in terms of
3
Children and Youth Services Review 136 (2022) 106397
standardized test results; however, this model has yet to be tested.
More recently, Becker et al. (2014) investigated relations between
physical activity, self-regulation, and early academic achievement. Re­
sults indicated that in terms of a direct effect, active play did not predict
emergent literacy and math. However, in the form of an indirect effect,
active play exerted effects on emergent literacy and math achievement
through its impact on self-regulation. In other words, more active play
was related to stronger self-regulation which then contributed to
stronger math and emergent literacy development. Our study tested a
similar model, using EF as a potential mediator of the relationship be­
tween physical well-being (motor competence and physical fitness) and
academic achievement. Our study also assessed a wider domain of ac­
ademic achievement (math, science, and language, compared to only
reading and math).
Finally, Schmidt et al. (2017) tested the mediating role of executive
functioning (updating, inhibiting, and shifting) in the association be­
tween motor ability (cardiovascular endurance, muscular strength,
motor coordination) and academic achievement (math, reading, and
spelling). While all three different motor abilities were positively and
directly linked to children’s academic achievements, EF only mediated
the relationship between motor coordination and achievement (not
cardiovascular endurance and muscular strength). Schmidt et al. (2017)
argue that these results suggest EF may be the mechanism that links
physical activity to academic achievement. Like Schmidt et al. (2017),
we examined EF as a potential mediator between motor competence/
physical fitness and academic outcomes in a younger sample.
Studies are needed to examine the potential mediational role of EFs
in the association between both motor competence and physical activ­
ities and academic achievement, using a longitudinal design and
powerful statistical analyses to explore possible causal relations. Much
of the previous research examining relationships among physical well-
being and achievement have been cross-sectional, making it difficult
to determine directionality (Haapala et al., 2020). As such, the use of a
longitudinal design in the present study is an important step for better
understanding the relationships among the constructs of interest. It is
likely that, at least in younger children, longitudinal analyses will pro­
vide better indicators of the developmental trajectories involved among
physical fitness, EFs, and academic achievement. As indicated above,
cross-sectional research does not always find associations between
physical fitness and achievement in younger samples. It is possible that
physical activity may not be concurrently associated with achievement,
but rather promotes skills (e.g., EF, self-regulation, working memory)
that are related with achievement in the longer-term (Becker et al.,
2014). Becker et al. (2014) hypothesize that the self-regulatory skills
promoted by physical activity in the preschool years might be related to
achievement in later years as children are exposed to new academic
challenges and rely on EF skills. Such a hypothesis informs our model,
which examines the relationship between physical fitness and associa­
tions with academic achievement one year later while EF skills are
developing.
1.6. Cultural context
Cultural context is important to consider when examining EF,
physical activity, and achievement. In a departure from most of the
previous research on physical activity, EF, and cognitive skills being
conducted in the U.S. or other Western countries, here we examine re­
lations between these constructs in China. There are important practices
in the Chinese education system that may be relevant to the constructs
considered here. Due to concerns about children’s health, the Chinese
government recently put forward learning and development guidelines
in 2012 for children ages 3–6 that attach importance to outdoor sports
activities. Such attention to outdoor activities is particularly important
for promoting children’s physical fitness and motor development. When
weather conditions permit, most preschools arrange about two hours of
outdoor sports activities every day, in which teachers organize children
Y. Chou et al.
to carry out various sports activities (Hu et al., 2014; Hu et al., 2015).
Chinese parents have also paid more attention to children’s physical
health and encouraged children to participate in more sports activities in
recent years (Hu et al., 2021; Liu, 2012). Such focus on physical activity
is also likely helpful for children to improve their executive function
(Lambourne et al., 2013; McNeill et al., 2018).
Examining constructs such as EF in the Chinese context is also
interesting given possible cultural influences. Previous research suggests
that Chinese children exhibit stronger EF skills compared U.S. children
and grow faster in these skills during their preschool years (Grabell
et al., 2015; Schmitt et al., 2018). Part of these differences are thought to
stem from culture—in typical Chinese preschools, children are taught to
sit still and listen to teachers’ lecture in a group setting for long periods
of time since they are three years old (Hu, 2015). In general, these skills
are thought to be more valued and emphasized in Chinese classrooms
compared to U.S. classrooms (Lan et al., 2009), and children begin
practicing these skills at earlier ages than children in Western cultures
(Chen et al., 1998). It is anticipated that this didactic collectivist
teaching style may have an impact on children’s developing EFs (Hu
et al., 2017).
1.7. The present study
Though some scholars have explored relations between physical
well-being, EFs, and academic achievement in children (Carson et al.,
2016; van der Niet et al., 2014), often only two of these three constructs
(EF, physical/motor activity, or achievement) are included. Several re­
searchers, however, suggest the need to examine potential mediational
links between physical fitness and/or motor development and children’s
academic outcomes, with EF possibly serving as a mediator between the
physical fitness-academic outcomes link (Becker et al., 2014; Howie &
Pate, 2012; Schmidt et al., 2017). Further, few studies have examined
relationships among these constructs in early childhood. Rather, many
studies explore these relationships in later elementary school or
adolescence. The present study aims to fill these gaps by examining
relations between physical well-being (physical fitness and motor
competence), EF, and achievement all in one study among preschool
children. Further, we explore EF as a potential mediator of the rela­
tionship between physical well-being and academic outcomes.
Using a sample of preschool children in the Guangdong province of
China, the current study examines these relations at the end of the
“Kindergarten” year. Kindergarten is the last year of preschool education
(age 5–6) in the Chinese early childhood education system. To examine
relations between physical well-being, EF, and academic outcomes, we
explore the following research questions:
1. What is the association between components of physical well-
being (physical fitness and motor competence) and academic
achievement?
Given that the literature generally shows positive links between
motor development and academic achievement, we hypothesized that
physical fitness and motor competence will be positively and signifi­
cantly associated with academic achievement.
2. Are children’s levels of physical well-being associated with their
EFs?
Based on previous research finding positive associations between
some forms of physical activity and EFs (Liu-Ambrose et al., 2010; Smith
et al., 2010; Spitzer & Hollmann, 2013; van der Niet et al., 2014), we
hypothesized that higher levels of physical fitness and motor compe­
tence would be positively associated with EFs.
3. Are EFs associated with academic achievement?
We expected that EFs would be significantly related to academic
achievement based on previous research findings (Best et al., 2009; Blair
& Razza, 2007, Bull et al., 2008; Etnier & Chang, 2009; van der Sluis
et al., 2007).
4. Does EF mediate the association between components of physical
well-being and academic outcomes?
4
Children and Youth Services Review 136 (2022) 106397
Similar to previous literature (Becker et al., 2014; Howie & Pate,
2012; Schmidt et al., 2017), we hypothesized that EF would partially
mediate the pathway from physical fitness and motor competence to
academic performance as children exit preschool using a novel sample of
preschool children in China.
2. Method
2.1. Participants
Data came from a larger longitudinal project investigating the
development of Chinese children (Hu et al., 2020). Participants were
preschool children recruited from Guangdong province by stratified
random sampling. Guangdong is the most populous province in China
and represents China’s recent rapid socioeconomic development. The
present study included two phases: baseline and follow-up. Baseline data
were collected in May of 2015 (Time 1, T1), and a one-year follow-up
took place in May of 2016 (Time 2, T2) when participants were in their
Kindergarten year. The sample was comprised of 273 children (141 boys
and 132 girls) ages 4 to 5 years at T1 (M = 4.62 years, SD = 0.49) from
30 preschools stratified by urbanicity (city/township vs. village). From
the school list provided by the local education agency, 11 preschools
were randomly selected from locations in cities/townships and 19 pre­
schools from rural villages. Within each preschool, one classroom was
randomly selected to participate in the project. In each target classroom,
8–10 children were randomly selected for direct assessment from the
classroom name list provided by the lead teacher.
2.2. Procedure
The present study went through rigorous IRB ethics review at the
first author’s institution (University of Macau: #MYRG20l5-00156-
FED). All procedures were in accordance with the 1964 Helsinki
declaration and its later amendments, and with APA ethical standards.
Preschool and parental consents and children’s assent were obtained.
