# Are play and screen time associated with British preschoolers’ mental health? Cross-sectional findings from the British Preschool Children’s Play Survey

## TL;DR

This study finds that adventurous play is linked to better mental health in young British children, while more screen time is associated with worse outcomes.

## Contribution

The study provides new evidence on how adventurous play and screen time affect preschoolers' mental health.

## Key findings

- More adventurous play is linked to lower internalizing scores and higher positive affect in preschoolers.
- Higher educational screen time is associated with worse mental health outcomes, including higher internalizing and negative affect scores.
- Adventurous play may moderate the negative effects of educational screen time on mental health.

## Abstract

To investigate associations between adventurous play, outdoor play and screen time and mental health (MH) in British preschool-aged children.

Cross-sectional.

A nationally representative sample of caregivers of 2–4 years old (n=1066) in England, Scotland and Wales (Britain), recruited through an online research data and analytics group (YouGov UK).

Caregivers of 1018 children provided valid complete-case data (age 2: n=298 (29%), age 3: n=365 (36%), age 4: n=355 (35%); female n=481 (47%); white: n=878 (81%)).

Four outcomes, derived from parent-report questionnaires: internalising and externalising scores (using the Strengths and Difficulties Questionnaire) and positive and negative affect scores (using the Positive and Negative Affect Schedule for Children-P). Linear regression was used to explore associations between the three exposures (time (in hours per week) a child spent: (1) playing adventurously; and engaging in (2) educational screen time and (3) recreational screen time) and the four outcomes; interactions between play and screen time variables were also tested. Models were adjusted for child and parental demographic variables.

For each additional hour per week a child engaged in adventurous play, they had lower internalising scores (−0.02 (−0.03 to –0.01)) and higher positive affect scores (0.04 (0.02 to 0.05)). More hours per day (vs <1 hour/day) of educational screen time and recreational screen time were associated with higher internalising and negative affect scores. Greater educational screen time was associated with lower positive affect and higher externalising scores, with adventurous play moderating the association between higher educational screen time, internalising and negative affect.

In British preschoolers, adventurous play is associated with better MH outcomes, whereas higher educational screen time was associated with poorer MH, indicating that adventurous play may benefit preschoolers’ MH or that preschoolers with better mental health are more likely to engage in adventurous play. Adventurous play may also offset possible negative associations with screen time.