My child hardly plays actively. How much do kids need?

Children aged 5 to 17 need an average of at least 60 minutes a day of moderate-to-vigorous activity across the week, according to the World Health Organization's 2020 guidelines, and the NHS says children aged 1 to 4 should be active for at least 180 minutes a day. Most Thai children fall short: Thailand's 2018 Report Card on physical activity found that only 26.2% of children and youth aged 6 to 17 reached 60 minutes, and only 8.7% took part in free, unorganised active play. The 60 minutes can be built up in short blocks, so the walk to school, games at break, play after school and family outings at the weekend all count. Keep recreational screen time in check, as the WHO guideline also advises.

How much active play does a child need each day?

The guidelines by age

Health agencies give similar targets. They are the amount of movement to aim for, not a test a child has to pass on a given day.

What the numbers mean in practice

For a primary school child, the US CDC says most of the 60 minutes should be activities such as walking or running that make the heart beat faster. On at least 3 days a week, it suggests including vigorous activity, muscle-strengthening activity such as climbing or push-ups, and bone-strengthening activity such as jumping or running. The CDC adds that 60 minutes may sound like a lot, but children may already be meeting it, and that choosing activities they enjoy helps.

The Ramathibodi Hospital @Rama column for school-age children suggests 60 minutes every day, and if that cannot be done in one go, adding it up in blocks of 10, 20 or 30 minutes.

How active are Thai children?

What Thai surveys found

Thailand has measured children's activity through national report cards and a long-running surveillance survey, led by Mahidol University's Institute for Population and Social Research and partners:

Young children too

Two recent studies looked at Thai preschoolers:

Why the numbers differ

The surveys mostly rely on what children or parents report, which can be over- or under-estimated, while the 2023 preschool study measured movement directly. The age groups, years and areas also differ: the urban preschool study covered 12 schools, and the 2020 round of the surveillance survey was done online rather than face to face. What they share is that a minority of Thai children reach the recommended amount.

What counts as active play?

Moderate and vigorous

The NHS guideline for ages 5 to 18 explains that moderate activity raises the heart rate and makes you breathe faster and feel warmer. A simple check is that your child can still talk, but not sing.

Ideas by age

Traditional Thai games that involve running, chasing and jumping, such as tag or rubber-band skipping, fit the same idea.

What gets in the way for Thai children?

Little free play at school

Looking at the 2018 report card, Katewongsa and colleagues noted that the Thai curriculum gives children few chances to move during lessons and not enough playing time during breaks, even where school facilities are available.

Screens at home

In the urban preschool study, the number of digital devices at home and the region where children lived went with whether they met the activity and screen time guidelines. The WHO 2020 guidelines advise children and teens to limit time spent sitting, particularly recreational screen time. For screen limits by age and caring for the eyes, see Kids on tablets for hours: how do I look after their eyes?

Girls, and the move to secondary school

In the 2018 report card, boys were more active than girls in every age group, and the surveillance study found girls had more difficulty keeping up or increasing their activity. The share of active children rose when they moved from late primary to early secondary school.

Heat

Thailand's heat makes outdoor play harder for much of the year. Plan active play for cooler times of day and keep water close by; see Is my child drinking enough water on hot school days?

How can we fit more active play into the day?

Add it up in short blocks

Use the 10-20-30 minute idea from the Ramathibodi column. For example: 10 minutes of walking to and from school or the bus stop, 20 minutes of running games at break, and 30 minutes of play after school before homework.

Play together as a family

In the 2018 report card, 71.0% of family members, such as parents and guardians, made activity and sport possible for their children. A walk after dinner, badminton in the soi or a trip to the park at the weekend gives the whole family a chance to move.

Use weekends

The urban preschool study found that children were more active, but also spent more time on screens, at weekends than on weekdays. Plan one active outing on each weekend day before screens go on.

Watch out for injuries

The NHS advises that children do activity suitable for their age, ability and experience, start new activities slowly and build up bit by bit, and use protective equipment such as helmets for cycling and skateboarding.

When should I talk to a doctor about my child's activity?

Health conditions

The NHS advises getting medical advice about exercising if a child has a health condition. Children living with a disability should, according to the NHS, aim for 20 minutes of activity a day, split into smaller chunks if needed, and do challenging but manageable strength and balance activities 3 times a week.

Movement skills

The US CDC's milestones list, for example, hopping on one foot by around 5 years. The CDC advises: if your child is not meeting one or more milestones, has lost skills they once had, or you have other concerns, act early, talk with your child's doctor and ask about developmental screening.

During play

If your child gets unusually short of breath, dizzy or unwell during play, stop the activity and see a doctor.