Play Behaviors in Children during the COVID-19 Pandemic: A Review of the Literature

2-Year-olds' free play during the COVID-19 pandemic

Free play is a natural activity in toddlerhood, depending on environmental conditions like available objects and the social environment. The COVID-19 pandemic and its consequences for parents' mental health held the potential to change toddlers' play environment. This cross-sectional study investigated 2-year-olds' (N = 97) free play with objects, and aspects of caregiver mental well-being in three cohorts during the pandemic in Germany. Caregivers reported their positive mental health (PMH), threat perception, perception of current family situation from negative to positive, and workload. We categorized toddlers' behavior in free play sessions in their homes with a fixed set of objects through behavioral coding. Play behavior did not differ between cohorts and did not correlate with caregivers' positive mental health, threat perception, and perception of family situation. A MANOVA revealed a significant main effect of cohort on PMH, threat perception and perception of family situation, qualified by two discriminant functions. Full sample analyses revealed that toddlers of caregivers perceiving a workload increase compared to the time before the pandemic showed less pretend play, and less functional and nonfunctional play. The results provide insights into 2-year-olds' play behavior during a global pandemic and highlight the role of caregiver availability for children's play.

The impact of the COVID-19 pandemic on children's occupations

Background

The COVID-19 pandemic changed the daily lives and limited everyday activities of children worldwide.

Objectives

To document the impact of the COVID-19 pandemic on children's occupations, the associated factors, and the impact on children's health, wellbeing, and development.

Methods

A narrative review was conducted by searching four databases (Scopus, MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews).

Results

A total of 35 articles met the inclusion criteria. Out of the 34 articles, 23 were relevant to the impact of the COVID-19 pandemic on occupations related to leisure (n = 17), productivity (n = 11), and self-care (n = 9). Ten articles highlighted specific factors that had been linked to changes in occupational engagement and child behavior. Ten articles focused on the impact of occupational disruption during COVID-19 on health, wellbeing, and general development.

Conclusion

The COVID-19 pandemic seems to have had a negative impact on children's occupations, while the restrictions were still in effect. Further research is needed to establish reliable conclusions.

An exploration of parent perceptions of a take-home loose parts play kit intervention during the COVID-19 pandemic

The restrictions introduced in response to the COVID-19 pandemic affected the regular routines of Canadians, including access to play and physical activity opportunities, while limiting social connections. In response to this, a recreation centre created take-home play kits that contained loose parts with the aim of facilitating unstructured play. Between August 2021 and January 2022, ten parents participated in semi-structured interviews via telephone or videoconferencing platforms that captured their experiences of the take-home play kits. Using Thematic Analysis, we identified themes and subthemes reflecting parent perceptions and experiences of the take-home play kit. Three themes emerged: (1 A forced renaissance of play; (2) Bringing unstructured play home, and; (3) Parenting is child's play. Parents shared how the pandemic resulted in decreased physical activity and social opportunities for their children. The parents described how the take-home play kits supported unstructured play as well as their perspectives on the importance of unstructured play. Parents in our study suggested that a take-home loose parts play kit could be a useful resource to help engage children in unstructured play in both indoor and outdoor environments.

Exploring Emotions Related to the COVID-19 Pandemic through Death Education: A Qualitative Study at Italian Primary Schools

BACKGROUND

The COVID-19 pandemic has impacted the lives of individuals, families, and children worldwide. In Italy, the implementation of measures such as lockdowns and distance learning in schools affected the mental health of children and families.

METHODS

This article employs a qualitative method to explore the efficacy of a death education project that aimed to help primary school children process the emotions and losses that they experienced during the COVID-19 pandemic. The study encompassed both the children who took part in the death education project and their teachers and parents to investigate their perspectives on the emotions of the minors and the effectiveness of the project.