Upon agreeing to participate, parents filled out the questionnaire
addressing family demographic information. The response rate for
parent questionnaires was high at 96%. One-on-one direct child as­
sessments were administered that included physical well-being (phys­
ical fitness and motor competence), EFs, and academic outcomes
(receptive vocabulary, math, and science). These academic outcome
assessments were conducted in preschools by research assistants (RAs)
who studied either early childhood education or educational psychol­
ogy, and they had all received rigorous training on the measures before
assessment. The training consisted of one day of intensive study of the
measures by a qualified trainer and passing a test on administration
procedures the following day of training. The well-being (physical
fitness and motor competence) tests were conducted in preschools by
RAs who studied Physical Education. The last author (researcher in
Sports Science) provided a rigorous two-day training to RAs including
passing a reliability test. Specifically, to pass the test to become a
qualified tester, each RA had to pass the threshold of 85% reliability
with the fifth author. Prior to the assessment, the RA initiated a casual
conversation with the child to build rapport. Each assessment took about
3 to 20 min depending on the task and child performance. Once a test
was completed, the child was given a 5-minute break. At the end of the
assessment, the child was given a picture book as a token of
appreciation.
2.3. Measures
Physical fitness. Physical fitness testing in preschool children was
measured at T1 by the Research on National Physical Fitness Surveil­
lance System in China. This test involved RAs taking children’s mea­
surements and noting their performance on various physical tasks
administered to them, included children’s height, weight, sitting body
Y. Chou et al.
flexion, and their performance on the following: standing long jump,
tennis ball throw length, both leg successive jumping, 10-meter run, and
the balance beam. According to reference tables supplied in the National
Physical Measurement Standards Manual (early childhood version;
General Administration of Sport of China, 2005), the raw score of each
item measured by the RAs was converted to a 5-point Likert scale score
in which a value of 1 denoted poor performance and a value of 5 re­
flected excellent performance. According to grading rules, items were
summed and divided into four grades: excellent (>31 points), good
(28–31 points), benchmark (20–27 points), and below benchmark (<20
points). In the present study, children’s average physical fitness level
was between benchmark and good (M = 27.11, SD = 4.17), and the
proportions for the four grades were 22.3%, 26.7%, 48.1% and 2.9%,
respectively. Given that the raw total score provided more information,
we used the summed scores instead of the grade scores in the analyses. It
is important to note that this measure of physical fitness varies from
those commonly included in previous studies as it is not simply a mea­
sure of aerobic fitness.
Motor competence. Children’s motor competence was measured at
T1 using the Movement Assessment Battery for Children – Second Edi­
tion (MABC-2; Henderson et al., 2007). The MABC-2 is designed to
identify and describe impairments in motor performance of children and
adolescents 3 through 16 years of age. This test has three components:
manual dexterity (3 items), aiming and catching (2 items), and balance
(3 items), which includes both fine and gross motor skills. The raw
performance score of each item was converted into a scaled score
ranging from 0 to 19. A higher total score on the MABC-2 indicates
better motor coordination ability. The validity of MABC-2 (age 3–6
years) in Chinese preschool children was reported to be good in terms of
content and construct validity based on a large survey conducted by Hua
et al. (2013).
Executive function (EF). Children’s executive function skills were
assessed at T2 using the Head-Toes-Knees-Shoulders task (HTKS;
McClelland et al., 2014). The task contains 30 items with three possible
answers: 0 = incorrect, 1 = self-correct, and 2 = correct. When children
were given the commands: “touch your head,” “touch your toes,” “touch
your shoulders,” or “touch your knees,” they were asked to do the
opposite (e.g., touch their heads when told to touch their toes). Before
the formal test, six practice trials were conducted but not included in the
scoring. During this task, children are required to integrate different
aspects of EF (i.e., working memory, inhibitory control, and cognitive
flexibility). The 30 items are divided into 3 sections, and each section
contains 10 items. If children got 4 points or above in the former section,
they would continue the task in the next section until the last section;
otherwise, the task stopped. In the present study, the Cronbach’s α for
this scale was 0.90.
Receptive vocabulary. Children’s receptive vocabulary was assessed
at both T1 and T2 using the Chinese Peabody Picture Vocabulary Test-R
(C-PPVT-R; Lu & Liu, 2005). Adapted from the PPVT-R (Dunn & Dunn,
1981), the C-PPVT-R consists of 125 items for assessing receptive lan­
guage for Chinese children between the ages of 3 and 12 (Lu & Liu,
2005). The test started at items matching the children’s chronological
age. During this task, children were shown a picture book with objects
on each page and asked to point to the one that matched the word
verbally presented by the tester. The C-PPVT-R has been widely used in
various studies because of its strong psychometric properties (Cheng
et al., 2009). In the present study, Cronbach’s α for this scale was 0.93 at
T1 and 0.97 at T2.
Mathematics achievement. Children’s math ability was assessed at
both T1 and T2 using the Test of Children Mathematics Achievement
(TCMA; Xie, 2014). The TCMA is a revised Chinese version of the Test of
Early Mathematics Ability (TEMA; Ginsburg & Baroody, 1990). The
TCMA consists of a total of 120 items, suitable for children ages 3 to 9.
This test assesses both informal mathematics knowledge (19 items) ac­
quired usually outside of formal schooling, and formal mathematics
knowledge (81 items) that often involves written symbols. For instance,
5
Children and Youth Services Review 136 (2022) 106397
in item 27 of the informal mathematics knowledge section, children are
asked to count the number of buttons on a page; in item 87 of the formal
mathematics knowledge section, children are asked to finish vertical
calculations on practice paper. There is evidence supporting the psy­
chometric properties of the TCMA in Chinese samples (Xie, 2014). In the
present study, Cronbach’s alpha was 0.88 at T1 and 0.96 at T2.
Science knowledge. Science knowledge was assessed at both T1 and
T2 using the Life Science Assessment (LiS) and Earth and Physical Sci­
ence Assessment (EPS) created by the MyTeachingPartner-Math/
Science research team (Kinzie et al., 2014). The LiS (22 items) tests
children’s understanding of the biological world, including living versus
non-living things, characteristics of plants and animals, human and
animal bodies, etc. The EPS (16 items) tests children’s understanding of
the earth and physical science, including scientific tools, weather,
temperature, material composition, and motion, etc. In the present
study, the Cronbach’s α for this scale was 0.86 at T1 and 0.83 at T2.
Family socio-economic status. In the family background survey,
multiple aspects of parent demographic information (father’s and
mother’s education level, income, and occupation) were collected at T1.
Specifically, educational level includes 7 categories ranging from “pri­
mary school” to “doctoral degree”; income was divided into 9 categories
ranging from “less than RMB 2,000 (equivalent to $300)” to “RMB
100,000 or more (equivalent to $15,017 or more)”; occupation was
coded into 5 categories ranging from “unemployment, job-waiting, part-
time job, or farmer” to “senior management personnel and senior pro­
fessional.” These indicators were transformed into z-scores and then
averaged to compute family socio-economic status (SES; Cohen et al.,
2006).
2.4. Data analysis
This study investigated relations between children’s physical well-
being (physical fitness and motor competence), EF, and academic out­
comes (receptive vocabulary, math, and science). Based on previous
studies, an integrative model with mediation analysis was proposed,
where physical well-being predicts academic outcomes through child
EF. In this study, we examined two physical well-being subscales in the
same model rather than two separate models to lower Type I error.
Though physical fitness and motor competence are both considered in­
dicators of physical well-being, they are treated separately in models. As
the three academic outcomes were highly correlated (correlation co­
efficients ranged from 0.48 to 0.75, ps < 0.001), we conducted explor­
atory factor analysis (EFA) and confirmatory factor analysis (CFA) based
on two-split subsamples to examine whether a single factor could be
formed to represent children’s overall academic skills.
Given the hierarchical data structure (children nested in schools),
hypotheses were tested with multilevel structural equation model
(MSEM; Rabe-Hesketh et al., 2012; Preacher et al., 2010). The MSEM
procedure partitions the variances of children observations into two
components, the between-school variances and within-school variances.
This ability offers more robust estimates of standard errors of parameters
than running a series of multilevel models (MLMs), especially in the
situations of testing the mediation hypotheses with nested data and
multiple outcomes (for detailed mathematical explanations and simu­
lation evidence, see Preacher et al., 2010).
More specifically, this model is referred to as a 1–1–1 design, where
predictors, mediators, and outcome variables are all measured at Level 1
(within-school level), but Level-1 units were nested within Level 2
(between-school level). To probe the sequence for how the variables
occur and to establish mediation, a longitudinal mediation model was
employed, depicted in Fig. 1 (a), with children’s physical well-being at
T1 as independent variables, academic outcomes at T2 as dependent
variables, and EF at T2 as the mediator. The demographic variables
(child’s age, gender, and family SES) and initial levels of academic
outcomes at T1 were included as control variables.
To test the multilevel mediation, we used the MSEM presented by
Y. Chou et al.
Fig. 1. Hypothesized 1–1–1 multilevel mediating model between children’s physical well-being (including fitness and motor competence), EF, and academic skills.
Note. Control variables: age, gender, family SES and the academic outcomes at T1.
