Peer-reviewed article
Early outdoor play predicts trajectories of child mental health in a population-based cohort.
Helen F Dodd, Kirsty Cordwell, Kathryn Hesketh, Avril Johnstone, Alejandro de la Torre-Luque et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study followed over 4,000 children in Scotland from ages 2-8 years to see if outdoor play in early childhood predicted their mental health as they grew older. Children who played outside more often as preschoolers were significantly less likely to develop increasing anxiety, depression, or behavioural problems as they got older. The findings suggest that encouraging outdoor play in young children may help prevent mental health difficulties.
Key points
- Children were tracked from age 2-4 for outdoor play frequency, then assessed for mental health symptoms at ages 4, 5, 6 and 8 years
- Three distinct mental health trajectories were identified: normative (stable low symptoms), increasing (moderate symptoms that got worse), and decreasing (high symptoms that improved)
- Each additional day of outdoor play per week in early childhood reduced the odds of being in the increasing or decreasing trajectory groups by 6-12% for both internalising and externalising problems
- The protective effect of outdoor play held true even after controlling for other factors like family circumstances and baseline health
- This is the first longitudinal evidence that early outdoor play predicts mental health trajectories across childhood
Limitations
The study relies entirely on parent-reported measures of both outdoor play and child mental health symptoms, which may be subject to recall bias and reporter bias. The research is specific to Scotland and may not generalise to other populations or cultural contexts.
Abstract
BACKGROUND: Outdoor play may offer developmental opportunities that support good mental health. Cross-sectional data indicate that more outdoor play is associated with better mental health, particularly internalising problems (e.g. anxiety and depression), but longitudinal research is lacking. We used a longitudinal cohort dataset to evaluate whether outdoor play at 2-4 years predicted children's mental health trajectories into middle childhood. METHODS: Data were from the Growing up in Scotland dataset. Parents/caregivers were asked how many days their child had played outside over the previous week when children were aged ~2, 3 and 4 years. When the children were aged ~4, 5, 6 and 8 years, parents/caregivers completed the Strengths and Difficulties Questionnaire measure of child mental health. We used growth mixture modelling (GMM) to identify trajectories over time for internalising and externalising symptoms separately. Next, we used multilevel multinomial regression to evaluate whether early outdoor play predicted trajectory classification. RESULTS: The analysis sample included 4,151 children. A three-class solution was optimal for internalising and externalising symptoms. The three trajectory groups differed on both symptom level at age 4 and slope as follows: normative (low with stable trajectory); increasing (moderate with increasing trajectory); decreasing (high with decreasing trajectory). After controlling for covariates, outdoor play significantly predicted trajectory class; children who played outdoors more often as preschoolers had significantly decreased odds (p < .001) of belonging to the increasing or decreasing trajectory groups, relative to the normative group, for internalising (increasing: OR = 0.92, decreasing: OR = 0.88) and externalising (increasing: OR = 0.94, decreasing: OR = 0.94) symptoms. CONCLUSIONS: This study uses nationally representative longitudinal data and provides the first evidence that early outdoor play predicts mental health trajectories across childhood. A key limitation is reliance on parent-report measures. The findings indicate that increasing outdoor play may be a useful public health approach to reduce child mental health problems.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Outdoor play in early childhood (ages 2-4 years)
- Population
- 4,151 children from the Growing up in Scotland nationally representative cohort
Key finding
Children with more outdoor play days per week at ages 2-4 had 8% lower odds of increasing internalising symptom trajectories (OR=0.92, p<0.001)