RESULTS

Distance learning posed challenges for the learning process and exacerbated social inequalities. The children suffered from limited social contact with their friends and experienced negative emotions, including anger, fear, and concern for the health of their loved ones. The death education project provided a safe space for children's emotional expression and facilitated their acquisition of coping strategies. Open communication between adults and children about illness and death proved effective in mitigating the psychological impacts of loss and preventing traumatic bereavement.

CONCLUSION

The findings highlight the utility of death education in enhancing children's ability to express their emotions and approach the topic of death more frankly.

Play as a Stress-Coping Method Among Children in Light of the COVID-19 Pandemic: A Review

The COVID-19 pandemic, which started in early 2020, has been a great source of stress for almost every person all around the world. However, this is particularly true for children. It is necessary to fully address the stress-related psychosocial issues connected with the pandemic, solely in children. Play is important for children's development, as it is a natural activity for every child. Through play and play-based interventions, children can communicate non-verbally, symbolically, and in an action-oriented manner. Therefore, play-based interventions may have the potential to be one of the coping strategies used by children who experience stress, especially during the COVID-19 pandemic. The aim of this narrative review was to show how play-based activities could help children deal with stress related to the COVID-19 pandemic in the non-clinical population. A systematic search of the literature in various databases was performed. The initial search provided 5,004 potentially eligible studies in various databases, and 42,201 records identified from Google Scholar. After excluding studies not meeting the inclusive criteria, nine papers were selected for this narrative review. This narrative review showed findings that play-based activities can have a positive effect during the COVID-19 pandemic on different stress levels in the children population. Additionally, the findings of this review highlight the importance of further research and implementation of play into many aspects of children's life.

A systematic appraisal of the information, engagement, aesthetic and functional quality of nutrition-related smartphone apps for children and adolescents

OBJECTIVE

Nutrition-related smartphone applications (apps) could improve children's nutrition knowledge and skills. However, little is known about the quality of nutrition-related apps for children. This study aimed to identify and evaluate the quality of nutrition-related smartphone apps designed for children ages 4-17.

DESIGN

This systematic appraisal is guided by the Protocol for App Store Systematic Reviews.

SETTING

Using Google's Advanced Search, we identified 1814 apps/1184 additional apps in an updated search on iOS, of which twenty-four were eligible. The apps' objective and subjective quality were evaluated using the twenty-three-item, five-point Mobile App Rating Scale. The objective quality scale consists of four subscales: engagement, functionality, aesthetics and information.

RESULTS

Most of the apps (75 %) focussed solely on promoting nutrition skills, such as making food dishes, rather than nutrition knowledge. Of the twenty-four apps, 83 % targeted children 4-8 years old. The app objective quality mean score was 3·60 ± 0·41. The subscale mean scores were 3·20 ± 0·41 for engagement, 4·24 ± 0·47 for functionality, 4·03 ± 0·51 for aesthetics and 2·94 ± 0·62 for information. The app subjective quality mean score was 2·10 ± 0·90.

CONCLUSIONS

More robust approaches to app development leveraging co-design approaches, including involving a multidisciplinary team of experts to provide evidence-based nutrition information, are warranted.

An Observational Study on Play and Physical Activity Associated with a Recreational Facility-Led Park-Based "Loose Parts" Play Intervention during the COVID-19 Pandemic

Play is a human right, yet opportunities for unstructured play are declining. The COVID-19 pandemic further reduced children's play opportunities. We conducted an observational study of a novel community-based intervention (play hubs) that facilitated unstructured play by offering loose parts in parks (Calgary, Canada) during the pandemic. Our descriptive study included systematic observation using the System for Observing Children's Activity and Relationships During Play (SOCARP) and Tool for Observing Play Outdoors (TOPO) to capture physical activity, play, and social and environment interactions among children participating in the play hubs for 10-weeks in 2021 (n = 160) and 2022 (n = 147). Play hub attendance was low. Most children observed were aged 5 to 12 years (2021: 93% and 2022 98%), with boys and girls represented (2021: 58% male/42% female and 2022: 52% male/48% female). Standing, sitting, and moderate activity were common activities. Physical, exploratory, and expressive play were common, while digital, bio, and rule-based play were less common. Children typically played alone or in small groups and engaged with loose parts or played in the open spaces. The play hubs encouraged unstructured play and promoted positive social interactions among children, despite the challenges of implementing a community-based intervention under pandemic public health restrictions.