Preacher et al. (2010), where we decompose the variance of Level 1 into
within and between components, thereby accounting for the potential
difference between relations at the child- and school-levels. As shown in
Fig. 1 (b), physical well-being variables (physical fitness, motor
competence), EF, and academic skills were decomposed into two com­
ponents (each of these components treated as a latent variable). To
ascertain the hypothesized indirect effects, we utilized a multivariate
extension of the product-of-coefficients strategy suggested by Preacher
and Hayes (2008). Specifically, the indirect effect was quantified as the
product of the mean Gibbs sample estimated of the regression
6
Children and Youth Services Review 136 (2022) 106397
coefficients. If the 95% credibility interval contains zero, the indirect
effect is significant and the mediation is established.
All analyses were implemented using SPSS 21.0 and Mplus 7.4
(Muthén & Muthén, 1998–2015). Given a small number of clusters (i.e.,
30 classrooms) in the present study, there existed a convergence prob­
lem and pseudo-significant effects caused by parameter and standard
error bias. We thus used Bayesian estimation instead of the default
maximum likelihood estimation to mitigate this situation (Depaoli &
Clifton, 2015). Without any previous knowledge on the parameters, the
noninformative prior distribution was specified using the default prior
Y. Chou et al. Children and Youth Services Review 136 (2022) 106397

settings available in Mplus. Under the Bayesian framework, an accept­
able model fit is expected to have a 95% confidence interval (CI) for the
difference in the chi-square statistic for the observed and simulated data
that contains zero, and a posterior predictive p-value (PPp) higher than
0.05 (Muthén & Asparouhov, 2012).
18.643], PPp = .452). In sum, we can conclude that the three indicators
of academic skills were valid and reliable, both at the within and be­
tween levels.
3.4. Testing for hypothesized mediation

3. Results Finally, we conducted the hypothesized mediation analysis using

3.1. Descriptive statistics
Means, standard deviations, and correlations among the study vari­
ables are presented in Table 1. The initial levels of academic outcomes
were positively associated with the one-year follow-up assessments. As
hypothesized, both physical fitness and motor competence correlated
positively to EF, receptive vocabulary, math, and science. Furthermore,
EF was positively and strongly correlated with all academic outcomes.
3.2. Validation of latent academic skills and aggregation at the school
level
Prior to estimating the full model, first, we assessed the validity of
the latent variables involved–academic skills at T1 and T2. The EFA
results suggested a dominant general factor explained 62.9% and 59.6%
of the total variance at T1 and T2, respectively. The CFA results provided
support for the applicability of the single-factor structure (T1: χ2/df =
1.758, CFI = 0.998, TLI = 0.986, RMSEA = 0.057, SRMR = 0.012; T2:
χ2/df = 2.662, CFI = 0.989, TLI = 0.973, RMSEA = 0.062, SRMR =
0.020). The standardized factor loadings ranged from 0.494 to 0.647.
To justify aggregation for school-level constructs based on
individual-level measures, we inspected the relative amount of variance
lying within- and between-schools by calculating the intra-class corre­
lation coefficient (ICC) of the manifest indicators. Cohen (1988) rec­
ommends that ICCs should be considered significant if >0.059. In this
study, the ICCs under the null models (without predictors and mediator)
were 0.50, 0.41, and 0.56 for receptive vocabulary, math, and science,
indicating the need for multilevel modeling. The ICCs for physical
fitness, motor competence, and EF were 0.18, 0.11, and 0.38 respec­
tively. These results substantiate the aggregation of measures at the
school level of analysis, and suggest that it is appropriate to use multi­
level modeling.
3.3. Model fit for a two-level CFA
Given the validation of multilevel model, we formulated a two-level
CFA for three indicators (receptive vocabulary, math and science)
measuring academic skills. The fit indices show that the model
accounted for the nested design and provided an appropriate description
of the data (maximum likelihood estimation, χ2/df = 4.919, CFI =
0.994, TLI = 0.981, RMSEA = 0.062, SRMRwithin = 0.064 and
SRMRbetween = 0.031; Bayesian estimation, 95% CI for Δχ2 = [− 17.015,
MSEM to investigate separate mediation effects at the within and be­
tween levels simultaneously. Table 2 shows results for total, direct, and
indirect relationships between physical well-being and academic skills.
We first discuss the results at the between-school level and then at the
within-school level.
At the between-school level, in terms of total effects, as hypothe­
sized, increased physical fitness at T1 was significantly associated with
increased average children’s academic skills (c1b = 3.095, p < 0.001) at
T2. This suggests schools with children with higher average levels of
physical fitness also had children with higher levels of academic skills. In
terms of hypothesized indirect effects, when the mediator, EF, was
included in the model (i.e., 1–1–1 MSEM), as predicted, increasing
physical fitness yielded higher EF (a1b = 3.221, p = .014), which in turn
predicted better children’s academic skills (bb = 0.443, p = .020). Other
indirect paths at the between-school level were nonsignificant. Results
of indirect effects of physical well-being on academic outcomes are
presented in the middle rows of Table 2. Average physical fitness at T1
had a positive and statistically significant indirect relationship with
average academic skills at T2 via EF (the product of coefficients a1b*bb
= 1.284, p = .033, 95% credibility interval = [0.079, 4.010]), after
controlling for initial academic skills at T1. The direct effect of physical
fitness on academic skills remained significant but was reduced (c1′ b =
1.706, p = .047). The proportional reduction in variance statistic is a
local effect size used in multilevel models (Peugh, 2010). Results showed
that the between variance decreased by 19.3% after adding the medi­
ator, EF, into the model.
In the context of notable school-level variance and in the presence of
significant between-school effects as reported above, and a small num­
ber of children nested within the same school, it is more difficult to find
significant within-school effects on top of the school-level effects.
Indeed, and contrary to our hypotheses, we did not find evidence of
direct associations between physical well-being and academic outcomes
(ps > 0.05), after controlling for initial levels at T1 at the child level
(within-child effects). This suggests that for individual children within
the same schools, greater physical well-being (either physical fitness or
motor competence) was not directly associated with increased academic
performance. In terms of indirect relationships, within schools,
increased child motor competence was associated with higher EF (a2w
= 0.246, p = .002), which was linked to better academic skills (bw =
0.127, p = .019). Using the product-of-coefficients approach, there was a
significant indirect effect of motor competence on academic skills
through EF (indirect effect a2w* bw = 0.029, p = .021, 95% credibility
interval = [0.011, 0.084]). Compared to the model without the

Table 1
Descriptive statistics and correlations for study variables (N = 273).
Mean SD 1 2 3 4 5 6 7 8 9 10 11

1. Physical fitness 27.11 4.17

2. Motor competence 83.26 11.13 0.27**
3. Executive function 45.20 14.95 0.19** 0.24**
4. Receptive vocabulary at T1 33.31 18.47 0.23** 0.14* 0.39**
5. Math at T1 26.26 12.73 0.19** 0.20** 0.47** 0.56**
6. Science at T1 67.48 15.05 0.26** 0.17** 0.45** 0.74** 0.56**
7. Receptive vocabulary at T2 53.60 23.29 0.26** 0.13* 0.42** 0.76** 0.54** 0.75**
8. Math at T2 42.49 14.45 0.24** 0.15* 0.52** 0.58** 0.78** 0.67** 0.55**
9. Science at T2 77.20 10.69 0.22** 0.07 0.45** 0.65** 0.43** 0.75** 0.69** 0.48**
10. Age 4.62 0.49 –0.14* –0.09 0.12 0.20** 0.27** 0.21** 0.17* 0.28** 0.13
11. Gender 0.48 0.50 –0.02 0.06 0.07 –0.01 –0.06 –0.01 –0.01 –0.04 0.02 –0.09
12. Family SES –0.01 0.75 0.08 –0.01 0.30** 0.59** 0.38** 0.51** 0.53** 0.37** 0.51** 0.14* –0.01

Notes. * p < .05, ** p < .01.

7
Y. Chou et al.
Table 2
Multilevel (mediation) models predicting academic skills from physical well-being via EF on between- and within-school levels.
Direct effect
Estimate Posterior S. 95% CI
D.
Between-school level
Physical fitness → Academic 1.706* 1.078 [0.062, 4.097]
outcome
Motor competence → Academic − 0.376 0.308 [− 1.005,
outcome 0.217]
Within-school level
Physical fitness → Academic 0.215 0.218 [− 0.188,
outcome 0.590]
Motor competence → Academic 0.025 0.068 [− 0.110,
outcome 0.161]
Notes. * p < 0.05, ** p < 0.01. EF = executive functioning (mediator). Control variables: age, gender, family SES and the academic outcomes at T1.
mediator, the proportional reduction in within-level variance was 4.1%.
