I’ve never been a fan of delayed school start times for high school students. The data just don’t impress me. But mostly I think delayed start times should be just one component of a broad community-wide initiative to address sleep hygiene that includes discussions about bedtimes, after-school schedules, and overuse of electronic devices. And I don’t see those discussions happening.

In most communities, delaying start times for adolescents will mean that younger children will be starting their school days earlier. Buses and drivers are finite and expensive resources that must be shared. Although I have heard it used as an argument against delayed school starts for high schoolers, an earlier start time for grade-school age children is not one of the downsides I include on my list of negatives. In fact, from my perspective, getting youngsters to school early is one of the few advantages of a delayed school start program for high school.

Unless they have been up watching late night television with their parents, most young children hit the ground running as the sun peeks over the horizon. Keeping an energized youngster entertained and out of trouble until it is time to go to the bus stop can be a challenge. Too often parents resort to television or other electronic devices to bridge this gap between wake up and school start. For some reason, this boundless morning energy of youth isn’t directed toward the mundane tasks of eating breakfast and getting dressed.

I recently heard of an exercise program that harnesses this early-morning energy of youth with positive and not surprising results. Underwritten by the Reebok athletic footwear manufacturer, the BOKS (Build Our Kids’ Success) program began in 2009 when a group of mothers in Massachusetts organized a before-school activity program in their local grade school ( “A before-school exercise program may help children thrive,” by Gretchen Reynolds, New York Times, Feb. 14, 2018). They may have been motivated primarily by the need to survive those difficult morning hours, but clearly they weren’t alone in their concerns, and the concept has spread to include 3,000 schools worldwide.

Hoping to document the anecdotal observations of the program’s success, researchers from Harvard and the Massachusetts General Hospital surveyed children in 24 schools (“Effects of Before-School Physical Activity on Obesity Prevention and Wellness,” Am J Prev Med. 2018. Feb 12. doi: 10.1016/j.amepre.2018.01.017 ). Participation in the program was voluntary, and the control group consisted of children whose families chose not to participate. Those children in the before-school activity program 3 mornings per week were more likely to have lower body mass index z scores and “demonstrated improvement in their student engagement scores.” The children who participated only 2 days per week had no significant changes in their body mass index scores. However, they did demonstrate “significant improvements in positive affect and vitality/energy.”

Of course, the study is riddled with caveats. The volunteers may have come from demographics that conferred on them an advantage even before the study began. Scaling the apparent success of the program to other school systems presents obvious problems including funding (even with support from a large corporation), the availability of volunteers, and possible resistance by teachers who might understandably view it as extending their workday. And, of course, it may come down to transportation as the limiting factor. It’s those buses again.

The early-morning energy of youth is a given. The problem is that many children find themselves in home environments in which that energy is squandered or at least misdirected. School can be the environment in which that physical exuberance is allowed to run its natural course. We simply need the will to invest in what needs to be done to make it happen.

Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine for nearly 40 years. He has authored several books on behavioral pediatrics, including “How to Say No to Your Toddler.” Email him at pdnews@frontlinemedcom.com .

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