Preschoolers' screen time in China before and during COVID-19 lockdown: a parental survey

OBJECTIVES

Since COVID-19 first appeared in Wuhan, China, in December 2019, the disease has spread rapidly across the country. To reduce the spread of infection, schools including kindergartens were closed. Prolonged home confinement can affect children's behaviour. Therefore, we investigated the change of preschoolers' total daily screen time during the COVID-19 lockdown in China.

DESIGN, SETTING AND PARTICIPANTS

In the parental survey, 1121 preschoolers, whose parents or grandparents completed an online survey from 1 June 2020 to 5 June 2020, were enrolled.

PRIMARY OUTCOME

Total daily screen time. Multivariable modelling was performed to identify factors associated with increased screen time.

RESULTS

The results showed that preschoolers' total daily screen time during lockdown(median 2.5 hours, IQR 2.5 hours) was significantly longer than it was before lockdown (median 1.5 hours, IQR 1.0 hour). Older age (OR 1.26, 95% CI 1.07 to 1.48), higher annual household income (OR 1.18, 95% CI 1.04 to 1.34),and decrease of moderate-vigorous physical activity (OR 1.41, 95% CI 1.20 to 1.66) were independently associated with increased screen time.

CONCLUSIONS

Preschoolers' total daily screen time significantly increased during lockdown.

The Impacts of COVID-19 Restrictions on Physical Activity in Children and Youth: A Systematic Review of Qualitative Evidence

BACKGROUND

The objectives of this systematic review were to synthesize qualitative evidence on the impacts of COVID-19 restrictions on physical activity (PA) for children and youth, and explore factors perceived to influence those impacts.

METHODS

Five databases (MEDLINE, Embase, SPORTDiscus, ERIC, and CINAHL) were searched initially in June 2021 and updated in December 2021 to locate qualitative articles considering COVID-19 restrictions and PA for children and youth (≤18 y old), in any setting. Eligibility, quality assessments, and data extraction were completed by 2 independent reviewers. Data were synthesized using meta-aggregation with confidence of findings rated using ConQual.

RESULTS

After screening 3505 records, 15 studies were included. Curriculum-based PA, organized sport, and active transportation were negatively impacted by COVID-19 restrictions. Negative changes were affected by COVID-19 exposure risks, inadequate instruction, poor access, screen time, and poor weather. Unstructured PA was inconsistently impacted; outdoor unstructured PA increased for some. Positive changes were facilitated by family co-participation, availability of outdoor space, and perceived mental health benefits.

CONCLUSION

Qualitative data indicated restrictions had a predominantly negative impact on PA for children and youth, but inconsistent impacts on unstructured PA. The improved contextual understanding offered by our review will be foundational knowledge for health strategies moving forward.

Developmental screening of full-term infants at 16 to 18 months of age after in-utero exposure to maternal SARS-CoV-2 infection

OBJECTIVE

To screen for neurodevelopmental delays in a cohort of full-term infants born to mothers with SARS-CoV-2.

STUDY DESIGN

This was a prospective, descriptive cohort study of full-term infants born to mothers with SARS-CoV-2 during pregnancy. Subjects underwent neurodevelopmental screening using the Ages and Stages Questionnaires^®-Third Edition (ASQ^®-3) at 16 to 18 months age.

RESULTS

Of 51 subjects, twelve (24%) were below cutoff, and twenty-seven (53%) were either below or close to the cutoff in at least one developmental domain. Communication (29%), fine motor (31%), and problem-solving (24%) were the most affected domains. There were no differences in outcomes between infants born to asymptomatic and mildly symptomatic mothers.