In sum, EF partially mediated the positive relationships between
children’s physical fitness and academic skills at the between-school
level, and between motor skills and academic skills at the within-
school level. Schools with children with better physical fitness also
had higher levels of EF, which resulted in higher levels of academic
skills. Within schools, children with better motor skills had greater EF
leading to better academic skills.
4. Discussion
This is the first study to our knowledge to investigate relations be­
tween preschool children’s physical well-being (physical fitness and
motor competence), executive functioning, and academic outcomes in
kindergarten using a sample from China. This study makes contributions
to the literature in several ways. First, unlike most studies that tend to
examine the direct association between children’s physical fitness or
motor competence and children’s academic and cognitive outcomes
(Chu et al., 2016; Haapala, 2013; van der Niet et al., 2014), we examined
the indirect association between these variables through a potential
underlying mechanism of EF as a mediator. Second, unlike previous
studies that tend to exclusively examine either children’s physical fitness
or motor competence (van der Niet et al., 2014; van der Fels et al.,
2015), this study comprehensively examined physical well-being by
including both components. Moreover, we utilized a longitudinal design
to examine the direct and indirect effects of physical fitness and motor
competence on the academic outcomes of preschool children at the end
of the kindergarten year. Third, while most studies look at children’s
language and math as cognitive outcomes (Lambourne et al., 2013), we
also tested children’s science, which makes for a more comprehensive
assessment of cognitive development. These three outcomes were
examined as a diverse latent construct of achievement. Finally, we add
nuance to the literature with multi-level models that inform us about
both within- and between-school relations between these constructs,
something which has not been done before.
4.1. Associations among physical well-being, executive functions, and
academic outcomes
In partial support of our hypotheses, findings revealed associations
between child physical well-being, executive functioning, and academic
outcomes as hypothesized, and our multilevel models indicated that
relations differed somewhat at the between- and within-school levels. In
terms of direct links between physical fitness and academic outcomes, at
the between-school level, schools with higher average child physical
fitness at T1 also had children with greater academic achievement at T2.
Hypothesized indirect effects were found - at the between-school level,
initial child physical fitness was related to academic outcomes at T2, and
this was mediated through increased EF; and at the within-school level
Children and Youth Services Review 136 (2022) 106397
Indirect effect Total effect
Estimate Posterior S. 95% CI Estimate Posterior S. 95% CI
D. D.
1.284* 1.057 [0.079, 4.010] 3.095** 1.264 [0.897, 5.830]
0.152 0.261 [− 0.233, − 0.191 0.378 [− 0.933,
0.811] 0.570]
− 0.006 0.035 [− 0.083, 0.205 0.220 [− 0.206,
0.062] 0.592]
0.029* 0.021 [0.011, 0.084] 0.056 0.070 [− 0.076,
0.195]
(differences between children at the same school), motor competence
was linked to greater academic achievement, again mediated by EF. In
other words, those schools with stronger physical fitness had higher
student average levels of academic achievement partly because they had
greater average levels of EFs, and children within a school who had
higher motor competence performed better partly because they had
better EF abilities.
In summary, our findings underscore the importance of physical
fitness and motor competence on Chinese children’s academic learning
at a critical transition point of schooling. These findings suggest that
fostering children’s physical well-being in early childhood may support
them as they transition into formal schooling. Physical well-being could
be an important area to target during early childhood education—some
research suggests that even among young children, both sedentary
behavior and physical activity tend to be stable over time (Carson et al.,
2019). Given the potential for children’s increased well-being to be an
important factor in fostering later success by promoting children’s EFs,
targeting this developmental domain early may promote long-term
benefits. The focus on physical well-being in early childhood is partic­
ularly important considering the current cultural context. In China, the
focus on academic achievement and the structure of the early childhood
education system (e.g., large class sizes, limited outdoor space) may
limit children’s ability to engage in physical activity (Hu et al., 2014).
4.2. Links between physical fitness, motor competence, and academic
skills
We hypothesized that preschoolers’ physical fitness and motor
competence would be related to children’s academic readiness (recep­
tive language, mathematics, and science). However, this hypothesis did
not receive the strong support that we had anticipated. The results did
show that, when looking across schools, higher physical fitness skills
was associated with higher achievement outcomes. This finding aligns
with a growing body of research with young children conducted in Euro-
American settings (Castelli et al., 2007; Davis & Cooper, 2011; Haapala,
2013; Lambourne et al., 2013; Van Dusen et al., 2011; Welk et al., 2010;
Wittberg et al., 2010) and supports the notion of emphasizing movement
and fitness in early childhood education.
However, our findings did not support the hypothesis that young
Chinese children with higher motor competence had better performance
on academics than those with lower motor competence. This finding
contrasts with other work that does find such relationships (Murrah,
2010). One possible reason for this lack of consistency was that our
measure of motor competence did not distinguish between fine motor
skills and gross motor skills. Previous literature suggests that fine motor
skills are more closely linked to academic achievement compared to
gross motor skills (Carlson et al., 2013), and our combined measure may
mask these effects. Nevertheless, as described above, our findings indi­
cate that a mechanism might exist such that EF mediates the association
8
Y. Chou et al.
between motor competence and academic achievement. This indirect
link supports recent findings in the literature (Schmidt et al., 2017).
4.3. The role of EF in academic differences associated with physical well-
being
The present study also showed that Chinese children’s EF ability is
related to varying levels of physical fitness at the between-school level
and motor competence at the within-school level. This finding corrob­
orates evidence from a growing body of research showing that EFs are
closely related to physical fitness (Castelli et al., 2007; Lambourne et al.,
2013) and motor competence at an early age (Hartman et al., 2010; Piek
et al., 2004; Ziereis & Jansen, 2015). Researchers have pointed out that
when children have better physical fitness and motor skills, they tend to
engage in more physical activity, which helps to improve EFs (Best,
2010). Doing exercise increases cerebral blood flow among some brain
regions in the short- or long- term which are important to EF skills,
including increased working memory performance, planning ability,
and inhibitory control (Best et al., 2009; Etnier et al., 1997). It is
important to note here that the movements involved in our measures of
motor competence and physical activity were not particularly mindful
and did not require much cognitive engagement, which is theorized to
be an important variable in understanding relations between fitness and
EF (Diamond & Ling, 2016). Thus, we show such links being present
even when the activities involved were fairly mindless (albeit during
assessment, not during a physical fitness intervention which was the
focus of Diamond and Ling).
Partially in line with our hypothesis, we found that physical fitness
and motor competence-related differences in academic achievement
were mediated by EF. This finding adds to evidence from recent cross-
sectional studies (Schmidt et al., 2017; Van der Niet et al., 2014). Spe­
cifically, behavioral regulation has been shown to be a partial mediator
for physical fitness-related disparities in academic achievement, and
physical fitness has a direct effect on academic achievement (van der
Niet et al., 2014). Together, these studies underscore the importance of
more fundamental child-level mechanisms of EF in explaining the gap in
academic outcomes at the exit point of kindergarten linked to physical
fitness in the prior preschool year. Physical fitness and motor compe­
tence are important to children’s EF (Castelli et al., 2007; Etnier et al.,
1997), and early regulatory abilities are foundational for learning in
academic domains, especially in math and science (Gelman & Brenne­
man, 2004; McClelland et al., 2014; Nayfeld et al., 2013; Ponitz et al.,
2009). Our longitudinal work here is in line with Becker et al. (2014)
who hypothesized that self-regulatory skills promoted by physical ac­
tivity in earlier preschool would be related to achievement in later years,
because when children are exposed to new, more academic challenges
later on, they have to rely on their EF skills, skills that are enhanced by
earlier exercise and skills that are still developing in early childhood. As
we know, EF consists of many crucial elements, such as response plan­
ning and cognitive flexibility, and these are considered foundational for
many academic tasks, especially mathematics (Bull et al., 2008; Sikora
et al., 2002) and reading (Van der Sluis et al., 2007). It is, thus, not
surprising that those with low physical fitness and motor competence
showed early disadvantage in academic achievement at the critical
transition to schooling.
Another potential explanation for the link between motor compe­
tence, EF and achievement is EF’s relationship to fine motor skills.
Though we did not examine fine motor skills specifically, evidence
suggests that fine motor skills, particularly those that require visual-
spatial integration (e.g., copying a figure), are strongly related to
math achievement (Pitchford et al., 2016). Further, fine motor skills are
thought to be theoretically linked to EF skills, and EF is increasingly
being considered an important mediator in relations between fine motor
skills in particular and achievement (Sulik et al., 2018).
