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Physical activity in young children across developmental and health states: the ActiveCHILD study
Niina Kolehmainen1, Christopher Thornton1, Olivia Craw1
1Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Insights
Young children, including those with developmental challenges, meet physical activity guidelines. Mobility capacity is key to activity levels, supporting inclusive expectations for all children.
Area of Science:
- Pediatrics
- Developmental Science
- Public Health
Background:
- Limited evidence exists on physical activity in young children across diverse developmental and health states.
- The ActiveCHILD UK cohort study addresses this gap using objective measurements.
- Investigates links between physical activity, child development, social factors, and quality of life.
Purpose of the Study:
- To examine the relationship between objectively measured physical activity and developmental/health factors in young children.
- To assess if children with developmental challenges meet physical activity recommendations.
- To understand predictors of physical activity levels in toddlers.
Main Methods:
- Utilized data from 282 children (12-36 months) recruited across England.
- Employed waist-worn accelerometers (ActiGraph 3GTX) for objective physical activity measurement.
- Applied hidden semi-Markov models (HSMM) for activity segmentation and multiple linear regression for analysis.
Main Results:
- Children averaged 6.44 hours active and 2.78 hours very active daily, with 91% meeting WHO guidelines.
- Mobility capacity was the strongest predictor for both total time active (any intensity) and time spent very active.
- No significant association was found between physical activity levels and health-related quality of life (HRQoL).
Conclusions:
- Findings challenge the notion that children with developmental problems require lower physical activity expectations.
- Young children across various developmental states can achieve recommended physical activity levels.
- Promoting inclusive and ambitious physical activity expectations is crucial for all children's rights and well-being.
Background:
Evidence about physical activity of young children across developmental and health states is very limited. Using data from an inclusive UK cohort, ActiveCHILD, we investigated relationships between objectively measured physical activity, child development, social context, and health-related quality of life (HRQoL).
Methods:
Children (12-36 months), purposively sampled across health pathways, developmental abilities, and sociodemographic factors, were recruited through thirteen National Health Service organisations in England. Data were collected from 07/2017 to 08/2019 on: weekly physical activity (3-7 days) using waist-worn accelerometer (ActiGraph 3GTX); sociodemographics, parent actions, child HRQoL, and child development using questionnaires; and child health conditions using clinical records. A data-driven, unsupervised method, called hidden semi-Markov model (HSMM) segmented the accelerometery data and provided estimates of the total time spent active (any intensity) and very active (greater intensity) for each child. Relationships with the explanatory factors were investigated using multiple linear regression.
Findings:
Physical activity data were obtained for 282 children (56% females, mean age 21 months, 37.5% with a health condition) covering all index of multiple deprivation deciles. The patterns of physical activity consisted of two daily peaks, children spending 6.44 (SD = 1.39) hours active (any intensity), of which 2.78 (SD = 1.38) hours very active, 91% meeting WHO guidelines. The model for total time active (any intensity) explained 24% of variance, with mobility capacity the strongest predictor (β = 0.41). The model for time spent very active explained 59% of variance, with mobility capacity again the strongest predictor (β = 0.76). There was no evidence of physical activity explaining HRQoL.
Interpretation:
The findings provide new evidence that young children across developmental states regularly achieve mainstream recommended physical activity levels and challenges the belief that children with development problems need lower expectations for daily physical activity compared to peers. Advancing the rights of all children to participate in physical activity requires inclusive, equally ambitious, expectations for all.
Funding:
Niina Kolehmainen, HEE/NIHR Integrated Clinical Academic Senior Clinical Lecturer, NIHR ICA-SCL-2015-01-00, was funded by the NIHR for this research project. Christopher Thornton, Olivia Craw, Laura Kudlek, and Laura Cutler were also funded from this award. Tim Rapley is a member of the NIHR Applied Research Collaboration North East and North Cumbria, with part of his time funded through the related award (NIHR200173). The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS, or the UK Department of Health and Social Care. The work of Kianoush Nazarpour is supported by Engineering and Physical Sciences Research Council (EPSRC), under grant number EP/R004242/2.