CONCLUSION

We observed increased risk of neurodevelopmental delays during screening of infants born at full-term to mothers with SARS-CoV-2 at 16 to 18 months age. These results highlight the urgent need for follow-up studies of infants born to mothers with SARS-CoV-2.

Movement, Play, and Games-An Essay about Youth Sports and Its Benefits for Human Development

The acknowledgment of the qualities and features of the world is made through the body, movement, and imagination. During their development, children learn new skills, complexify their thoughts, and become more autonomous. The progressive increase in motor repertoire in children reflects a more unified and solid self. Nowadays, there is a generalized restriction of the movement of children. It starts at home when parents establish rigid and/or phobic attachments with their children; it can be also observed at school which is more and more based on rigid learning rhythms and obsessive ideas about students' performance, and finally in urban areas where free and outdoor play has considerably decreased during recent decades. The current lifestyles in Western societies resulted in a decrease in play among children. The culture influences the dominant types of psychopathology and, during childhood, mental suffering is often expressed with the increase (turmoil) or decrease (inhibition) of the body movement. Sports are underpinned by movement and play; they are a powerful tool in health promotion and an excellent way to assign meaning to movement. This work is an essay about the importance of play and youth sports in child development.

Positive experiences in the parent-child relationship during the COVID-19 lockdown in Poland: The role of emotion regulation, empathy, parenting self-efficacy, and social support

Despite the impact of the COVID-19 outbreak being largely negative on parents and children, for some families, lockdown could also bring about some positive effects, for example, increased emotional closeness, and more time for joint activity. The aim of the current study was to investigate cross-sectionally the most important correlates of the positive experiences in the parent-child relationship among Polish mothers and fathers during the lockdown in the initial phase of the COVID-19 outbreak. In May 2020, 228 mothers and 231 fathers completed the Brief version of the Empathic Sensitivity Questionnaire, Difficulties in Emotion Regulation Scale Short Form, Social Support Scale, Parenting Self-Agency Measure, and Scale of Positive Experiences in Parent-Child Relationship during the COVID-19 lockdown. Our results showed that parenting self-efficacy and social support were the strongest correlates of positive experiences in the parent-child relationship in both mothers and fathers during the lockdown. Perspective-taking was positively related to the positive experiences in mothers, whereas personal distress was positively associated with the positive experiences in the parent-child relationship in fathers. Our results point to factors of potential importance in designing preventive and therapeutic interventions for mothers and fathers to enhance positive experiences in the parent-child relationship during the pandemic.

The Impact of Time Spent in Natural Outdoor Spaces on Children's Language, Communication and Social Skills: A Systematic Review Protocol

There has been increasing interest over the past decade with regard to the health and wellbeing implications of time spent outdoors in nature for children. Universal systematic reviews of evidence report benefits to physical health, social-emotional mental health and wellbeing, cognition and academic learning. Internationally, there is indicative evidence to suggest outdoor engagement with nature may also impact children's language and communication skills, skills that are critical to development, education, social relationships and life opportunities. Yet, at present such evidence has not been synthesised. Despite evidence for the benefits of the outdoors, the amount of time children are spending outdoors is in rapid decline, and has been further exacerbated by the COVID-19 pandemic. Alongside this are increasing numbers of children starting primary education with significant speech, language and communication needs (SLCN) which remain persistent over time. With established wide-reaching benefits of nature to children's physical and mental health and psychological development, there is a need to further explore the more specific impacts of the natural environment on children's language, communication and social skills, which could provide a unique opportunity to consider nature as a universal public health intervention for SLCN. The current review will aim to synthesise existing qualitative and quantitative evidence of the impact of time spent in natural outdoor spaces on the language, communication and social skills of 2-11-year-old children. Literature will be searched across seven databases and considered for inclusion against inclusion and exclusion criteria. Potential implications of the review include informing public health practice and policy for child development and education, informing priorities for speech, language, and communication interventions, and providing directions for future international research.