9
Children and Youth Services Review 136 (2022) 106397
5. Limitations and future directions
This study has several limitations. First, although we used a repre­
sentative sample of Chinese preschool children in the southeastern
Guangdong province, caution must be taken when generalizing findings
to contexts outside of Guangdong. Future studies should focus on
replicating the current study in other provinces especially in areas rep­
resenting different levels of socioeconomic development (e.g., regions in
middle and western China), and in other countries. Second, although we
used a longitudinal design (children’s physical fitness and motor
development in preschool and outcome data the following year), it is
still a correlational study which does not allow us to draw causal con­
clusions. Indeed, it is possible that the direction of causality also goes
from EF to physical fitness; however, we were not able to test that
alternative possibility because physical fitness and motor development
were only measured at T1. Future studies should examine potential
bidirectional associations.
Third, although this study underscores the importance of physical
well-being and behavioral regulation to children’s early academics,
there are other child-level mechanisms, such as approaches to learning
and social skills, that might mediate the effect of physical well-being on
children’s academic skills. Also, it is suggested that researchers should
follow up on children through primary school to examine the long-term
effects of physical well-being on children’s later academic outcomes.
Fourth, the use of a single measure of EF is another limitation of the
study. Further studies should investigate the effects of several measures
of EF, especially since relations between physical fitness, EFs, and aca­
demic outcomes appear to be specific and only found for certain mea­
sures, activities, and outcomes (Diamond & Ling, 2016; Schmidt et al.,
2017). Last, researchers should investigate ways to improve children’s
physical fitness and motor competence in light of early childhood edu­
cation curriculum reform in China (Hu et al., 2017). For example, what
constitutes an adequate level of physical activity and culturally sensitive
physical activities interventions for Chinese preschool classrooms?
Answering research questions such as these will provide significant
implications for practice and promoting optimal child development.
6. Implications
This study provides important implications for early childhood ed­
ucation policy and practice. In China, parents often prioritize academic
achievement for young children at the expense of promoting children’s
interest in exploring and physical play (Hu et al., 2014). Physical well­
ness cannot be enhanced without spending quality time playing and
exercising both outdoors and indoors. It is essential that young children
have time to engage in physical activities, such as running vigorously,
sliding, climbing, jumping, and playing with balls, which are crucial to
healthy physical development (Bento & Dias, 2017). Our findings urge
parents to place more emphasis on children’s physical well-being by
encouraging them to spend more time involved in a variety of sports and
physical activity.
In relation to early childhood education practice, the current situa­
tion is not optimistic in terms of environments and curricula for
fostering children’s physical well-being. Research shows poor to medi­
ocre outdoor environments in Chinese ECE settings due to lack of sta­
tionary and portable equipment that can stimulate a variety of skills (Hu
et al., 2014). This problem is intensified because of the large class size
within most Chinese preschools, which means that children have to take
turns using outdoor equipment like swings, slides, and ball games, which
leads to less overall vigorous physical activity (Hu et al., 2014). The fact
that we found direct effects between fitness and child academic out­
comes specifically at the between-school level reinforces the notion that
school-level policies and support for child physical fitness and well-
being matter for child outcomes.
Moreover, due to the curriculum features of Chinese preschools,
which prioritize time for academic learning in whole-group teaching
Y. Chou et al.
formats, children have limited access to both indoor and outdoor
physical activities (Hu et al., 2014). Even when time is assured for
physical activities, children often have to passively wait for a turn or
they are required to engage in whole group activities rather than
choosing to play freely. As we know, children get the most out of
physical activities when they can choose what to play and how to play
independently (Bento & Dias, 2017). This study highlights the impor­
tance of children’s motor development and physical fitness for academic
performance.
Funding information
The research was supported by the project “The Effects of Preschool
Program Quality on Children’s Mid- to Long-term Learning and Devel­
opment Outcomes: A Follow-up Three-year Longitudinal Study” (Uni­
versity of Macau Multi-Year Research Grant; MYRG20l8-00024-FED).
Also, this work was partially supported by the Natural Science Foun­
dation of Fujian Province of China (No. 2021J01657) and the Program
for Probability and Statistics: Theory and Application (No. IRTL1704) to
the fourth author.
CRediT authorship contribution statement
Yuju Chou: Conceptualization, Validation. Bi Ying Hu: Conceptu­
alization, Project administration, Supervision. Adam Winsler: Writing –
original draft, Writing – review & editing. Huiping Wu: Methodology,
Formal analysis, Writing – original draft. Jordan Greenburg: Writing –
original draft. Zhaowei Kong: Investigation, Data curation.
Declaration of Competing Interest
The authors declare that they have no known competing financial
interests or personal relationships that could have appeared to influence
the work reported in this paper.
Acknowledgements
The authors of this article deeply appreciate the support given by the
University of Macau. The research was supported by the project “The
Effects of Preschool Program Quality on Children’s Mid- to Long-term
Learning and Development Outcomes: A Follow-up Three-year Longi­
tudinal Study” (University of Macau Multi-Year Research Grant;
MYRG20l8-00024-FED). Also, this work was partially supported by the
Natural Science Foundation of Fujian Province of China (No.
2021J01657) and the Program for Probability and Statistics: Theory and
Application (No. IRTL1704) to the fourth author.
References
Angevaren, M., Aufdemkampe, G., Verhaar, H. J. J., Aleman, A., & Vanhees, L. (2008).
Physical activity and enhanced fitness to improve cognitive function in older people
without known cognitive impairment. The Cochrane Database of Systematic Reviews,
3, CD005381. https://doi.org/10.1002/14651858.CD005381.pub3
Arbuthnott, K., & Frank, J. (2000). Trail making test, part B as a measure of executive
control: Validation using a set-switching paradigm. Journal of Clinical and
Experimental Neuropsychology, 22(4), 518–528. https://doi.org/10.1076/1380-3395
(200008)22:4;1-0;FT518
Becker, D. R., McClelland, M. M., Loprinzi, P., & Trost, S. G. (2014). Physical activity,
self-regulation, and early academic achievement in preschool children. Early
Education and Development, 25(1), 56–70. https://doi.org/10.1080/
10409289.2013.780505
Bento, G., & Dias, G. (2017). The importance of outdoor play for young children’s
healthy development. Porto Biomedical Journal, 2(5), 157–160. https://doi.org/
10.1016/j.pbj.2017.03.003
Best, J. R. (2010). Effects of physical activity on children’s executive function:
Contributions of experimental research on aerobic exercise. Developmental Review, 30
(4), 331–351. https://doi.org/10.1016/j.dr.2010.08.001
Best, J. R., Miller, P. H., & Jones, L. L. (2009). Executive functions after age 5: Changes
and correlates. Developmental Review, 29(3), 180–200. https://doi.org/10.1016/j.
dr.2009.05.002
10
Children and Youth Services Review 136 (2022) 106397
Best, J. R., Miller, P. H., & Naglieri, J. A. (2011). Relations between executive function
and academic achievement from ages 5 to 17 in a large, representative national
sample. Learning and Individual Differences, 21(4), 327–336. https://doi.org/
10.1016/j.lindif.2011.01.007
Biddle, S. J. H., & Asare, M. (2011). Physical activity and mental health in children and
adolescents: A review of reviews. British Journal of Sports Medicine, 45(11), 886–895.
https://doi.org/10.1136/bjsports-2011-090185
Biddle, S., Ciaccioni, S., Thomas, G., & Vergeer, I. (2019). Physical activity and mental
health in children and adolescents: An updated review of reviews and an analysis of
causality. Psychology of Sport and Exercise, 42, 146–155. https://doi.org/10.1016/j.
psychsport.2018.08.011
Blair, C., & Razza, R. P. (2007). Relating effortful control, executive function, and false
belief understanding to emerging math and literacy ability in kindergarten. Child
Development, 78(2), 647–663. https://doi.org/10.1111/j.1467-8624.2007.01019.x
Bull, R., Espy, K. A., & Wiebe, S. A. (2008). Short-term memory, working memory, and
executive functioning in preschoolers: Longitudinal predictors of mathematical
achievement at age 7 years. Developmental Neuropsychology, 33(3), 205–228. https://
doi.org/10.1080/87565640801982312
Burton, A. W., & Rodgerson, R. W. (2001). New perspectives on the assessment of
movement skills and motor abilities. Adapted Physical Activity Quarterly, 18(4),
347–365. https://doi.org/10.1123/apaq.18.4.347
Carlson, A. G., Rowe, E., & Curby, T. W. (2013). Disentangling fine motor skills’ relations
to academic achievement: The relative contributions of visual-spatial integration and
visual-motor coordination. The Journal of Genetic Psychology, 174(5–6), 514–533.
https://doi.org/10.1080/00221325.2012.717122
Carson, V., Hunter, S., Kuzik, N., Wiebe, S. A., Spence, J. C., Friedman, A., … Hinkley, T.
(2016). Systematic review of physical activity and cognitive development in early
childhood. Journal of Science and Medicine in Sport, 19(7), 573–578. https://doi.org/
10.1016/j.jsams.2015.07.011
Carson, V., Lee, E.-Y., Hesketh, K. D., Hunter, S., Kuzik, N., Predy, M., Rhodes, R. E.,
Rinaldi, C. M., Spence, J. C., & Hinkley, T. (2019). Physical activity and sedentary
behavior across three time-points and associations with social skills in early
childhood. BMC Public Health, 19(1), 27. https://doi.org/10.1186/s12889-018-
6381-x
Carson, V., Rahman, A. A., & Wiebe, S. A. (2017). Associations of subjectively and
objectively measured sedentary behavior and physical activity with cognitive
development in the early years. Mental Health and Physical Activity, 13, 1–8. https://
doi.org/10.1016/j.mhpa.2017.05.003
Castelli, D. M., Hillman, C. H., Buck, S. M., & Erwin, H. E. (2007). Physical fitness and
academic achievement in third-and fifth-grade students. Journal of Sport and Exercise
Psychology, 29(2), 239–252. https://doi.org/10.1123/jsep.29.2.239
Castro-Piñero, J., Artero, E. G., España-Romero, V., Ortega, F. B., Sjöström, M., Suni, J.,
& Ruiz, J. R. (2010). Criterion-related validity of field-based fitness tests in youth: A
systematic review. British Journal of Sports Medicine, 44(13), 934–943. https://doi.
org/10.1136/bjsm.2009.058321
Chaddock-Heyman, L., Erickson, K. I., Voss, M., Knecht, A., Pontifex, M. B., Castelli, D.,
… Kramer, A. (2013). The effects of physical activity on functional MRI activation
associated with cognitive control in children: A randomized controlled intervention.
Frontiers in Human Neuroscience, 7(11), 72. https://doi.org/10.3389/
fnhum.2013.00072
Chen, X., Hastings, P. D., Rubin, K. H., Chen, H., Cen, G., & Stewart, S. L. (1998). Child-
rearing attitudes and behavioral inhibition in Chinese and Canadian toddlers: A
cross-cultural study. Developmental Psychology, 34, 677–686. https://doi.org/
10.1037/0012-1649.34.4.677
Cheng, H.-C., Chen, H.-Y., Tsai, C.-L., Chen, Y.-J., & Cherng, R.-J. (2009). Comorbidity of
motor and language impairments in preschool children of Taiwan. Research in
Developmental Disabilities, 30(5), 1054–1061. https://doi.org/10.1016/j.
ridd.2009.02.008
Chu, C.-H., Chen, F.-T., Pontifex, M. B., Sun, Y., & Chang, Y.-K. (2016). Health-related
physical fitness, academic achievement, and neuroelectric measures in children and
adolescents. International Journal of Sport and Exercise Psychology, 1–16. https://doi.
org/10.1080/1612197X.2016.1223420
Coe, D. P., Peterson, T., Blair, C., Schutten, M. C., & Peddie, H. (2013). Physical fitness,
academic achievement, and socioeconomic status in school-aged youth. Journal of
School Health, 83(7), 500–507. https://doi.org/10.1111/josh.12058
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Erlbaum.
Cohen, S., Doyle, W. J., & Baum, A. (2006). Socioeconomic status is associated with
stress hormones. Psychosomatic Medicine, 68(3), 414–420. https://doi.org/10.1097/
01.psy.0000221236.37158.b9
Davis, C. L., & Cooper, S. (2011). Fitness, fatness, cognition, behavior, and academic
achievement among overweight children: Do cross-sectional associations correspond
to exercise trial outcomes? Preventive Medicine, 52, S65–S69. https://doi.org/
10.1016/j.ypmed.2011.01.020
Depaoli, S., & Clifton, J. P. (2015). A Bayesian approach to multilevel structural equation
modeling with continuous and dichotomous outcomes. Structural Equation Modeling:
A Multidisciplinary Journal, 22(3), 327–351. https://doi.org/10.1080/
10705511.2014.937849
Diamond, A. (2000). Close interrelation of motor development and cognitive
development and of the cerebellum and prefrontal cortex. Child Development, 71(1),
44–56. https://doi.org/10.1111/1467-8624.00117
Diamond, A. (2012). Activities and programs that improve children’s executive
functions. Current Directions in Psychological Science, 21(5), 335–341. https://doi.
org/10.1177/0963721412453722
Diamond, A., & Ling, D. S. (2016). Conclusions about interventions, programs, and
approaches for improving executive functions that appear justified and those that,
Y. Chou et al.
despite much hype, do not. Developmental Cognitive Neuroscience, 18, 34–48. https://
doi.org/10.1016/j.dcn.2015.11.005
Dunn, L. M., & Dunn, L. M. (1981). Manual for the Peabody Picture Vocabulary Test-
Revised. Circle Pines, MN: American Guidance Service.
Dwyer, T., Sallis, J. F., Blizzard, L., Lazarus, R., & Dean, K. (2001). Relation of academic
performance to physical activity and fitness in children. Pediatric Exercise Science, 13
(3), 225–237. https://doi.org/10.1123/pes.13.3.225
Etnier, J. L., & Chang, Y.-K. (2009). The effect of physical activity on executive function:
A brief commentary on definitions, measurement issues, and the current state of the
literature. Journal of Sport and Exercise Psychology, 31(4), 469–483. https://doi.org/
10.1123/jsep.31.4.469
Etnier, J. L., Nowell, P. M., Landers, D. M., & Sibley, B. A. (2006). A meta-regression to
examine the relationship between aerobic fitness and cognitive performance. Brain
Research Reviews, 52(1), 119–130. https://doi.org/10.1016/j.
brainresrev.2006.01.002
Etnier, J. L., Salazar, W., Landers, D. M., Petruzzello, S. J., Han, M., & Nowell, P. (1997).
The influence of physical fitness and exercise upon cognitive functioning: A meta-
analysis. Journal of Sport and Exercise Psychology, 19(3), 249–277. https://doi.org/
10.1123/jsep.19.3.249
Fabre, C., Chamari, K., Mucci, P., Massé-Biron, J., & Préfaut, C. (2002). Improvement of
cognitive function by mental and/or individualized aerobic training in healthy
elderly subjects. International Journal of Sports Medicine, 23(6), 415–421. https://doi.
org/10.1055/s-2002-33735
Gelman, R., & Brenneman, K. (2004). Science learning pathways for young children.
Early Childhood Research Quarterly, 19(1), 150–158. https://doi.org/10.1016/j.
ecresq.2004.01.009
General Administration of Sport of China. (2005). 国民体质测定标准手册 (幼儿部分)
[National Physical Measurement Standards Manual (early childhood version)]. Beijing,
China: Peoples Sports Publishing.
Ginsburg, H. P., & Baroody, A. J. (1990). Test of Early Mathematics Ability: Examiner’s
manual. Austin, TX: Pro-Ed.
Grabell, A.S., Olson, S.L., Miller, A.L., Kessler, D.A., Felt, B., Kaciroti, N.,...Tardif, T.
(2015). The impact of culture on physiological processes of emotion regulation: A
comparison of US and Chinese preschoolers. Developmental Science, 18, 420–435. doi:
10.1111/desc.12227.
Haapala, E. A. (2013). Cardiorespiratory fitness and motor skills in relation to cognition
and academic performance in children: A Review. Journal of Human Kinetics, 36(1),
55–68. https://doi.org/10.2478/hukin-2013-0006
Haapala, E. A., Haapala, H. L., Syväoja, H., Tammelin, T. H., Finni, T., & Kiuru, N.
(2020). Longitudinal associations of physical activity and pubertal development with
academic achievement in adolescents. Journal of Sport and Health Science, 9(3),
265–273. https://doi.org/10.1016/j.jshs.2019.07.003
Haga, M. (2008). The relationship between physical fitness and motor competence in
children. Child: Care, Health & Development, 34(3), 329–334. https://doi.org/
10.1111/j.1365-2214.2008.00814.x
Hardy, L. L., Barnett, L., Espinel, P., & Okely, A. D. (2013). Thirteen-year trends in child
and adolescent fundamental movement skills: 1997–2010. Medicine and Science in
Sports and Exercise, 45(10), 1965–1970. https://doi.org/10.1249/
MSS.0b013e318295a9fc
Hartman, E., Houwen, S., Scherder, E., & Visscher, C. (2010). On the relationship
between motor performance and executive functioning in children with intellectual
disabilities: Motor and executive functioning in children with ID. Journal of
Intellectual Disability Research, 54(5), 468–477. https://doi.org/10.1111/j.1365-
2788.2010.01284.x
Henderson, S. E., Sugden, D. A., & Barnett, A. L. (2007). Movement Assessment Battery for
Children-2. London. UK: Harcourt Assessment.
Howie, E. K., & Pate, R. R. (2012). Physical activity and academic achievement in
children: A historical perspective. Journal of Sport and Health Science, 1(3), 160–169.
https://doi.org/10.1016/j.jshs.2012.09.003
Hu, B. Y. (2015). Comparing cultural differences in two quality measures in Chinese
kindergartens: The early childhood environment rating scale-revised and the
kindergarten quality rating system. Compare: A Journal of Comparative and
International Education, 45(1), 94–117. https://doi.org/10.1080/
03057925.2013.841468
Hu, B. Y., Kong, Z., & Roberts, S. K. (2014). The policies and practice of preschoolers’
outdoor play: A Chinese perspective on greeting the millennium. Childhood
Education, 90(3), 202–211. https://doi.org/10.1080/00094056.2014.910378
Hu, B. Y., Li, K., De Marco, A., & Chen, Y. (2015). Examining the quality of outdoor play
in Chinese kindergartens. International Journal of Early Childhood, 47(1), 53–77.
https://doi.org/10.1007/s13158-014-0114-9
Hu, B. Y., Quebec Fuentes, S., Ma, J., Ye, F., & Roberts, S. K. (2017). An examination of
the implementation of mathematics lessons in a Chinese kindergarten classroom in
the setting of standards reform. Journal of Research in Childhood Education, 31(1),
53–70. https://doi.org/10.1080/02568543.2016.1244581
Hu, B. Y., Teo, T., Nie, Y., & Wu, Z. (2017). Classroom quality and Chinese preschool
children’s approaches to learning. Learning and Individual Differences, 54, 51–59.
https://doi.org/10.1016/j.lindif.2017.01.007
Hu, B. Y., Wu, H., Winsler, A., Fan, X., & Song, Z. (2020). Parent migration and rural
preschool children’s early academic and social skill trajectories in China: Are ‘left-
behind’ children really left behind? Early Childhood Research Quarterly, 51, 317–328.
https://doi.org/10.1016/j.ecresq.2019.12.011
Hu, B. Y., Wu, Z., & Kong, Z. (2021). Family physical activities choice, parental views of
physical activities, and Chinese preschool children’s physical fitness and motor
development. Early Childhood Education Journal, 1–13. https://doi.org/10.1007/
s10643-021-01190-5
11
Children and Youth Services Review 136 (2022) 106397
Hua, J., Gu, G., Meng, W., & Wu, Z. (2013). Age band 1 of the movement assessment
battery for children-second edition: Exploring its usefulness in mainland China.
Research in Developmental Disabilities, 34(2), 801–808. https://doi.org/10.1016/j.
ridd.2012.10.012
Kinzie, M. B., Whittaker, J. V., Williford, A. P., DeCoster, J., McGuire, P., Lee, Y., &
Kilday, C. R. (2014). MyTeachingPartner-Math/Science pre-kindergarten curricula
and teacher supports: Associations with children’s mathematics and science
learning. Early Childhood Research Quarterly, 29(4), 586–599. https://doi.org/
10.1016/j.ecresq.2014.06.007
Kramer, A. F., & Erickson, K. I. (2007). Capitalizing on cortical plasticity: Influence of
physical activity on cognition and brain function. Trends in Cognitive Sciences, 11(8),
342–348. https://doi.org/10.1016/j.tics.2007.06.009
Lambourne, K., Hansen, D. M., Szabo, A. N., Lee, J., Herrmann, S. D., & Donnelly, J. E.
(2013). Indirect and direct relations between aerobic fitness, physical activity, and
academic achievement in elementary school students. Mental Health and Physical
Activity, 6(3), 165–171. https://doi.org/10.1016/j.mhpa.2013.06.002
Lan, X., Ponitz, C. C., Miller, K. F., Li, S., Cortina, K., Perry, M., & Fang, G. (2009).
Keeping their attention: Classroom practices associated with behavioral engagement
in first grade mathematics classes in China and the United States. Early Childhood
Research Quarterly, 24, 198–211. https://doi.org/10.1016/j.ecresq.2009.03.002
Leonard, H. C., & Hill, E. L. (2014). The impact of motor development on typical and
atypical social cognition and language: A systematic review. Child and Adolescent
Mental Health, 19(3), 163–170. https://doi.org/10.1111/camh.12055
Liu, Y. T. (2012). 2000–2010年我国3～6岁幼儿体质动态变化的研究 [Dynamic changes
of physiques of Chinese 3–6 year-old preschoolers from 2000 to 2010]. Shandong
Sports Science & Technology, 34(6), 88–92. https://doi.org/10.3969/j.issn.1009-
9840.2012.06.021
Liu-Ambrose, T., Nagamatsu, L. S., Graf, P., Beattie, B. L., Ashe, M. C., & Handy, T. C.
(2010). Resistance training and executive functions: A 12-month randomized
controlled trial. Archives of Internal Medicine, 170(2), 170–178. https://doi.org/
10.1001/archinternmed.2009.494
Lopes, V. P., Stodden, D. F., Bianchi, M. M., Maia, J. A. R., & Rodrigues, L. P. (2012).
Correlation between BMI and motor coordination in children. Journal of Science and
Medicine in Sport, 15(1), 38–43. https://doi.org/10.1016/j.jsams.2011.07.005
Lu, L., & Liu, H. (2005). 修订毕保德图画词汇测验 [Peabody Picture Vocabulary Test –
revised manual]. Taipei, Taiwan: Psychological Publishing.
Lubans, D. R., Morgan, P. J., Cliff, D. P., Barnett, L. M., & Okely, A. D. (2010).
Fundamental movement skills in children and adolescents: Review of associated
health benefits. Sports Medicine (Auckland, N.Z.), 40(12), 1019–1035. https://doi.
org/10.2165/11536850-000000000-00000
Luz, C., Rodrigues, L. P., Meester, A. D., & Cordovil, R. (2017). The relationship between
motor competence and health-related fitness in children and adolescents. PLoS ONE,
12(6), Article e0179993. https://doi.org/10.1371/journal.pone.0179993
McClelland, M. M., Cameron, C. E., Duncan, R., Bowles, R. P., Acock, A. C., Miao, A., &
Pratt, M. E. (2014). Predictors of early growth in academic achievement: The Head-
Toes-Knees-Shoulders task. Frontiers in Psychology, 5, 1–14. https://doi.org/
10.3389/fpsyg.2014.00599
McNeill, J., Howard, S. J., Vella, S. A., & Cliff, D. P. (2020). Longitudinal associations of
physical activity and modified organized sport participation with executive function
and psychosocial health in preschoolers. Journal of Sports Sciences, 38(24),
2858–2865. https://doi.org/10.1080/02640414.2020.1803037
McNeill, J., Howard, S. J., Vella, S. A., Santos, R., & Cliff, D. P. (2018). Physical activity
and modified organized sport among preschool children: Associations with cognitive
and psychosocial health. Mental Health and Physical Activity, 15, 45–52. https://doi.
org/10.1016/j.mhpa.2018.07.001
Moreau, D., & Conway, A. R. A. (2013). Cognitive enhancement: A comparative review of
computerized and athletic training programs. International Review of Sport and
Exercise Psychology, 6(1), 155–183. https://doi.org/10.1080/
1750984X.2012.758763
Murrah, W. M. (2010). Comparing Self-Regulatory and Early Academic Skills as Predictors of
Later Math, Reading, and Science Elementary School Achievement. Doctoral
Dissertation. Virginia: University of Virginia.
Muthén, L. K., & Muthén, B. O. (1998–2015). Mplus user’s guide (7th ed.).
Muthén, B., & Asparouhov, T. (2012). Bayesian structural equation modeling: A more
flexible representation of substantive theory. Psychological Methods, 17, 313–335.
Nayfeld, I., Fuccillo, J., & Greenfield, D. B. (2013). Executive functions in early learning:
Extending the relationship between executive functions and school readiness to
science. Learning and Individual Differences, 26, 81–88. https://doi.org/10.1016/j.
lindif.2013.04.011
Ortega, F. B., Ruiz, J. R., Castillo, M. J., & Sjöström, M. (2008). Physical fitness in
childhood and adolescence: A powerful marker of health. International Journal of
Obesity, 32(1), 1–11. https://doi.org/10.1038/sj.ijo.0803774
Pearce, A. L., Leonhardt, C. A., & Vaidya, C. J. (2018). Executive and reward-related
function in pediatric obesity: A meta-analysis. Childhood Obesity, 14(5), 265–279.
https://doi.org/10.1089/chi.2017.0351
Peugh, J. L. (2010). A practical guide to multilevel modeling. Journal of School
Psychology, 48(1), 85–112. https://doi.org/10.1016/j.jsp.2009.09.002
Piek, J. P., Dyck, M. J., Nieman, A., Anderson, M., Hay, D., Smith, L. M., & Hallmayer, J.
(2004). The relationship between motor coordination, executive functioning and
attention in school aged children. Archives of Clinical Neuropsychology, 19(8),
1063–1076. https://doi.org/10.1016/j.acn.2003.12.007
Pitchford, N. J., Papini, C., Outhwaite, L. A., & Gulliford, A. (2016). Fine motor skills
predict maths ability better than they predict reading ability in the early primary
school years. Frontiers in Psychology, 7. https://doi.org/10.3389/fpsyg.2016.00783
Ponitz, C. C., McClelland, M. M., Matthews, J. S., & Morrison, F. J. (2009). A structured
observation of behavioral self-regulation and its contribution to kindergarten
Y. Chou et al.
outcomes. Developmental Psychology, 45(3), 605–619. https://doi.org/10.1037/
a0015365
Preacher, K. J., & Hayes, A. F. (2008). Contemporary approaches to assessing mediation
in communication research. In A. F. Hayes, M. D. Slater, & L. B. Snyder (Eds.), The
Sage sourcebook of advanced data analysis methods for communication research (pp.
13–54). Sage.
Preacher, K. J., Zyphur, M. J., & Zhang, Z. (2010). A general multilevel SEM framework
for assessing multilevel mediation. Psychological methods, 15(3), 209–233. https://
doi.org/10.1037/a0020141
Rabe-Hesketh, S., Skrondal, A., & Zheng, X. (2012). Multilevel structural equation
modeling. In R. H. Hoyle (Ed.), Handhook of structural equation modeling (pp.
512–531). New York, NY: Guilford.
Reinert, K. R. S., Po’e, E. K., & Barkin, S. L. (2013). The relationship between executive
function and obesity in children and adolescents: A systematic literature review.
Journal of Obesity, 2013, Article 820956. https://doi.org/10.1155/2013/820956
Robinson, L. E., Stodden, D. F., Barnett, L. M., Lopes, V. P., Logan, S. W., Rodrigues, L. P.,
& D’Hondt, E. (2015). Motor competence and its effect on positive developmental
trajectories of health. Sports Medicine (Auckland. N.Z.), 45(9), 1273–1284. https://
doi.org/10.1007/s40279-015-0351-6
Schmidt, M., Egger, F., Benzing, V., Jäger, K., Conzelmann, A., Roebers, C. M., &
Pesce, C. (2017). Disentangling the relationship between children’s motor ability,
executive function and academic achievement. PLoS ONE, 12(8), Article e0182845.
Schmitt, S. A., Korucu, I., Purpura, D. J., Whiteman, S., Zhang, C., & Yang, F. (2018).
Exploring cross-cultural variations in the development of executive function for
preschoolers from low and high socioeconomic families, 0165025418785469
International Journal of Behavioral Development. https://doi.org/10.1177/
0165025418785469.
Sikora, D. M., Haley, P., Edwards, J., & Butler, R. W. (2002). Tower of London test
performance in children with poor arithmetic skills. Developmental Neuropsychology,
21(3), 243–254. https://doi.org/10.1207/S15326942DN2103_2
Smiley-Oyen, A. L., Lowry, K. A., Francois, S. J., Kohut, M. L., & Ekkekakis, P. (2008).
Exercise, fitness, and neurocognitive function in older adults: The “selective
improvement” and “cardiovascular fitness” hypotheses. Annals of Behavioral
Medicine: A Publication of the Society of Behavioral Medicine, 36(3), 280–291. https://
doi.org/10.1007/s12160-008-9064-5
Smith, P. J., Blumenthal, J. A., Hoffman, B. M., Cooper, H., Strauman, T. A., Welsh-
Bohmer, K., … Sherwood, A. (2010). Aerobic exercise and neurocognitive
performance: A meta-analytic review of randomized controlled trials. Psychosomatic
Medicine, 72(3), 239–252. https://doi.org/10.1097/PSY.0b013e3181d14633
Spitzer, U. S., & Hollmann, W. (2013). Experimental observations of the effects of
physical exercise on attention, academic and prosocial performance in school
settings. Trends in Neuroscience and Education, 2(1), 1–6. S2211949313000045.
Sulik, M. J., Haft, S. L., & Obradović, J. (2018). Visual-motor integration, executive
functions, and academic achievement: Concurrent and longitudinal relations in late
elementary school. Early Education and Development, 29(7), 956–970.
12
Children and Youth Services Review 136 (2022) 106397
Syväoja, H. J., Tammelin, T. H., Ahonen, T., Kankaanpää, A., & Kantomaa, M. T. (2014).
The associations of objectively measured physical activity and sedentary time with
cognitive functions in school-aged children. PLoS ONE, 9(7), Article e103559.
Timmons, B. W., Leblanc, A. G., Carson, V., Connor Gorber, S., Dillman, C., Janssen, I.,
Kho, M. E., Spence, J. C., Stearns, J. A., & Tremblay, M. S. (2012). Systematic review
of physical activity and health in the early years (aged 0–4 years). Applied Physiology,
Nutrition, and Metabolism, 37(4), 773–792. https://doi.org/10.1139/h2012-070
Tomporowski, P. D., McCullick, B., Pendleton, D. M., & Pesce, C. (2015). Exercise and
children’s cognition: The role of exercise characteristics and a place for
metacognition. Journal of Sport and Health Science, 4(1), 47–55. https://doi.org/
10.1016/j.jshs.2014.09.003
Tsai, Y.-J., Huang, C.-J., Hung, C.-L., Kao, S.-C., Lin, C.-F., Hsieh, S.-S., & Hung, T.-M.
(2020). Muscular fitness, motor competence, and processing speed in preschool
children. European Journal of Developmental Psychology, 17(3), 415–431.
van der Fels, I. M. J., te Wierike, S. C. M., Hartman, E., Elferink-Gemser, M. T., Smith, J.,
& Visscher, C. (2015). The relationship between motor skills and cognitive skills in
4–16 year old typically developing children: A systematic review. Journal of Science
and Medicine in Sport, 18(6), 697–703. https://doi.org/10.1016/j.jsams.2014.09.007
van der Niet, A. G., Hartman, E., Smith, J., & Visscher, C. (2014). Modeling relationships
between physical fitness, executive functioning, and academic achievement in
primary school children. Psychology of Sport and Exercise, 15(4), 319–325.
van der Niet, A. G., Smith, J., Scherder, E. J. A., Oosterlaan, J., Hartman, E., &
Visscher, C. (2015). Associations between daily physical activity and executive
functioning in primary school-aged children. Journal of Science and Medicine in Sport,
18(6), 673–677.
van der Sluis, S., de Jong, P. F., & van der Leij, A. (2007). Executive functioning in
children, and its relations with reasoning, reading, and arithmetic. Intelligence, 35(5),
427–449.
Van Dusen, D. P., Kelder, S. H., Kohl, H. W., Ranjit, N., & Perry, C. L. (2011). Associations
of physical fitness and academic performance among schoolchildren. Journal of
School Health, 81(12), 733–740. https://doi.org/10.1111/j.1746-1561.2011.00652.
x
Welk, G. J., Jackson, A. W., Morrow, J. R., Haskell, W. H., Meredith, M. D., &
Cooper, K. H. (2010). The association of health-related fitness with indicators of
academic performance in Texas schools. Research Quarterly for Exercise and Sport, 81
(sup3), S16–S23.
WHO. (2017). World health statistics 2017: monitoring health for the SDGs, Sustainable
Development Goals (p. 2017). Geneva: World Health Organization.
Wittberg, R., Cottrell, L. A., Davis, C. L., & Northrup, K. L. (2010). Aerobic fitness
thresholds associated with fifth grade academic achievement. American Journal of
Health Education, 41(5), 284–291. https://doi.org/10.1080/
19325037.2010.10599155
Xie, R. S. (2014). 学童数学成就测验 [Test of Children Mathematics Achievement, 3–9
years]. Taipei, Taiwan: Psychological Publishing.
Ziereis, S., & Jansen, P. (2015). Effects of physical activity on executive function and
motor performance in children with ADHD. Research in Developmental Disabilities, 38,
181–191. https://doi.org/10.1016/j.ridd.2014.12.005